Oral health and systemic health outcomes: A call for interdisciplinary action
Abstract
Abstract Objectives To make the case, from periodontology and dental public health, for interdisciplinary action on oral and systemic health, and to set out recommendations for practice, policy, education, and research. Materials and Methods A joint working group of the European Federation of Periodontology (EFP) and the European Association of Dental Public Health (EADPH), with public‐health stakeholders and delegates from organized medicine (the World Heart Federation, WONCA Europe and the European Forum for Primary Care), synthesized the epidemiological, mechanistic, preventive and health‐systems evidence, and developed consensus recommendations. Results Oral diseases affect around 3.5 billion people and share modifiable risk factors (free sugars, tobacco, and alcohol) and social and commercial determinants with the major non‐communicable diseases (NCDs); inadequate oral hygiene is an additional oral‐specific factor. This argues for integrating oral health into general health through a common risk factor approach rather than disease silos. Periodontitis has the strongest evidence for systemic interactions and, unusually among oral diseases, its treatment improves glycemic control in diabetes and inflammatory or vascular surrogates, though evidence for major clinical events remains limited; other links rest largely on shared risk factors and mechanisms (an asymmetry of evidence, not of public‐health importance). Prevention and integrated care remain under‐implemented. Conclusions Oral health must be recognized as integral to general health and embedded within NCD strategies and universal health coverage through interprofessional, intersectoral action that also tackles the social and commercial determinants and reduces inequalities. Clinical Relevance Equipping all health and social‐care professionals to promote oral self‐care, screen and refer, and prioritize periodontal prevention and treatment, can improve both oral and systemic outcomes.
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Authors: Moritz Kebschull, Ryan Demmer, Nigel Pitts, Huda Yusuf, Gitana Rėderienė, Nicolaos Donos, Wim Teughels, Raman Bedi, Orsolya Nemeth, Mia Rakic, Stephanie Tubert-Jeannin, Raimondo Ascione, Francesco D’Aiuto, james deschner, Thomas Dietrich, Mili Doshi, Julian Fisher, Ramon Juanatey, Madianos Phoebus, Katalin Nagy, Barry Quinn, Saulė Skinkytė, Lina Stangvaltaite‐Mouhat, Maria van den Muijsenbergh, Josep Vilaseca, Nicola X West, Anton Sculean, Andreas Stavropoulos, Kenneth A. Eaton, Joint EFP/EADPH Working Group
Institutions: University of Pennsylvania, Columbia University, University of Liverpool, KU Leuven, University of Bristol, Vilnius University, Radboud University Nijmegen, University of Szeged, University of Bern, Malmö University, Imperial College Healthcare NHS Trust, Johannes Gutenberg University Mainz, University of Birmingham, Mayo Clinic in Arizona, Universitat de Vic - Universitat Central de Catalunya, Althaia, University of Kent, Queen Mary University of London, Birmingham City University, Mayo Clinic, National and Kapodistrian University of Athens, King's College London, North Bristol NHS Trust, University of Portsmouth, Radboud University Medical Center, Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, At Bristol, Institut Català de la Salut, Clermont Université, Obuda University, Surrey and Sussex Healthcare NHS Trust, University College Birmingham, University of Clermont Auvergne, NIHR Birmingham Biomedical Research Centre, University of South-Eastern Norway, Center for Research in Molecular Medicine and Chronic Diseases, Bristol Clinical Commissioning Group, World Heart Federation, Birmingham Community Healthcare NHS Trust, Logon (Slovenia), University Of Bristol Dental Hospital