The bigger picture

We operate in small regions of the mouth in a compact (but indisputably important) area of the body, using precision instruments and relying on tiny adjustments in metrics to guide our advice on prevention and on treatment progress. While that is as it should be, there is a considerable risk that we miss the bigger picture, the context in which we and our teams and patients exist, the wider world that influences and dictates important changes in our otherwise microcosmic working environment.

Some years ago, in discussions with the previous editor Mike Grace, we pondered on what readers really valued and wanted from the BDJ. We settled on one key word. Survival. What does a dentist need to know to survive? This has a graduation from survival in the surgery, then the practice, the high street, the town or city escalating to the country and ultimately the world. It is a concept that can be applied to virtually all our daily activities. What affects us as individuals, family members, work colleagues, citizens, nationals and humans? An aching back through to the prospect of nuclear war, the progression is fairly simplistic but easy to conceptualise. Perhaps, think globally act locally.

With the BDJwe have been attempting for some time to include an awareness of this progression, balancing for example, the detail of the clinical refinements of minimal intervention techniques through to the complexity of dental care delivery systems to wider considerations of sustainable dentistry. To this end, we joined dozens of other international journals in 2021 by simultaneously publishing an editorial from the Health Alliance on Climate Change, of which the BDA is a member organisation.¹ For the cover series of this volume of the journal, we are taking this one stage further by considering the United Nation's Sustainable Development Goals (SDGs) and the relevance they have to dentistry, our patients and their oral health. At its heart, the 17 SDGs are an urgent call for action by all countries, developed and developing, in a global partnership. They recognise that ending poverty and other deprivations must go hand-in-hand with strategies that improve health and education, reduce inequality, and spur economic growth, all while tackling climate change and working to preserve our oceans and forests.

Our aim here is not to blame [...] or paint a pessimistic view but to raise an awareness of how larger factors affect the smallest, yet still significant, determinants of health

That may seem like a bit of stretch from measuring a 6 mm periodontal pocket on the distal aspect of an upper right first molar, yet the chain of cause and effect links all of our actions and concerns. Our aim here is not to blame, to wag a finger or paint a pessimistic view but to raise an awareness of how larger factors affect the smallest, yet still significant, determinants of health and delivery of care. The 2030 Agenda for Sustainable Development was adopted by all United Nations Member States in 2015 and provides a shared blueprint for peace and prosperity for people and the planet, now and into the future. The SDGs build on decades of work by countries and the UN, including the UN Department of Economic and Social Affairs. Transforming our world: the 2030 Agenda for Sustainable Development with its 17 SDGs was adopted at the UN Sustainable Development Summit in New York in September 2015, supplemented by the Paris Agreement on Climate Change (December 2015) and is now represented by the annual High-level Political Forum on Sustainable Development which serves as the central UN platform for the follow-up and review of the SDGs.

Although there are 17 SDGs, we only have 12 covers in a volume so we have had to select the dozen that we feel are most appropriate for this purpose but not necessarily the most important overall. The full list is: No poverty; zero hunger; good health and wellbeing; quality education; gender equality; clean water and sanitation; affordable and clean energy; decent work and economic growth; industry, innovation and infrastructure; reduced inequality; sustainable cities and communities; responsible consumption and production; climate action; life below water; life on land; peace, justice and strong institutions; partnerships to achieve the goals. Readers are urged to check out the fuller details at https://sdgs.un.org/goals. For each issue between now and December, we will also publish content and contributions relevant to the illustrated SDG. Some of this will reference work already published as in the case of this issue with SDG 1 No Poverty, through from news items to opinion and research papers.²

While stressing survival, our intention is not to be alarmist nor to add to already stressful lives and livelihoods, rather to add some prompts about the importance of raising our eyes from saliva and contact points to clean water and building sustainable cities and communities.