Scientists are calling for radical reform of dental care, tighter regulation of the sugar industry and greater transparency around conflict of interests in dental research to tackle the high and rising toll of oral disease such as mouth cancers.

In a challenge to the global health community, a series in the Lancet medical journal argues that 3.5 billion people suffering from oral disease have been let down.

Oral disease includes tooth decay, gum disease and oral cancer and affects almost half of the global population. Untreated dental decay is the most common health condition worldwide. Lip and oral cavity cancers are among the top 15 most common cancers in the world, say researchers.

“Dentistry is in a state of crisis,” said Prof Richard Watt, chair and honorary consultant in dental public health at University College London and the lead author of the series. “Current dental care and public health responses have been largely inadequate, inequitable and costly, leaving billions of people without access to even basic oral health care.

“While this breakdown in the delivery of oral healthcare is not the fault of individual dental clinicians committed to caring for their patients, a fundamentally different approach is required to effectively tackle to the global burden of oral diseases.”

High-tech treatment has taken priority over prevention in wealthy countries such as the UK, say the researchers. Around the world, the heavy marketing of sugary drinks is causing increasing damage to dental health, they argue.

By 2020 Coca-Cola intends to spend $12bn (£9.5bn) on marketing its products across Africa, in contrast to WHO’s total annual budget in 2017 of $4.4bn, they write.

Watt said: “Sugar consumption is the primary cause of tooth decay. The UK population is consuming far too much sugar – considerably higher than the Department of Health and WHO recommends.

“A particular concern is the high levels of sugar in processed commercial baby foods and drinks which encourage babies and toddlers to develop a preference for sweetness in early life. We need tighter regulation and legislation to restrict the marketing and promotion of sugary foods and drinks if we are to tackle the root causes of oral conditions.”

Cristin Kearns, of the University of California, San Francisco, and Prof Lisa Bero, of the University of Sydney, warn in a linked commentary of financial links between dental research organisations and the processed food and drink industries.



“Emerging evidence of industry influence on research agendas contributes to the plausibility that major food and beverage brands could view financial relationships with dental research organisations as an opportunity to ensure a focus on commercial applications for dental caries interventions – such as xylitol, oral hygiene instruction, fluoridated toothpaste and sugar-free chewing gum – while deflecting attention from harm caused by their sugary products,” they write.