Scottish Dental

Sugar in processed meals ‘fuelling oral health crisis’

15 August, 2019 / infocus
 

Call for tighter global regulations as study says commercial baby food and drinks ‘encourage preference for sweetness in early life’

ORAL health has been isolated from traditional healthcare and health policy for too long, despite the major global public health burden of oral diseases, according to a new Lancet Series. 

Failure of the global health community to prioritise the burden of oral health has led to calls from its authors for the radical reform of dental care, tightened regulation of the sugar industry, and greater transparency around conflict of interests in dental research.

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. Lip and oral cavity cancers are among the top 15 most common cancers in the world. In addition to lower quality of life, oral diseases have a major economic impact on both individuals and the wider health care system.

The Lancet Series on Oral Health, led by University College London (UCL) researchers, brought together 13 academic and clinical experts from 10 countries to better understand why oral diseases have persisted globally over the last three decades, despite scientific advancements in the field, and why prevalence has increased in low and middle-income countries (LMICs), and among socially disadvantaged and vulnerable people, no matter where they live.

“Dentistry is in a state of crisis,” said Professor Richard Watt, Chair and Honorary Consultant in Dental Public Health at UCL and the series’ lead author. 

“Current dental care and public health responses have been largely inadequate, inequitable, and costly, leaving billions of people without access to even basic oral health care. 

“While this breakdown in the delivery of oral healthcare is not the fault of individual dental clinicians committed to caring for their patients, a fundamentally different approach is required to effectively tackle to the global burden of oral diseases.”

In high-income countries (HICs), dentistry is increasingly technology-focused and trapped in a ‘treatment-over-prevention’ cycle, thus failing to tackle the underlying causes of oral diseases, say the authors. In low-income countries the current situation is most bleak, they say, with even basic dental care unavailable and most disease remaining untreated.

Sugar consumption, the underlying cause of tooth decay, is rising rapidly across many LMICs. While sugary drinks consumption is highest in HICs, the growth in sales of sugary drinks in many LMIC is substantial; by 2020, Coca-Cola intends to spend US$12bn on marketing its products across Africa in contrast to WHO’s total annual budget of $4.4bn.

“The use of clinical preventive interventions such as topical fluorides to control tooth decay is proven to be highly effective, yet because it is seen as a ‘panacea’, it can lead to many losing sight of the fact that sugar consumption remains the primary cause of disease development,” said Professor Watt.  “We need tighter regulation and legislation to restrict marketing and influence of the sugar, tobacco and alcohol industries, if we are to tackle the root causes of oral conditions.”

The Lancet Series authors have called for wholesale reform of the dental care model in
five key areas: 

• Close the divide between dental and general healthcare.
• Educate and train the future dental workforce with an emphasis on prevention.
• Tackle oral health inequalities through a focus on inclusivity and accessibility.
• Take a stronger policy approach to address the underlying causes of oral diseases.
• Redefine the oral health research agenda to address gaps in LMIC knowledge.

Ending the neglect of global oral health: time for radical action. Prof Richard G Watt, PhD; Prof Blánaid Daly, PhD; Prof Paul Allison, PhD; Prof Lorna M D Macpherson, PhD; Renato Venturelli, MSc; Prof Stefan Listl, PhD; et al. www.tinyurl.com/y5xoqcca

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