WHO includes three dental preparations in list of essential medicines for first time

Global recognition of benefits from topical fluoride-containing preparations, glass ionomer cement, silver diamine fluoride hailed as 'huge step forward for oral health'

The World Health Organization announced Oct. 1 updates to its Model List of Essential Medicines for Adults and Children, three of which – topical fluoride-containing preparations (such as toothpaste), glass ionomer cement and silver diamine fluoride – are dental treatments featured for the first time.

The updated essential medicines list, which includes 20 new medicines for adults and 17 for children, had never deemed these dental preparations as essential until now.

“This marks a major achievement for oral health and public health,” said Jessica Meeske, D.D.S., immediate past chair of the ADA Council on Advocacy for Access and Prevention.

“As a practicing pediatric dentist who sees a large number of low-income, high caries-risk patients, I have seen the benefits of fluoride, glass ionomer cement and silver diamine fluoride, and I am glad that their usefulness is recognized globally as essential.”

Under the leadership of Benoit Varenne, D.D.S., Ph.D., Dental Officer at WHO Headquarters in Geneva, Switzerland, the NYU Dentistry WHO Collaborating Center for Quality-improvement, Evidence-based Dentistry supported the applications for all three dental treatments for submission to the WHO Expert Committee, which included coordinating contributors, gathering evidence and drafting the application dossiers.

Adding them to the list for adults and children is a huge step forward for oral health and the prevention and treatment of dental caries, said Habib Benzian, D.D.S., Ph.D., co-director of the NYU Dentistry WHO Collaborating Center for Quality–improvement, Evidence-based Dentistry and research professor at the NYU College of Dentistry.

“With untreated caries affecting more than 2.5 billion people around the world, we need to change the paradigm towards priority for prevention and highly cost-effective care,” he said. “With the new essential medicine list now in place, stakeholders must ensure the dental preparations reach those who need them. This will require the translation of the global recommendations to national policy and action, including universal availability, steady supply, affordability and use of the essential dental medicines in primary oral health care.”

Sodium fluoride — without any further specification and as the only dental substance — has been on the WHO Model list since 1973 under the category of essential micronutrients, Dr. Benzian said, but the fact was not widely known and it had no visible public health effect. This update of the WHO essential medicines list includes a new section on dental preparation, he added, and the previous listing for fluoride was transferred from the section for essential micronutrients to the new section for dental preparations.

The executive summary of the report said that its executive committee noted that the burden of oral diseases, particularly untreated dental caries, represents a significant public health problem globally.

“The committee noted that these products offer relevant benefits and can be used in atraumatic restorative treatment techniques and in non-specialized settings in alignment with WHO guidance on oral health interventions,” according to the summary.

The lists are updated every two years by an expert committee, made up of recognized specialists from academia, research and the medical and pharmaceutical professions.

The decision came months after the WHO adopted a resolution on oral health  calling for the development of a global strategy, action plan, and monitoring framework for improvement of oral health globally until 2031, its first resolution on oral health since 2007.

The World Health Organization model list of essential medicines and those for children is found online.