2019–2020
ANNUAL REPORTAn Overview from the Global Chair
This has been a very busy and productive year for the ACFF (www.acffglobal.org) and it is a pleasure to summarise some of the key activities and achievements in this Annual Report. I would like to share updates on the 5elements of the Charity’s current global focus:
1.

Expanding and improving partnerships – The Global Collaboratory for Caries Management,
led by King’s College London and its International Partners, links the work of the ACFF withthat of the ICDAS Foundation – through both the ICCMS™ (www.iccms-web.com) and
CariesCare International (www.cariescareinternational.com). This synergistic collaborative
activity has been developing well over the past year. Other partnerships, such as with the IAPD
(International Association for Paediatric Dentistry), and International Education Associations
have also been developed.

2.

Driving Policy development – A wide range of stakeholders have been brought together thisyear working at the third of our unique Dental Policy Labs to co-create a practical road map
to take us ‘Towards Oral and Dental Health through Partnership”. This Lab complements theprevious two and brought together representatives of the oral health and dental industries withChief Dental Officers, Behavioural Change and Policy experts. Together they explored how
industries can both assist and benefit from “enabling positive behaviour in caries prevention andcontrol amongst patients and the public”.

3.

Supporting local Chapters – In this Report we only have space to include highlights from 7 ofour 28 Chapters across the Continents. The highlights this year are from Chapters in locations
ranging from Colombia to Japan, to “Pan-Europe”, to Spain, to North Africa/Middle East andto India. They are all carrying out a wide range of activities to meet the ACFF Global Goals,
as well as local Goals which reflect local priorities, cultures and needs. These activities are ademonstration of the ACFF “Global” approach (in which Global aims are delivered locally).

4.

Aligning on best practice – We have been working on securing implementation of best evidence
to improve caries prevention and management through both ICCMS™ – the International
Caries Classification and Management System (which is focussed on the domains of Research,
Public Health and Education) and CariesCare International (focussed on delivering ICCMS™
in dental practice). This work has built on sequential evolution over the last decade which
has culminated this year in: i) a new FDI Policy Statement on ‘Carious Lesions and First
Restorative Treatment’ and ii) the publication of the CariesCare International Practice Guide
incorporating the “4Ds” approach to Caries Management.

5.

Building an effective, collaborative, multi-stakeholder network – ACFF has been continuing
to utilise the “Win6 Cube” approach to consider the needs of and to communicate with key
stakeholders locally and globally. These include Dentists and their teams; Governments and
Health Systems; Patients and the Public; Payers and Insurers; Guidance producers; and theDental and Oral Health Industries. The report from the 3rd Dental Policy Lab provides a
strategy going forward for implementing the outputs of all three Labs through the new ‘King’s
College London/ACFF Dental Policy Lab Network’.

I hope that you find the information in this 2019/20 Report useful, please do consult the ACFF website(www.acffglobal.org) if you need further information about how the ACFF and its Partners are continuing to
make progress in achieving our Global Goals and moving towards a Cavity Free Future.
Professor Nigel Pitts: ACFF Global Chair, King’s College London
The ACFF fully recognise that the world has changed due to the Covid-19 pandemic.
Please be assured that the ACFF and GCCM remain well and are working virtually.

ACFF(cont’d)
Chapters 2019-2020
The Alliance is formed of 28 Chapters spanning over 40 countries worldwide and a
growing ACFF Members network which draws together interested parties fromaround the world, collaborating to work towards a Cavity-Free Future.

Colombia .  .  .  .  .  .  .  .  .  .  .  .  .  .  . May 2011
Mexico.  .  .  .  .  .  .  .  .  .  . September 2011
Brazil.  .  .  .  .  .  .  .  .  .  .  .  .  . January 2012
Venezuela. .  .  .  .  .  .  .  .  .  .  .  .  . April 2012
China.  .  .  .  .  .  .  .  .  .  .  . September 2012
Central America .  .  .  .  .  .  .  . June 2013
Pan-Europe.  .  .  .  .  .  .  .  .  .  .  .  . July 2013
Turkey.  .  .  .  .  .  .  .  .  .  .  .  .  . August 2013
Malaysia .  .  .  .  .  .  .  .  .  .  . October 2013
Greece.  .  .  .  .  .  .  .  .  .  . December 2013

Australia/
New Zealand .  .  .  .  .  .  .  . January 2014
India. .  .  .  .  .  .  .  .  .  .  .  .  . February 2014

France.  .  .  .  .  .  .  .  .  .  . November 2014
Slovakia. .  .  .  .  .  .  .  .  .  .  . January 2015

