NEW DELHI: As India is facing a significant burden of oral diseases, with over 70% of the population affected, a global initiative was launched on Wednesday to address the oral health burden and strengthen health systems to ensure that high-quality oral health services are available, affordable and accessible to all.
Despite being preventable, oral diseases, including oral cancer, which accounts for over 30 per cent of all cancers in the country, continue to be under-addressed, leading to increased healthcare costs and worsening public health outcomes.
This four-year project CORE, an initiative for Community Focussed Oral Health Research for Equity will cover over 14 lakh marginalised and disadvantaged communities in Delhi, Gujarat, Haryana, and Rajasthan.
The project was led in India by the Public Health Foundation of India (PHFI), in partnership with Jamia Millia Islamia University and Jan Swasthya Sewa Sansthan, in collaboration with institutes like Queen Mary University of London, University College London and many other globally renowned oral health experts. It aims to develop a comprehensive strategy to reduce the oral health burden in India, as well as in other low- and middle-income countries (LMICs) like Kenya, Colombia, and Brazil.
Speaking with this paper, Prof. K. Srinath Reddy, distinguished Professor of Public Health, PHFI, said, “Good oral health is essential for every person on earth throughout life. Besides teeth being directly linked to nutrition, gum disease triggers inflammation, affecting many organs, including the heart, blood vessels, and the brain. From caries to cancer, there are many oral diseases which should be prevented but also provided restorative care when they occur.”
Despite the widespread need for accessible and affordable oral health services, most countries have not included them in the universal health coverage programme.
“This affects vulnerable sections of the population deprived of needed care. The multi-country CORE study, which will map the unmet community needs for oral health services, will help to spotlight the extent of equity gaps in oral health services and catalyse the inclusion of essential oral health services in national programmes for universal health coverage,” said Dr Reddy, who launched the project.
Indians have a relatively high incidence of dental caries in permanent teeth compared to the entire South Asian population, with about a third of the Indian population experiencing caries that require dental treatment. Caries also known as tooth decay or cavities, is a common disease when bacteria in the mouth produce acid that dissolves teeth enamel.
Approximately 16% of the Indian population suffers from severe periodontal (disease of gums) problems. In India, oral cancer accounts for over 30% of all cancers in the country, with age-adjusted rates being as high as 20 per 100,000 population.
The project CORE aims to emphasise meaningful community engagement, reaching out to the most marginalised populations and capacity building to ensure the interventions are sustainable and impactful.
The initiative aims to understand oral health inequalities' patterns, mechanisms, and impacts while developing public health interventions to reduce these disparities.
It will also study the influence of the sugar and tobacco industries on oral health, evaluating commercial factors that affect public health and creating strategies to mitigate their impacts.
It will assess the economic burdens and barriers within current oral health systems, develop policy reforms integrating oral health into primary healthcare, and reduce out-of-pocket expenditure. The idea is also to create and test feasible interventions to reduce oral health inequalities while incorporating community input.
The local communities will be engaged in research design and intervention development, particularly for disadvantaged groups who often lack access to care.
The program will also include a robust capacity-building component. This will involve training early-career researchers, offering postgraduate training, and running short courses to make the local institutions better equipped to address oral health challenges in the future.
The project aims to establish sustainable oral health research capacity in India by building partnerships between local and international institutions.
Also, it will reduce oral health inequalities and promote better oral health in the population by developing scalable, evidence-based interventions that can be integrated into public health policies.
Prof Sanjay Zodpey, President of PHFI, said that by collaborating with local communities, stakeholders, and international experts, we aim to reshape oral health research, integrate community perspectives, and advocate for systemic reforms.”
“Oral health is at a tipping point. Globally, it is now recognised as a global health priority. The CORE programme is a new global health research initiative that works across India, Brazil, Kenya, and Colombia to investigate oral health inequalities. A key element of the programme is working with local communities to co-produce new solutions to improve oral health,” said Professor Richard Watt, UCL, Chair of Dental Public Health.
The research team was awarded a prestigious grant by the National Institute for Health and Care Research, UK, to help improve health outcomes and re-orient health systems to effectively address the oral health burden.