Dental Policy Lab 1 - towards a cavity-free future

Christopher R Vernazza,Catherine Mayne,Marco E Mazevet,Nigel B Pitts

doi:10.1038/s41415-021-3723-3

Christopher R Vernazza, Catherine Mayne + Show 2 more

Open Access

https://doi.org/10.1038/s41415-021-3723-3

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Abstract

Although many dental professionals argue that prevention of oral diseases, including dental caries, will benefit both the patient and public finances, a paradigm shift has yet to happen in most countries. The literature has demonstrated that caries prevention and control is possible, but authorities have yet to implement health systems that allow patients to stay in a good health state. 'Policy Labs' are an innovative policy-making initiative that allow a positive collaboration between the many stakeholders around a given policy issue. In July 2017, 24 international experts, including representatives of both international and European Chief Dental Officers associations, were gathered for the first Alliance for a Cavity-Free Future/King's College London Dental Policy Lab to identify the main barriers for a change, and concrete actions to facilitate a policy shift towards increased resource allocation in prevention. A comprehensive report and well-received infographic summarising the key recommendations (explored in this paper) were produced to explain the situation and highlight the value of a cavity-free world to policymakers, demonstrating where change is needed. The first Dental Policy Lab proved to be an efficient way to generate new ideas and concrete ways to implement them, and has led to several subsequent initiatives worldwide.

Highlights

Despite professionals, public health organisations and dental associations widely advocating for a greater focus on prevention, limited progress has occurred in reorienting dental health systems including general dental practice services
Though the prevalence of dental caries has been decreasing in many countries, there is an increasingly uneven distribution of caries across populations, following a distinct socioeconomic gradient, with an increase in caries prevalence in the ageing population, who are keeping their teeth for longer than before
The report was designed to be understood by all stakeholder groups including non-dental professionals

Summary

Introduction

Public health organisations and dental associations widely advocating for a greater focus on prevention, limited progress has occurred in reorienting dental health systems including general dental practice services. Dental caries is still the most prevalent condition worldwide in adults and affects more than 600 million children worldwide.[1] This situation, even in developed countries such as the UK, has been described as ‘criminal and unacceptable’,2 with caries remaining the most common reason for hospital admissions in children, with over 25,000 admissions of 5–9-year-olds in England in 2018–2019.3. The use of preventive approaches in oral health (including dental caries). There is widespread acceptance that it is possible to maintain teeth in a healthy state and keep teeth from going down the ‘repeat restorative spiral’, which is costly in both health and financial terms. Many strategies have been described in the literature, ranging from community-based interventions such as water fluoridation to chairside dietary advice and minimally invasive dentistry.[4] terminology differs across various specialist silos, prevention is usually classified into three categories (Table 1)

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