Whole-Body Health

Oral health has often been isolated within health systems in many countries, separating the mouth from the body and underestimating the importance of oral health for general health. Many oral diseases share common social determinants and modifiable risk factors with the most common noncommunicable diseases (NCDs), making oral health a key indicator of overall well-being. In recent decades, evidence and understanding of systemic disease and the distribution of dental pathogens throughout the body has increased.

Understanding the circular relationship between oral and general health

Oral health is a basic human right and vital to maintaining general health and a good quality of life. Moreover, the WHO Bangkok Declaration “No Health without Oral Health” clearly articulates how integral a healthy mouth is to overall physical health, mental health and wellbeing. The Whole-Body Health project is focused on raising awareness of what is now reorganised as a circular relationship between oral and general health, with each impacting the other in a continuous manner, by acknowledging and promoting the latest research in this area. It also aims to encourage individuals and National Dental Associations to advocate for the inclusion of oral health into national non-communicable disease (NCD) strategies.

Unfortunately, the wide spectrum of oral diseases such as caries, periodontal disease, dental trauma, dental erosion, and mouth cancer continue to be a major global public health challenge. Poor oral health and untreated oral diseases are associated with multiple health conditions including cardiovascular diseases and increased risk of stroke, and diabetes which has a circular relationship with periodontal disease, each able to influence and worsen the other. Periodontitis during pregnancy is linked to low birth weight, preterm birth and pre-eclampsia.

In patients with chronic kidney disease, it may lead to a worse long-term prognosis. Further associations are known between oral health and osteoporosis, obesity, Alzheimer’s Disease, respiratory diseases (including COVID-19), inflammatory bowel disease and rheumatoid arthritis.

Given the strong associations between oral health and NCDs, poor oral health should also be considered a risk factor for NCDs beyond oral diseases. For this reason, the Whole-Body Health project strives to promote access to integrated care services that include oral health.

Project Goals

Goal 1

Raise awareness of the importance of whole-body health in oral healthcare.

Goal 2

Provide guidance for health professionals to communicate with their patients about oral-systemic disease.

Goal 3

Support and encourage National Dental Associations to advocate for the inclusion of oral health in national NCD action plans and strategies, consistent with FDI’s Vision 2030 advocacy strategy.

Whole-Body Health Diagram

New research is constantly emerging that associates oral health with overall health independently of common risk factors. As oral healthcare and medical professionals, it is important that we understand the strength of this research evidence base and can communicate it to our patients and use it to advocate for enhanced and integrated care plans.

The FDI Whole Body Health platform is designed to share with you the latest research linking oral health with overall health and support your exploration of these relationships. Given the need for an overarching assessment of the maturity of the field and quality of evidence, an Evidence Mapping frameworks approach has been adopted that focuses on the quantity, diversity, and structural maturity of the literature rather than pooled statistical analysis.

The evidence hierarchy for each health condition has been assessed according to its baseline structural maturity and graded as nascent, emerging, established, mature. A high-level grading scale has then been employed to rate the maturity of the field for each condition as: Speculative, Associative, Causal-probable, Validated. These terms are explained in more detail below.

We hope you find the platform enlightening, and as new research emerges this page will be updated.

Categorisation of the Evidence Hierarchy:

Nascent (Very Low): Case reports, expert opinion, mechanistic studies/lab models.
Emerging (Low): Cross-sectional studies, retrospective case-control studies.
Established (Moderate): Prospective cohort studies with longitudinal data.
Mature (High): Multiple randomized controlled trials (RCTs) or large-scale, multi-site studies.

High-Level Grading Scale:

Level-1 (Speculative): Mainly lab/animal data or small, unreplicated human studies; high risk of bias.
Level-2 (Associative): Strong observational links, however causal directionality or confounding is unproven.
Level-3 (Causal-Probable): Longitudinal human data with consistent dose-response and well-controlled for confounders.
Level-4 (Validated): Trial data that has been replicated or definitive prospective evidence.