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Cited by 4,054Dental Health and Care UtilizationOral microbiology and periodontitis researchOral Health Pathology and Treatment

Oral diseases: a global public health challenge

Open access
Peres, Marco A, Macpherson, Lorna M D, Weyant, Robert J, Daly, Blánaid, Venturelli, Renato, Mathur, Manu R, Listl, Stefan, Celeste, Roger Keller +5 more·2019·The Lancet
DOI 10.1016/s0140-6736(19)31146-8
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Abstract

Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, greatly reducing quality of life for those affected. The most prevalent and consequential oral diseases globally are dental caries (tooth decay), periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers in a Series on oral health, we describe the scope of the global oral disease epidemic, its origins in terms of social and commercial determinants, and its costs in terms of population wellbeing and societal impact. Although oral diseases are largely preventable, they persist with high prevalence, reflecting widespread social and economic inequalities and inadequate funding for prevention and treatment, particularly in low-income and middle-income countries (LMICs). As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned. Children living in poverty, socially marginalised groups, and older people are the most affected by oral diseases, and have poor access to dental care. In many LMICs, oral diseases remain largely untreated because the treatment costs exceed available resources. The personal consequences of chronic untreated oral diseases are often severe and can include unremitting pain, sepsis, reduced quality of life, lost school days, disruption to family life, and decreased work productivity. The costs of treating oral diseases impose large economic burdens to families and health-care systems. Oral diseases are undoubtedly a global public health problem, with particular concern over their rising prevalence in many LMICs linked to wider social, economic, and commercial changes. By describing the extent and consequences of oral diseases, their social and commercial determinants, and their ongoing neglect in global health policy, we aim to highlight the urgent need to address oral diseases among other NCDs as a global health priority.

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Crossref · 10.1016/s0140-6736(19)31146-8

Cites

142 of 142 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

26 of 63 cited sources checked · 4 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Oral diseases are among the most prevalent diseases globally.

    “Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, depriving people of health, wellbeing, and the ability to achieve their full potential.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [3] Kassebaum, 2017, Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors, J Dent Res source
  • Premisecitation

    The westernised model of modern dentistry is unaffordable and inappropriate in many LMIC.

    “The 'westernised' model of modern dentistry (high technology and treatment focused) is unaffordable and inappropriate in many LMIC.8”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [8] Yee, 2002, The burden of restorative dental treatment for children in third world countries, Int Dent J source

      The Abstract concludes that traditional restorative treatment of children's caries is beyond the financial capabilities of most low-income nations. It also says prescribing unaffordable treatment when resources are scarce is unethical. The paper does not establish that the broader, high-technology model of modern dentistry is unaffordable or inappropriate across LMIC. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    Dental caries is the most common disease globally.

    “Despite being largely preventable, oral diseases are highly prevalent conditions affecting over 3.5 billion people around the world, with dental caries being the most common disease globally with increasing prevalence in many low and middle-income countries (LMIC)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [3] Kassebaum, 2017, Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors, J Dent Res source
  • Premisecitation

    Dental caries prevalence is increasing in many LMIC.

    “Despite being largely preventable, oral diseases are highly prevalent conditions affecting over 3.5 billion people around the world, with dental caries being the most common disease globally with increasing prevalence in many low and middle-income countries (LMIC)”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [3] Kassebaum, 2017, Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors, J Dent Res source

      The Results report that untreated caries was the most prevalent condition studied, and the Discussion reports 3.5 billion people with untreated oral conditions in 2015. But the Introduction says only that declines in caries experience were less obvious in low-income countries; it does not establish increasing caries prevalence in many low- and middle-income countries. The Results’ global increase in case counts does not establish that country-specific prevalence trend. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [4] Petersen, 2005, The global burden of oral diseases and risks to oral health, Bull World Health Organ
  • Premisecitation

    Gingivitis may lead to periodontitis in susceptible individuals with a compromised immune response.

    “In susceptible individuals with a compromised immune response, gingivitis may lead onto periodontitis which progressively destroys the periodontal tissue support including the bone surrounding teeth.16”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [16] Pitts, 2017, Dental caries, Nat Rev Dis Primers source

      The Prevention section mentions compromised immunity as a consideration in dental-caries prevention, but does not connect it to gingivitis or periodontitis. Searches for gingivitis, periodontitis, and destruction of periodontal tissue found no passage in our copy addressing the claimed progression. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • May combine two claims. 29
  • Classified as probably not a substantial claim. 34

  • May combine two claims.

