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Response to 'Medical card holders travelling 'unprecedented distances' to access dental treatment'

09 December 2021

letter to the editor

With reference to the article ‘Medical card holders travelling 'unprecedented distances' to access dental treatment’ (4th December 2021) – regular dental visits are a key component of good oral health. As with anything, if issues are caught early, they are easier and less expensive to treat. In the case of early detection of mouth cancer, it may be lifesaving and ensure a better quality of life.

The other important part of prevention is health promotion and empowering individuals to take good care of their teeth and mouth. There are several things that people can do, this includes brushing their teeth twice a day and eating less sugar, especially between meals.

The Lancet published a series of papers in 2019 which outline the need to be both patient and health centred rather than solely disease centred, and that there needs to be more focus on promoting and maintaining oral health and oral health equality.

They also highlight sugar consumption as a global issue which needs to be reduced. They discuss the role of the global sugar industry in promoting sugar consumption and the required upstream policies to address this. An excellent example of a recent upstream policy is the introduction of sugar tax in Ireland in 2018. However, the funds raised from this are not ringfenced/invested into public health measures such as the promotion of children’s health and wellbeing as is the case in the UK, something which could be considered?

It is the view of the Dental Health Foundation that a holistic approach must be taken when considering oral health, including the role that managing a reduction in sugar consumption can play and its impact on dental caries and health. It is heartening to see the recent publication of the new ‘Roadmap for Food Product Reformulation in Ireland’ as a start to reducing the level of sugar in processed foods. UK Research published this year (Pell et al 2021) suggests that consumption of sugar from soft drinks fell within a year of sugar tax introduction in the UK, without affecting sales (the soft drinks industry reduced the sugar content in their products) but benefiting public health.

The World Health Organization recommends limiting free sugars intake to less than 10% of total energy intake – and ideally even further, to less than 5% to minimise the risk of dental caries throughout the life course. It is essential that the taskforce established to oversee the roadmap includes oral health as an additional non-communicable disease of critical importance, bearing in mind that tooth decay is the most common chronic childhood disease.

It is clearly an area where further research is required and where researchers, and policy makers in both the Department of Health and Department of Finance could collaborate.