Skip to main content

Sustainability: The Need to Transform Oral Health Systems

  • Chapter
  • First Online:
Sustainable Dentistry
  • The original version of the chapter has been revised. The last name of James Coughlan was unfortunately published with an error. The initially published version has now been corrected. A correction to this chapter can be found at https://doi.org/10.1007/978-3-031-07999-3_14

Abstract

This chapter explores the role of system transformation in the drive towards sustainability. This chapter presents this broad vision of sustainability in dentistry by coupling sustainability with dentistry’s social contract, or the mutual commitments and reciprocal obligations that dentistry shares with society by virtue of being a regulated health profession. Healthcare systems need to be more focussed on efficient, appropriate treatment (based on evidence) to not only become more efficient but also to reduce their overall environmental impact (Hensher, et al., Health Economics, Policy and Law 15:419–439, 2020). A number of system characteristics need to be considered from an environmental, fiscal, and social perspective. The chapter views the lens of six building blocks for health systems strengthening; service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance.

Sustainability isn’t about reducing your environmental emissions; it needs a system reconstruct; and all of these building blocks are pivotal in building a sustainable dental system.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Change history

  • 14 October 2023

    A correction has been published.

Notes

  1. 1.

    1,420,220,285 kilotonnes of carbon. Multiplying this by 3.07136E-06 using the RECIPE formula.

References

  1. Hensher M, Tisdell J, Canny B, Zimitat C. Health care and the future of economic growth: exploring alternative perspectives. Health Econ Policy Law. 2020;15(4):419–39. https://doi.org/10.1017/S1744133119000276.

    Article  PubMed  Google Scholar 

  2. World Health Organisation. Oral Health 148th Meeting. https://www.dentalhealth.ie/assets/files/pdf/oral_heatlh_who_148th_meeting_jan_2021_-_report_by_director_general.pdf.

  3. World Health Organisation. https://www.who.int/news/item/27-05-2021-world-health-assembly-resolution-paves-the-way-for-better-oral-health-care.

  4. Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, Guarnizo-Herreño CC, Kearns C, Benzian H, Allison P, Watt RG. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–260. https://doi.org/10.1016/S0140-6736(19)31146-8. Erratum in: Lancet. 2019;394(10203):1010.

  5. Sheiham A. Is there a scientific basis for six-monthly dental examinations? Lancet. 1977;2(8035):442–4. https://doi.org/10.1016/s0140-6736(77)90620-1.

    Article  PubMed  Google Scholar 

  6. FDI Sustainability in Dentistry. https://www.fdiworlddental.org/sustainability-dentistry.

  7. Australian Dental Association. Dentistry and sustainability. https://www.ada.org.au/Professional-Information/Policies/Dental-Practice/6-21-Dentistry-and-Sustainability.

  8. Canadian Dental Association. https://cda-adc.ca/en/about/media_room/news_releases/2009/11_16_09.asp.

  9. World Health Organization. Monitoring the building blocks of health systems. https://www.who.int/WHO_MBHSS_2010_full_web.

  10. Primary health care on the road to universal health coverage: 2019 monitoring report. Geneva: World Health Organization; 2019. https://www.who.int/healthinfo/universal_health_coverage/report/uhc_report_2019.pdf?ua=1.

  11. Masterclass. What is universal health care? https://www.masterclass.com/articles/what-is-universal-health-care#what-are-the-advantages-of-universal-health-care.

  12. Stockton DA, Fowler C, Debono D, Travaglia J. World Health Organization building blocks in rural community health services: an integrative review. Health Sci Rep. 2021;4(2):e254. https://doi.org/10.1002/hsr2.254.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Peterson-KFF Health System Tracker. Health spending. https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/.

  14. Peterson-KFF Health System Tracker. Life expectancy. https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/#item-le_life-expectancy-at-birth-in-years-2017_dec-2019-update.

  15. Peterson-KFF Health System Tracker. Quality US healthcare. https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-healthcare-quality-and-access-haq-index-rating-2016.

