key: cord-0846333-68n3ster
authors: nan
title: Department of Error
date: 2021-12-31
journal: The Lancet
DOI: 10.1016/s0140-6736(21)02785-9
sha: 2fdfcf85fc7b01b6ea1c1f632e0f1c4598180219
doc_id: 846333
cord_uid: 68n3ster

nan

www.thelancet.com Vol 398 December 18/25, 2021 resources for oral health as well as the predominance of the private practitioner model to deliver oral health care. Frank Lobbezoo and Ghizlane Aarab suggest strengthening dental-medical integration as an additional strategy to address oral diseases. These are notable aspects to consider in the context of a future WHO global oral health strategy and countrylevel reforms of health-care systems towards universal oral health coverage. The Lancet Series on oral health highlighted the stark inequities in the availability and geographical distribution of oral health profes sionals. 2 Many health planners still use traditional simplistic provider-to-population ratios as benchmarks for national workforce planning, ignoring the need for more comprehensive and systemic reform that also includes new answers to the question of who provides which type of care to whom, and where. 3 Needs-based workforce planning can address inequities in availability and access to (oral) health care resulting from the current oral health-care framework that is dentist-centred. This planning will not only entail changes to the way oral health professionals are trained and where they practice, but also how they collaborate and interface effectively with other health professionals within a patient-centred, culturally competent health-care system that is aiming to offer universal primary (oral) health care. Producing better oral health-care coverage for the millions currently with little access will only be possible through innovative models of task shifting and integration. Dental-medical integration in education and care is one aspect in this context, yet much wider and broader efforts involving an array of oral and general health professionals, as well as non-health professionals, will be needed. This integration should be facilitated through clear definitions of essential oral health-care services, allowing for the determination of who does what and how, combined with evidence-informed plans for the sustainable financing of services. 4 Many countries have a rapidly expanding private dental education sector driven by business interests, requiring stronger governmental regulation and coordination. 2 Assuring quality and comparability between training institutions is a core function of such oversight. 5 The current similarity of dental curricula across the globe, built on high-income country models, rather than a diversity of curricula as assumed by Sarode and Sarode, is part of the problem as to why oral health care does not meet population needs. Moreover, traditional role models, outdated curricula, vested professional interests, and rigid laws regulating dental practice stand in the way of pragmatic progress towards innovative and rational approaches to expand access to and coverage of essential oral health-care services and oral disease prevention. 6 As Cohen and colleagues 7 stated, "the dental profession is overtrained for what they do and undertrained for what they should be doing. Control of the most common oral diseases requires relatively little training and could and should be performed in most cases by community health care workers".

WHO has shared a first discussion draft of the global oral health strategy, and worked on incorporating feedback received during a previous public consultation period. 8 The draft addresses the need for new oral health workforce models based on "a public health approach to oral health [that] strives to provide the maximum oral health benefit for the largest number of people by targeting the most prevalent and/or severe oral diseases and conditions". 8 This vision, together with rigorous and novel oral health workforce planning and training, will be part of the solution to the global burden of untreated oral disease.

We declare no competing interests. 

The WHO global strategy for oral health: an opportunity for bold action

Ending the neglect of global oral health: time for radical action

Needs-based planning for the oral health workforce -development and application of a simulation model

Pandemic considerations on essential oral health care

Global Strategy for Human Resources for Health: Workforce 2030

Modernizing scope-of-practice regulations -time to prioritize patients

Dentistry in crisis: time to change. La Cascada Declaration

WHO discussion paper: draft global strategy on oral health