FOREWORD PROF VEERASAMY YENGOPAL DEAN, FACULTY OF DENTISTRY, UWC

TheUnitedNationshasputforward17SustainableDevelopmentGoals(SDGs)aspartoftheirglobal call to action to end poverty, protect the earth’s environment and climate, and ensure that people everywhere can enjoy peace and prosperity. The aim of SDG-3 is to ensure healthy lives and promotewell-beingfor all

Thisgoalfocusesonthefollowingkeyareasofhealthandwell-being:

• Mater nal mortality

• Neonatal and child mor tality

• Infectious diseases

• Non-communicable diseases

• Substance abuse

• Road traffic accidents

• Sexual and reproductive health

• Universal Health Coverage

• Environmental

• Health

The challenge for all health categories including Dentistry is to align their research, training and teaching activities so that at least some of the SDG goals are addressed in a manner that leads to an improvement in the health and well-being of people’s lives. A good starting point to highlight the roleofdentistryandmore specifically oralhealthcareinpromotingwell-beingamong individualsandcommunities is the recent World Health Organization Resolution on Oral Health adopted in 2021. The Resolution urged Member States to address key risk factors of oral diseases shared with other noncommunicable diseases suchashighintakeoffreesugars,tobaccouseandharmful use of alcohol, and to enhance the capacities of health professionals. It also recommended a shift from the traditional curative approach towards a preventive approach that includes the promotion of oral health within the family, schools and workplaces, and included timely, comprehensive and inclusive care within the primary healthcare system. This was a significant milestone for oral health as for the first time, there was an acknowledgement of the important link between oral health and general health.

The early recognition of infectious diseases and referral for treatment in the early phases has significant health outcomes for patients. For example, in patients who are HIV infected, in over 60% of patients, the first sign or symptom of underlying diseases occurs in the mouth. Early diagnosis and referral of these patients into wellness programs significantly improve their quality of life, well-being and life expectancy. The other important fact to note about Dentistry is that it is one of the most expensive professions to train and is one of the most expensive services to offer at a primary healthcare level. Within this context, even the richest countries of the world have realised that the curative approach of treating common oral diseases such as tooth decay (caries), gum disease (gingivitis & periodontitis), etc is not sustainable.

Most oral health conditions are largely preventable and can be treated in their early stages but treatment is often not affordable as usually not part of universal health coverage packages. Thus, there is a focus on prevention and oral health promotion activities such as education, behavioural change, lifestyle change, healthy eating, dietary advice, placement of fissure sealants, etc. The use of fluoride, which can substantially reduce the risk of dental caries, remains inaccessible in many parts of the world. The Western Cape has some of the highest tooth decay rates in the world. Almost 60% of children under the age of six in this province have tooth decay. The facilities for treating children are limited as they often need treatment under general anaesthesia and this is expensive. Children often wait up to six months before getting access to care. Studies have shown that this delay in treating tooth decay has significant adverse health effects: children who have severe tooth decay (called early childhood caries) have delayed developmental milestones such as lower weight and height, stunting, and lag behind in other milestones such as speech development. This is in addition to the significant hours lost in education as these children miss schooling, and there is also an economic impact as their parents or guardians have to take time off from work to take their children to the dentist for emergency pain and sepsis treatment.

The Faculty of Dentistry has focused its training programs on prevention and oral health promotion activities that aim to keep adult and child patients healthy. Our community-based programs also our students to offer oral health care in communities where access is a problem and students are also able to consider the environmental and social factors that impact oral health when they are making clinical decisions. The competing priorities in the province, the quadruple burden of disease impacting the province, the COVID pandemic, and limited resources have required Dentistry to focus its resources on programs that prevent oral disease and change health behaviour.