Oral diseases: a global public health challenge – Authors' reply

We thank Jean-Noel Vergnes and Marco Mazevet for their interest in our Series paper on the global public health challenge of oral diseases,1Peres MA Macpherson LMD Weyant RJ et al.Oral diseases: a global public health challenge.Lancet. 2019; 394: 249-260Summary Full Text Full Text PDF PubMed Scopus (950) Google Scholar and we thank Himmatrao and Pramodini Bawaskar for sharing their experience of oral health in India. We agree with Vergnes and Mazevet that comparable, up-to-date national oral health epidemiological data are scarce, even for a high-income country such as France. As the authors rightly highlight, the global epidemiological overview of dental caries, periodontal diseases, and tooth loss presented in our paper relied entirely on the latest available data on oral conditions provided by the Institute of Health Metrics Global Burden of Disease Study (GBD). We did not question the validity of these data because the GBD uses elaborate data selection, estimation, and analysis methodologies described elsewhere.2Kassembaum NJ Bernabe E Dahiya M Bhandari B Murray CJL Marcenes W Global burden of untreated dental caries: a systematic review and metaregression.J Dent Res. 2015; 94: 650-658Crossref PubMed Scopus (882) Google Scholar Questions about unexpected country data or possible errors would be best addressed to the colleagues leading the analysis of oral conditions within the GBD. We appreciate that Vergnes and Mazevet recognise that the global challenges for oral health outlined in our paper also apply in the French context. The absence of reliable routine epidemiological surveillance data on oral health is an unfortunate reality, and one of the root causes that led to the neglect of global oral health. However, the traditional approach of separate surveys of oral diseases conducted at regular intervals is costly and resource-intensive, and has little relevance for service planning and evaluation. Instead, we recommend that standardised and comparable oral disease surveillance systems are needed to assess the full extent and severity of oral conditions globally. The use of a range of clinical epidemiological disease measures should be complemented with appropriate indicators that assess the wider population effects of oral conditions. Established and commonly used oral health indicators should be aligned and integrated with non-communicable disease (NCD) surveillance systems to allow for comparability with, and monitoring of, global NCD targets and the UN Sustainable Development Goals. WHO has a key role in leading the development and strengthening of integrated oral health surveillance systems globally. WHO guidelines for public health surveillance state that countries have an obligation to develop appropriate, feasible, and sustainable public health surveillance systems; countries have an obligation to ensure that the data collected are of sufficient quality, including being timely, reliable, and valid; and that planning for public health surveillance should be guided by transparent governmental priority setting.3WHOWHO guidelines on ethical issues in public health surveillance. World Health Organization, Geneva2017Google Scholar These ambitious goals can be achieved only by engaging academics, health providers, professional bodies, and governments as part of a concerted effort to improve the priority of oral conditions. We declare no competing interests. Oral diseases: a global public health challengeOral diseases are among the most prevalent diseases globally and have serious health and economic burdens, greatly reducing quality of life for those affected. The most prevalent and consequential oral diseases globally are dental caries (tooth decay), periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers in a Series on oral health, we describe the scope of the global oral disease epidemic, its origins in terms of social and commercial determinants, and its costs in terms of population wellbeing and societal impact. Full-Text PDF Oral diseases: a global public health challengeWe read the Series paper by Marco Peres and colleagues1 and woul dlike to highlight the state of oral health in India. Full-Text PDF Oral diseases: a global public health challengeIn their Series paper, Marco Peres and colleagues1 reproduce a map of the estimated global prevalence of untreated dental caries in permanent teeth for 2017. France is reported to be one of the five countries in the world where prevalence is higher than 50%. This prevalence seems surprisingly high for a country where the public health insurance system leaves routine dental treatments (examinations, extractions, restorations, and endodontic treatments) with no out-of-pocket charges for more than 95% of the population. Full-Text PDF