Oral Health in the Age of Climate Change

In recent years, the Intergovernmental Panel on Climate Change (IPCC) has raised concerns about the population health implications of a changing climate. ¹ Hazardous air quality, extreme temperatures, poor water quality, and intensified extreme weather can cause serious health risks among communities, particularly those that are highly susceptible to a changing climate. ² While its direct and indirect effects on general health have been extensively documented, its implications on oral health are largely underresearched. ³

Evidence suggests that climate change can exacerbate socio-economic vulnerabilities, significantly impacting access to dental care and the dynamics of oral diseases. ³ For instance, climate change can affect the pathogenesis of dental caries or periodontitis due to changes in the transmissibility of oral microbes associated with direct contact with environmental stressors. ³ Furthermore, extreme weather events such as floods or excess rainfall can result in poor drinking water supplies, which can further influence the prevalence of oral diseases such as dental fluorosis or dental erosion, increasing oral health inequality. ⁴ Despite this, the biological pathways linking climate and oral health are unclear.

Currently, the majority of scientific literature focuses on exploring a possible association between environmental exposure and population oral health outcomes or related epidemiological studies that can reflect on the causality of this association. For instance, emerging evidence from time-series studies has revealed that higher pollution levels or lower temperatures can increase the risk of pulpitis, periodontitis, and oral cancers, with lag effects varying from day 0 to up to 15 days.^{5, 6} However, an indication of association does not reflect impact pathways, thereby limiting our understanding of this subject. Therefore, with this letter, we would like to draw your attention to the urgency of the matter and how future studies can be shaped to fill this evidence and knowledge gap. Recently published scoping reviews and narrative summaries have proposed a directive blueprint for future studies.^{3, 4} They suggested that comprehensive but individual-level-focused epidemiological studies must be conducted to understand the mechanism of action on the body’s physiology. We want to emphasize that future studies, in addition to what existing literature suggests, should focus on regions with higher vulnerability to a changing climate, particularly in Sub-Saharan Africa and South Asia.

With a changing climate and intensified frequency of extreme events, prioritizing dental care can lower the burden of climate-induced health shocks. Evidence from future studies will be instrumental in guiding our understanding of climate-resilient dentistry with suitable mitigation and adaptation measures and guiding policy decisions at the intersection of climate and oral health.