Philippines.  .  .  .  .  .  .  .  .  .  .  .  . May 2014

North Africa/Middle East
(NAME).  .  .  .  .  .  .  .  .  .  .  . February 2015

South Africa .  .  .  .  .  .  .  .  .  .  . June 2014

Italy.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . April 2015

Central Eastern
Europe.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . June 2014

Thailand. .  .  .  .  .  .  .  .  . September 2015

Russia .  .  .  .  .  .  .  .  .  .  . September 2014

Canada/United States .  .  .  .  .  .  . October 2015

Nigeria.  .  .  .  .  .  .  .  .  .  .  .  . October 2014

Nordic .  .  .  .  .  .  .  .  .  .  .  . February 2016

Poland .  .  .  .  .  .  .  .  .  .  .  .  . October 2014

Japan. .  .  .  .  .  .  .  .  .  .  .  . February 2018

Czech Republic. .  .  .  .  .  . October 2014

Spain. .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . June 2019

WWW.ACFFGLOBAL.ORG

UpdateThe Global Collaboratory for Caries Management (GCCM) – 2019/20
There are three already successful elements with compatible goals which are being brought together into anumbrella group, to scale up and integrate in order to make bigger and more sustainable global differences andreduce duplication of effort. The 3 elements are:
• ACFF – Alliance for a Cavity-Free Future – with its wide range of activities and 28 Chapters(International integrated policy and prevention focussed charity and Network led from King’s)• ICDAS Foundation – International Caries Detection and Assessment System(International health-professional focussed charity and Network led from King’s)• King’s College London UK and International Partners – (the caries focus here, with Partners, is spread
across Education, Research, Quality Improvement and Implementation Science with the wider King’s
network, including its Policy Institute)and partners

GCCM

Global Collaboratory
for Caries Management
working withICDAS Foundation and ACFF

International Caries Classiﬁcation and Management System – ICCMS™
= ICCMS™ in Practicewww.acffglobal.org www.kcl.ac.uk/dentistry/research/impact

www.iccms-web.com

www.icariescare.com

The overall concept of the Collaboratory: bringing together proven networks and Global links fromACFF and ICDAS with related expertise from King’s and its Partners in key areas to work together
synergistically. The concept links to King’s “Vision 2029” Strategy which is to “Make the World a
Better Place” – and in particular to its renewed “Service to Society” mission. This Collaboratory works
to address tooth decay across the lifecourse and has scaled-up and accelerated impact to a global level,
bringing together organisations, groups and individuals who share a common aim to make progress
towards a “Cavity-Free Future” in which primary, secondary and tertiary prevention of caries is delivered more effectively worldwide.
Building on both King’s research findings and the global evidence from the last two decades across caries
detection, assessment, care planning and prevention, GCCM has continued to facilitate international
impacts through implementing “ICCMS™ Guidance” and “joining-up” clinical and dental public healthactions. Recently it has also created impacts in new domains, including shifting international policy
towards preventive dental medicine.

WWW.ACFFGLOBAL.ORG1

Update (cont’d)
ACFF and IAPD Bangkok Declaration – August 2019
THE PRIORITIES ARE TO:EARLY
CHILDHOOD
CARIES   

ONE

TWO

RAISE AWARENESS OF
EARLY CHILDHOOD CARIES

LIMIT SUGAR INTAKE         
           FOUR
KEY AREAS
THREE

FOUR

PERFORM TWICE DAILYTOOTHBRUSHINGPROVIDE FIRSTPREVENTIVE GUIDANCE

    
  
 

 
           
  

An output from the IAPD Global Summit on Early Childhood Caries, 2018. This document was facilitated by support from the Alliance for a Cavity-Free Future.
Reference: Pitts, N, Baez, R, Diaz-Guallory, C, et al. Early Childhood Caries: IAPD Bangkok Declaration. Int. J Paediatr Dent. 2019;29: 384-386.

The ACFF was approached by the IAPD to help
secure change in the awareness, public health and clinical approaches to the frequently invisible, but severe,
global problem of Early Childhood Caries, a condition
that affects >600million children worldwide. The
outcome was that ACFF was asked to help IAPD withfacilitating a successful Global Summit on ECC; thiswas held in Bangkok in November 2018 and produced
a very widely distributed ACFF-led communication
tool, the “Bangkok Declaration on Early Childhood
Caries” (which has been published in all 7 International Journals of Paediatric Dentistry worldwide
and translated into 12 languages) which seeks to raiseawareness of the condition across public and medical
stakeholders, limit sugar intake under 2 years (for longterm caries, cardiovascular and obesity benefits), getfamilies to perform twice daily brushing with fluoride
toothpaste and find these children a dental home.

