Executive Summary: National Oral Health Research Strategy Development – April 2023

Introduction

Oral health and oral health care in Canada and internationally are at an important watershed moment with significant potential to take significant steps forward. Internationally, it has been recognized that dental decay is the most common non-communicable disease globally and that gum disease and oral cancer, among other oral diseases, also make-up significant global health problems. Furthermore, these diseases and their significant impacts, such as pain, financial burden, time off work or school etc., are distributed unequally in populations, with the poorest, most marginalized groups suffering the highest burden of oral diseases. This pattern of significant and inequitable burden of oral disease is also true in Canada. Unfortunately, the traditional model of dental care is ineffective in managing this situation. Recognizing this, the WHO has decided to develop a global oral health strategy and related action plan. In this action plan, while also promoting “upstream” approaches to address social, commercial and political determinants of health, including oral health, the WHO has called for oral health care to be integrated into medical care and made part of universal health care. Recognizing the significant cost barrier to accessing dental care in Canada, the federal government introduced an interim Canada Dental Benefit in December 2022. This temporary benefit provides support to eligible families who need it most and gives children under 12 the opportunity to get much-needed dental care. The Benefit was the first step towards fulfilling the federal government’s commitment to the development of a long- term, Canada-wide dental care plan for all people living in Canada with an annual family revenue of less than $90,000, including children and adolescents, people with disabilities and elderly people. Budget 2023 announced $13 billion over five years (starting in 2023-24) and $4.4 billion ongoing to Health Canada to implement the Canadian Dental Care Plan, which could benefit up to nine million Canadians.

On top of this, Statistics Canada is currently running cycle 7 of the Canadian Health Measures Survey (CHMS), including an oral health element. Data and sample collection is in process and will be completed by December 2024, with the release of the data and samples for additional analyses due in 2026. This release of data and samples will enable researchers to compare the oral health of Canadians in 2023-24 with that from the last CHMS survey, including oral health measures, in 2007-09. The release of these new data and samples will also permit scientists to address multiple other important research questions, for instance, investigating links between oral and general health and the extent and determinants of inequities in oral health and oral health care.

In the meantime, there are also multiple advances in the world of health and science, as well as societal changes and challenges that need to be incorporated into oral health care and the training of oral health care professionals. Examples include: the integration of artificial intelligence and machine learning in science, health and health care; the use of advanced telecommunications in telehealth; the need to adopt more sustainable strategies and approaches in health care, including dental care, to reduce its impact on the climate; and the need to create more inclusive, equitable governance of health care systems, science and data management.

Given these global changes in health and science, as well as initiatives in oral health and oral health care internationally and in Canada, CIHR’s Institute for Musculoskeletal Health & Arthritis (IMHA) has decided that this is an excellent opportunity to create Canada’s first national oral health research strategy (NOHRS;). In collaboration with key stakeholders (the Association of Canadian Faculties of Dentistry [ACFD], Canadian Association of Dental Research [CADR], Network for Canadian Oral Health Research [NCOHR], Canadian Dental Association [CDA], Canadian Dental Hygienists Association [CDHA], the Denturist Association of Canada [DAC] and the Canadian Dental Therapists Association [CDTA]), IMHA organized an in- person meeting to initiate the creation of this NOHRS in March 2023, in Ottawa. This document outlines the main research themes emerging from that meeting, as well as the next steps towards publishing the NOHRS in March 2024.

NOHRS meeting goals

  1. Convene a broad community of people committed to better oral health to work toward a national oral health research strategy.
  2. Discuss potential themes and also priorities for a national oral health research strategy.
  3. Co-create the next steps and overall plan for a national oral health research strategy to be launched in September 2024Footnote *.

Emerging, draft research themes

The following is a list of research themes emerging from the aforementioned meeting. This list of six themes is initial and draft, not final, i.e. it is recognized that through further consultation over the coming months, this list is likely to evolve. Furthermore, the order of themes in the list does not reflect any form of priority.

Next steps

This draft list of research themes for the NOHRS is a starting point towards a final document in March 2024. Going forward, we anticipate the process to include the steps outlined below, although we will likely adjust the plan as we receive feedback, create the teams preparing the NOHRS and move forward over the coming months:

Addendum: In line with the plan detailed in the next steps, a steering committee was convened in April 2023, co-chaired by Dr. Leigha Rock and Dr. Paul Allison, with representatives from CIHR- IMHA, CADR, ACFD, NCOHR and the national oral health professional members’ associations: Dr. Raj Bhullar, Ondina Love, Dr. Belinda Nicolau, Dr. Robert Schroth, Dr. Sonica Singhal, Dr. Ana Miriam Velly, Iona Worden-Driscoll, Dr. Karim Khan, Dr. Dawn Richards, Dr. Hetty Mulhall, Dr. Rosie Twomey

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