    Premisecitation

    Oral diseases are a neglected topic, rarely seen as a priority in health policy.

    “Oral diseases are however a neglected topic, rarely seen as a priority in health policy.7”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [7] Benzian, 2011, Political priority of global oral health: an analysis of reasons for international neglect, Int Dent J source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Oral diseases affect over 3.5 billion people around the world.

    “Despite being largely preventable, oral diseases are highly prevalent conditions affecting over 3.5 billion people around the world, with dental caries being the most common disease globally with increasing prevalence in many low and middle-income countries (LMIC)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [3] Kassebaum, 2017, Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors, J Dent Res source
    • Rests on an assumption: Oral diseases are largely preventable.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The WHO has called on member states to develop appropriate multi-sectoral approaches to deal with the marketing of foods and non-alcoholic beverages to children.

    “Indeed, the WHO has called on member states to develop appropriate multi-sectoral approaches to deal with the marketing of foods and non-alcoholic beverages to children.136”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [136] Buse, 2017, Healthy people and healthy profits? Elaborating a conceptual framework for governing the commercial determinants of non-communicable diseases and identifying options for reducing risk exposure, Global Health source

      The Discussion (page not provided) describes WHO’s multisectoral coordination mechanism and reports how many countries have policies on food and beverage marketing to children. The Background (page not provided) also discusses regulating such marketing, but neither passage says WHO called on member states to develop multisectoral approaches for it. Searches for that call and for WHO recommendations on marketing to children found no such passage in our copy. (LLM, conf=0.72)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 2010, untreated caries in deciduous teeth was the 10th most prevalent health condition affecting 9% of the global child population.

    “In 2010, untreated caries in deciduous teeth was the 10 th most prevalent health condition affecting 9% of the global child population; the global age-standardised prevalence remained unchanged between 1990 and 2010 (9%); the age-standardised global incidence was 15,205 cases per 100,000 person-years in 2010 slightly and not significantly fewer than the 15,437 cases per 100,000 cases reported in 1”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [3] Kassebaum, 2017, Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors, J Dent Res source

      The Results report untreated caries in deciduous teeth at 7.8% age-standardized prevalence in 2015, and the Discussion says it affected 573 million children that year. Neither passage establishes the claimed 2010 figure of 9% of children or its ranking as the 10th most prevalent condition; the reported 7.8% is not specified as a percentage of children. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Homeless people living in high-income countries have more untreated dental caries, more severe tooth loss, and are more likely to experience toothache compared to the general population.

    “Homeless people living in high-income countries have more untreated dental caries, more severe tooth loss, and are more likely to experience toothache compared to the general population.[45][46][47][48][49]”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [45] Peres, 2011, The influence of family income trajectories from birth to adulthood on adult oral health: findings from the 1982 pelotas birth cohort, Am J Public Health source

      The Discussion (page unavailable) reports more dental caries, including untreated cavities, among poorer members of a Brazilian birth cohort than among their better-off peers. It does not study homeless people in high-income countries or report their tooth loss or toothache compared with the general population. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [46] Celeste, 2018, Do socioeconomic inequalities in pain, psychological distress and oral health increase or decrease over the life course? Evidence from Sweden over 43 years of follow-up, J Epidemiol Community Health source

      The Introduction and Results describe socioeconomic differences in self-reported tooth condition in Swedish cohorts, comparing poorer with non-poor participants. Our copy does not address homeless people or compare their untreated caries, tooth loss, or toothache with the general population (searched: homeless, untreated dental caries, tooth loss, toothache). (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [47] Aldridge, 2018, Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis, Lancet source

      The Findings and Interpretation (page unavailable) report broad health inequities among homeless populations but do not address dental outcomes. Searches of our copy for caries, tooth loss, toothache, and oral health found no passage comparing these outcomes with the general population. (LLM, conf=0.75)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 2010, 158 million people or 2.3% of the global population was completely edentulous.

