Dr Dympna Kavanagh: Oral Health Is Essential to Overall Heal

Nathalie Schüller, Dental Tribune International

Thu. 25 September 2025

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Dr Dympna Kavanagh is chief dental officer in Ireland’s Department of Health and chair of the Platform for Better Oral Health in Europe. A specialist in dental public health, Dr Kavanagh has long advocated for the integration of oral health into broader health systems and policies. During her presentation at EuroPerio11 in Austria, she addressed the evolving global health landscape and the role of civil society in supporting the World Health Organization (WHO) Global Oral Health Action Plan (2023–2030). Dental Tribune International met with her to talk about Europe’s oral health priorities, reducing inequalities in oral care and what lies ahead as the UN was preparing for its 2025 high-level meeting on non-communicable diseases on 25 September in New York in the US.

Dr Kavanagh, WHO’s Global Oral Health Action Plan (2023–2030) outlines 100 concrete actions and 11 global targets to be met by 2030. What are the biggest barriers you see in translating this global road map into practical national policies across EU member states?
The WHO Global Oral Health Action Plan (2023–2030) is certainly ambitious, and from a European perspective, we welcome that ambition. Many EU member states are high-income countries, and the plan provides a valuable push for policymakers to give greater priority to oral health.

However, one of the greatest barriers remains the stark inequalities across Europe. What is feasible for some countries may be far out of reach for others. This makes it crucial for EU policymakers to adopt a united approach, working collectively to support member states in implementing the plan.

The EU has an important role to play here. It is a strong global voice within WHO, but has not always used that voice effectively in relation to oral health. Strengthening that role—and ensuring consistent advocacy at the EU level—will be essential if we are to turn global targets into practical, equitable national policies across Europe.

So, the goal is to convince policymakers that many other diseases can stem from an unhealthy mouth?
Yes, absolutely. That is one of our biggest challenges. Oral health has traditionally been siloed, treated as something separate from the rest of the body. Yet the evidence of the last decade clearly shows how closely oral health is linked with general health. Conditions such as diabetes and cardiovascular disease are strongly connected, and we now see emerging evidence of links with dementia and mental health. Poor oral health not only shares common risk factors—like tobacco use, alcohol and sugar consumption, and poor diet—but can also actively worsen other non-communicable diseases.

This growing body of research gives us powerful tools to convince policymakers, the health community and the public that oral health is fundamental to overall health. As WHO emphasises, there is no health without oral health. That is also the focus of the upcoming UN high-level meeting.

One of WHO’s key goals is to ensure that 80% of the world’s population has access to essential oral health services by 2030. How is the Platform for Better Oral Health in Europe supporting progress towards universal access to oral healthcare in Europe, particularly for vulnerable and underserved communities?
Our manifesto focuses strongly on addressing inequalities in Europe because oral health is one of the clearest markers of social deprivation. Oral disease patterns often reflect financial situation, social standing and cultural background. The World Economic Forum has highlighted major disparities, especially in out-of-pocket costs.

“Oral health has traditionally been siloed, treated as something separate from the rest of the body.”

The Platform for Better Oral Health in Europe works to bring evidence to policymakers, especially in countries with limited subsidies or awareness of oral health. Our message is that essential and preventive services—not a fully comprehensive system—can make a significant difference. As WHO points out, prevention is highly cost-effective: every €1 invested can save up to €7 in treatment costs.

That means prioritising the basics: access to oral health examinations, reliable evidence-based advice and consistent messaging on common risk factors such as tobacco use, alcohol and sugar consumption, and poor diet. We also encourage practical measures that have been shown to work, such as supporting water fluoridation, promoting fluoride toothpaste, reducing sugar consumption and, where feasible, introducing sugar taxes. Countries that have adopted these policies have already seen measurable public health benefits, including reduced consumption of sugary drinks.

For vulnerable groups—such as those who may not regularly visit a dentist, for cultural or economic reasons—it is essential to provide access to general and oral health advice outside of dental clinics. At the same time, dental visits must continue to be recognised as a core part of essential care.