  16. Bressler RD. The mortality cost of carbon. Nat Commun. 2021;12(1):4467. https://doi.org/10.1038/s41467-021-24487-w.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Fee PA, Riley P, Worthington HV, Clarkson JE, Boyers D, Beirne PV. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev. 2020;2020(10)

    Google Scholar 

  18. Ramsay CR, Clarkson JE, Duncan A, Lamont TJ, Heasman PA, Boyers D, et al. Improving the quality of dentistry (IQuaD): a cluster factorial randomised controlled trial comparing the effectiveness and cost-benefit of oral hygiene advice and/or periodontal instrumentation with routine care for the prevention and management of perio. Health Technol Assess (Rockv). 2018;22(38):vii–143.

    Google Scholar 

  19. Clarkson JE, Pitts NB, Goulao B, Boyers D, Ramsay CR, Floate R, et al. Risk-based, 6-monthly and 24-monthly dental check-ups for adults: the interval three-arm rct. Health Technol Assess (Rockv). 2020;24(60):1–138.

    Article  Google Scholar 

  20. MacNeill AJ, McGain F, Sherman JD. Planetary health care: a framework for sustainable health systems. Lancet Planet Heal. 2021;5(2):e66–8.

    Article  Google Scholar 

  21. Public Health Wales. ACORN Assessment of Clinical Oral Risks & Needs For Routine Patients. 2020. http://www.primarycareone.wales.nhs.uk/sitesplus/documents/1191/Routine patient ACORN.pdf.

  22. World Health Organization regional office for Europe. The case for investing in public health: the strengthening public health services and capacity—a key pillar of the European regional health policy framework health 2020. 2014.

    Google Scholar 

  23. Duane B, Dixon J, Giwa A, Aldana C, Couglan J, Henao D, et al. Embedding environmental sustainability within the modern dental curriculum—exploring current practice and developing a shared understanding. Eur J Dent Educ. 2021;25(3):541–9.

    Article  PubMed  Google Scholar 

  24. Patel K, Jenkyn I. An introduction to clinical governance in dentistry. Br Dent J. 2021;230:539–43. https://doi.org/10.1038/s41415-021-2839-9.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Birch S, Ahern S, Brocklehurst P, Chikte U, Gallagher J, Listl S, et al. Planning the oral health workforce: time for innovation. Community Dent Oral Epidemiol. 2020;49:17–22.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lighter DE. How (and why) do quality improvement professionals measure performance? Int J Pediatr Adolesc Med. 2015;2:7–11.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Sustainable Development Unit. Reporting on sustainability. Available on request from Greener NHS. https://www.england.nhs.uk/greenernhs/. Accessed May 2019.

  28. Department for Business, Energy & Industrial Strategy. Greenhouse gas reporting: conversion factors 2017. https://www.gov.uk/government/publications/greenhouse-gas-reporting-conversion-factors-2017. Accessed May 2019.

  29. Duane B, Hyland J, Rowan JS, Archibald B. Taking a bite out of Scotland’s dental carbon emissions in the transition to a low carbon future. Public Health. 2012;126:770–7.

    Article  PubMed  Google Scholar 

  30. Duane B, Berners Lee M, White S, Stancliffe R, Steinbach I. An estimated carbon footprint of NHS primary dental care within England. How can dentistry be more environmentally sustainable? Br Dent J. 2017;223:589–93.

    Article  PubMed  Google Scholar 

  31. Grant P, Bailey SL. Calculate the carbon footprint of your hospital. BMJ. 2010;341:c2366.

    Article  Google Scholar 

  32. Wicke DM, Lorge RE, Coppin RJ, Jones KP. The effectiveness of waiting room notice-boards as a vehicle for health education. Fam Pract. 1994;11:292–5.

    Article  PubMed  Google Scholar 

  33. Mortimer F, Isherwood J, Wilkinson A, Vaux E. Sustainability in quality improvement: redefining value. Future Healthcare J. 2018;5:88–93.

