WHO/Europe calls for urgent action on oral disease as highest rates globally are recorded in European Region

More than half of adults in the WHO European Region suffered from severe oral disease in 2019, the highest prevalence globally, a new report shows, urging Member States to increase access to safe, effective and affordable basic oral health care opportunities as part of universal health coverage.

Copenhagen, April 20, 2023

Universal health coverage cannot be achieved without oral health care. National health insurance plans must include free or affordable access to oral health care. This is the key message of the new oral health status report released today by the World Health Organization European Region. The call comes in response to alarming figures contained in the report that the region, which covers 53 countries in Europe and Central Asia, has the highest prevalence of major oral disease cases, as well as dental caries (cavities and cavities) in permanent teeth. Highest prevalence worldwide.

Main findings

The latest data shows:

  • Of all six WHO global regions, the European Region has the highest prevalence of major oral disease cases (50.1% of the adult population). These include the highest prevalence of dental caries in permanent teeth of all WHO regions, accounting for 33.6% of the European Region population, equivalent to nearly 335 million cases in 2019.
  • The region has the second highest proportion of tooth loss cases (25.2%), with approximately 88 million people aged 20 years or older. This represents a prevalence of 12.4%, the highest among WHO regions and almost double the global prevalence of 6.8%.
  • The Region has the second highest estimated number of new cases of oral cancer among WHO regions, with nearly 70,000 cases and accounting for 18.5% of the total estimated global cases. In 2020, more than 26,500 people died from oral cancer in the region.
  • Of the 53 countries in the European region, 34 (66.7%) do not have a national oral health policy.
  • Eleven countries (23.4%) have no staff dedicated to oral diseases in the non-communicable diseases unit of the Ministry of Health.

The report outlines progress in a number of areas, including a significant decline (7.2%) in the prevalence of caries in primary teeth (commonly referred to as deciduous or deciduous teeth) in children aged 1-9 years between 1990 and 2019, as well as a decline in the prevalence of caries in permanent teeth in this age group (3.9%). However, the overall picture is deeply concerning.

The greatest needs, the least access to services

Oral health care services are primarily provided by private fee-paying practitioners and, therefore, most patients incur high out-of-pocket costs.

Government programs and insurance plans provide only partial or no coverage for oral health care.

Within the region, 10 countries spend less than US$10 per person per year on oral health care, while 14 countries spend between US$11 and US$50. Health care providers have the least access to services.

Health starts from the mouth

“Oral health is an important component of health care. Many of our most basic human functions – speaking and communicating, eating, breathing and especially smiling, depend on good oral health,” said Hans Henry, WHO Regional Director for Europe Dr. Krueger said. “Untreated cavities can affect the quality of life of people of all ages, but are particularly harmful in childhood because they can cause problems that last a lifetime. In children, cavities can affect school attendance and academic performance. Untreated cavities Severe dental caries can interfere with nutrition and growth. In many high-income countries, removal of dental caries under general anesthesia is the leading cause of hospitalization in young children. In adults, untreated dental caries can be a major cause of absenteeism and affect quality of life and work. Oral health does impact many areas of our lives, but it rarely gets the attention it deserves when it comes to health policies and insurance plans.

Dr Carina Ferreira-Borges, WHO/Europe Regional Advisor on Alcohol, Illicit Drugs and Prison Health, added: “There is strong evidence that oral disease disproportionately affects vulnerable and marginalized groups, including low-income people, people with disabilities, the elderly, etc. The recommendations in this report also address these inequalities, directing resources to where they are most needed.”

Drivers of Injury

Oral diseases are mainly caused by sugar consumption, smoking, alcohol consumption, trauma and lack of oral hygiene. At the policy level, key drivers include:

  • Saturation (availability) of substances with high sugar content, especially sugary drinks;
  • Aggressive marketing of substances high in sugar, especially to children, as well as tobacco and alcohol;
  • Difficulties in accessing primary/community oral health services;
  • There is insufficient exposure to fluoride in water supplies and oral hygiene products such as toothpaste.


“Dental caries is the most common non-communicable disease worldwide – but it’s not. We know what needs to be done. The aim of this report is to encourage governments and health authorities to increase access to safe, effective and affordable basic oral health services opportunities as part of national plans for universal health coverage,” Dr. Krueger continued. “This is the best way to address oral health inequalities while simultaneously tackling multiple non-communicable diseases and improving overall population health.”

The recommendations in the new WHO/Europe report complement those in the Global Oral Health Action Plan, which outlines 100 initiatives by Member States, the WHO Secretariat, international partners, civil society organizations and the private sector. proposed actions, accompanied by a global oral health action plan.

Among its key recommendations, the new report from the European region specifically recommends that governments:

  • Develop a new national oral health policy, consistent with the WHO global strategy for oral health and national non-communicable diseases (NCD) and universal health coverage (UHC) policies;
  • Allocate dedicated staff and funding to oral health within the Ministry of Health or other national government health agencies and ensure integration with the non-communicable diseases and universal health coverage agenda;
  • Implement policy measures to reduce free sugar intake, such as mandatory nutrition labeling on pre-packaged foods; Reframe targets to reduce sugar content in food and drink; Public food procurement policies to reduce the supply of high-sugar foods; Protect children Policies to protect against the harmful effects of food marketing; Taxation of sugary drinks and high-sugar foods;
  • Incorporate oral health into primary care at all service levels with the required staffing levels, skill sets and competencies;
  • Develop innovative oral health workforce models that include oral health professionals and other primary health care workers to meet population oral health needs.

“The case for expanding universal health coverage comes from health, human rights and economic perspectives,” said Dr. Gauden Galea, strategic advisor to the Special Initiative on Noncommunicable Diseases and Innovation, WHO Regional Director for Europe, at the launch of the new report at the WHO Regional Office for Europe in Copenhagen. , strengthening policy in the areas of nutrition, tobacco and alcohol. By doing so, we are fundamentally improving oral health and a range of other key areas of health, including diabetes, cancer and cardiovascular disease, all key action areas. The responsibility lies with governments and health policymakers. We at WHO/Europe will support our Member States in this regard. Let us work together to make universal health coverage for oral health a reality.”

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