It is well established that the major oral diseases and NCDs share the same social determinants and common risk factors. Particularly important among the latter are tobacco, alcohol, and dietary sugar intake. It is imperative that oral healthcare professionals (OHCPs) understand the importance of these associations because it is in large measure based on this evidence that the WHO has encouraged an integrated approach to chronic disease prevention.
A multi-sectorial approach to oral health
The challenge that the burden of oral disease presents is immense and will not be met effectively by the dental profession continuing to work in a dental silo! It will require closer engagement with the health professionals, engagement with – and advocacy on behalf of – civil society, and a high degree of leadership.
What the Oral Health Team can do:
1. Understanding health determinants
All members of the oral health team should acquire a thorough understanding of the importance that social determinants play in oral as well as in general health. They should have a thorough understanding of how the conditions in which people are born, live, work, and age affect their health and how they can act to tackle these.
2. Partnerships with communities
Dentists and the oral health team should engage in partnership with communities to help them better understand and tackle the social, economic, and environmental factors that determine oral health and increase inequalities.
3. Collaborating with primary care
Dentists and the oral health team should engage with colleagues such as primary health care professionals in the development of cross-sectoral partnerships so that oral health promotion strategies become incorporated into all strategies for health.
4. Acting as health advocates
Dentists should become advocates for health, particularly oral health, with their patients and the wider community. This should include an emphasis on acting as enablers, helping to make healthy choices the easier choices and empowering people to take control of their own lives and health.
A New Profession!
The leaders within the dental profession must increase understanding among them of the central role that the social determinant of health play in creating persistent inequalities in oral disease. Advocating for reductions in common risk factors will allow dentistry to take part in championing the value of health equity, create clarity of goals, and integrate oral health into monitoring of general health. National dental associations should advocate for policies that will address inequalities in oral and general health effectively. They should advocate for much greater emphasis on controlling dietary sugars and tobacco use, reducing excessive alcohol consumption, and making healthy choices the easy choices.
Health Promotion
Current approaches to the control of oral disease are of limited effectiveness and economically unsustainable. Oral diseases share the same common risk factors and social determinant as the major NCDs. Thus, to reduce the growing global threat so society of poor oral health, the focus must shift toward a greater emphasis on health promotion and the integration of oral health with general health in all strategies.
Reference: David M. Williams (2019): Common risk factors: the link between oral and systemic disease. In: Glick M (2019): The oral- systemic health connection. 2. ed., QUINT PUBL, US-Batavia.