IAPD = International Associationof Paediatric Dentistry

FDI ADA Summit 2019, San Francisco – September 2019
On Saturday 7th September, the ACFF held its 10th Annual Summit meting in San Francisco at the FDI/ADA World Dental Congress 2019. The event was a success with broad coverage of ACFF’s activities over theprevious 12 months, and invited speakers covering issues around Early Childhood Caries, Modern Caries Management, and links between new classifications of Caries and Periodontal Diseases. Further details are available
here:
markets.businessinsider.com/news/stocks/alliance-for-a-cavity-free-future-tenth-annual-summit-focuses-onfresh-perspectives-for-comprehensive-oral-care-1028509294

2WWW.ACFFGLOBAL.ORG

Update (cont’d)
ICCMS™ Concepts endorsed by FDI - September 2019
Internationally, the FDI World Dental Federation represents all of the 200 National Dental Associations (NDAs)
and its World Dental Parliament debates and decides consensus FDI Policy Statements. In 2019 the FDI Science
Committee proposed a new, specific, FDI Policy Statement on “Carious Lesions and First Restorative Intervention”. This international guidance was adopted by the FDI World Dental Parliament at meetings held at San
Francisco in 2019 and has now been published on the FDI website (www.fdiworlddental.org/resources/policystatements/carious-lesions-and-first-restorative-treatment) and is being recommended to >1 million dentists in
200 National Dental Associations worldwide.
The new Policy Statement explicitly states that the “FDI World Dental Federation supports a shift in caries
management from restorative treatment to measures that arrest and prevent caries development including monitoring, following the concepts of International Caries Classification and Management System (ICCMS™).” In2019, parallel activity by a group of experts, including members of the ICDAS Foundation, also led to publicationin the British Dental Journal of the “CariesCare Practice Guide: consensus on evidence into practice (please see
below). A supporting British Dental Journal Editorial in the September issue advocated adoption of CariesCare
International “ICCMS™ in Practice” 4D model worldwide, and confirms that the Practice Guide is being
increasingly seen as a way of delivering both the new FDI policy as well as supporting upstream public healthapproaches to caries prevention.

Policy
FDI World Dental Federation supports a shift in caries
management from restorative treatment to measuresthat arrest and prevent caries development including
monitoring, following the concepts of International
Caries Classification and Management System (ICCMS™).

CariesCare International – September 2019
CariesCare International, launched in Copenhagen in 2018, isfocussed on delivering ICCMS™ in dental practice settings.
It is part of the ICDAS Foundation and has enjoyed a year of
great progress, publishing two key articles, first in the British
Dental Journal in September 2019. These are: ‘CariesCare
practice guide: consensus on evidence into practice’ and an accompanying example of its use in practice ‘Caries classificationand management in the context of the CariesCare International(CCI™) consensus: a clinical case study’. The Practice Guide
was developed and agreed following two Workshops held atKing’s College London and then cascaded wider, involving theconsensus recommendations of 44 experts from 17 Countries.
Members of the ACFF’s Expert Panel had significant input into
the process and these publications, and the effects of the papers
have already been far-reaching. Translations will be available
French, Spanish, German, Portuguese and Japanese (in national dental Journals and Associations), as part of systematic
local implementation. The papers are also now available on the
CariesCare International website (cariescareinternational.com).

WWW.ACFFGLOBAL.ORG3

Update (cont’d)Expert Panel Meeting, Washington - October 2019
On Friday 4th October 2019, members of the Alliance’s Expert
Panel travelled to Washington, USA for the annual Expert Panel
Meeting. The event, as is customary, covered much ground aroundthe numerous global developments of the ACFF, as well as enabling
discussion, reflection and planning for the future. We thank everyone involved with the Expert Panel Meeting for their commitmentin the planning and facilitation of this event, and to all attendees(many of whom travelled great distances in order to be present).
Members of the Expert Panel (pictured) include: Myron Allukian(USA), Ihsane Ben Yahya (Morocco), Marsha Butler (USA), Chet
Douglass (USA), Wendell Evans (Australia), Mikako Hayashi(Japan), Alice Horowitz (USA), Corrie Jongbloed-Zoet (Netherlands), Ari Kupietzky (Israel), Stefania Martignon (Colombia), Tim
Newton (UK), Rick Niederman (USA), Prathip Phantumvanit(Thailand), Nigel Pitts (UK), Livia Tenuta (Europe) and Mahesh
Verma (India).

