The hazards of being human – and a dentist
Featured Products Promotional FeaturesPosted by: Dental Design 8th May 2024
I was interested to learn recently that the general health of the English population has been almost unchanged since the 1990s. Statistics[i] show that the proportion of adults in good and very good health has remained similar between 1993 and 2023. This is true of adults and children, both males and females. I found this curious given the advancements that have been made in medicine, technology and scientific thinking over the past three decades – why are these medical strides not positively impacting general health?
The World Health Organization (WHO) had a similar thought in 2019, when it published a 5-year strategic plan to enhance global public health. The mandate[ii] focused on promoting health, keeping the world safe and serving the vulnerable. At the time, the WHO also recognised 10 key threats to global health,[iii] including air pollution and climate change; noncommunicable diseases; antimicrobial resistance; weak primary health care; vaccine hesitancy; and fragile and vulnerable settings. The remainder of the list focused on specific illnesses that were predicted to have a greater impact on the world in the future – a future global influenza pandemic; high-threat pathogens (i.e. Ebola); dengue fever; and HIV.
Of course, some of these issues are well outside our control or influence as mere individuals, but for others, we do have a part to play. Increasing our sustainability as families, businesses and communities has been on the agenda for some time, and we are all responsible for keeping this up. Vaccine uptake is a more difficult subject, and while not the focus of this article, I continue to encourage my patients, family and friends to do proper research in the field before refusing a vaccination. As a dental professional, I am also proactive in the fight against antibiotic resistance, prescribing relevant medications only when absolutely necessary.
Moving away from the WHO’s ‘big 10’, there are many other areas in which we as dental professionals can affect change to improve the health of the nation. For example, nearly 13% of the UK population still smokes – that’s 6.4 million people.[iv] As the single greatest preventable cause of death in the world today,[v] the habit is certainly one of the barriers to improved public health. Diet, nutrition and exercise is another area that we should be advising on to enhance general health. Approximately 63% of British people are overweight and 27% are obese,[vi] putting them at a significantly increased risk of several chronic health conditions from diabetes to cancer.[vii] Excessive alcohol consumption is another risk factor driving preventable ill health, as misuse can affect almost every organ in the body and cause anything from liver disease to heart disease and cancer.[viii] Approximately 24% of UK adults regularly drink over the recommended amount of alcohol,[ix] so helping more people stay within safer limits is essential.
Such a topic couldn’t be reviewed by a dental professional without commenting on the oral health of the nation too. Just some of the headline figures show that 27% of adults in England have tooth decay, as do 11% of 3-year-olds and almost 25% of 5-year-olds.[x] In addition, almost half of UK adults have periodontitis.[xi] With an extensive body of evidence demonstrating the impact of poor oral health on systemic health,[xii] the benefits of enhancing oral care standards for the improvement of general public health cannot be emphasised enough.
The final area that I want to consider is stress. Stress can cause or exacerbate a wide range of systemic diseases and pathological conditions. These include brain function complications, memory impairment and problems with the immune, cardiovascular, gastrointestinal and endocrine systems.[xiii] Stress can also have a substantial impact on mental health, leading to increased risk of anxiety and depression,[xiv] as well as aggravating physical health concerns[xv] in what can become a vicious circle.
Dental professionals are sadly no strangers to stress, with more than half (55%) of UK dentists responding to a 2019 survey[xvi] admitting that their work was very or extremely stressful. Perhaps of even more concern, dentists scored lower on life satisfaction and happiness, and higher on anxiety compared to the general population.
As such, there is much we can do as individuals – as human beings not just as dental care providers – to improve public health. The healthcare professional in us will default to focusing on the advice and support we can provide patients in making healthier lifestyle decisions. These are important, but we mustn’t neglect our own health in the process. We too need to avoid habits like excessive alcohol consumption, ensure a balanced diet and remain physically active. We must also look to manage our stress levels wherever possible and maintain our general wellbeing.
Despite all the inroads made across the medical sector – the innovative technologies, rapid diagnostic workflows and comprehensive treatment solutions – much still needs to be done to enhance public health. The barriers may vary significantly in scale, but together we can, and should, all continue to drive improvements.
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[i] HSE Health Survey. General Health. http://healthsurvey.hscic.gov.uk/data-visualisation/data-visualisation/explore-the-trends/general-health.aspx [Accessed January 2024]
[ii] World Health Organization. Thirteenth General Programme of Work 2019-2023. https://www.paho.org/en/documents/thirteenth-general-programme-work-2019-2023-promote-health-keep-world-safe-serve [Accessed January 2024]
[iii] World Health Organization. Ten threats to global health in 2019. Newsroom. Spotlight. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019 [Accessed January 2024]
[iv] Office for National Statistics. Adult smoking habits in the UK: 2022. Released September 2023. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2022#:~:text=Based%20on%20APS%20data%2C%20the,20.2%25%20of%20the%20population). [Accessed January 2024]
[v] Public Health Agency. Stopping smoking. https://www.publichealth.hscni.net/directorate-public-health/health-and-social-wellbeing-improvement/stopping-smoking#:~:text=Smoking%20contributes%20to%20not%20only,here%2C%20all%20of%20them%20avoidable. [Accessed January 2024]
[vi] NHS England. Food and nutrition. https://www.england.nhs.uk/ahp/greener-ahp-hub/specific-areas-for-consideration/food-and-nutrition/#:~:text=Two%2Dthirds%20of%20the%20British,%25%20compared%20to%2020%25). [Accessed January 2024]
[vii] Public Health England. Health matters: obesity and the food environment. Scale of the obesity problem. March 2017. https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment–2 [Accessed January 2024]
[viii] The Health Foundation. Addressing the leading risk factors for ill health. February 2022. https://reader.health.org.uk/addressing-leading-risk-factors [Accessed January 2024]
[ix] Alcohol Change UK. Alcohol statistics. Alcohol in the UK. https://alcoholchange.org.uk/alcohol-facts/fact-sheets/alcohol-statistics [Accessed January 2024]
[x] House of Commons Library. Oral health and dentistry in England. May 2021. https://commonslibrary.parliament.uk/research-briefings/cdp-2021-0072/ [Accessed January 2024]
[xi] Department of Health & Social Care. Office for health Improvement & Disparities. Chapter 5: periodontal diseases. November 2021. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-5-periodontal-diseases [Accessed Januaru 2024]
[xii] Botelho J, Mascarenhas P, Viana J, Proença L, Orlandi M, Leira Y, Chambrone L, Mendes JJ, Machado V. An umbrella review of the evidence linking oral health and systemic noncommunicable diseases. Nat Commun. 2022 Dec 9;13(1):7614. doi: 10.1038/s41467-022-35337-8. PMID: 36494387; PMCID: PMC9734115.
[xiii] Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017 Jul 21;16:1057-1072. doi: 10.17179/excli2017-480. PMID: 28900385; PMCID: PMC5579396.
[xiv] Mind. Stress. What is stress? https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/what-is-stress/ [Accessed January 2024]
[xv] Mental health UK. Mental health and physical health. https://mentalhealth-uk.org/help-and-information/mental-health-and-physical-health/ [Accessed January 2024]
[xvi] Collin, V., Toon, M., O’Selmo, E. et al. A survey of stress, burnout and well-being in UK dentists. Br Dent J 226, 40–49 (2019). https://doi.org/10.1038/sj.bdj.2019.6