For vulnerable and underserved communities, where paying rent or even buying sufficient food may be a struggle, regular visits to the dentist may not be a priority. Where can those in such circumstances turn for reliable advice?
From a public health perspective, we need to take a universal approach, but it is equally important to apply a proportional approach that recognises the extra support required by the most vulnerable in society. Universal policies—such as sugar taxes—are essential, but we must also ensure that additional measures are in place to reach those most at risk.

For example, how do people know how to shop for healthy food? Is there consistent availability of affordable basics? Could we begin to classify toothpaste as an essential good and make it cheaper or even free for those who need it most so that oral health is not reduced to a choice between bread and toothpaste?

These are the kinds of conversations we need to have with governments in order to move forwards and recognise oral health as a fundamental health necessity. For the most vulnerable—such as the homeless, refugees, smokers and those with alcohol dependency, who are at greater risk of oral cancer—we must ensure access to oral health examinations. Similarly, as people age, essential oral health measures become increasingly important in detecting oral cancer, periodontal disease and other conditions associated with ageing and medication use. In short, it is about having a universal framework while also creating targeted, cost-effective measures that protect and support the most deprived communities.

Rising out-of-pocket costs are pushing many EU citizens to seek care abroad. From a policy perspective, what levers—be they funding models, EU regulations or national reforms—do you believe are the most promising to reduce oral health inequalities and improve affordability?
From a policy perspective, the most promising levers to reduce inequalities and improve affordability are grounded in economics, workforce reform and prevention. First, economic evidence is increasingly in favour of dentistry. Studies by health economists and the World Economic Forum have shown that prevention is highly cost-effective. Every euro spent saves several euros in treatment, providing a strong basis to shift funding towards preventive services.

Second, Europe faces a workforce crisis in dentistry, driven by major disparities in workforce availability between North and South and by an ageing population retaining more teeth. Expanding roles for oral health professionals other than dentists could help reduce costs and increase access, but this requires harmonised education and political will.

Third, we must ensure that oral health funding is directed towards health, not aesthetics. Rising demand for cosmetic procedures like whitening, fillers and Botox risks diverting limited professional capacity away from essential oral care. Regulatory clarity is needed to keep oral health focused on prevention and treatment rather than luxury services.

Finally, affordability is linked to broader EU policies. The phase-out of amalgam is one example where environmental regulation has had cost implications, making prevention and innovation even more critical. The EU can help by promoting best practices, incentivising prevention and ensuring that oral health remains central in discussions of universal health coverage.

In short, the levers that matter most are economic (funding prevention), structural (addressing workforce shortages and roles) and regulatory (keeping oral health focused on essentials). Together, these can make oral healthcare more affordable and accessible, particularly for vulnerable and underserved communities.

Integration of essential oral care into primary healthcare is a core element of the WHO strategy. What are the most promising models of this integration in Europe, and how can we ensure that they are scalable and sustainable? Are there any common difficulties in pursuing this integration?
Within the WHO European Region, one promising initiative is the brief intervention programme that promotes the idea that every primary care provider—whether a doctor, nurse or dentist—should deliver consistent risk and health advice. This approach reinforces the idea that oral health is inseparable from general health.

“Every primary care provider—whether a doctor, nurse or dentist—should deliver consistent risk and health advice.”

There are several effective integration models already emerging in Europe. In dentistry, for example, some practices are incorporating general health screening into routine dental visits, such as measuring blood pressure during periodontal examinations or assessing blood glucose levels given the strong links with diabetes and cardiovascular disease. During the COVID-19 pandemic, we also saw dentists participating in vaccination programmes—an example of how oral health professionals can contribute to wider public health needs. Similarly, tobacco cessation advice and other lifestyle counselling can be readily delivered in dental settings.

The Netherlands have highlighted this as a measure of best practice, routinely referring patients for dental screening as part of a comprehensive health evaluation. This ensures that oral health is not overlooked in vulnerable populations. The UK has also piloted models in which dental teams screened patients for cardiovascular risks, and there are encouraging early results in the identification of previously undiagnosed conditions.

