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Oral Health is Global Health

Department of Orofacial Sciences, School of Dentistry, University of California-San Francisco, Box 0422, Room S-612, San Francisco, CA 94143-0422, USA; greenspand{at}dentistry.ucsf.edu

Key Words: global health • oral-capacity-building research networks

I ADR President Bayne, AADR President Rekow, Honored Guests, Fellow Board Members, Colleagues, Ladies and Gentlemen.

I thank you, the members of the IADR, for the honor of my election to the office of President of the Association. This is the most significant professional recognition afforded to me in my career, and I am deeply moved by your confidence in me. I want to thank the hard-working Association staff, my fellow IA and AA Board members, and innumerable others in both Associations with whom I have worked and will continue to work. To my colleagues at UCSF who have supported me, and who (here I have to say, I hope) will continue to do so, in doing all this, a huge thank-you!

We are remarkable that in the 87 years of our existence as the IADR, our meetings, our interests, and our contributions have spanned the entire spectrum of knowledge in dozens of fields related to oral diseases. We are an example of something truly rare in these days of hyper-specialization and intellectual silos. We are a body that spans the entire spectrum of biomedical, social and behavioral, chemical, physical and engineering sciences (I surely will be in trouble soon for missing something!) in order to understand and control oral diseases.

I think you will all agree that, in recent decades, there have been huge advances in our understanding and even control of the major diseases with which we are concerned, at least in the resource-rich nations.

However, in even these nations there can be little ground for complacency:

• There continues to be an epidemic of caries in special populations;
  
• we must accept the ever-poor prognosis of oral cancer; and
  
• there are huge problems of access to care for the underserved.
  

These problems pale to insignificance when compared with the global oral health problems of the resource-poor nations. Sadly, these combine overlapping epidemics of the acute and intractable oral health problems of poverty and lack of education or care, with the very same problems we in the resource-rich nations face:

• dental caries—unrecognized, untreated, and all of its maxillofacial complications;
  
• huge problems of periodontal disease, of unknown extent in most countries;
  
• the huge problems of access to care for the underserved, which often means almost the entire population of whole countries;
  
• the ubiquitous oral manifestations of HIV disease, with 40 or more million HIV-positive people, and increasing daily, most of whom are destined to get oral lesions unless treated, and only about 10% whom receive anti-retroviral therapy; and
  
• oral features of other major infectious diseases, such as tuberculosis.
  

Perhaps worst of all is the lack of interest on the part of national leaders in developing and providing cost-effective approaches to the prevention and treatment of oral diseases.

So, what is my point?

The issue is: Will we—we who are, or at least should be, the intellectual engine of progress and change in the control of oral disease globally—will we be part of the solution?

Are we focusing enough of our attention on fundamental, cross-cutting, and far-reaching basic, translational, and clinical approaches to the control of oral disease globally? Or are we instead too immersed in dealing with them in compartments, not only geographically but also conceptually, without attacking the underlying, fundamental issues?

In most of the countries of the world, even those represented among the membership of the IADR, manpower or capacity is woefully inadequate for the task.

Even if there were adequate or nearly adequate numbers of dental health-care providers, let alone investigators, access to care and poverty are still major hurdles, and funds for research into local problems are widely absent. Even if the solution to global oral health problems were the training of more dentists, specialists, and allied oral health workers—a questionable and non-evidence-based assertion—we would still have the problem of the magnet effect of the rich countries attracting many of those people.

Surely, our challenge is to energize and motivate, and to involve everyone, but most particularly our younger colleagues.

To all of us, then, I would say:

As you pursue your own research interests, develop projects and even new fields of science, try to think beyond the confines of your dental school, your university, or even your own country, and try instead to visualize the impact of your work in, indeed tailor that work to, a global oral health context. Try to reach out, electronically and through meetings such as this, to your contemporaries across the globe, a globe that is becoming smaller every year.

We are a global community:

Let us continue to (really) put the "International" into the IADR. Let us go beyond our marvelous success in establishing Divisions and free-standing Sections and Federations. Let us go beyond our small Regional Development Grants Program and our cordial links with the WHO and the FDI. Let us build on these with a concerted, coordinated effort to build capacity for research into technologically sophisticated, multi-disciplinary approaches to solving our most pressing oral global health problems.

That, my colleagues, is my challenge to us all.

Journal of Dental Research, Vol. 86, No. 6, 485 (2007)
DOI: 10.1177/154405910708600601


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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Greenspan, D. Search for Related Content PubMed PubMed Citation Articles by Greenspan, D. Social Bookmarking                         What's this?