World Health Organization 's global oral health status report: Paediatric dentistry in the spotlight

The Global Oral Health Status Report 2022 (GOHSR) by the World Health Organization is the first global, comprehensive assessment of the burden of oral diseases.1 It identifies opportunities and difficulties for achieving universal oral health coverage by 2030. It is intended to serve as a reference for prioritising oral health in global, regional, and national contexts. The report seeks to establish a baseline of information to spur action from all stakeholders to address oral diseases in the context of global health agendas.2 The report's most concerning finding is the prevalence of oral diseases and conditions overall, which stands at 45%, or almost 3.5 billion people who have one or more untreated oral diseases which are largely preventable. The alarming all-time high numbers suggest that efforts to prevent and control oral illnesses have been largely ineffective. The report is divided into four subsections.3 Under the section on the burden of the major diseases affecting oral health, the illnesses are presented in the order of frequency of occurrence. Deciduous tooth caries is first on the list and is the most prevalent, followed by caries of permanent teeth. Periodontal diseases, edentulism and oral cancer rank third, fourth and fifth in impact. Deciduous tooth caries is predicted to affect 43% of people worldwide. The Western Pacific Region is expected to have the highest prevalence (46%), and the African Region to have the lowest (39%). According to the income category, the distribution of instances varies substantially. It is most commonly reported in upper-middle-income nations (45.6%), with the lowest recorded prevalence in high-income countries (38.3%; a decrease of 3% from 1990 to 2019), low-income countries (40%) and lower-middle-income countries (42.9%). The second most common oral health condition, dental caries of permanent dentition, has an average global prevalence of 29% and up to 2 billion cases worldwide. The regions with the highest cases are South-East Asia (526 million) and Western Pacific (464 million). Lower-middle-income countries (816 million) and upper-middle-income countries are predicted to have the highest cases (690 million). Thus, 75% of untreated caries in permanent teeth cases are reported in middle-income nations. Even though caries development is thought to be multifaceted and influenced by factors linked to social, physical, environmental, behavioural, health services and commerce, free sugar in foods and beverages has been recognised as the most prevalent risk factor. Furthermore, the other oral health issues of public concern present in childhood and are of interest to a paediatric dentist are congenital malformations, Noma and traumatic dental injuries. Orofacial clefts are the most prevalent form of human deformity, occurring in 1000–1500 infants globally.4 They can appear alone (70%) or as a component of a syndrome. Noma begins as a gum sore that quickly develops into acute necrotising gingivitis in 2–6-year-old children. Malnutrition, infectious infections, poor oral and general hygiene, and compromised immune systems contribute to Noma, which is mostly fatal. Noma and traumatic dental injuries affect around 1 billion people, with around 20% prevalence for children aged up to 12 years.5 The report's section on possibilities and challenges draws attention to the gaps in the health service model. For various reasons, dental therapy is a treatment-based approach with minimal emphasis on preventative measures. Access, availability and affordability of oral health care remain critical concerns for low-income and disadvantaged groups despite tremendous advancements in clinical settings. There are an estimated 4 million oral health professionals worldwide, including dentists, assistants, hygienists and therapists, although their distribution varies greatly. While low-income countries record a dentist-population ratio of 0.57:10 000, it is more than 12 times lower than high-income countries' 6.85:10 000 ratios. Significant knowledge gaps also reflect the high incidence of oral health problems. Population-level oral health surveillance data are only available in less than one-third of all countries, and high-income nations heavily dominate oral health research agendas. Digital technology integration has primarily been used to diagnose, plan and treat oral diseases, with little effort towards patient education or preventive measures. The report urges a renewed emphasis on the integration of oral health care with primary health care as well as the inclusion of prevention and oral health promotion in settings outside of specialised oral health facilities. Paediatric dentistry is a speciality that emphasises preventive care and treats oral diseases with the highest prevalence, therefore, the GOHSR becomes important to paediatric dentists. In an era where the specialty has expanded much beyond caries care, it calls for further deliberation in paediatric dental societies to return the focus to addressing caries of primary dentition. The use of settings outside of clinical facilities and the incorporation of digital technology hold the key to raising awareness of oral health conditions that impact children. When GOHSR throws the spotlight on paediatric dentists to realise the aim of universal health coverage for oral health, the response of the paediatric dental society should be carefully considered. The authors acknowledge the support of the Faculty of Christian Dental College, Ludhiana, Punjab, India.