WHA74.5

Having considered the consolidated report by the Director-General; 2

Recalling resolutions WHA60.17 (2007) on oral health: action plan for promotion and integrated disease prevention, WHA69.3 (2016) on the global strategy and action plan on ageing and health 2016–2020: towards a world in which everyone can live a long and healthy life, WHA72.2 (2019) on primary health care; and decisions WHA72(11) (2019) on the follow-up to the political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases and WHA73(12) (2020) on the Decade of HealthyAgeing 2020–2030;

Mindful of the 2030 Agenda for Sustainable Development, in particular Sustainable Development Goal 3 (Ensure healthy lives and promote well-being for all at all ages), and recognizing the important intersections between oral health and other Sustainable Development Goals, including Goal 1 (End poverty in all its forms and everywhere), Goal 2 (End hunger, achieve food security and improved nutrition and promote sustainable agriculture), Goal 4 (Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all) and Goal 12 (Ensure sustainable consumption and production patterns);

Recalling the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases (2011), recognizingthat oral diseases pose a major challenge and could benefit from common responses to noncommunicable diseases;

Recalling also the political declaration of the high-level meeting on universal health coverage (2019), including the commitment therein to strengthen efforts to address oral health as part of universal health coverage;

Mindful of the Minamata Convention on Mercury (2013), a global treaty to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds, calling for phase-down of the use of dental amalgam taking into account domestic circumstances and relevant international guidance; and recognizing that a viable replacement material should be developed through focused research;

Recognizing that oral diseases are highly prevalent, with more than 3.5 billion people affected by them, and that oral diseases are closely linked to noncommunicable diseases, leading to a considerable health, social and economic burden, 3 and that while there have been notable improvements in some countries, the burden of poor oral health remains, especially among the most vulnerable in society;

Noting that untreated dental caries (tooth decay) in permanent teeth occurs in 2.3 billion people, more than 530 million children have untreated dental caries of primary teeth (milkteeth) and 796 million people are affected by periodontal diseases; 4noting also that early rates of childhood caries are highest among those in vulnerable situations; and aware that these conditions are largely preventable;

Noting also that oral cancers are among the most prevalent cancers worldwide with 180 000 deaths each year, 5 and that in some countries they account for the most cancer-related deaths among men;

Noting further the economic burden due to poor oral health and that oral diseases worldwide account for US$ 545 billion in direct and indirect costs, 6 ranking poor oral health among the most costly health domains, such as diabetes and cardiovascular diseases;

Also taking into account that poor oral health – apart from pain, discomfort and lack ofwell-being and quality of life – leads to school and workplace absenteeism, 7 leading to short falls in learning and productivity losses;

Concerned about the effect of poor oral health on quality of life and healthy ageing both physically and mentally; and noting that poor oral health is a regular cause of pneumonia for elderly people, particularly those living in care facilities, and for persons with disabilities;

Aware that poor oral health is a major contributor to general health conditions, and noting that it has particular associations with cardiovascular diseases, diabetes, cancers, pneumonia and premature birth; 8

Noting that noma, a necrotizing disease starting in the mouth, is fatal for 90% of affected children in poor communities, mostly in some regions in Africa, and leads to lifelong disability and often social exclusion;

Concerned that the burden of poor oral health reflects significant inequalities, between and within countries, disproportionally affecting low- and middle-income countries, mostly affecting people from lower socioeconomic backgrounds and other risk groups, such as persons who cannot maintain their oral hygiene on their own due to their age or disability;

Acknowledging the many risk factors that oral diseases share with noncommunicable diseases, such as tobacco use, harmful use of alcohol, a high intake of free sugars and poor hygiene, and therefore the necessity to integrate strategies on oral health promotion, prevention and treatment into overall noncommunicable disease policies;

Recognizing that adequate intake of fluoride plays an important role in the development of healthy teeth and in the prevention of dental caries; and recognizing the need to mitigate the adverse effects of excessive fluoride in water sources on the development of teeth; 9

Concerned about the potential environmental impact caused by the use and disposal of mercury-containing dental amalgam, and the use of toxic chemicals for developing X-ray photographs;

Concerned also that oral health services are among the most affected essential health services because of the coronavirus disease (COVID-19) pandemic, with 77% of countries reporting partial or complete disruption;

Highlighting the importance of oral health and interventions with a life course approach;

Noting that a number of oral and dental conditions can act as indicators of neglect and abuse, especially among children, and that oral health professionals can contribute to the detection of child abuse and neglect,