A key indicator of overall health, quality of life and well-being is oral health. It encompasses a range of conditions and diseases which include congenital anomalies such as cleft lip and palate, dental caries, oral and dental trauma, oral cancer, oral manifestations of HIV infection, noma, periodontal (gum) disease and tooth loss. The 2017 Global Burden of Disease Study estimated that worldwide 3.5 billion people are affected by oral disease. According to the International Agency for Research on Cancer, cancers of the lip and oral cavity are among the 15 most common cancers in the world, with nearly 180,000 deaths each year.
Most oral diseases and conditions share modifiable risk factors with the main non-communicable diseases (cancer, cardiovascular disease, chronic respiratory diseases and diabetes). These risk factors include smoking, alcohol consumption, and unhealthy diets high in free sugars, all of which are on the increase globally. There is a proven relationship between oral health and general health. Diabetes mellitus is reported, for example, to be linked to the development and progression of periodontitis. In addition, there is a causal link between high consumption of sugars and diabetes, obesity and dental caries.
Poor oral health causes millions of people in devastating pain and increases the financial burden on society. Oral diseases can affect a person’s performance at school and at work and can cause social and personal problems. The psychosocial impact of many oral diseases considerably reduces the quality of life.
Oral diseases disproportionately affect poor and socially disadvantaged members of society. There is a very consistent and strong association between socioeconomic status (income, level of education and occupation) and the prevalence and severity of oral diseases. This association persists throughout life, from infancy through old age, and among populations in high-, middle- and low-income countries.
Oral health treatments are expensive, accounting for an average of 20% of direct health expenditure in most high-income countries. The demand for oral health care exceeds the capacity of health care systems in most low- and middle-income countries, and many people in some high-income countries are unable to afford appropriate care. .
Prevention and response
Adoption of the Tokyo Declaration on Dental Care and Oral Health for Healthy Longevity was done in 2015. The declaration called on policymakers and health professionals to dramatically reduce the global burden of oral health-related diseases, promote better access and equity to oral health services, and mainstream oral health care programs. oral health in the broader development agenda. Greater advocacy is needed to increase the place of oral health on the global health agenda, for policies that address the determinants of poor oral health, and to ensure that health care dental work are accessible to all without financial difficulties.
Reducing oral health problems requires reform of dental care systems to shift the focus from invasive dental treatment to prevention and control of oral disease based on person-centered care. Stronger policies are also needed to tackle the determinants of oral and noncommunicable diseases and to tackle inequalities through universal and inclusive access to health care.
A three-year roadmap (2019-2021), is currently implemented by the WHO oral health program comprising a mix of normative work and practical support to countries through five priority activities. A top priority is the development of the WHO Global Oral Health Report, to be launched in the second quarter of 2021. Targeting policymakers and decision makers, the report will outline the burden, challenges and actions priorities to renew the global commitment to improve health in noncommunicable disease programs and universal health coverage.