Indian Journal of Dental Research

: 2019  |  Volume : 30  |  Issue : 4  |  Page : 483--485

Global oral health: A proposal for a change of picture

Gerhard K Seeberger 
 President of the Academy of Dentistry International, New York, USA

Correspondence Address:
President Gerhard K Seeberger
President of the Academy of Dentistry International, New York

How to cite this article:
Seeberger GK. Global oral health: A proposal for a change of picture.Indian J Dent Res 2019;30:483-485

How to cite this URL:
Seeberger GK. Global oral health: A proposal for a change of picture. Indian J Dent Res [serial online] 2019 [cited 2019 Dec 11 ];30:483-485
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For more than half a century, the picture of the global oral health has seen two unchallenged protagonists: the oral health profession with the dentist as the undisputed expert in making correct diagnoses and treatment proposals to maintain and reconstitute oral health, guided by the ethical principle primum nihil nocere;[1] and the sugar, food and beverage industry, an uncontested business expert, guided by the ethical principle of 'making profit'.[2]

While the purpose of the first ethical principle is to guarantee life, quality of life and wellbeing, the purpose of the second is to be a powerful driver of entrepreneurial energy important to business 'and' to society.

A big difference in searching for the good of mankind? No! Both engage in society's welfare.

A big difference in outcomes? Difficult to say! Sugar business is growing; non-communicable diseases (NCDs) are on the rise; and untreated caries of permanent teeth is still the most prevalent disease since a decade.[3] A win-win situation if looking only at numbers.

A big difference for people? Yes!

The oral health profession has not been able to keep pace with the need for oral disease prevention, oral health promotion and quality care, and the sugar-producing and -using industry is marching towards vertiginous profits, especially in the new markets like China, India, other parts of Asia, and Africa.[4],[5],[6]

The recent status of the global oral health is outlined in the recent Lancet Executive Summary, Series, Comments, Editorial, and Perspectives on oral diseases.[7],[8],[9],[10],[11],[12],[13],[14] The development of the picture described is sufficiently and inertially looked at since almost 60 years. At this point, it is worth remembering the days when tackling the sugar argument was the dentists' domain. They informed their society about adequate oral-disease-prevention measures, the choice of a healthy diet, avoiding by the same token tooth and liver disease, while offering oral health. And if a restitutio ad integrum of oral tissues was not possible, they diligently looked after a quality restitutio ad functionem! Have dentists been kept out as potential opposers of the sugar business on purpose? Is this why oral health is not a priority on the political agenda of almost any state on the globe?

Private and public dentists from all over have shown to contribute substantially to health and wealth as long as they have been the real leadership of oral health.[15] They are the pioneering profession of prevention in medicine, as has been pointed out by the former World Health Organisation's (WHO) DG Margaret Chan in 2012,[16] and they are pioneers in developing good economies for people, the oral health profession, the medical profession and for any other profession. Supported by the dental industry, dentists smartly contributed, continue to contribute and foster WHO DG Tedros Adhanom Ghebreyesus' hope that'in years to come, the term quality care will fall into disuse as there is no other kind'.[17]

For too long, the sugar industry has raised profits on a market without regulation and legislation. The increasing number of victims of free sugar consumption is the result of a global economic system that currently favours wealth creation over health creation. Considering that sugar is a gateway drug for other addicting substances and behaviours, such as alcohol, tobacco, other non-legalized drugs and technologies, this scenario has no other chance than ending up in a disaster. The supporting research for this has been delivered by two expert groups: economists and physicians. Both measure reactions, and one gives the explanation for the results of the other. Societies consuming free sugar over a liver's metabolic capacity are less efficient and more depressive and on their best way to extinction. Who says this? Bankers and endocrinologists.[18],[19] Economy is the mathematics of bankers, and endocrinology is the mathematics of medicine! And there is nothing to discuss about it! Increasing poverty, the growing numbers of refugees, critical illiteracy and depression in younger generations are leading to an unstoppable decrease of the market for high-end products of any kind.

Our political leaders had ample time, as they were solicited by two fundamental articles from dentists, to deepen their knowledge about the reasons for the neglect of oral health as a priority on the political agenda 8 and 5 years ago.[20],[21] After all, oral health is a core element of health and a fundamental human right. This right cannot be fought for by the oral health profession alone anymore.[8] The support of the dental industry is no longer sufficient to tackle the constantly growing negative effects of sugar with new techniques and technology, and the support of the pharmaceutical industry of the medical profession in tackling other NCDs does not suffice to invert the stream of NCDs towards new frightening heights anymore.

The FDI World Dental Federation with its vision to 'lead the world to optimal oral health' shall do everything to be the undisputed leader in marching towards this goal. Optimal oral health is an intrinsic part of the United Nations (UN) 2030 Agenda and more specifically, the Sustainable Development Goal, SDG 3, good health and wellbeing. FDI must spearhead a new global oral health movement aiming at improving oral health, reducing pain and suffering especially for children and elderly, and strengthening efforts to address oral health as part of Universal Health Coverage to better contribute to the overall efforts of the NCD movement.[11] This demands rather a change of the oral healthcare system and reconsidering the oral healthcare workforce than a change of players.[22] It is illogical that a bank proposes sugar tax based on their research when we can learn from the effects of tobacco tax that approximately 20% of the world's population are smokers (35% males)[23] and this number has not changed over the last three decades despite several tobacco tax increases.[24],[25] Recent research has shown that decreasing tobacco sales are reciprocally linked to a black-market increase, mainly driven by the tobacco industry.[26]

How unfair and cowardly do we want to look when proposing sugar tax to health-illiterate and sick people, who are not victims because of their own behaviour but victims of environmental exposure? How fair, instead, would it be to tax alcohol, sugar and tobacco before production and not before consumption? Any conflict of interest with the pharma industry?[27] How about advocating for oral health as our colleagues successfully did 60 years ago, turning misled oral-health-illiterates into critical health-literates and thus benefitting a happier, healthier and more effective society? Why are we afraid to invert a system, the healthcare system included, that pays toll to a physical/material world governed by the law of entropy,[28],[29] while a biological world that we are an intrinsic part of must tend to lower entropy and increase syntropy? The latter is the energy of life as Luigi Fantappiè, an Italian mathematician, pointed out in his work with Albert Einstein and Robert Oppenheimer.[30] If oral disease and NCDs are the result of the prevalence of entropy then, for the sake of complementarity, oral health needs now, after 60 years of damage, a system where syntropy is the driver. Business does not need to panic, as business will not be left behind, since it depends on living people, who are potential customers.

The FDI World Dental Federation's recent activities have shown that it is the unchallenged global advocator for an applied oral health concept able to deliver patient-centered outcomes. To better tackle the global burden of oral disease including the related cost burden and to realize its vision of 'optimal oral health for all' leaving no one behind, it must strive towards a concept guaranteeing for people-centered outcomes. The latter demands for strong FDI governance and a membership vividly involved in building undisputed global oral health leadership. Why, just to start with, not appreciate a famous sentence of Anne Frank: 'How wonderful it is that nobody needs to wait a single moment before starting to improve the world.'


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