    Article  Google Scholar 

  34. Mortimer F, Isherwood J, Pearce M, Kenward C, Vaux E. Sustainability in quality improvement: measuring impact. Future Healthcare J. 2018;5(9):4–97.

    Google Scholar 

  35. Sustainable Development Unit. An integrated metrics approach module. https://www.england.nhs.uk/greenernhs/. Accessed May 2021.

  36. Listl S, Chiavegatto Filho ADP. Big data and machine learning BT. In: Peres MA, Antunes JLF, Watt RG, editors. Oral epidemiology: a textbook on oral health conditions, research topics and methods. Cham: Springer International Publishing; 2021. p. 357–65. https://doi.org/10.1007/978-3-030-50123-5_23.

    Chapter  Google Scholar 

  37. World Health Organization. World Health Organization Model List of Essential Medicines—22nd List. Geneva; 2021.

    Google Scholar 

  38. World Health Organization. World Health Organization Model List of Essential Medicines for Children—8th List. 2021.

    Google Scholar 

  39. The shame in a failure to introduce a comprehensive child dental health programme throughout all of the United Kingdom Perspect Public Health. 2019;139(1):15–16. https://doi.org/10.1177/1757913918815428.

  40. Langley J, Wolstenholme D, Cooke J. Collective making as knowledge mobilisation: the contribution of participatory design in the co-creation of knowledge in healthcare. BMC Health Serv Res. 2018;18:585. https://doi.org/10.1186/s12913-018-3397-y.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Kutzin J. Health financing for universal coverage and health system performance: concepts and implications for policy. Bull World Health Organ. 2013;91(8):602–11. http://www.who.int/entity/bulletin/volumes/91/8/12-113985.pdf.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Yazbeck AS, Savedoff WD, Hsiao WC, Kutzin J, Soucat A, Tandon A, et al. The case against labor-tax-financed social health insurance for low- and low-middle-income countries. Health Aff (Millwood). 2020;39(5):892–7.

    Article  PubMed  Google Scholar 

  43. Allin S, Farmer J, Quiñonez C, Peckham A, Marchildon G, Panteli D, et al. Do health systems cover the mouth? Comparing dental care coverage for older adults in eight jurisdictions. Health Policy (New York). 2020;124(9):998–1007.

    Article  Google Scholar 

  44. Bedi R. The sugar tax: a leadership issue for the dental profession and an opportunity to demonstrate that oral health is part of general health. Contemp Clin Dent. 2018;9:149–50.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Cashin C, Sparkes S, Bloom D. Earmarking for health: from theory to practice. Geneva: World Health Organization; 2017. https://apps.who.int/iris/rest/bitstreams/1082540/retrieve.

    Google Scholar 

  46. Benzian H, Hobdell M, Holmgren C, Yee R, Monse B, Barnard JT, et al. Political priority of global oral health: an analysis of reasons for international neglect. Int Dent J. 2011;61(3):124–30.

    Article  PubMed  Google Scholar 

  47. Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–60. https://doi.org/10.1016/S0140-6736(19)31146-8.

    Article  PubMed  Google Scholar 

  48. Ottersen T, Elovainio R, Evans DB, McCoy D, McIntyre D, Meheus F, et al. Towards a coherent global framework for health financing: recommendations and recent developments. Heal Econ Policy Law. 2017;12(2):285–96.

    Article  Google Scholar 

  49. Wagstaff A. Measuring financial protection in health. Policy Research Working Paper Series 4554. 2008. https://openknowledge.worldbank.org/handle/10986/6570.

  50. Spending on health in Europe: entering a new era. Copenhagen: WHO Regional Office for Europe; 2021. License: CC BY-NC-SA 3.0 IGO. https://www.euro.who.int/en/publications/abstracts/spending-on-health-in-europe-entering-a-new-era-2021.

  51. Bernabé E, Masood M, Vujicic M. The impact of out-of-pocket payments for dental care on household finances in low and middle income countries. BMC Public Health. 2017;17(1):1–8. https://doi.org/10.1186/s12889-017-4042-0.