Of course, challenges remain. Dentistry has historically been siloed from mainstream healthcare, so integration requires a cultural shift—both for dentists to see themselves as part of the broader health system and for other healthcare professionals to accept oral health as part of their remit.

You’ve spoken about the importance of aligning oral health messaging with political and public priorities. How can oral health advocates better frame their messages to gain the attention and action of policymakers?
One of the key lessons that we have learned through the Platform for Better Oral Health in Europe is that effective advocacy begins with aligning our agenda to the political priorities already on the table. For example, cardiovascular health is currently a major focus at EU level. Rather than approaching policymakers with a separate agenda, we link oral health to cardiovascular disease, which is already on their radar. Similarly, regarding the EU Tobacco Products Directive, we emphasised the connection with oral cancer and periodontal disease. By positioning oral health within existing policy debates, we gain far greater traction.

It is also important to use language that resonates beyond the dental community. In the past, oral health advocacy was often framed in technical or clinical terms. Today, we talk in terms of cost-savings, quality of life, employment and social participation. For instance, poor oral health can mean lost school days, missed work or reduced confidence in job interviews. One in three young people say that oral health affects their job—a tangible reality for policymakers.

Finally, oral health needs to be presented as an integral part of everyday life, not as a separate issue. It affects mental health, social inclusion and healthy ageing and is relevant to a wide range of environmental topics—including clean water and mercury regulation. Our goal is to ensure that oral health is embedded not only in every health policy but also across broader EU policies where it has an impact. By aligning with political priorities, speaking in accessible and relatable terms, and grounding our arguments in solid evidence, oral health advocates can capture attention and drive meaningful policy action.

“Our goal is to ensure that oral health is embedded not only in every health policy but also across broader EU policies where it has an impact.”

The WHO strategy emphasises that responsibility for progress does not rest solely with governments. What role do you see for professional associations, academic institutions and even patients in advancing the oral health agenda in Europe?
One of the biggest challenges in oral health, compared with other areas of health, is the absence of a strong patient or public voice. This makes it even more important for oral health associations, academic institutions and patients themselves to step up in advancing the agenda.

Oral health associations have a critical role to play. Within the Platform for Better Oral Health in Europe, for example, we leave our professional arguments at the door and focus on the public health perspective. Oral health associations can bring evidence, highlight inequalities and advocate for oral health as part of overall health. They can also ensure that continuing education equips dental professionals with a deeper understanding of public health and of the place of oral health in the broader health system.

Academic institutions are equally important. They shape the training of future professionals and must ensure that curricula go beyond technical skills to include prevention, health economics and interdisciplinary collaboration. This helps to embed oral health more firmly into universal health coverage and non-communicable disease strategies.

For patients and the public, the key is building stronger representation. That means supporting champions who are willing to share their stories—whether they are community members, people living with oral cancer or even well-known figures whose experiences can resonate widely. These voices bring real-life meaning to statistics, helping policymakers and professionals alike to understand the human and social impact of poor oral health.

What are your top priorities going into the UN high-level meeting? What kind of political commitments or alignment from EU member states would signal meaningful progress?
Our top priority going into the UN high-level meeting is for oral health to be explicitly recognised within the non-communicable disease agenda. That recognition—acknowledging both the global and European burden of oral disease—would mark a major step forwards.

Equally important is ensuring that oral health is connected to the broader policy discussions around shared risk factors such as tobacco use and alcohol and sugar consumption. We would like to see those risk factors addressed in the declaration and Europe committing to uphold strong standards in these areas. That would give us the political momentum to move forwards at national level.

Only a few months ago, oral health risked being left out altogether, so its inclusion would already be a meaningful achievement. Longer term, we would like to see concrete goals—such as commitments around sugar taxation, alcohol control and self-care—but these discussions can only happen once oral health is firmly on the agenda.

So, for this meeting, a clear mention of oral health in the declaration and the inclusion of the main risk factors would already represent significant progress. It would signal that EU member states are ready to translate global recognition into national policy discussions and that oral health is finally gaining its rightful place in the wider non-communicable disease framework.