Interview: Alarming burden of non-communicable diseases in COVID-19 new normal
According to FDI World Dental Federation, non-communicable diseases (NCDs) are the leading disease burden worldwide. The multifaceted relationships between chronic conditions such as diabetes, cardio-vascular problems and cancers, and oral diseases has been investigated in multiple studies. However, scientists from Masaryk University in Brno in the Czech Republic are now concerned that the prevention of NCDs is being neglected during the SARS-CoV-2 pandemic. Therefore, Dr Abanoub Riad from the Department of Public Health at Masaryk University and his colleagues have addressed their concerns in a letter to the editor-in-chief of the journal Oral Diseases, Dr Giovanni Lodi. In an interview with Dental Tribune International, Riad explains the reasoning behind their concerns.
Dr Riad, what inspired your letter to the editor?
We have been sharing the thoughts set out in this letter since the beginning of the SARS-CoV-2 outbreak, because we predicted that the response strategies for SARS-CoV-2 would be double-edged in the sense that they might negatively impact the palliative care of people living with NCDs and the essential health services provided for them. At the time of writing this letter, we found that all the opinion articles suggested recommendations to reopen dental clinics amid the pandemic; therefore, we felt that it was the right moment to call attention to the alarming burden of oral diseases that would be seriously neglected in these critical times.
In the letter, you criticised the neglect of NCD prevention and the lack of education about NDCs during the SARS-CoV-2 pandemic. How did you come to that conclusion?
Well, there are a number of reasons that led us to this conclusion. Reorientation of health budgets to respond to SARS-CoV-2, while most of the world’s economies are strained owing to lockdown measures, has decreased the supply of medications and technologies required for NCD management. Secondly, the psychological costs of the sudden surge of cases and the implementation of physical distancing cannot be overlooked, because increased risk perceptions will enhance the behavioural risk factors of NCDs, for example sedentary habits, unhealthy nutrition, alcohol consumption and smoking. Thirdly, our weakened health systems and burnt-out healthcare workers will not be able to continue providing care to NCD patients while managing this unprecedented pandemic. In our opinion, oral diseases can’t be taken out of this context because we know that they can ideally be tackled through the common risk approaches to targeting of other NCDs and their interactions with each other are well presented to the public and policymakers.
“More resources should be allocated for behavioural research to comprehensively understand the health-related perceptions and attitudes of the public”
In your opinion what needs to be done to eliminate this imbalance?
This imbalance is caused by global health inequalities. Whereas dentistry as a profession tries to provide the best available service to its patients, it fails to tackle the socio-economic and cultural disparities of oral health within society, especially in crisis settings. Firstly, we need to evaluate what has happened to the physical and oral health of the population during the pandemic; this pretty much means that more resources should be allocated for behavioural research to comprehensively understand the health-related perceptions and attitudes of the public. We need to be proactive when it comes to teledentistry applications and to remember that our prime role as oral healthcare professionals is to encourage patients to attain the highest available level of oral health through prevention rather than intervention. I suggest that oral hygiene should be as important as hand hygiene in order to overcome this gap.
Have you received any feedback so far?
Yes, we have had a number of comments from our colleagues and even from dental public health experts who strongly agreed with our proposals in this letter. I was rather surprised to learn that our opinion piece ranked 19th out of 850 articles from the same journal (Oral Diseases) in number of social interactions [according to Altmetric].
Is there anything else you would like to add?
We cannot insist more on the importance of observational studies during this period that aim to understand people’s perceptions and attitudes towards oral hygiene and towards seeking dental care, especially among underserved groups. We are not sure when this pandemic will become a part of our history; therefore, we need to be resilient in our decisions and prioritise prevention over intervention in our efforts, because a surging demand for dental services may occur at any moment and it could really collapse our oral healthcare systems that will be operating under limitations. Can we afford this bill? Personally, I don’t think we can withstand this tsunami if it happens, but I’m sure we can prevent it from happening.
Editorial note: The letter to the editor of Oral Diseases can be accessed in full here.