    “In 2010, 158 million people or 2.3 % of the global population was completely edentulous (no natural teeth).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] Marcenes, 2013, Global burden of oral conditions in 1990–2010: a systematic analysis, J Dent Res source

      The Results report that severe tooth loss affected an estimated 2% of the global population in 2010; the Discussion says the prevalence calculation was based on total tooth loss. Our copy does not give the claimed 158 million people or the more precise 2.3% figure (searched: “158,” “2.3,” and Table 1 prevalence). (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The proportion of income needed to purchase sugar-sweetened beverages has decreased worldwide since 1990 but particularly in LMIC.

    “Another example of how consumer prices can influence oral health is given by the proportion of income needed to purchase sugar-sweetened beverages which has decreased worldwide since 1990 but particularly in LMIC.139”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [139] Lobstein, 2015, Child and adolescent obesity: part of a bigger picture, Lancet source

      The Food supplies and market controls section reports rising worldwide soft-drink sales during 2007–11, especially in low- and middle-income countries. It does not report the proportion of income needed to buy sugar-sweetened beverages or a change in that proportion since 1990. Searches for beverage affordability and prices relative to income found no supporting passage. (LLM, conf=0.75)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Buse and colleagues have expanded on the role of industry in influencing decision-making and describe a conceptual framework for governing the commercial drivers of NCD risk.

    “Buse and colleagues have expanded on the role of industry in influencing decision-making and describe a conceptual framework for governing the commercial drivers of NCD risk.128”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [128] Lee, 2014, The ethical imperative of addressing oral health disparities, J Dent Res source

      The Introduction presents a framework for oral health disparities and discusses social determinants and population-level approaches. Our copy does not address Buse and colleagues, industry influence on decision-making, or a framework for governing commercial drivers of NCD risk (searched those terms and a paraphrase). (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Lifetime prevalence of dental caries has declined in the last four decades, mainly in high-income countries, with the most significant decline seen in 12-year-old children.

    “Epidemiological evidence indicates that lifetime prevalence of dental caries has declined in the last four decades, but this is mainly in high-income countries with the most significant decline seen in 12-year-old children.30,31”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [30] Mehanna, 2013, Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer–systematic review and meta-analysis of trends by time and region, Head Neck source
    • cites [31] Conway, 2015, Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries, Int J Cancer source

      The Abstract and Results (pages not provided) address socioeconomic factors and head and neck cancer risk, not dental caries. Searches for declining lifetime caries prevalence and for trends in high-income countries and 12-year-old children found no passage addressing the claim. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    According to GBD 2015, 3.5 billion people worldwide live with dental conditions, mostly untreated dental caries, severe periodontal disease, edentulism and severe tooth loss.

    “According to the Global Burden of Disease (GBD 2015) study, 3.5 billion people worldwide live with dental conditions which are mostly: untreated dental caries in the deciduous and the permanent dentitions, severe periodontal disease, edentulism (complete tooth loss) and severe tooth loss (having between 1 and 9 remaining teeth).3”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [3] Kassebaum, 2017, Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors, J Dent Res source

      The Discussion reports 3.5 billion people with untreated oral conditions in 2015 and lists untreated caries, severe periodontal disease, and total tooth loss. However, the Methods (Data Input) define total tooth loss as complete loss of natural teeth; our copy does not support adding severe tooth loss defined as 1–9 remaining teeth to that list. (LLM, conf=0.90)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Coca-Cola and PepsiCo alone account for over a third of worldwide soft drinks sales.

    “These two companies alone account for over a third of worldwide soft drinks sales 141”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [141] McKee, 2018, Revisiting the corporate and commercial determinants of health, Am J Public Health source

      The paper discusses corporate power (Abstract, page unavailable) and mentions Coca-Cola in a reference (References, page unavailable), but neither passage gives soft-drink sales figures. Searches for PepsiCo and worldwide soft-drink market share found no passage supporting the claim that the two companies account for over a third of sales. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Findingnone given

    Globally over 3.5 billion people suffer from oral diseases which are chronic and progressive in nature starting in early childhood and progressing across adolescence, adulthood and into later life.

    “Globally over 3.5 billion people suffer from oral diseases which are chronic and progressive in nature starting in early childhood and progressing across adolescence, adulthood and into later life.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Oral diseases have serious health and economic burdens, depriving people of health, wellbeing, and the ability to achieve their full potential.

    “Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, depriving people of health, wellbeing, and the ability to achieve their full potential.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    Personal consequences of chronic untreated oral diseases are often severe and include unremitting pain, sepsis, reduced quality of life, lost school days, family disruption, and decreased work productivity.

