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Lancet series, co-authored by NYU's Benzian, calls for 'radical reform' of oral healthcare

July 18, 2019

A special Lancet Series on Oral Health, published today in The Lancet, presents an "urgent need for radical reform" of oral healthcare to prioritize prevention and integrate dentistry into primary care. The series is comprised of two papers, both co-authored by Habib Benzian, DDS, MScDPH, PhD, the associate director of global health and policy for NYU College of Dentistry's World Health Organization (WHO) Collaborating Center for Quality-improvement, Evidence-based Dentistry--the only WHO Collaborating Center on oral health in the Americas.

Oral diseases, including tooth decay, gum disease, and oral cancers, are major global public health problems affecting half of the world's population, but they have gone largely unnoticed.

"This immense disease burden is an important starting point to rethink the current oral healthcare approach, which leaves large parts of the world's population without access to even basic dental care," said Benzian, who is also an adjunct professor at NYU's Colleges of Dentistry and Global Public Health. "By dedicating a special series to oral health, The Lancet is creating visibility and urgency for a long-overlooked public health crisis, and my co-authors and I offer solutions to improve global oral health and reduce inequalities."

In high-income countries, oral healthcare is dominated by treatment--including high-tech, high-cost interventions--rather than tackling the underlying causes of disease and preventing it. In low- and middle-income countries, however, dentistry is largely unavailable and unaffordable.

As part of prioritizing prevention, the Lancet Series also examines the need to reduce sugar, alcohol, and tobacco consumption to improve oral health and other chronic conditions. Sugar, in particular, is recognized as the leading cause of tooth decay. The authors call for the adoption of a range of policy changes to protect and improve health, including taxing sugary drinks and stronger regulation on advertising targeting children.

The Lancet Series also explores the problematic rift among oral healthcare, mainstream healthcare, and health policy. The series provides recommendations for system-wide reforms.

"Oral healthcare is isolated from mainstream healthcare. Thus we need a fundamentally different approach that integrates the two. A reformed oral healthcare system needs to incentivize prevention, embrace a wider team of health professionals, including primary care and mid-level providers, use evidence-based treatments, and respond to the diverse needs of local populations," said Benzian. "The growing global momentum towards universal health coverage provides a unique opportunity to reform oral healthcare. Bold efforts in Brazil and Thailand have demonstrated that major reforms are possible and can benefit oral health. Countries like France have embraced the principles of universal health coverage and are now changing their systems to include oral healthcare in innovative ways."

"Prevention is a key factor in reforming oral healthcare, and it is currently underutilized," added Richard Niederman, DMD, chair of the Department of Epidemiology & Health Promotion at the NYU College of Dentistry and director of the WHO Collaborating Center. "Our studies of cavity prevention programs for U.S. children show that these programs prevent tooth decay, improve school attendance and performance, and are cost-effective and cost-saving."

The Lancet Series on Oral Health was led by researchers at the University College London and brings together 13 academic experts from 10 countries. The Lancet will launch the new series on Wednesday, July 24 in London. Benzian will share key policy recommendations at the event, speaking alongside other authors, invited global health leaders, and The Lancet's editor-in-chief, Richard Horton. [Add livestream link from UCL, if available, and #GlobalOralHealth]

NYU Dentistry's WHO Collaborating Center will continue the conversation on reforming oral healthcare and universal health coverage with a United Nations (UN) side event in collaboration with The Lancet and the World Economic Forum. The event will take place September 22 in New York City, preceding the UN High-Level Meeting on Universal Health Coverage on September 23 during the UN General Assembly high-level week.

New York University

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