By Dr. Joseph D. Lim
Oral diseases do not occur in isolation.
Oral diseases occur along with other noncommunicable diseases or NCDs.
Oral diseases are linked to a range of modifiable risk factors common to many NCDs. These include sugar consumption, tobacco use, alcohol abuse, poor hygiene, and the underlying health system, social and commercial determinants of health.
These determinants include demographics such as gender, age, ethnicity, and poverty as well as factors such as education and social status; violence and racism, stigma and discrimination. They include exposure to the marketing of products harmful to health such as tobacco. Or they could be exposure to pollution. And so on.
The common risk factors in oral diseases are also caused by the burden of many chronic diseases, the very same risk factors associated with cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes — currently the leading cause of death globally.
This is why it is important that social and commercial determinants of health in general should be considered in reducing the burden of oral diseases.
The World Health Organization’s (WHO) monitoring framework that tracks progress in preventing and controlling NCDs covers nine global targets and 25 indicators. However, despite being one of the most prevalent NCDs globally, there are no indicators related to oral health specifically. It is a missed opportunity.
The Bangkok Declaration of No Health Without Oral Health, adopted at the WHO Global Oral Health Meeting in 2024, aims to address this issue.
It calls for the inclusion of three targets related to oral health:
(1) By 2030, 80 percent of the global population is entitled to essential oral healthcare services as part of Universal Health Care (the Philippine version is popularly known hereabouts as PhilHealth).
(2) By 2030, the combined global prevalence of the main oral diseases and conditions over the life course shows a relative reduction of 10 percent.
(3) By 2030, 50 percent of countries implement measures aiming to reduce free sugars intake.
To achieve these targets, it is essential that oral health is included in Universal Health Care coverage and policies concerning noncommunicable diseases.
“While ongoing political commitment to oral health is important, it is essential to translate these commitments into tangible actions to address the oral health needs of the 3.7 billion people who remain largely underserved,” says the FDI World Dental Federation (FDI), the largest umbrella group for all dental associations worldwide.
Oral health interventions must prioritize marginalized population groups such as low-income earners; people living with disability; older people living alone or in care homes; people who are refugees, in prison or living in remote and rural communities; and people from minority and/or other socially marginalized groups, according to the FDI.
The fourth United Nations High Level Meeting (UN HLM4) on NCDs (HLM4) will take place on September 25 this year in New York. It will be an opportunity to address the challenges of oral health care, according to the FDI.
It represents a “critical opportunity for governments to adopt a bold, action-oriented and achievable agenda, one that recognizes oral health as an essential component of both NCDs and broader health strategies,” the FDI states.
In the months leading to HLM4, the FDI and the International Association for Dental, Oral and Craniofacial Research are calling on governments “to adopt a whole-of-government, whole-of-society, health-in-all-policies approach” to the challenges of noncommunicable diseases.
This approach, they say, will shift the predominant focus of oral health away from technical interventions towards an approach based on the right to health, strengthened by robust oral health research, and consideration of the social, commercial and health system determinants of health.
It is an opportunity not to be missed.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De La Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com/WDJ