Dental Policy Lab 2019, London, November 2019
The ‘Dental Policy Lab’ has been a successful, dynamic initiative first launched in 2017 by ACFF working
with the Policy Institute at King’s College London. The annual Dental Policy Labs have comprised a series ofcollaborative workshops that bring together a diverse group of experts, challenging them with solving a pressing
issue within clinical practice and public health policy. Dental Policy Labs 1 and 2 explored and addressed thesignificant questions: ‘How do we accelerate a policy shift towards increased resource allocation for caries prevention
and control?’ and ‘How can we create and implement acceptable prevention-based dental payment systems to achieve
and maintain health outcomes?’ respectively, with immediate impact on global health policy ensuing.
The 2017 Lab and the publication of its Report and Infographic has seen the French National Health Service(Assurance Maladie), the ICDAS / ICCMS™ Group, the Chief FDI Dental Officers/Dental Public Health
Section of FDI and other groups taking action based on the Lab’s findings.
The most recent 24-hour Dental Policy Lab took place from Monday 18th to Tuesday 19th November 2019,and focused on, and vigorously explored the overarching question of ‘How can the oral and dental health industries
benefit from enabling positive behaviour in caries prevention and control amongst patients and the public?’ With a rangeof participants from the oral and dental industries as well as behaviour change experts, and leaders from numerous
sectors including national public health, leading international dental and oral health organisations, and academics,
the 2019 Dental Policy Lab made significant breakthroughs. The feedback from this meeting was exceptional, withparticipants working together to co-create pragmatic and ambitious solutions to the complex issues addressed.

4WWW.ACFFGLOBAL.ORG

Update (cont’d)

Publication of the Dental Policy Lab 3 Report, March 2020
On 13th March 2020, the eagerly anticipated report resulting from the latest Dental Policy Lab was published,entitled ‘Towards Oral and Dental Health through Partnership: How can the oral health and dental industries benefit from enabling positive behaviour in caries prevention and control amongst patients and the public?’ (capturing theoverarching policy question addressed by the Lab). The report details the discussions and findings of the thirdand final Dental Policy Lab, lists the broad range of internationally influential academics and industry experts in
attendance, and provides a strategy for implementing the findings of not only this Lab, but the outputs of all three
through the new ‘King’s College London/ACFF Dental Policy Lab Network.’
Professor Nigel Pitts, Chair of ACFF Global commented that “The third Dental Policy Lab was unique, andexciting, and brought together a range of people who do not normally have the opportunity to collaborate.”
Professor John Girkin (Durham University and NirVisio Ltd.), a participant of the Dental Policy Lab echoed
this, confirming that “Getting together the large range of people that are in this Lab, from the people at the top of
public health through to the people that are at the top of the companies through to the people like me that invent
things, and bringing them all in the same room at the same time and hearing different people’s perspectives, thisis a huge benefit.”
Each Lab has seen enthusiastic ‘buy-in’ from all delegates, and this keenness was once again shown by attendees
at the latest Lab, particularly in forming the new King’s College London/ACFF Dental Policy Lab Network in orderto drive forward the plan of advancing the four key areas (identified in the report’s summary) in collaboration
with the King’s Global Collaboratory for Caries Management, with the end goal of achieving a cavity-free futureworldwide.
The Dental Policy Lab 3 full report can be viewed here: https://doi.org/10.18742/pub01-024 (click the title
under the ‘Documents’ subheading to download the full report) and a press release published in the British Dental
Journal is available to read here: https://www.nature.com/articles/s41415-020-1558-y

WWW.ACFFGLOBAL.ORG5

Update (cont’d)Launch of the website for CariesCare International – April 2020
The Executive of CariesCare International has worked over the year to build a range ofresources to help Dental Practices understand and implement the ICCMS™ 4D modelof care in routine clinical practice. A key part of this work was realised in April with thelaunch of an initial version of a new, dedicated, CariesCare International (CCI) website:

This website guides users through the advances made since the launch of CCI in Denmark (2018) and has
downloadable copies of the Consensus Guide for practice (and related clinical case) which have been publishedin BDJ and other journals. It also contains other relevant information on the history of ICDAS and ICCMS™,
the Executive Committee and team as well as news. The website will be fed with more content soon (including
e-learning on “How to implement CariesCare International (CCI) in the dental practice” - in Spanish andEnglish).
The CCI web page is linked to other related web pages (e.g. ICDAS/ICCMS™ and ACFF) and social media.
Web link: https://cariescareinternational.com
Facebook page: fb.me/cariescareinternational
Messenger: m.me/cariescareinternational
Twitter: @CariescareI

6WWW.ACFFGLOBAL.ORG

Partnerships Activity
Following the successful summit in Bangkok and resulting Bangkok
Declaration on childhood caries and subsequent 2019 ACFF World
Cavity Free Future Day campaign, the ACFF are pleased to reporton the continued, deeper collaboration with the IAPD, and will
work to continue this into the future.