    “The personal consequences of chronic untreated oral diseases are often severe and include unremitting pain, sepsis, reduced quality of life, lost school days, family disruption, and decreased work productivity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    Oral diseases disproportionally affect poorer and marginalised groups in society, being very closely linked to socioeconomic status and broader social determinants of health.

    “Oral diseases disproportionally affect poorer and marginalised groups in society being very closely linked to socioeconomic status and the broader social determinants of health.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisenone given

    Oral diseases are highly prevalent across the life course and have a significant negative impact on individuals, communities and wider society.

    “Despite being largely preventable, oral diseases are highly prevalent across the life course and have a significant negative impact on individuals, communities and the wider society.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Oral diseases are largely preventable.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Oral conditions disproportionally affect poorer and socially disadvantaged members of society.

    “Oral conditions disproportionally affect poorer and socially disadvantaged members of society.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Oral diseases can be considered a sensitive clinical marker of social disadvantage and an early indicator of population ill health linked to deprivation.

    “Indeed, oral diseases can be considered as a sensitive clinical marker of social disadvantage, a 'canary in the coalmine' with oral diseases being the early indicator of population ill health linked to deprivation.5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Watt, 2018, Oral health disparities in children, Pediatr Clin North Am source

  • May combine two claims.

    Premisereasoning

    Oral conditions are chronic and strongly socially patterned.

    “As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Oral diseases are a global public health problem with particular concern over rising prevalence in many LMIC linked to wider social, economic and commercial changes.

    “Oral diseases are truly a global public health problem with particular concern over rising prevalence in many LMIC linked to wider social, economic and commercial changes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisenone given

    Oral diseases are chronic and progressive in nature; dental caries affects very young children but is a lifelong condition that tracks across adolescence, adulthood and later life.

    “Oral diseases are chronic and progressive in naturefor example dental caries affects very young children but is a lifelong condition that tracks across adolescence, adulthood and into later life.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Oral diseases and oral health inequalities are directly influenced by wider social and commercial determinants.

    “Oral diseases and oral health inequalities are directly influenced by the wider social and commercial determinants, the underlying drivers of poor population oral health.6”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Watt, 2012, Integrating the common risk factor approach into a social determinants framework, Community Dent Oral Epidemiol source

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    Free sugars consumption impacts the prevalence of both caries and overweight/obesity, and associated conditions such as diabetes.

    “Of particular concern is the impact of free sugars consumption on the prevalence of both caries and overweight/obesity, and associated conditions such as diabetes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Premisenone given

    There is increasing recognition of the influence, power and impact of the global sugar industry as a threat to public health.

    “There is increasing recognition of the influence, power and impact of the global sugar industry as a threat to public health, which requires tighter regulation and legislation by governments.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given

    If caries progresses to cavitation, it can cause significant pain and discomfort, and when it spreads to the dental pulp, infection, sepsis and tooth loss.

    “If caries progresses and leads to cavitation, the condition can cause significant pain and discomfort, and, when it spreads to the dental pulp, infection, and ultimately sepsis and tooth loss.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Societal costs of treating oral diseases are a very high economic burden to families and the health care system.

    “The societal costs of treating oral diseases are a very high economic burden to families and the health care system.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    Poor children, socially marginalised groups, and older people suffer the most from oral diseases and have more limited access to dental care.

    “Poor children, socially marginalised groups, and older people suffer the most from oral diseases and have more limited access to dental care.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    Oral diseases have a significant impact causing pain, sepsis, reduced quality of life, lost school days, family disruption, decreased work productivity, and considerable dental treatment costs for individuals and the wider health care system.

    “Oral diseases have a significant impact causing pain, sepsis, reduced quality of life, lost school days, family disruption, decreased work productivity, and the costs of dental treatment can be considerable for both individuals, and the wider health care system.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In high-income countries, dentistry is failing to meet the needs of large segments of their populations and is increasingly focusing on aesthetic treatments largely driven by profit motives and consumerism.

    “In high-income countries, dentistry is failing to meet the needs of large segments of their populations and is increasingly focusing on the provision of aesthetic treatments largely driven by profit motives and consumerism.9”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Holden, 2018, Consumer-driven and commercialised practice in dentistry: an ethical and professional problem?, Med Health Care Philos source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Dental caries is the localised destruction of dental hard tissues by acidic by-products from the bacterial fermentation of free sugars.

