Untreated caries in permanent teeth was the most prevalent health condition in 2010, affecting 35% of the global population, or 2·4 billion people worldwide. In 2010, severe periodontitis was the sixth-most prevalent health condition, affecting 10·8% of people, or 743 million, worldwide.
Worldwide in 2015, dental diseases accounted for US$356·80 billion in direct costs and US$187·61 billion in indirect costs.
Is oral health the next big SDH (Social Determinant of Health)? A focus in this month’s Lancet is the neglect of global oral health. Most of our Readers know that oral self-care can be a challenge with older adults due to physical limitations, finances, and access, but oral and periodontal disease affects nutrition, is a source of pain, tooth loss, consequent low self-regard, low quality of life, and can lead to other diseases such as sepsis and undiagnosed cancers.
The Lancet’s two articles, Oral diseases: a global public health challenge and Ending the neglect of global oral health: time for radical action (open access, registration required on these links) point out the current allopathic model does not fit the wider societal need, and come down hard on the social and economic origins (very hard on Western dental practice, the sugar industry, and food providers). However, the articles are light on solutions other than universal health care and community based dental practice. Even in less-developed countries like India and Brazil, practitioners don’t migrate to poor, rural areas. It is true, however, that much of dentistry, at least in the US, has an increasing focus on cosmetic restoration.
Here is a wide-open area for telehealth development. Some areas to explore:
- Creating wider access to dentistry that treats immediate problems
- Greater access to proactive dental care, whether dental checkups and to encourage better self-care
- Connecting rural fixed or mobile clinics staffed by technicians or locally trained staff with dentists for remote screening and scheduling care.