World Oral Health Day: Delivering Optimal Oral Health for All
Dentists are confronting the fallout from a year of disrupted dental care and treatment.

One of the unquantified side effects (or health impacts) of the pandemic has been in a place few people cared to look very deeply – that is our mouths.

For significant parts of the past year, dentists’ chairs in many offices around the world sat empty – as COVID-19 disrupted routine dental treatments. During the early days of the first lockdowns a year ago, we were able to accept patients for emergency dental treatments only.

Patients’ fear of leaving their homes resulted in delays and cancellations of regular checkups, while others simply delayed pending treatment. And most of the patients we saw during this period were suffering from severe tooth pain resulting from unfinished or delayed treatment, ultimately culminating in either an extraction or a permanent restoration of the tooth.

On top of that, the dental profession had been called out (falsely) as being one of the most unsafe in terms of pandemic risks.

COVID-19 and Dental Safety

Most dental practices have now been able to re-open (both in and out of lockdowns), by reinforcing our already stringent infection prevention and control protocols as necessary and according to regulations.

We also have updated data showing that the profession has experienced significantly lower infection rates of SARS-CoV-2 than other healthcare professions in the USA, in Europe and beyond.

Preliminary data on the COVID-19 infection rate among dentists and other healthcare workers, suggest that COVID-19 infection in dental practice may be less likely than in other healthcare settings.

Dental practices are proven to be safe. Despite this, an underlying fear in the general public of contracting COVID-19 persists and has resulted in many of our patients delaying regular check-ups and only booking an appointment once they are already in pain or with infections that require complicated treatment. We encourage our higher-risk patients to have a dental check-up every three to six months – many have quite clearly put off a visit for nearly a year, which has led to extractions that could have been avoided.

This is serious cause for alarm, as these initial oral health issues can transform into broader health concerns. High-risk patients – tobacco users, pregnant women, people with diabetes – who are more susceptible to gum disease and tooth decay can also be more vulnerable to other diseases. Poor oral health has been linked to a host of other health conditions including heart disease and stroke, cancers, and respiratory disorders.

If the call for investing in health systems as part of universal health coverage has largely fallen on deaf ears until now, COVID-19 has certainly forced the issue. This pandemic has severely exacerbated health inequities across the spectrum.

Increasing Burden of Oral Disease

It has never been more apparent that overall health and oral health are absolutely intertwined and cannot exist independently. This World Oral Health Day we need to acknowledge the reality that precedes COVID-19: a picture of an increasing burden of oral disease across the board, matched by inadequate population-level prevention strategies and ineffective care for those in need. We must advocate for oral health professionals (and our profession more broadly) to be actively involved in all efforts to improve health for all and leave no one behind.

Optimal oral health for all is certainly an aspirational goal, but what does it actually stand for? How can we make this goal truly meaningful to oral health professionals, patients and people alike?

Universal Coverage for Oral Health

Any genuine move towards oral health for all first needs to embrace the idea of universal coverage for oral health. This starts with driving better oral health awareness campaigns for public benefit, guaranteeing that by 2030 essential oral health services are integrated into primary healthcare in every country. This shift requires focusing on prevention and early detection of diseases, making oral healthcare available and accessible in both urban and rural areas, and ensuring the affordability of appropriate oral healthcare for all.

It will also be essential to integrate oral health into the general health and development agenda by 2030. This means addressing the shared social, moral, and commercial determinants of health and recognising that untreated oral disease is the most common health condition globally—accounting for a considerable fraction of the overall noncommunicable disease burden.

A Resilient Oral Health Workforce

Finally, by 2030, we need to build a resilient oral health workforce by tackling both the plethora and scarcity of oral health professionals and auxiliaries. This model of an oral health workforce would focus on the prevention of oral diseases; screen for and monitor systemic health conditions; integrate environmentally friendly, innovative, and appropriate technologies to benefit patients; and implement oral health resource and workforce planning in cooperation with governments, educators, and oral health professionals.

Let’s not overlook the obvious: as dentists, we are highly skilled health professionals allied with our medical colleagues. Just look to the role many dentists are playing in delivering the COVID-19 vaccine around the world today. This pandemic has also confirmed that we are veterans in adopting those measures considered to protect against the novel coronavirus: protective gear like masks, gloves, and goggles as well as well as established sterilization and disinfection procedures. Our value should not be underestimated, today and in the future.

Dentists have played an important role in testing for COVID-19 and delivering vaccines around the world.

Oral Health for All

Oral health for all will not happen overnight – it will require ongoing education and awareness around the broader health issues linked with noncommunicable diseases that help to change the narrative and reinforce oral health as an essential health priority. We must focus on evidence-based dentistry and critical thinking, educate and train oral healthcare professionals to advocate for oral health, empower our patients to take responsibility for their own health and well-being, and engage with industry partners around emerging technologies.

The goal of oral heath for all will also require the collective vision and engagement of many stakeholders across the spectrum: industry partners, academics, educators, and researchers.

And let’s not forget policy makers. Governments at all levels must commit to leading the conversation around oral health in their countries and allocate sufficient resources to tackle the oral disease burden.

Perhaps most critically, we need the buy-in of the population at large, who are potentially the most powerful advocates of all to lead the world to optimal oral health.

Dr Gerhard Konrad Seeberger, president of FDI World Dental Federation.

Dr Gerhard Konrad Seeberger is president of FDI World Dental Federation and a private practitioner based in Cagliari, Italy. He is a member of numerous scientific societies (implant dentistry, periodontology). and a regular contributor to Italian and international journals. He was awarded a doctor honoris causa in medicine from Yerevan State University in Armenia and is an honorary member of several national dental associations (Bulgarian Dental Association, Chicago Dental Society, Mexican Dental Association, Romanian Association of Private Practitioners).

Image Credits: FDI World Dental Federation, FDI World Dental Federation, Flickr – Navy Medicine, FDI World Dental Federation.

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