A new report shows that more than half of all adults in the WHO European Region had a major oral disease in 2019, the highest prevalence in the world, and urges Member States to increase Access to safe, effective and affordable essential oral health care within the framework of universal health coverage. .
Copenhagen, April 20, 2023
Universal health coverage cannot be achieved without oral health care. National health coverage programs should include access to oral health care services, either free or at an affordable price. This is the main message of the new situation report on oral health in the WHO European Region launched today. This call follows alarming figures contained in the report that the Region (covering 53 countries in Europe and Central Asia) has the highest prevalence of cases of major oral diseases and the highest prevalence of caries – cavities and dental caries – permanent teeth. worldwide.
Main findings
The most recent data shows:
- The European Region has the highest prevalence of cases of major oral diseases (50.1% of the adult population) among the six WHO regions in the world. This includes the highest prevalence of caries of permanent teeth in any WHO region, which, at 33.6% of the population in the European Region, accounts for almost 335 million cases in 2019.
- The Region has the second highest proportion of tooth loss cases (25.2%), with approximately 88 million people aged 20 or over. This translates to a prevalence of 12.4%, the highest among WHO regions and almost double the global prevalence of 6.8%.
- The Region also has the second highest estimated number of new cases of oral cancer, almost 70,000, or 18.5% of the total estimated cases worldwide. More than 26,500 deaths in the Region were attributable to oral cancer in 2020.
- Of the 53 countries in the European Region, 34 (66.7%) did not have a national oral health policy.
- Eleven countries (23.4%) did not have dedicated oral disease staff within the noncommunicable diseases department of the Ministry of Health.
The report highlights progress in some areas, including a significant decline (7.2%) between 1990 and 2019 in the prevalence of cavities in primary teeth – commonly known as baby teeth or baby teeth – among children aged 1 to 9 years, as well as a drop (3.9%) in the prevalence of caries of permanent teeth in this age group. The overall picture, however, is deeply worrying.
Greater need, less access to services
Oral health care services are largely provided by private, fee-for-service practitioners and, as a result, most patients incur high out-of-pocket costs.
Government programs and insurance plans provide only partial or no coverage for oral health care.
In the Region, 10 countries spend less than US$10 per person per year on oral health care, while 14 countries spend between US$11 and US$50. This is extremely problematic because research shows that those with the greatest need for oral health care are those who have the least access to services.
Health starts in the mouth
“Oral health is an essential part of health care. Many of our most basic human functions – speaking and communicating, eating, breathing and, most importantly, smiling – depend on good oral health,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Untreated dental caries can affect the quality of life of people at any age, but are particularly detrimental during childhood because they create problems that can last a lifetime. In children, dental caries affects school attendance and academic performance. Severe, untreated cavities can impair nutrition and growth. In many high-income countries, extraction of decayed teeth under general anesthesia is the main reason for hospitalization of young children. In adults, untreated caries can be a major cause of absenteeism and affect quality of life and work. Oral health has a real impact on many areas of our lives, but it rarely receives the attention it deserves when it comes to health policies and coverage plans.
WHO/Europe Regional Advisor on Alcohol, Illicit Drugs and Prison Health, Dr Carina Ferreira-Borges, added: “There is strong evidence that oral diseases disproportionately affect Disadvantaged and marginalized groups – people on low incomes, people living with disabilities, older people living alone or in care homes, people who are refugees, in prison or living in rural communities. The recommendations in this report also address these inequalities, directing resources where they are most needed.”
Harm factors
Oral diseases are mainly caused by sugar consumption, smoking, alcohol consumption, trauma and lack of oral hygiene. At the policy level, the main factors are:
- saturation (availability) of substances with a high sugar content, especially sugary drinks;
- aggressive marketing of substances with a high sugar content, particularly targeting children, as well as tobacco and alcohol;
- limited access to primary/community oral care services;
- inadequate exposure to fluoride found in the water supply and in oral hygiene products such as toothpaste.
Recommendations
“Tooth decay is the most common non-communicable disease in the world – but it doesn’t have to be. We know what to do. The objective of this report is to encourage governments and health authorities to increase access to safe, effective and affordable essential oral health care within the framework of national universal health coverage programs,” continued the Dr. Kluge. “This is the best way to address oral health inequalities while simultaneously tackling multiple non-communicable diseases and improving the overall health of the population. »
The recommendations contained in the new WHO/Europe report complement those of the Global Action Plan for Oral Health, which presents 100 actions proposed to Member States, the WHO Secretariat, international partners, organizations of civil society and the private sector, and is accompanied by a global action plan. monitoring framework to track implementation progress.
Among its key recommendations, the new report for the European region specifically advises governments:
- develop new national oral health policies that align with the WHO Global Oral Health Strategy and national policies on noncommunicable diseases (NCDs) and universal health coverage (UHC) ;
- allocate dedicated staff and funds for oral health within the Ministry of Health or other national government health agency, ensuring integration with NCD and UHC programs;
- implement policy measures to reduce the consumption of free sugars, such as mandatory nutrition labeling on prepackaged foods; reformulation targets to reduce the sugar content of foods and drinks; public food purchasing policies aimed at reducing sugar-rich food offerings; policies to protect children from the harmful effects of food marketing; and taxes on sugary drinks and foods high in sugar;
- integrate oral health care into primary health care at all levels of service, with the required staffing, skills and competencies;
- develop an innovative oral health workforce model, including oral health professionals and other primary health care workers, to meet the oral health needs of the population dental.
Speaking at the launch of the new report at the WHO Regional Office for Europe in Copenhagen, Dr Gauden Galea, Strategic Advisor to the Regional Director’s Special Initiative on Noncommunicable Diseases and Innovation, WHO /Europe, said: “The case for expanded universal health coverage and strengthening policies in the areas of nutrition, tobacco and alcohol is powerful, from a health, rights perspective of man and the economy. In doing so, we radically improve oral health and a range of other critical health areas, including diabetes, cancer and cardiovascular disease. Responsibility for all key policy areas lies with government and health policy makers. At WHO/Europe, we are here to support our Member States in this area. Let’s work together to make oral health under universal health coverage a reality.”
