Oral diseases affect close to 3.5 billion people worldwide. At least 10% of the global population suffer from severe periodontal (gum) diseases. Oral cancer, meanwhile, is one of the three most common cancers in the Asia-Pacific region.
World Oral Health Day, this year, has the theme “Be proud of your Mouth”. It’s important to reflect on the status, gravity and policies around oral health. Most oral diseases and conditions share modifiable risk factors with other non-communicable diseases, like cardiovascular diseases, cancer, chronic respiratory diseases and diabetes. These risk factors include tobacco use, alcohol consumption and diets high in free sugars.
Altered oral health results in pain, suffering, disability, loss of productivity and low self-esteem. The Mayo Clinic finds that poor dental health increases the risk of bacterial infection in the bloodstream. This can affect a person’s heart valves. There is also a strong connection between diabetes and cardiovascular disease. Research points to diabetics benefiting from good periodontal treatment.
Expanding oral healthcare in developing countries
Oral health literacy has a definite social gradient. A lack of awareness of preventive and promotive oral care, like mouth rinsing and tooth brushing, result in a lower sense of the importance for oral health services.
In most high-income countries dental treatment averages 5% of total health expenditure and 20% of out-of-pocket health expenditure. Most low- and middle-income countries, however, can’t provide proper oral health services. Treatment for oral health conditions is expensive and usually not part of universal health coverage (UHC).
In India, oral diseases are one of the leading contributors to disability. They affect individuals of all age groups, irrespective of any socioeconomic factors. Tooth decay among 12-year-old’s ranges between 23.0 %-71.5 %, while 35-45 year-old adults have suffering rates of 48.1%-86.4%.
Oral health in India is yet to receive priority status from the central and state government. Most of the Indian population remains uncovered for oral health benefits. Private health insurance companies provide minimal coverage for inpatient, trauma-related oral health services. Public sector insurances provide coverage only for a limited number of oral health procedures.
Unlike other noncommunicable diseases, there has been no separate budgetary allocation for oral health yet, but, with the launch of the National Oral Health Programme in 2014, it is increasingly on the agenda. e-DantSeva is a digital platform that provides oral health information through a website and mobile application. The Indian National Oral Health Policy has entertained different draft policies, but real progress has been slow.
Stakeholders should commit themselves in equal standing to oral health as to general health. We must promote greater access and equity in oral health services and should integrate oral health programmes into our wider development agendas.
A resolution on oral health adopted at WHO’s 2021 World Health Assembly is a step in the right direction. It calls for the development of a global oral health strategy by 2022 and an action plan by 2023. This would include a monitoring framework aligned with noncommunicable disease and universal health coverage agendas.
The draft National Oral Health Policy of India has rightly laid down its objectives to better understand the oral health status of the country. It focusses on improving the health systems performance, and aims to establish an oral health management information system. The most important recommendation is a concerted effort whereby oral health aligns to policies for noncommunicable disease control. Here, the Common Risk Factor Approach is seen as a major strategy. This will avoid duplication of efforts and subsequently address socio-political factors linked to orofacial trauma, including tobacco-use, alcohol-use, and unhealthy eating habits.
Prevention is key to good oral health. It is imperative for all related individuals, organizations and institutions to realize their roles and responsibilities in this effort. Various stakeholders, in countries like India, must partner up to build capacity within the oral healthcare delivery system.
With a country of over a billion and 66% population residing in her villages, policies need to be tailored-made for the socio-demographic profile. Low levels of awareness, strained and skewed infrastructure and resources, lack of motivation and research, will all contribute to efficiencies in programme rollout.
This Oral Health Day we should inspire change by highlighting the importance of oral health. Good oral health positively impacts general health, well-being and quality of life. That is something worth taking action for.
Article By: Ruma Bhargava, Project Lead, Fourth Industrial Revolution for Health, India, World Economic Forum, C4IR India; Dr. Ramprasad V.P, Professor and Head, Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal
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