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Debate: The four deans of health: Remember the dentists in the closer to home healthcare service

Dental care and treatment must be integrated into the strategy for a unified closer to home healthcare service, write the country's four deans of health. They also present four suggestions for how this can be achieved.

2019.02.07

More time for research and a one-year rotation for newly qualified dentists are two of the items on the wish list of the four deans of health for the strategy for a healthcare service that is closer to home.

By Ulla M. Wewer, Dean of Health and Medical Sciences (KU), Lars Bo Nielsen,Dean of the Faculty of Health (AU), Ole Skøtt, Dean of the Faculty of Health Sciences (SDU), and Lars Hvilsted Rasmussen, Dean of the Faculty of Medicine (AAU).

Everyone agrees that the focal point should be our fellow citizens and patients. There is also agreement that this applies regardless of whether this is to ensure a good labour and birth at the beginning of life, to receive highly-specialised treatment for a potentially fatal or chronic disease or is a question of respect and care for the most vulnerable and ill amongst us.

But how do we integrate dental and oral health into the plans for personalised medicine and a healthcare system that is closer to home? Oral health is closely related to the individual’s health and well-being, but it is also dependent on socio-economic factors – among other things due to high user fees.

Dental care is part of any closer to home healthcare service

As dean’s of health, we believe that what we need to do now is to stop and ask ourselves and everyone else whether research, prevention, education and development in the dental care area which we are able to deliver is sufficient to move with the times and meet future needs. 

Our answer is: No, it is not sufficient. Not when we think of e.g. technological developments (imaging, big date, AI, omics, new medicines), evidence-based treatment of many severe primary diseases in the oral cavity, and the many unpleasant side effects following treatment of serious diseases in other organs such as cancer.

Furthermore, we have a growing elderly population who still have their own teeth, and this section of the population naturally expects good dental care in order to safeguard their quality of life. We should certainly not forget the group of people in our welfare society who cannot afford to go to the dentist, where treatment is not free as it is at the doctors. 

Inflammation of the oral cavity such as periodontitis can influence the course of other diseases, including diabetes, cardiovascular disease and likely also rheumatoid arthritis and neurodegenerative diseases such as Alzheimer's and Parkinson's. So yes, dental care is part of the whole person and their health and thus also part of a healthcare system that is respectful and also closer to home.

Four proposals for a healthcare service that is closer to home

We know from daily experience how difficult it is to ‘manage to do everything’ in the dental environments at the universities, and the pressure has become excessive at the universities, including in the dental care area. The consequence can easily be that the time allocated to research is deprioritised.

When questioned directly, the Danish Council for Independent Research – Medical Sciences replies that they have received fewer applications over the past few years from the two dental research environments at University of Copenhagen and Aarhus University.
As a way of proactively incorporating the area of dental care and treatment into the future strategy and ensuring a whole healthcare service that is closer to home and provides high quality for all citizens, we propose the following initiatives for research and education:    

  • More research and education, including research-based continuing education focusing on personalised medicine in the dental care area.           
  • A one-year rotation for newly-qualified dentists with access to research.           
  • Cross-disciplinary and sectoral activities in the areas of research, development and intervention within the dental care area – preferably entrenched at the universities.       
  • Elimination of the two percent savings at the universities. 
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