PERSPECTIVES
The role of the FDI World Dental Federation in global oral health
Habib M. BenzianI,1; Charlotte NackstadII; Johann T. BarnardIII
IDevelopment and Public Health Manager, FDI World Dental Federation, 13 chemin du Levant, L'Avant Centre, 01210 Ferney-Voltaire, France (email: hbenzian@fdiworldental.org)
IICommunications Manager, FDI World Dental Federation, Ferney-Voltaire, France
IIIExecutive Director, FDI World Dental Federation, Ferney-Voltaire, France
The FDI World Dental Federation is a federation of 157 dental associations in 136 countries, representing more than 900 000 dental professionals worldwide. Its main roles are to bring together the world of dentistry, to represent the dental profession on a global level and to stimulate and facilitate the exchange of information across borders.
The idea of forming an international dental federation was first discussed at a meeting of the Copenhagen Dental Society, held in Copenhagen in 1894. In 1900, during a congress in Paris, the Fédération dentaire internationale (FDI) was created in order to "forward dental education".
As one of the two oral health-related nongovernmental organizations in official relations with WHO, the FDI has a long history of collaboration with the Organization, which is based on the FDI's mission "to promote optimal oral and general health for all peoples".
Key activities of the FDI
Policy-making
In order to contribute to the development and dissemination of policies, standards and information related to all aspects of oral health care around the world, the FDI issues policy statements that set out current thinking on various issues related to oral health, the practice of dentistry and dental public health. These declarations, which are based on evidence where possible and are also the results of consensus among groups of experts, are disseminated to oral health professional organizations worldwide and serve as templates for national policy formulation.
Representation
Acting on behalf of its member associations, the FDI is the global voice of dentists and other oral health professionals. The legal framework of the practice of dentistry and other professional issues are elements of the FDI's representative functions with WHO, the United Nations and the European Union. The FDI protects the interests of its member associations and promotes the formation of professional organizations in countries where there are none. Adherence to the FDI and access to the support of the international family of health professionals helps such organizations to develop and strengthens their role at the national level.
Advocacy
Focus on the gaps and inequalities in oral and general health status is a major public health activity of the FDI, which promotes appropriate policies, education and technology. The reduction of risks to health such as tobacco use and high sugar intake are on the FDI's agenda for action, as well as the promotion of fluorides to prevent dental decay.
Interaction
The Annual World Dental Congress organized by the FDI is a major event aiming at information sharing between all stakeholders in international oral health. It is also a major source of income for the Federation. The official relations with WHO and other international organizations are of crucial importance for implication in consensus building, advocacy and policy formulation at the highest international levels. A strong, comprehensive set of ethical guidelines governs these relations, and is important to safeguard the independence and credibility of the FDI.
Achievements in FDI-WHO collaboration
Global goals for oral health
In 1981, the FDI and WHO jointly established global goals for oral health for the year 2000 (1). During the following decades most high-income countries reached or even exceeded these goals, but for many low-income countries they remain a remote aspiration. A joint working group composed of the FDI, the International Association for Dental Research (IADR) and WHO developed new goals for oral health for the year 2020 (2), whose focus draws on the experience and evaluation of the previous goals and acknowledges the recognition of oral health as an integral part of general health. The new goals also encourage a broader view of oral health and indicators by including other diseases and conditions as well as dental caries.
Oral health in the African Region
In April 2004, FDI organized the Planning Conference for Oral Health in the African Region, cosponsored by WHO. The aims of the conference were to sensitize political leaders to the link between oral health and general health, to raise awareness of oral health issues in the region, and to propose effective strategies to integrate oral health into existing health-care systems.
Participants approved the Nairobi Declaration on Oral Health in Africa (3). The declaration recognizes that good oral health is a basic human right and emphasizes that oral health is an integral part of general health and is subject to the same determinants. Governments and all stakeholders were urged to increase their efforts to provide appropriate, safe and affordable oral health services for all.
National oral health policies
A workshop was jointly organized with the WHO Regional Office for Africa in February 2005 to develop a draft framework for a national oral health policy for Rwanda for 20052010. For the first time ever, a vision for oral health in Rwanda was formulated, and recommendations were made to the ministry of health in order to provide acceptable, affordable and accessible health services to all communities in the country.
Science transfer
The FDI does not undertake any research of its own but works (according to its mission statement) "to advance and promote the art, science and practice of dentistry". In close collaboration with the IADR and other organizations, the FDI organizes educational programmes to translate evidence into practice by facilitating the transfer of recent research findings to the oral health professionals of the world.
Tobacco control
From the outset the FDI was a strong supporter of WHO's Framework Convention on Tobacco Control and participated actively in all hearings, consultations and negotiations as a member of the Framework Convention Alliance. The FDI promotes and advocates for a more active role of the dental team in tobacco control and encourages its member associations in various ways to support this at their respective national professional and political levels. On World Tobacco Day 2005, a joint FDI/WHO advocacy guide for oral health professionals was launched (4).
Future activities and challenges
The FDI will play a crucial role in resolving important issues for oral health and for the dental profession in the near future, some of which are described below.
The dental workforce and the misdistribution of oral health personnel in the world, both between and within countries, needs to be continuously monitored with regard to dentists, dental educators and allied personnel. The FDI will help to develop internationally accepted standards of care, workforce planning and integration in primary health-care systems. Illegal oral care is a major concern in many countries, as it puts patients at high risk.
Migration of both oral health professionals and patients will increase, posing difficult challenges to national health authorities and professional organizations. In cooperation with its partners, the FDI will foster the international coordination and dissemination of best practices.
The growing risks to health and oral health need to be tackled by all oral health professionals and their organizations in the most efficient and appropriate way, such as involvement of the dental team in tobacco control, nutritional advice and HIV prevention.
Making oral health care and preventive services available, accessible and affordable remains a major challenge. Further development of integrative approaches in general health programmes and primary health care is needed to improve access and to reduce inequalities.
Close collaboration between WHO and other organizations will be the key to meeting these and other global oral health challenges. WHO should use the opportunity offered by the FDI, with its expertise and global network, to increase and expand its activities in the area of oral health. 
Competing interests: none declared.
References
1. Aggeryd T. Goals for oral health in the year 2000: cooperation between WHO, FDI and the national dental associations. International Dental Journal 1983;33:55-9.
2. Hobdell M, Petersen PE, Clarkson J, Johnson N. Global goals for oral health 2020. International Dental Journal 2003;53:285-8.
3. Nairobi Declaration on Oral Health in Africa. Adopted at: Planning Conference for Oral Health in the African Region, 1416 April 2004, Nairobi, Kenya. Available from: http://www.fdiworldental.org/public_health/2_1nairobi.html
4. World Health Organization and FDI World Dental Federation. Tobacco or oral health. An advocacy guide for oral health professionals. Ferney-Voltaire; World Dental Press: 2005. Available from: http://www.fdiworldental.org/public_health/assets/Tobacco/
Tobacco_or_Oral_Health.pdf
1 Correspondence should be sent to this author.