EFP reacts to Zero Draft of 4th UN High-Level Meeting: "Time to put the mouth back into the body"

The European Federation of Periodontology (EFP) has voiced deep concern over the omission of oral health from the Zero Draft of the political declaration for the upcoming 4th United Nations High-Level Meeting on Non-Communicable Diseases (NCDs). This silence comes despite overwhelming global evidence that oral diseases - particularly gum disease (periodontitis) and tooth decay - are among the most prevalent and costly health conditions worldwide.

In 2019, oral diseases affected over 3.6 billion people more than diabetes, cardiovascular disease, cancer, chronic respiratory disease, and mental disorders combined. The economic toll is staggering, with direct treatment costs for caries, severe periodontitis, and tooth loss estimated at $357 billion annually—almost 5% of global health expenditure.

Yet, beyond the numbers, lies a profound human cost. In 2021, oral diseases accounted for more years lived with disability than any other Level 3 disease. These conditions significantly impair speech, nutrition, daily function, mental and social wellbeing, and quality of life. There is also clear scientific evidence linking periodontitis with an increased risk of systemic NCDs, including diabetes and cardiovascular disease, and with premature mortality.

"Oral diseases are not just about teeth: they are about lives," says Professor Spyros Vassilopoulos, EFP president. "We must stop treating the mouth as separate from the body. Neglecting oral health undermines the credibility of any strategy on non-communicable diseases."

As a board member of the Platform for Better Oral Health in Europe, the EFP supports its recent statement and reiterates its call for the inclusion of oral health in the final political declaration of the 2025 UN High-Level Meeting. The EFP also urges all member states to uphold the 2024 Bangkok Declaration by the World Health Organization (WHO), which affirms that "there is no health without oral health," and to integrate oral care into national health policies and public health frameworks.

Oral diseases are largely preventable. Evidence shows that prevention-focused strategies, particularly those promoting effective self-care for periodontal health, can result in major cost savings. In Europe alone, such approaches could save billions of euros per decade. Moreover, the burden of oral diseases falls most heavily on disadvantaged populations, amplifying health inequalities. Tackling these conditions through preventive care can help narrow these disparities and deliver substantial societal benefits.

The EFP is a strong advocate of the WHO’s Global Strategy on Oral Health (2023–2030), which provides a framework for integrating oral health into universal health coverage and broader NCD policies. It urges EU institutions and national governments to align with this vision and ensure oral diseases are not overlooked in future global health declarations.

"It is time to act," says Professor Anton Sculean, EFP secretary general. "The evidence is there. The solutions are there. What we need now is political will. Oral health must be recognised, resourced, and integrated into the global response to non-communicable diseases."

The EFP calls on the EU and its member states to support WHO efforts and ensure that oral health features prominently in the final declaration of the 4th UN High-Level Meeting. Only then can we truly claim to address the burden of NCDs, and finally put the mouth back into the body.

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