Dentistry is in a ‘state of crisis’ around the world because people are eating too much sugar and smoking and drinking too much.
People are being afflicted by higher levels of tooth decay, mouth cancer and gum disease, a study has found, because their oral health is so bad.
Wealthy countries such as the UK are trapped in a treatment-over-prevention cycle, with underlying problems being ‘neglected’ by public health policy in favour of fixing problems when they arise.
Particularly concerning is the population’s excessive sugar consumption, which the dentists said needs urgently addressing.
They are calling for radical reform of dental care which teaches the future dental workforce an emphasis on prevention.
According to a review of the evidence, ‘inadequate’ health responses has left 3.5billion people with poor dental care and a radical reform is needed.
People should prevent tooth decay instead of going to the dentist when it’s already too late, top doctors have warned (stock image)
‘Dentistry is in a state of crisis,’ Professor Richard Watt, chairman and honorary consultant in dental public health at University College London, and lead author of the review.
‘A fundamentally different approach is required to effectively tackle the global burden of oral diseases.’
In the first paper of a two-part series in the Lancet, Professor Watt and colleagues looked at the quality oral care across the world.
Around 158million people, or 2·3 per cent of the global population, were completely toothless in 2010, reflecting the ‘end game’ for someone’s teeth, often due to not caring for their teeth.
A development in high-tech treatment has taken priority over prevention in high-income countries, the authors wrote.
Research finds pain in the teeth and mouth are the biggest contributor to a low quality of life, affecting more than a quarter of adults in Britain every four weeks.
WHY IS SUGAR BAD FOR TEETH?
Sugary food and beverages are one of the main causes of tooth decay.
Bacteria in the mouth break down the sugar in your mouth which produces acid.
The acid dissolves the tooth surface, called the enamel, which is the first stage of tooth decay.
Some sugars occur naturally in food and drink, such as fruit, honey and milk.
The naturally occurring sugar in dried fruit, such as raisins, dates and apricots, can also contribute to tooth decay.
Other foods have sugar added to them by the manufacturer, which is sometimes called processed food, including cakes, biscuits, flavoured milks and chocolate.
Cavities, which are large holes in the teeth, are also created by acids.
Without treatment, cavities can progress past the enamel and into the deeper layers of the tooth, causing pain and possible tooth loss.
Acids remove minerals from the enamel through a process called demineralization.
This process is reversed by minerals in the saliva which strengthen the teeth again.
However, there is only so much that minerals, including calcium, phosphates and fluoride can do to prevent the effects of sugar on teeth if a person is eating a lot of sugary foods and drink.
Children are at risk of a ‘lifetime history of dental pain’ if tooth decay is not addressed quickly, evidence shows.
Dental problems can result in time off school and have a negative effect on school performance, the researchers found.
They said: ‘Oral diseases have substantial effects, causing pain, sepsis, reduced quality of life, lost school days, family disruption, and decreased work productivity, and the costs of dental treatment can be considerable.’
Oral health conditions share many of the same underlying risk factors as non-communicable diseases, such as sugar consumption, tobacco use and harmful alcohol consumption.
Sugar consumption, the underlying cause of tooth decay, was rising rapidly across many low and middle-income countries.
While sugary drinks consumption was highest in high-income countries, sales are growing in many low-income countries.
Researchers said the prevention of tooth decay, one of the most common chronic diseases globally, requires worldwide implementation of the World Health Organisation’s guideline on sugar intake.
The WHO recommends individuals consume less than 10 per cent of total energy intake from free sugars and that intake below 5 per cent would be beneficial.
The global dental research community has an important role in the implementation of the guidelines, the Lancet oral health series argues.
The researchers said: ‘Dental treatment alone cannot solve this problem. A radically different approach is now needed to tackle this global health challenge.
‘Current dental care and public health responses have been largely inadequate, inequitable, and costly, leaving billions of people without access to even basic oral health care.’
The study sets out that in middle-income countries, the burden of oral diseases is considerable, but oral care systems are often underdeveloped and unaffordable to the majority.
While in low-income countries, the situation is most bleak, with even basic dental care unavailable and most disease remaining untreated.
Researchers said the burden of oral diseases was on course to rise, as more people were exposed to the main risk factors for oral diseases.
Prof Watt said: ‘The use of clinical preventive interventions such as topical fluorides to control tooth decay is proven to be highly effective, yet because it is seen as a “panacea”, it can lead to many losing sight of the fact that sugar consumption remains the primary cause of disease development.
‘We need tighter regulation and legislation to restrict marketing and influence of the sugar, tobacco and alcohol industries if we are to tackle the root causes of oral conditions.’
The researchers called for stronger policy approaches to address the underlying cause of oral diseases.
Expenditures on various diseases in the EU in 2015 show dental diseases ranked third (€90billion) behind diabetes (€119billion) and cardiovascular diseases (€111billion).