Combined approach needed to address oral health inequalities and systemic health burden

'Time to put your money where your mouth is: addressing inequalities in oral health' is the new Economist Impact white paper published today, commissioned by the EFP (European Federation of Periodontology) with support from Haleon. The paper explores the escalating burden of periodontitis and caries, highlighting the critical associations between these two diseases, and proposing a combined approach to level up the population's oral and systemic health outcomes.

A new caries prevention and care cost calculator is introduced in the paper, revealing direct treatment costs of US$357 billion yearly, which represents 4.9% of global health expenditure. Productivity losses due to caries, severe periodontitis, and severe tooth loss amount to an estimated $188 billion annually.

The calculator, which estimates the long-term direct costs associated with managing dental caries between the ages of 12 and 65 years in six countries (Brazil, France, Germany, Italy, Indonesia, and the UK), also revealed:

• The overall direct costs of caries varied from $10,284 billion in Italy to $36,231 billion in Brazil, partly due to differences in population sizes.
• The largest per-person costs were estimated in the UK ($22,910) and were lowest in Indonesia ($7,414).
• The direct costs of caries were highest in the most deprived group across all countries except Indonesia and Germany, where it was highest in the least deprived, followed closely by the most deprived.

Oral diseases impact nearly half the world's population, surpassing the burden of most common non-communicable diseases (NCDs). With dental caries affecting more than two billion people globally and severe gum disease ranking second with over one billion cases, this paper emphasizes the pressing need for action. By targeting common risk factors such as diet, tobacco, and alcohol use, it unveils a transformative opportunity to mitigate not only oral diseases but also those NCDs like diabetes, heart disease, cancer, and stroke that are linked to oral disease.

Report initiator and contributor Professor Nicola West, EFP secretary general, said: "Time to put your money where your mouth is: addressing inequalities in oral health" is a timely reminder that there is no overall health without oral health. Oral diseases have surpassed all other non-communicable diseases in global prevalence, and for the majority of people, gum disease and tooth decay are totally preventable. Through this paper, the EFP is calling on policy makers and budget holders to put their money where their mouth is", highlights Professor West.

Building on the success of a previous Economist white paper on the cost of gum disease, "Time to take gum disease seriously", which demonstrated the positive return on investment achieved through home-based preventive care and early diagnosis, the new white paper also introduces a conceptual framework detailing the progression of caries, spanning from a healthy tooth to an unsalvageable carious state. This innovative model outlines preventive interventions, such as maintaining oral hygiene by brushing with fluoridated toothpaste, applying topical fluoride and strategically targeting different stages to hinder or prevent caries development.

As a global leader in consumer health, Haleon's purpose is to deliver better everyday health with humanity. We are proud to have supported this initiative from both the EFP and Economist Impact Unit. It represents a further important step to better understand and raise awareness of the importance of Oral Health Promotion and Prevention, to help support the WHO action plans on oral health."

Steve Mason, Global Medical Lead for Oral Health at Haleon

To encourage better oral health globally, it's time to take decisive action. The paper showcases the need for stakeholders to invest and collectively champion preventive measures, promoting a better alignment between policy, public health, payment systems, and clinical practice.