Global Oral Health

The new millennium ushered in exceptional opportunities for dentistry, including technological advances, precision science, and professional connectivity and collaboration. At the same time, we are still facing extraordinary hurdles to achieving individual and population oral health. The burden of oral diseases continues to be one of the most prevalent of all health conditions worldwide and is expected to rise without an adequately trained and equitably distributed workforce. For the first time in human history, the majority of those who need dental care are now older adults requiring more complicated treatments over longer life expectancies, relative to young people and children. More people today live in urban areas instead of rural regions, increasing exposures to common risk factors for noncommunicable conditions and dental diseases, such as processed sugars and tobacco products. Once considered primarily illnesses of the wealthy, noncommunicable diseases are now leading drivers of low quality of life and mortality in all parts of the world, rich or poor. These rapidly blurring boundaries present global opportunities and unprecedented challenges that do not exist within national borders.^1–3

The dental profession cannot treat our way around or through the obstacles ahead.² This special issue on global oral health illuminates actionable solutions and provides insights into new and necessary directions for dentistry. The first article in this collection illustrates my personal self-reflection as a dentist in today’s rapidly evolving world. I share my career progression from a private practice dentist to a global health professional, striving for health equity and social justice in a world where oral health is influenced more by zip code that genetic code.

Change starts with our students, many of whom identify as global citizens in an interconnected world. Brady et al. share competency-based approaches for training future dental professionals. They describe the internationalization of dentistry and service learning models that can assist in better preparing them for sustainable and ethical engagement in global health. Global health for our profession means more than reactionary treatments for only those who can access it. It means an innovative focus on prevention and health promotion including through a redefined and expanded definition of community partnership. Patel and Adyatmaka explain their community-driven program that integrates participation from local community members themselves. Their program supports the World Health Organization’s global strategy for disease prevention; it introduces a novel concept of “Dental Immunization,” a metaphorical description of their comprehensive program designed to create and sustain community resistance to dental caries. Danesh et al. expand on the effectiveness of community partnership using the approach of Community Based Participatory Research, integrating leadership and participation from indigenous community members at all stages of their project from conception to dissemination of results. For example, indigenous community leaders known as Cultural Advisors participated as authors on their manuscript, despite not having e-mail addresses (a common requirement to publish and one that we take for granted as a norm in our academic culture). Their inclusive approach empowered local communities with agency over their own needs and uncovered not only risk factors for disease but protective factors that led to community success in oral health improvements.

The final article in this issue by Hackley et al. put forth a call to action, charging the dental profession to contemplate our history of altruism and outreach and reconsider whether it is time we “do good better.” They challenge the status quo of traditional approaches to global service and outreach and allow readers to reconsider our purpose in today’s global oral health landscape. In my own article at the beginning of this special, I pose several questions that have plagued me throughout my career evolution, including where do outreach and short-term clinical service volunteering fit within the modern global oral health agenda? How can we reorient dental education and oral health care from a primarily curative focus to one that emphasizes partnership in health promotion, prevention, and holistic well-being? Can our global health endeavors truly place the power and priority back into communities, while still participating in this work ourselves? The authors throughout this special issue provide case examples that help to answer these pressing questions. Hackley et al. conclude the issue with thoughtful guidelines for moving beyond our “elevators and forceps,” strengthening dentistry’s engagement in our world, and forging a pathway aligned with global health in the 21^st century.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Brittany Seymour

Brittany Seymour is Associate Dean for Faculty Affairs and Associate Professor in the Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine.