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Dr Nigel Carter, OBE, Chair of the Platform for Better Oral Health in Europe and Chief Executive of the Oral Health Foundation, comments on the current state of the oral care system in Europe. (Photograph: Oral Health Platform)
Dr Nigel Carter, OBE

Dr Nigel Carter, OBE

Tue. 5. March 2019


Although recent decades have seen incredible progress in the prevention of caries in the general population, good oral health for all is still not a reality in today’s Europe. The Platform for Better Oral Health in Europe is working to promote best practices in oral healthcare and prevention and to identify robust oral health data to highlight to policymakers the importance of tackling persisting disparities in oral health across and within EU countries.

In today’s Europe, having decayed, missing or filled teeth remains the norm rather than the exception. Inequalities in oral health and dental care across EU countries have dramatically increased in recent years, which is unacceptable in the twenty-first century. Years of austerity measures and ever-growing pressures on health and social care budgets have had a significant impact on dental care systems in Europe. While some EU countries have implemented effective prevention policies, others are still struggling to give oral health the place it deserves in their public health policies.

Our focus has been to showcase the evidence that oral health is a determining factor for quality of life and essential for well-being. As such, oral health is an integral part of general health. Moreover, the economic burden of oral diseases is severe for EU member states, estimated at 5–10 per cent of public health expenditure in high-income countries, according to the World Health Organization. Beyond the direct health and economic impacts, poor oral health has indirect consequences, such as a reduction in productivity due to lost workdays and poorer educational attainment due to lost schooldays.

"Oral health inequalities constitute a significant public health problem"

Oral health inequalities constitute a significant public health problem, and action is required at the policy level on the broader social and environmental determinants of health. Addressing the burden of oral diseases requires a holistic, but comprehensive and integrated policy response across Europe. If successful, prioritising improvement of oral health across Europe will lead to healthier EU citizens by helping to prevent and protect against other diseases. In addition, it will result in a reduction in overall healthcare expenditure for treating other chronic diseases.

Integration of oral health into public health policies

The Platform for Better Oral Health in Europe is a joint initiative of the Association for Dental Education in Europe, the Council of European Chief Dental Officers, the European Association of Dental Public Health, the Pan-European Region of the International Association for Dental Research and the Oral Health Foundation. The Platform has 16 associate members, covering many specialist societies within dentistry, and its work is supported by the Wrigley Oral Healthcare Program and GlaxoSmithKline.

The Platform’s goal is to create a common European approach to improved oral health outcomes through research, education, promotion and access to care. In order to raise awareness of the role that oral health plays in general health, the Platform currently focuses on two specific work streams that fall neatly within the competences of the European institutions:

Including more oral health data in Health at a Glance: Europe

Over the past two years, the Platform has worked to identify a number of key health indicators that collectively reflect a range of important and relevant oral health outcomes and has been advocating to the European Commission and the Organisation for Economic Co-operation and Development for their inclusion in upcoming editions of the Health at a Glance: Europe report series. The platform has identified the following four indicators, which are deemed the most robust currently available from a methodological standpoint, while also covering a wide geographical range of European countries, thus allowing for cross-continent comparison:

  • Oral health status: dental caries prevalence (DMF index) data for 12-year-olds
  • Economic burden of oral diseases: dental care expenditure and productivity loss
  • Link between oral health and other non-communicable diseases: oral cancer
  • Health inequalities: educational and occupational inequalities in oral health.

Collecting and sharing best practices in oral healthcare across Europe

The Platform has been working on developing a systematic method, in line with the criteria used by the European Commission’s Joint Action on Chronic Diseases programme, to collect best practices in oral healthcare, with a focus on promotion and prevention across Europe. The Platform is about to issue a call to collect best practices, with the objective of developing a renewed and more comprehensive European repository of best practices in oral healthcare. By providing good examples of programmes that address oral health issues, we aim to support better-informed policy-making.

To learn more about the Platform’s activities, please visit

Europe Healthcare Oral health Prevention

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