    “Dental caries is the localised destruction of dental hard tissues (enamel and dentine) by acidic by-products from the bacterial fermentation of free sugars.11,12”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [11] 2008

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [12] Fejerskov, 2003

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Globally, severe periodontitis was the sixth-most prevalent health condition affecting nearly 11% or 743 million people worldwide.

    “Globally, severe periodontitis was the sixth-most prevalent health condition affecting nearly 11% or 743 million people worldwide.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Frencken, 2017, Global epidemiology of dental caries and severe periodontitis— a comprehensive review, J Clin Periodontol source

  • May combine two claims.

    Premisecitation

    The adverse influence of corporate players in governmental public health policy is well documented, with coherence of approaches often apparent across industries.

    “The adverse influence of corporate players in governmental public health policy is well documented, with coherence of approaches often apparent across industries 140”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [140] Nestle, 2015

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Knai and colleagues have proposed a systems approach for analysing the commercial determinants of health.

    “Knai and colleagues have proposed a systems approach for analysing the commercial determinants of health.140”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [140] Nestle, 2015

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Oral diseases disproportionally affect poorer and marginalised groups in society being very closely linked to socioeconomic status and the broader social and commercial determinants.

    “Oral diseases disproportionally affect poorer and marginalised groups in society being very closely linked to socioeconomic status and the broader social and commercial determinants.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Overall, the burden of untreated dental caries for primary and permanent dentition remained relatively unchanged over the last 30 years, challenging the conventional view that dental caries burden has generally improved.

    “Overall, the burden of untreated dental caries for primary and permanent dentition remained relatively unchanged over the last 30 years challenging the conventional view that dental caries burden has generally improved.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Efforts employed by corporate players include criticising health-promotion policies as overbearing governmental interference (nanny state) and insisting on the importance of consumer choice and individual responsibility.

    “Efforts employed include criticising health-promotion policies as overbearing governmental interference (nanny state) and insisting on the importance of consumer choice and individual responsibility.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [140] Nestle, 2015

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Knai and colleagues argue that corporations have an impact through being able to create systems that are resilient to public health interventions, having the capacity to adapt and diversify.

    “Knai and colleagues argue that corporations have an impact through being able to create systems that are resilient to public health interventions, having the capacity to adapt and diversify.140”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [140] Nestle, 2015

  • May combine two claims.

    Interpretationreasoning

    Oral diseases are a significant global public health problem which are highly prevalent and have major negative impacts on individuals, communities and society.

    “Oral diseases are a significant global public health problem which are highly prevalent and have major negative impacts on individuals, communities and society.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Lip and oral cavity cancers are among the top 15 most common cancers in the world with 500,550 incident cases in 2018.

    “Lip and oral cavity cancers are among the top 15 most common cancers in the world with 500,550 incident cases in 2018.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] 2019

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Rates of oral cancers are greater among men, older age-groups, and those from poorer backgrounds, with socioeconomic inequalities observed both between and within countries.

    “Rates of oral cancers are greater among men, older age-groups, and those from poorer backgroundswith socioeconomic inequalities observed both between and within countries.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Winn, 2015, The INHANCE consortium: toward a better understanding of the causes and mechanisms of head and neck cancer, Oral Dis source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    A systems approach has the potential to promote a better understanding of the broader political, institutional, and cultural contexts in which health outcomes, risk factors and behaviours are embedded.

    “Such an approach has the potential to promote a better understanding of the broader political, institutional, and cultural contexts in which health outcomes, risk factors and behaviours are embedded.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Untreated caries in permanent teeth was the most prevalent health condition in 2010, affecting 35% of the global population or 2.4 billion people worldwide.

    “Untreated caries in permanent teeth was the most prevalent health condition in 2010 affecting 35% of the global population or 2.4 billion people worldwide.32”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Marthaler, 2004, Changes in dental caries 1953–2003, Caries Res source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    According to IARC, lip and oral cavity cancers are among the top 15 most common cancers in the world.

    “According to the International Agency for Research on Cancer, lip and oral cavity cancers are among the top 15 most common cancers in the world.24”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] 2019

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Increasing consumption of free sugars particularly in LMIC is causing an increase in dental caries, as well as other NCDs such obesity and diabetes.

