21 Sep 2018

On 21 September, 19 organisations representing the European oral health community sent the below open letter to Commissioner Andriukaitis, calling him to highlight the prominent role that good oral health can play in addressing the challenge of non-communicable diseases during the UN High-Level Meeting on Non-Communicable Diseases on 27 September.

Download the open letter here: Open Letter – Oral Health Community to Commissioner Andriukaitis – UN NCD Conference

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Oral health: the missing link in tackling Non-Communicable Diseases

A call from the European oral health community to the European Commission

Dear Commissioner Andriukaitis,

We, representatives of 19 organisations representing the European oral health community, are writing to you on the occasion of the Third United Nations (UN) High-level Meeting on Non-Communicable Diseases (NCDs) and the corresponding Political Declaration planned for adoption on 27 September in New York City.

While we appreciate the commitment of UN Member States to tackle the growing impact of non-communicable diseases on the health of the population globally, we are highly disappointed that the draft Political Declaration does not recognise the burden that oral conditions represent both for individual patients and the society as a whole, as well as the role that good oral health can play in maintaining good health and well-being.

We understand that the European Union, as an observer member, cannot submit amendments to the Declaration directly, however, we would like to bring the following points to your attention, which we trust you will take in serious consideration.

Oral health is an integral part of general health and better prevention would save health systems millions of euros

 Oral health is integral to the general health of citizens in the EU and has an impact across the life course; from childhood, through the links between dental decay and growth, to older adulthood through the evidence linking poor oral health to decline in physical and cognitive function.

In addition, oral diseases affect nearly 100% of the world’s population during their lifetime and create an unnecessary financial burden on patients and the entire healthcare systems[1]. For instance, untreated dental decay in permanent teeth is the single most prevalent non-communicable disease on the planet, whilst it is easily preventable through the promotion of healthy eating and oral hygiene. Furthermore, poor oral health shares common risk factors such as poor diet, alcohol and smoking with other major diseases such as CVD and diabetes. The common risks expand beyond the lifestyle to the broader environmental and social factors that are the “causes of the causes”.

Finally, the economic burden of oral diseases is severe for EU member states, estimated at 5-10% of public health expenditure in high-income countries according to the WHO, as well as a reduction in productivity due to lost work days and poorer educational attainment due to lost school days.

Oral diseases are increasingly linked to systemic diseases

Gum disease and extensive tooth loss are being increasingly linked with diabetes, cardiovascular disease, respiratory disease, and dementia[2]. Oral health professionals can help prevent and identify NCDs at an early stage. As such, good oral health can contribute considerably to maintaining health overall.

Moreover, the poor and socially disadvantaged suffer higher levels of oral diseases in a comparable way to the prevalence of heart disease, stroke, and dementia. Oral health inequalities constitute a significant public health problem. As such, action is required on the broader social and environmental determinants of health.

Addressing the burden of oral diseases and NCDs requires a holistic, but comprehensive and integrated policy response across Europe. If successful, prioritising improvement of oral health across Europe will lead to healthier EU citizens by helping to prevent and protect against other diseases. In addition, it will result in a reduction in overall health care expenditure for treating other chronic diseases.

Oral health should not be forgotten in the fight against non-communicable diseases

Despite the unacceptably high disease burden, oral health is still not considered a priority issue and has remained low on the global health and development agenda. For the reasons outlined above, it can and should no longer be overlooked. That is why, when you take the floor in New York City, we would like to respectfully encourage you to:

• Highlight the prominent role that good oral health can play in addressing the challenge of non-communicable diseases;
• Ask UN Member States to recognise the need to address oral diseases through an increased focus on prevention, in order to mitigate the social, economic and developmental burdens on their populations and health care systems.

We trust that you will take into consideration the concerns of our large oral health community and will advocate for promoting good oral health, preventing oral and related non-communicable diseases through addressing common risks factors outlined above.

Sincerely yours,

[1] Kassebaum N.J., Smith A.G.C., Bernabé E., Fleming T.D., Reynolds A.E., Vos T., Murray C.J.L., Marcenes W. and GBD 2015 Oral Health Collaborators (2017) Global, Regional, and National Prevalence, Incidence, and Disability Adjusted Life Years for Oral Conditions for 195 Countries, 1990–2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. Journal of Dental Research. 2017; 96(4) 380–387.

[2] Liljestrands J.M. et al. (2015) Missing Teeth Incident Cardiovascular Events, Diabetes, and Death. Journal of Dental Research. 2015; 1-8.

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Signatories

• Platform for Better Oral Health in Europe
• Association for Dental Education in Europe (ADEE)
• Alliance for a Cavity Free Future (ACFF)
• Arbeitsgemeinschaft Zahnmedizin für Menschen mit Behinderung (German Association for Dentistry for Persons with Disability or Special Needs)
• Council of European Chief Dental Officers (CECDO)
• European Association of Dental Public Health (EADPH)
• European Academy of Pediatric Dentistry (EAPD)
• European Dental Hygienist Federation (EDHF)
• European Dental Students Association (EDSA)
• European Federation of Orthodontic Specialists Associations (EFOSA)
• European Federation of Periodontology (EFP)
• European Orthodontic Society (EOS)
• European Organisation for Caries Research (ORCA)
• International College of Dentists – European section
• Ivoren Kruis (Ivory Cross)
• Oral Health Foundation
• Pan-European Region – International Association for Dental Research (PER-IADR)
• Russian Dental Association (RDA), Section “Prevention of Dental Diseases”
• Union Française pour la Santé Bucco-Dentaire (UFSBD)