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root causes

Big Sugar and government neglect to blame for dental healthcare's 'state of crisis'

In Ireland, vulnerable people have more untreated dental disease, and poorer oral health-related quality of life than others.

GLOBAL DENTISTRY IS in “a state of crisis”, and has been isolated from traditional healthcare for too long, despite the major global public health burden of oral diseases, according to the ‘Series on Oral Health’ published in The Lancet this week.

The report claims that “the tactics used by the sugar industry include discrediting major research and recommendations on diet and nutrition, enlisting the support of politicians to block reports and policy, and funding ostensibly independent organisations to obtain access to key decision makers and to legitimise statements downplaying the role of sugars in the aetiology of disease”.

It warns about the spend and influence of companies selling products high in sugar content, stating that the consumption of sugary drinks is highest in America, Australasia, and western Europe.

The study says that in high-income countries, dentistry is increasingly technology-focused and trapped in a treatment-over-prevention cycle, failing to tackle the underlying causes of oral diseases.

“Oral health conditions share many of the same underlying risk factors as non-communicable diseases, such as sugar consumption, tobacco use and harmful alcohol consumption,” the study states.

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

“However, oral diseases are a neglected issue, rarely seen as a priority in health policy,” the study says.

“Even in settings with resources, dentistry is not meeting the needs of large segments of the national population and is increasingly focusing on the provision of aesthetic treatments, largely driven by profit motives and consumerism.”


Oral 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 Ireland, vulnerable children and adults have more untreated dental disease, and poorer oral health-related quality of life compared to the general population in Ireland.

Older adults in Ireland with an intellectual disability are twice as likely to be edentulous – have no teeth – compared to the general population.

Professor Blánaid Daly, Dublin Dental University Hospital & School of Dental Sciences, Trinity College Dublin, and a co-author of the series said:

While there have been substantial improvements in the population’s oral health across Ireland, vulnerable groups, such as the very young, people with disabilities, frail older people and marginalised groups, continue to experience poor oral health and large gaps in their access to routine dental care.

In addition to lower quality of life, oral diseases have a major economic impact on both individuals and the wider healthcare system. The treatment of oral diseases costs €90 billion per year across the EU, the third-most expensive condition behind diabetes and cardiovascular diseases.

Chair and Honorary Consultant in Dental Public Health at University College London and lead author of the Series, Professor Richard Watt, said: “Globally dentistry is in a state of crisis. 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.

“…A fundamentally different approach is required to effectively tackle to the global burden of oral diseases.”

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