    “Increasing consumption of free sugars particularly in LMIC is causing an increase in dental caries, as well as other NCDs such obesity and diabetes.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Free sugars are used in the production of many processed foods and drinks, and soft drinks are a major source of sugar in the global diet.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    PepsiCo has set aside US$12 billion for its Indian operations by 2020.

    “PepsiCo has set aside US$12 billion for its Indian operations by 2020.142”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [142] 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The accumulated revenues of Coca-Cola and PepsiCo in 2014 exceeded the GDP of Slovakia and another 125 countries around the globe.

    “a sum that exceeds the GDP of Slovakia and another 125 countries around the globe.143”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [143] 2003

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Coca-Cola and PepsiCo had accumulated revenues in excess of US$100 billion in 2014.

    “with accumulated revenues in excess of US$100 billion in 2014 142”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [142] 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The WHO's total budget for 2017 was US$4.4 billion.

    “In contrast, the WHO's total budget for 2017 was US$4.4 billion.149”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [149] O'Connor

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Although sugary drinks consumption is highest in North America, Latin America, Australasia and Western Europe, sales are now falling in many high-income countries and instead significant growth is expected in many low and middle-income countries.

    “Although sugary drinks consumption is highest in North America, Latin America, Australasia and Western Europe, sales are now falling in many high-income countries and instead significant growth is expected in many low and middleincome countries.125”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [125] Nowjack-Raymer, 2007, Numbers of natural teeth, diet, and nutritional status in US adults, J Dent Res source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 2013 US drinks companies alone spent US$866 million on advertising sugary drinks and energy drinks.

    “In 2013 US drinks companies alone spent US$866 million on advertising sugary drinks and energy drinks.148”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [148] Sheiham, 2015, Diet and dental caries, J Dent Res source

  • May combine two claims.

    Premisecitation

    Industry is increasingly targeting its marketing campaigns to specific ethnic minority groups; US$83 million was spent on marketing sugary drinks and energy drinks on Spanish language television in the US, a 44% increase since 2010.

    “Industry is also increasingly targeting its marketing campaigns to specific ethnic minority groups -US$83 million was spent on marketing sugary drinks and energy drinks on Spanish language television in the US, a 44% increase since 2010.148”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [148] Sheiham, 2015, Diet and dental caries, J Dent Res source
    • Rests on an assumption: Direct marketing to children and young people include brand appearances on prime-time television programmes, marketing in social media and mobile marketing.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Coca-Cola outlined plans to invest more than US$4 billion in China between 2015 and 2017 and by 2020 they intend to spend US$12 billion on marketing their products across Africa.

    “Coca-Cola outlined plans to invest more than US$4 billion in China between 2015 and 2017 and by 2020 they intend to spend US$12 billion on marketing their products across Africa.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [142] 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

52 of 52

  • The paper relies on this without support.

    Oral diseases are largely preventable.

    “Even though oral diseases are largely preventable, they persist with high prevalence as a reflection of pervasive social and economic inequalities, along with inadequate funding for prevention and treatment, particularly in low and middleincome countries (LMIC).”

  • The paper relies on this without support.

    In many LMIC oral diseases remain largely untreated because treatment costs exceed available resources.

    “In many LMIC oral diseases remain largely untreated as the treatment costs exceed available resources.”

  • The paper relies on this without support.

    The current model of dental care delivery and clinical preventive policy has failed to tackle the global burden of oral diseases.

    “The current model of dental care delivery and clinical preventive policy has failed to tackle the global burden of oral diseases.”

  • The paper relies on this without support.

    Many dentists are not well trained in providing care for patients with complex medical problems.

    “Additionally, many dentists are not well trained in providing care for patients with complex medical problems.”

  • The paper relies on this without support.

    Advertising to children is extensive, via multiple channels, with profound effects on food preferences, purchase requests, consumption patterns and health.

    “Advertising to children is extensive, via multiple channels, with profound effects on food preferences, purchase requests, consumption patterns and health.”

  • The paper relies on this without support.

    The soft drinks industry spends a great deal on advertising and marketing their products.

    “The soft drinks industry spends a great deal on advertising and marketing their products.”

  • The paper relies on this without support.

    Direct marketing to children and young people include brand appearances on prime-time television programmes, marketing in social media and mobile marketing.

    “Direct marketing to children and young people include brand appearances on prime-time television programmes, marketing in social media and mobile marketing.”

