Tip Sheets

How to cover efforts in your town to improve oral health around the world

By Mary Otto

I earlier wrote about a story by Sara Schilling of the Tri-City Herald in Kennewick, Washington, that offered her readers a glimpse into world of a local “adventure dentist.”

When dentist Bart Roach isn’t taking care of his own patients or helping at a local clinic serving the poor, he is traveling to faraway places such as Cambodia or Guatemala to help people who are suffering from oral disease. “You have an obligation to give back to your community and your global community,” Roach explained. Schilling had caught up with the dentist as he was preparing for a trip to the Ladakh region of India. The newspaper plans to provide updates on his journey, which he will make with a group called Global Dental Relief (GBR).

The nonprofit, based in Denver, Colorado, organizes teams of volunteer dentists, hygienists and dental assistants who are willing to bring care to places where oral health professionals are in very short supply, from India and Guatemala to Vietnam and Kenya. Volunteers such as Bart Roach return home with insights into life and health around the world. You may have someone in your community who has such stories to tell.

GBR is not alone in its philanthropic work. The American Dental Association offers a directory of groups and the places they serve. Here is a tip sheet of global oral health resources that might be useful if you decide to take on such an assignment:

Fédération Dentaire Internationale

Curious about the tooth decay rate in Chile? The dentist-per-patient ratio in Denmark? Oral cancer prevalence in Oman? The Fédération Dentaire Internationale, or FDI World Dental Federation, is a useful source. Founded in Paris in 1900 and headquartered in Geneva, Switzerland, FDI represents more than 200 national dental associations and 1 million dentists working in more than 130 countries across the globe.

This FDI atlas table offers data reflecting the oral health status of nations around the world.

Photo courtesy of Bart Roach

Oral Health Worldwide, a white paper produced by FDI, offers another take on global oral disease. The report includes charts illustrating the impacts of oral conditions on overall health, the impacts of systemic disease on oral health and a world map with the colors of countries keyed to percentage of tooth decay among school aged children. In case you are wondering, 70 percent of the world’s 6-19 year olds have tooth decay. The highest rate of decay in this age group can be found in Argentina, where a reported 100 percent of kids suffer. The lowest is Japan with 16 percent.

As in the United States, the poor across the world bear a disproportionate burden of tooth decay and periodontal disease. In areas of Sub-Saharan Africa, Asia, and South America, children contending with poverty, poor hygiene and malnutrition face an additional risk. Tens of thousands contract noma, a disfiguring and often fatal gangrene that starts in the mouth.

In addition to promoting oral health policy at national and international levels, FDI sponsors an annual World Dental Congress that draws dental researchers, providers and advocates from dozens of countries. The meeting for this year is planned for Sept 22-25 in Bangkok Thailand.

Global Burden of Diseases Study

Now for some huge oral health numbers from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) which is funded by the Bill and Melinda Gates Foundation and aims to offer the world’s most comprehensive measurement of epidemiological levels and trends.

Tooth decay, gum disease and other oral problems impact an estimated 3.9 billion people worldwide. And among the 291 diseases systematically compared for worldwide impact by GBD, untreated tooth decay in permanent teeth tops the list. The problem affects an estimated 2.4 billion people worldwide, according to a March 2015 systematic review and analysis compiled by researchers using GBD resources.

Untreated decay in deciduous (baby) teeth, the tenth most prevalent condition in the GBD study, impacts 621 million children globally. Severe gum disease, or periodontitis, which leads to tooth loss and which has possible links with a range of other illnesses, also is prevalent, currently affecting more than 11 percent of the world’s population.

World Health Organization

The World Health Organization (WHO) has identified oral disease as an international concern and has set goals for addressing serious care shortages and deep health disparities found in countries and regions around the globe.

WHO frequently weighs in with research and preventive strategies for these and other oral diseases. Earlier this year, the international agency issued new guidelines calling for reduced sugar intake worldwide.

“We have solid evidence that keeping intake of free sugars to less than 10 percent of total energy intake reduces the risk of overweight, obesity and tooth decay,” said Dr Francesco Branca, director of WHO’s Department of Nutrition for Health and Development. “Making policy changes to support this will be key if countries are to live up to their commitments to reduce the burden of noncommunicable diseases.”

WHO also targets tobacco use as a risk factor for gum disease, diseases including oral cancer and birth defects. The increasing use of tobacco products among young, poor and marginalized people worldwide, “will considerably affect the general and oral health of future generations,” according to the group.

In China where tobacco is blamed for approximately 1 million deaths a year, WHO recently hailed landmark legislation banning indoor smoking in Beijing.

The group also supports fluoride programs and a variety of other international oral health initiatives.

International Association for Dental Research

The International Association for Dental Research, based in Alexandria, Virginia, is a network of more than 11,000 scientists working worldwide on research related to oral health and disease.

The nonprofit organization produces several peer-reviewed journals including the Journal of Dental Research, which just published a new critical review of literature examining the role of sugar in tooth decay.