Sugar, tobacco and alcohol ‘contributing to growing burden of oral diseases’

Sugar, tobacco and alcohol are contributing towards the growing burden of oral diseases on global public health, scientists say.

Researchers argue 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% of total energy intake from free sugars and that intake below 5% would be beneficial.

The global dental research community has an important role in the implementation of the guidelines, the Lancet oral health series argues.

“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 series said.

“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.

“While this breakdown in the delivery of oral healthcare is not the fault of individual dental clinicians committed to caring for their patients, a fundamentally different approach is required to effectively tackle the global burden of oral diseases.”

According to the study, in high-income countries (HIC) dentistry is increasingly technology focused and trapped in a treatment-over-prevention cycle.

This, researchers said, meant it was failing to tackle the underlying causes of oral diseases.

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.

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.

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 HIC, the growth in sales of sugary drinks in many low-income countries was substantial.

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 series authors have called for the divide between dental and general healthcare to close, and for the future dental workforce to be educated and trained with an emphasis on prevention.

They also called for stronger policy approaches to address the underlying cause of oral diseases such as tooth decay, gum disease and oral cancer.