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Tackling oral health inequalities in the UK and globally

UCL research has revealed why marginalised groups suffer more from oral diseases including tooth decay and mouth cancers – which has informed policy to reduce such inequalities.

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28 April 2022

UCL research has revealed why marginalised groups suffer more from oral diseases including tooth decay and mouth cancers – which has informed policy to reduce such inequalities.  

An estimated 3.5 billion people around the world suffer from oral diseases such as tooth decay, gum disease and mouth cancers. In addition to the pain and direct health risks, oral conditions also affect people’s ability to actively participate in everyday life, particularly in terms of eating, speaking, smiling and socialising. Despite oral diseases being common, and longstanding public oral health education campaigns, socially disadvantaged, more vulnerable or marginalised groups of people are more likely to suffer from them and have poorer outcomes if they do.  

The UCL Dental Public Health Group (DPHG) has led research showing this ‘oral health gap’ shares the same underlying drivers as inequalities in other noncommunicable diseases such as cancer and heart disease.  

The complex drivers of oral health inequalities 

Professors Richard Watt and George Tsakos from the UCL Dental Public Health Group (DPHG) head the world’s leading oral health inequalities research programme. Their work has demonstrated that many of the underlying reasons for poor oral health are shared with other so-called ‘lifestyle’ diseases which are more likely to affect disadvantaged groups, for example heart disease, diabetes and cancer.  

As well as analysing UK and European surveys on oral and general health and investigating oral health in vulnerable groups such as UK care home residents, they have also carried out innovative research alongside disadvantaged groups across the world. This has demonstrated how behavioural, psychological, social and political factors such as welfare system and policies influence oral health inequalities and the shape the ability of socially disadvantages and vulnerable groups to look after their oral health. 

Shaping policy in the UK and globally  

The DPHG’s findings on the impact of oral health on UK care home residents informed Public Health England’s (PHE) development of a toolkit for improving oral health in vulnerable older people, to be used in care homes and in the community. PHE expanded their work on oral health inequalities by commissioning DPHG to investigate the oral health gap across the whole UK population. Their report will inform future oral health policy, including NHS commissioning of dental services and public health programmes. 

In 2019 the World Health Organisation (WHO) designated DPHG as the world’s only Collaborating Centre on Oral Health Inequalities and Public Health. Professor Watt and the WHO Director General co-authored a 2020 report, based on DPHG research, that added oral diseases to WHO’s strategy for non-communicable diseases. It committed WHO to 20 detailed actions to reduce global oral health inequalities. A WHO Resolution on oral health based on DHPG research was formally adopted in January 2021.

Research synopsis

Closing the oral health gap by influencing national and international policy

Oral diseases such as tooth decay, gum disease and mouth cancers affect an estimated 3.5bn people globally, disproportionately affecting poorer and marginalised groups. The UCL Dental Public Health Group (DPHG) has led research showing this oral health gap shares the same underlying drivers as inequalities in other noncommunicable diseases such as cancer and heart disease. Their findings have influenced policy to reduce these oral health inequalities in the UK and globally.

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