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Global policy

Beyond the dental silo

Sir, we read with interest and a degree of amusement the recent editorial from our worthy BDJ editor-in-chief who, in his customary style, raises some interesting points which we would like to address.1

First, we would like to thank him and the senior BDA staff for attending and participating in the recent UCL-Lancet launch event to mark the publication of the Oral Health Series.2,3 They joined an international audience who enjoyed presentations delivered by the co-authors and a lively discussion from an invited panel of leading policy advocates.

We feel it is important to explain the background to The Lancet series which was commissioned by the editorial team recognising their neglect of oral health. Such series are intended to provide an overview and introduction of a topic, and while not new to a dental readership the subject will certainly be so to The Lancet's global medical and policy audience.

Dr Hancocks rightly acknowledges the high esteem of The Lancet, its influence and its global policy reach. It is surprising therefore that he bemoans their interest in setting forth a future agenda to address the global neglect of oral health. Sometimes outsiders are best able to see the way ahead rather than those of us who are too narrow and fixated with the minutiae of oral health.

It is incorrect of Dr Hancocks to state that the overriding message of the series was that 'individual treatment was no longer the way forward'. We call for radical reform of oral health care systems to enable clinicians to deliver high quality and appropriate care to their patients, combined with policy changes to promote population oral health and reduce inequalities. It is also important to acknowledge that the issues raised equally apply to high- middle and low-income countries. In the UK many positive developments have occurred in oral health and dentistry in recent years. However, many challenges remain. Our population still suffers from a significant burden of oral diseases; we have persistent inequalities in oral health across our populations; and many in the dental profession are dissatisfied with their NHS contract. Oral health systems across the UK require urgent reform to enhance prevention, promote greater equity and access, deliver high quality care, be better integrated with the wider NHS, and improve staff morale and wellbeing.

Following publication of the series the authors are now in discussion with The Lancet to discuss options for a Lancet Commission on Oral Health which would bring together dental, medical, members of the public and policy experts to further develop a detailed action plan for oral health. A video of the launch event is available at:


  1. 1.

    Hancocks S. Global oral health; eggs and stones. Br Dent J 2019; 227: 173.

  2. 2.

    Peres M A, Macpherson L M D, Weyant R J et al. Oral diseases: a global public health challenge. Lancet 2019; 394: 249-260.

  3. 3.

    Watt R G, Daly B, Allison P et al. Ending the neglect of global oral health - time for radical action. Lancet 2019; 394: 261-272.

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Correspondence to R. G. Watt.

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Watt, R., Daly, B., Mathur, M. et al. Beyond the dental silo. Br Dent J 227, 329 (2019).

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