    Article  Google Scholar 

  52. Anopa Y, McMahon AD, Conway DI, Ball GE, McIntosh E, Macpherson LMD. Improving child oral health: cost analysis of a national nursery toothbrushing programme. PLoS One. 2015;10(8):1–18.

    Article  Google Scholar 

  53. World Health Organization. From value for money to value-based health services: a twenty-first century shift. 2020. https://www.who.int/choice/publications/vbhs.pdf?ua=1.

  54. Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477–81. https://doi.org/10.1056/NEJMp1011024.

    Article  PubMed  Google Scholar 

  55. Listl S. Value-based oral health care: moving forward with dental patient-reported outcomes. J Evid Based Dent Pract. 2019;19(3):255–9. https://doi.org/10.1016/j.jebdp.2019.101344.

    Article  PubMed  Google Scholar 

  56. Kastenbom L, Falsen A, Larsson P, Sunnegårdh-Grönberg K, Davidson T. Costs and health-related quality of life in relation to caries. BMC Oral Health. 2019;19(1):1–8.

    Article  Google Scholar 

  57. Public Health England. York Health Economics Consortium. A rapid review of evidence on the cost-effectiveness of interventions to improve the oral health of children aged 0–5 years About Public Health England. 2016. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/560972/Rapid_review_ROI_oral_health_5_year_old.pdf.

  58. Eow J, Duane B, Solaiman A, Hussain U, Lemasney N, Ang R, et al. What evidence do economic evaluations in dental care provide? A scoping review. Community Dent Health. 2019;36(2):118–25.

    PubMed  Google Scholar 

  59. Sharma D, Aggarwal AK, Downey LE, Prinja S. National healthcare economic evaluation guidelines: a cross-country comparison. Pharmacoecon Open. 2021;5(3):349–64. https://doi.org/10.1007/s41669-020-00250-7.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Janosky JE, Armoutliev EM, Benipal A, et al. Coalitions for impacting the health of a community: the Summit County, Ohio, experience. Popul Health Manag. 2013;16(4):246–54. https://doi.org/10.1089/pop.2012.0083.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Kings Fund. Integrated Care Systems explained. https://www.kingsfund.org.uk/publications/integrated-care-systems-explained#what-are-ICSs.

  62. European Commission. Tools and methodologies to assess the efficiency of health care services in Europe. https://ec.europa.eu/health/sites/default/files/systems_performance_assessment/docs/2019_efficiency_en.pdf.

  63. Kingdon J. The reality of public policy making. In: Danis M, Clancy CM, Churchill LR, editors. Ethical dimensions of health policy. Oxford: Oxford University Press; 2002. p. 97–116.

    Google Scholar 

  64. Sabatier PA. An advocacy coalition framework of policy change and the role of policy-oriented learning therein. Policy Sci. 1988;21(2/3):129–68. http://www.jstor.org/stable/4532139.

    Article  Google Scholar 

  65. Shiffman J, Smith S. Generation of political priority for global health initiatives: a framework and case study of maternal mortality. Lancet. 2007;370:1370–9. www.thelancet.com.

    Article  PubMed  Google Scholar 

  66. Parkhurst J. The politics of evidence: from evidence-based policy to the good governance of evidence. Routledge; 2017. p. 1–182.

    Google Scholar 

  67. BDJ. Nature. Sustainable dentistry. https://www.nature.com/collections/djidaaddgi/.

  68. Duane B, Borglin L, Pekarski S, Saget S, Duncan HF. Environmental sustainability in endodontics. A life cycle assessment (LCA) of a root canal treatment procedure. BMC Oral Health. 2020;20(1):348. https://doi.org/10.1186/s12903-020-01337-7.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brett Duane .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Duane, B. et al. (2022). Sustainability: The Need to Transform Oral Health Systems. In: Duane, B. (eds) Sustainable Dentistry. BDJ Clinician’s Guides. Springer, Cham. https://doi.org/10.1007/978-3-031-07999-3_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-07999-3_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-07998-6

  • Online ISBN: 978-3-031-07999-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics