Friday, March 18, 2016

World Oral Health Day: Increasing Access in the United States and Across the Globe

By Natalia I. Chalmers, DDS, PhD, DentaQuest Institute

When I talk about oral health, I refer to everything from cavities to mouth cancer to nutrition, from babies to people of all ages, from dentists to hygienists to all health professionals. And I don’t only think about America.

According to the FDI World Dental Federation (FDI), 90 percent of people worldwide will suffer from oral health problems in their lifetime. This alarming statistic underscores the need for World Oral Health Day, held annually on March 20.

This observance pushes those of us passionate about oral health to take action to reduce the incidence of dental disease, while providing a moment in time for us to elevate the issue globally. To commemorate World Oral Health Day 2016, I took a look at the global burden of untreated caries and how we stack up against our neighbors across the pond when it comes to oral health.

Global Burden of Untreated Caries

According to the World Health Organization, caries is the fourth-most expensive chronic disease to treat. While the prevalence and incidence of untreated caries remained static between 1990 and 2010, there is evidence (as noted in the Journal of Dental Research article also linked above) that the burden of untreated caries is shifting from children to adults.

Oral Health in the United States vs. United Kingdom

It is a common misconception that Americans have “better” teeth than the British, a stereotype perpetuated in the entertainment industry. However, a recent study published in the British Medical Journal shed light on the actual oral health differences between the two countries, illustrating that, in fact, the picture is more complex.

In the study, researchers looked at data from the English Adult Dental Health Survey (ADHS) and the U.S. National Health and Nutrition Examination Survey (NHANES) to analyze baseline measures, such as the number of missing teeth and oral health’s impact on daily life. The analysis yielded some of the following results:
  • U.S. adults had more missing teeth than their U.K. counterparts (an average of 7.31 to 6.97 missing teeth, respectively).
  • The impact of poor oral health on U.K. daily life was more prevalent.
  • The highest U.S. socioeconomic group had better oral health, while those in the lowest U.K. socioeconomic group had better oral health.

While these results indicate there is room for improvement in both countries, the last finding stood out to me.

Researchers in the study suggest this finding may be due to differences in how health care is funded in each country. U.K. dentistry is largely supplied by the National Health Service, while it’s largely dependent on access to dental insurance for Americans. 

Differences aside, these results point to the larger problem at hand — barriers to access in the United States.

Most Americans who fall within the lower socioeconomic category lack access to care, education, and transportation, which subsequently impacts the incidence of disease. One potential reason those with low socioeconomic status thrive in the United Kingdom is that they have resources that connect them with proper oral health care. 

This issue of access and resources is an important factor when evaluating disease causation — when we increase access, we improve oral health.

Greater Access Can Lead to Better Outcomes

So we know the burden of untreated caries is shifting from children to adults. There is evidence that the U.S.-U.K. oral health gap is not as large as we may think. Imagine what this means for our misconceptions about oral health in general across the globe.

Knowing disparities are complex, I hope this World Oral Health Day becomes the global call to increase access to oral health care for all. Let’s elevate the conversation and raise awareness: with support, access to preventive services will increase health outcomes globally and bring relief to all 90 percent of the world’s population in need.