  • The paper relies on this without support.

    Free sugars are used in the production of many processed foods and drinks, and soft drinks are a major source of sugar in the global diet.

    “Although free sugars are used in the production of many processed foods and drinks, soft drinks are a major source of sugar in the global diet.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The predominance of curative demand among caregivers who do not regularly seek dental care and who have a limited perception of the importance of prevention is consistent with previous studies indicating that preventive dentistry has not yet been fully incorporated into routine practice.

    “In this study, the predominance of curative demand among caregivers who do not regularly seek dental care and who have a limited perception of the importance of prevention is consistent with previous studies indicating that, despite improvements in access, preventive dentistry has not yet been fully incorporated into routine practice [22,23].”

    From Socioeconomic, Educational, Cultural, and Oral Health Practices Among Caregivers Declining Their Children's Participation in School-Based Oral Health Promotion Programs: A Cross-Sectional Study (2026) · cites this paper as [23]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • This preventable health challenge leads to a negative aftermath affecting vulnerable groups through their inability to remain active in society, emotional trauma and loss of productivity.

    “This preventable health challenge leads to a negative aftermath affecting vulnerable groups through their inability to remain active in society, emotional trauma and loss of productivity.”

    From Oral health in Africa: a neglected public health priority (2026) · cites this paper as [34]

    The Introduction describes oral diseases as largely preventable, disproportionately affecting disadvantaged people, and impairing socialising through pain or embarrassment. The Economic burden section identifies reduced involvement in social activities and productivity losses. These passages support social and economic harms, but do not establish the stronger claims of an inability to remain active in society or emotional trauma. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • There is a potential failure of healthcare systems in protecting individuals at risk of oral diseases.

    “Thus, highlighting a potential failure of healthcare systems in protecting individuals at risk of oral diseases (34).”

    From Oral health in Africa: a neglected public health priority (2026) · cites this paper as [34]

Cites

Flagged first, then by citations

4 of the 146 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Faulks, 2006, Defining the population requiring special care dentistry using the International Classification of Functioning, Disability and Health–a personal view, J Disabil Oral Health, 7, 143
  2. Llodra Calvo, 2012, Encuesta de salud oral de España 2010, RCOE, 17, 13

Cited by

Sorted by citations

Related

Authors
Peres, M. A., Macpherson, L. M. D., Weyant, R. J., Daly, B., Venturelli, R., Mathur, M. R., Listl, S., Celeste, R. K., Guarnizo-Herreño, C. C., Kearns, C., Benzian, H., Allison, P., & Watt, R. G.
Affiliations
  • Griffith University (AU)
  • University of Glasgow (GB)
  • University of Pittsburgh (US)
  • Trinity College Dublin (IE)
  • University College London (GB)
  • Public Health Foundation of India (IN)
  • Radboud University Nijmegen (NL)
  • Universidade Federal do Rio Grande do Sul (BR)
  • Universidad Nacional de Colombia (CO)
  • University of California, San Francisco (US)
  • New York University (US)
  • McGill University (CA)
Corresponding author
Watt, Richard G
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2019-07
Volume
394
Issue
10194
Pages
249-260
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(19)31146-8
OpenAlex
W2956655325
Cited by
4,054
References
146
Citations by year
2026: 772 · 2025: 719 · 2024: 689 · 2023: 582 · 2022: 560 · 2021: 431 · 2020: 267 · 2019: 28 · 2012: 1
FWCI
45.36
Type
journal article
Language
en
Update notices
erratum (2019-09-21)
Open access
Licence
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Griffith Research Online (submittedVersion, cc-by-nc-nd)
Funders
National Institute for Health and Care Research (NIHR-INF-0386, PB-PG-0212-27029, NF-SI-0515-10032)
Topics
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Dentistry › Periodontics › Oral Health Pathology and Treatment
Keywords
oral diseases, dental caries, periodontal disease, tooth loss, oral cancer, non-communicable diseases, social determinants of health, economic burden, low- and middle-income countries, access to dental care, oral health policy, global health priorities
MeSH terms
Dental Caries, Persons with Disabilities, Humans, Mouth Diseases, Mouth Neoplasms, Periodontal Diseases, Public Health, Socioeconomic Factors, Global Health, Prevalence, Cost of Illness, Health Status Disparities

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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