The global burden of oral disease

3.5 billion patients suffer of untreated caries, severe periodontal disease or edentulism worldwide according the the report Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990–2015 by Kassebaum and colleagues

3.500.000.000 persons. 

What really means this number? Counting non-stop, at one number a second, it would take you 31 years, 251 days, 7 hours, 46 minutes, and 39 seconds to count to 1 billion. Hence you will require at least 110 years to count to 3.5 billion.

Considering that there are approximately 2 million dentists worldwide, if each dentist start to treat with traditional dentistry this burden of oral disease, each dentist will require to treat at least 19.444 patients. And with the traditional, expensive and time consuming restorative, surgical and traditional procedures, means an average of 44 years of work for each dentist. Just to treat the actual burden of disease.

Forthy-four years of work of one dentist doing the same that have been doing the last 200 years. Most probably we will use composite instead amalgam, implants instead removable dentures. But if we decide to keep doing that we have been doing the last 200 years we should expect no change at all in the current and future situation. Also if we use this number, 3.5 billion, to hire more dentists or boy more dental equipment.

This number is a call to fundamentally change the way we treat oral disease. It's a definitive call to move from traditional and surgical treatments with no evidence of effectiveness to scientifically, valid, reliable and replicable treatments aimed to improve the oral health of people and communities.

What to do? 

Even having enough evidence available in guidelines to improve oral health, there are three critically areas to improve yet:

  1. Change the way we teach dentistry. Currently we spend more time teaching dental materials, impression materials and how to extract teeth and to few time to discuss how people make choices, the importance of nutrition and how to maintain oral health and prevent diseases. Also dental schools should graduate more leaders, key persons who can be disruptive, creative, compassive and inspiring. 
  2. Change the way we pay the dentists for dental treatments.  And here the key is to decide what an ethical reimburse system should pay
  3. Leave space for allied professionals to get involved in the oral health: more hygienist, dental auxiliares but also nurses, physicians and teachers. Oral health is too important a matter to be left to the dentists.


Kassebaum, N.J., Smith, A.G.C., BernabĂ©, E., Fleming, T.D., Reynolds, A.E., Vos, T., Murray, C.J.L., Marcenes, W., Abyu, G.Y., Alsharif, U., Asayesh, H., Benzian, H., Dandona, L., Dandona, R., Kasaeian, A., Khader, Y.S., Khang, Y.H., Kokubo, Y., Kotsakis, G.A., Lalloo, R., Misganaw, A., Montero, P., Nourzadeh, M., Pinho, C., Qorbani, M., Blancas, M.J.R., Sawhney, M., Steiner, C., Traebert, J., Tyrovolas, S., Ukwaja, K.N., Vollset, S.E., Yonemoto, N., 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. Journal of Dental Research 96, 380–387. doi:10.1177/0022034517693566

Here the detail of the state of oral health worldwide