Oral diseases: a global public health challenge

Abstract

Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, depriving people of health, wellbeing, and the ability to achieve their full potential. By virtue of their high prevalence, the most consequential oral diseases affecting global health are: dental caries, periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers, we describe the scope of the global oral disease epidemic, describe its origins in social and commercial determinants, and its costs in terms of human suffering and societal impact. Even though oral diseases are largely preventable, they persist with high prevalence as a reflection of pervasive social and economic inequalities, along with inadequate funding for prevention and treatment, particularly in low and middleincome countries (LMIC). As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned. Poor children, socially marginalised groups, and older people suffer the most from oral diseases and have more limited access to dental care. In many LMIC oral diseases remain largely untreated as the treatment costs exceed available resources. The personal consequences of chronic untreated oral diseases are often severe and include unremitting pain, sepsis, reduced quality of life, lost school days, family disruption, and decreased work productivity. The societal costs of treating oral diseases are a very high economic burden to families and the health care system. Oral diseases are truly a global public health problem with particular concern over rising prevalence in many LMIC linked to wider social, economic and commercial changes. By describing the extent and consequences of oral diseases, their roots in social and commercial determinants, and their ongoing neglect in global health policy, we aim to highlight the urgency of addressing oral diseases as a global health and NCD priority. 4 Key messages  Oral health is an integral element of overall health and wellbeing enabling individuals to perform essential daily functions.  Oral diseases include a range of chronic clinical conditions that affect the teeth and mouth including dental caries (tooth decay), periodontal (gum) disease and oral cancers.  Despite being largely preventable, oral diseases are highly prevalent conditions affecting over 3.5 billion people around the world, with dental caries being the most common disease globally with increasing prevalence in many low and middle-income countries (LMIC)  Oral diseases disproportionally affect poorer and marginalised groups in society being very closely linked to socioeconomic status and the broader social determinants of health.  Oral diseases have a significant impact causing pain, sepsis, reduced quality of life, lost school days, family disruption, decreased work productivity, and the costs of dental treatment can be considerable for both individuals, and the wider health care system.  Oral conditions share common risks with other non-communicabl...

Occlusal support predicts tooth loss in older Japanese people

“…Thus, our results may not apply to all older adults, such as hospitalized patients or those requiring long‐term care. However, it should be noted that oral diseases persist with high prevalence, reflecting widespread social and economic inequality and inadequate funding for prevention and treatment, particularly in low‐income and middle‐income countries . Because Japan is a high‐income country, the results of this study may not apply to low‐income and middle‐income countries.…”

Dietary patterns associated with dental caries in adults in the United States

“…In 2011, 91% of American adults aged 20‐64 experienced dental caries . Untreated dental decay adversely affects quality of life, social relations and health . Further, direct oral healthcare expenditures in the United States are significant, exceeding $105 billion .…”

“…1 Untreated dental decay adversely affects quality of life, social relations and health. 2,3 Further, direct oral healthcare expenditures in the United States are significant, exceeding $105 billion. 4 Coronal caries forms throughout the lifespan 5,6 and is the primary cause of tooth loss in older adults, accounting for most of older adults' oral health expenditures.…”

Current state of play regarding dental extractions in patients with haemophilia: Consensus or evidence‐based practice? A review of the literature

“…Oral diseases, including tooth decay, gum disease and oral cancers, affect almost half of the global population, with untreated dental decay the most common health condition worldwide. Despite this substantial burden, integrated oral healthcare pathways within the general medical pathway have been neglected with calls for radical reform of dental care systems whose models have failed to combat the global challenge of oral diseases which is rarely included in universal health coverage …”

“…Despite advances in other areas of medicine, the prevalence of oral disease continues to increase in low‐income and middle‐income countries, and among socially disadvantaged and vulnerable people, no matter where they live. Therefore, tooth extraction remains among the most frequent invasive procedures in general population . It is likely to be the most common surgical procedure required in people with haemophilia (PWH), especially those living in countries with restricted resources: a recent report looking at patient reported outcomes in haemophilia suggested that the mouth was the single most common site of perceived life‐threatening bleeding amongst those individuals…”