Oral diseases are the most common form of non-communicable diseases (NCDs) in the world. Globally, these conditions affect approximately 3.5 billion people – nearly half the world’s population.
Long a neglected topic in global health circles, oral diseases affect approximately 1 billion more people than all five main NCDs – mental disorders, heart disease, diabetes, chronic respiratory diseases and cancer – and the number of global cases has increased by more than 1 billion. last 30 years. Today, the WHO team responsible for the oral health agenda is still made up of just 3 people.
“It’s a huge burden,” Dr. Benoit Warren, WHO Team for Oral Health Strategy, told Health Policy Watch. “And this burden is increasing, especially in low- and middle-income countries.”
And the world is starting to take notice. The WHO’s Global Oral Health Status Report published on Friday reflects a new focus on the importance of oral diseases. Incorporating data from 194 countries, the report is the first comprehensive overview of oral disease burden worldwide.
This follows guidelines by the World Health Assembly to adopt a watershed resolution on oral health in 2021, agreeing on the objective of universal health coverage for oral health services by 2030.
“The adoption by WHO member states of a historic resolution on oral health at the World Health Assembly in 2021 was an important step forward,” said WHO Director-General Dr Tedros Ghebreyesus. “WHO is committed to providing guidance and support to countries so that all people, wherever they live and whatever their income, have access to the knowledge and tools they need.”
First comprehensive global report highlights glaring inequalities
Three out of every four people affected by oral health conditions live in low- and middle-income countries. Oral diseases are part of the NCD family, but have not yet been well integrated into the global NCD agenda.
“All oral diseases show strong social gradients, affecting the most vulnerable and disadvantaged population groups,” the report found. “People with low incomes, people with disabilities, people who are refugees, older people living alone or in care homes, those in prison or living in remote and rural communities, children and people from minority and other socially marginalized groups generally But carry more burden.
Globally, the pattern of inequality in the distribution of oral disease burden can be compared to that of cancer, heart disease or diabetes. Oral health shared the common risk factors of all forms of tobacco and alcohol use as well as high sugar intake.
“One of the key messages from this report is that we are part of the NCD family because we share common risk factors with other major NCDs,” Warren said. “We need to invest in this upstream population-based strategy in collaboration with other programs and countries.”
Inequalities also exist at the sub-national level. Public and private services are more concentrated in wealthy urban areas due to the need for expensive technology to provide care, often in rural areas with no access to even the most basic oral health services.
Back to basics: essential care often overlooked by oral health systems
Oral diseases are largely preventable. On paper, the ideal oral health system should focus on the delivery of preventive care, and support patients with education in self-care practices to promote independence. Necessary care is of paramount importance, but the current model being practiced around work focuses on the complex.
“Most countries have modeled their oral care systems on dental care models from high-income countries that are based on high-technologies and specialized providers.” said Dr Benoit Warren, leader of the WHO’s oral health team. “And the workforce is more or less all concentrated in urban areas.”
The emulation of the high-income country model is often characterized by a “system-level failure in the model of care and provision of oral health services”, characterized largely by expensive high-tech equipment and materials, highly specialized providers and very few Relies on middle tier providers. the report notes.
A model contingent’s reliance on a highly specialized workforce – with many roles requiring up to 7 years of education – does a disservice to the provision of simple, non-invasive pain-relieving treatments for populations lacking access to sophisticated oral care facilities .
The report emphasizes the benefits of training other health professionals in the provision of essential oral health services to increase access to non-urban areas and reduce the huge disparity in the distribution of the highly specialized workforce.
At the time of writing, sub-Saharan Africa and parts of Southeast Asia reported the lowest absolute numbers of professional-to-population ratios for oral health care in the world.
“We hope that the approaches outlined in the report will improve the situation and reduce disparities,” Warren said.
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