The ACFF will be working closely with CariesCare International
this year, with a strategic focus on delivering Goal 4 of the ACFF
Global Goals (Goal 4 – “ACFF and its Chapters, members andpartners should work to promote integrated, comprehensive andlocally appropriate caries prevention and management systems andmonitoring approaches”). CariesCare International (CCI) is part of
the ICDAS Foundation charity promoting a patient-centred, riskbased approach to caries management designed for dental practice.
This comprises a health outcomes-focused system that aims tomaintain oral health and preserve tooth structure in the long-termby sharing the same goals as the International Caries Classificationand Management System (ICCMS™).
The 4D System takes the dental team through a four-step structured and practice-friendly process which leads to personalisedinterventions specific for each individual patient’s risks and needs.
The four interlinked steps in the cycle (4D’s) are:1st D:		
Determine caries-risk;
2nd D:		D
 etect lesions, stage their severity and Assess their activity
status;3rd D:		D
 ecide on the most appropriate care plan for the specificpatient at that time; and4th D:		Do the preventive and tooth-preserving care which isneeded (including risk-appropriate preventive care; control
of initial non-cavitated lesions; and conservative restorative
treatment of deep dentinal and cavitated caries lesions).

The ACFF have continued to work in partnership with both theInternational Federation of Dental Hygienists (IFDH) and International Association of Dental Students (IADS), both of which
are committed members of our Expert Panel.
The ACFF will be continuing to collaborate with its partnerorganisations in the future, with discussions around 2020 World
Cavity-Free Future Day already underway.

WWW.ACFFGLOBAL.ORG7

What Are Our Goals? (cont’d)What Are Our Goals?
The ACFF Goals are central to everything we do. Striving to meet each individual aim moves us
further towards achieving our stretch goal:
Goal 1 – Every child born in 2026 and thereafter should stay cavity-free during their
lifetime.
Goal 2 – ACFF and its Chapters will work towards ensuring that ninety percent ofdental schools and dental associations accept the philosophy behind the“new” approach of “caries as a continuum” in order to improve dental
caries prevention and management.
Goal 3 – A
 CFF and its Chapters will work collaboratively with a broad range oforganisations to achieve a reduction in caries inequality within and acrosscountries, in the context of both oral and general health.
Goal 4 – A
 CFF and its Chapters, members and partners should work to promote
integrated, comprehensive and locally appropriate caries prevention andmanagement systems and monitoring approaches.
In order to achieve these goals, we believe that global leaders, organisations and individuals–
such as country and community leaders, health and dental health professionals, public policy
and education communities, and the public – need to collaborate to learn more about caries,
and take the required action in order to influence change in behaviour, education and policy on
a local, regional and global level; this is reflected in the ACFF Declaration.

As a unifier, collaborator and global influencer, the ACFF’s work builds on existing country
initiatives by introducing a new understanding of caries as a disease continuum andhelping countries adopt more comprehensive strategies for caries prevention and management. Our goals help demonstrate the ACFF’s unwavering commitment to achieving
measurable success and driving change in the caries paradigm.

8WWW.ACFFGLOBAL.ORG

Digital NewsIn August 2019, the ACFF unveiled their brand new website, with the full site available in
English, French and Spanish. www.acffglobal.org

Since the global launch, sub-sites have been created by several Chapters, including Australia/New Zealand,
Canada/US, Francophone, Japan, Pan-Europe and Poland, with further expansion planned for 2020-21.
The Global website has a wealth of resources for professionals and the public and is updated frequently with news
stories. In addition, the website has a dedicated Members Section, offering the opportunity for interested individuals to become an ACFF member, free of charge, and receive networking opportunities, resources, a quarterly
newsletter and an invitation to join the private ACFF Members group on Facebook.

Colleagues from the Global Collaboratory teams
collaborated to design useful online e-learning via
the ICCMS™ website, along with numerous otherresources, all of which are available here:
https://www.iccms-web.com

WWW.ACFFGLOBAL.ORG9

World Cavity-Free Future Day 2019
World Cavity-Free Future Day (WCFFDay) is an initiative founded by
ACFF; it is celebrated annually around the world on 14th October, and 2019
marked its fourth year. As a global awareness day, it has been designed to bring
together dental and healthcare professionals and groups from around the world
to further spread the message that cavities are preventable and it is possible tostay cavity-free. The 2019 campaign was based on the theme ‘Babies are Sweet
Enough’ which aimed to spread the urgent message of Early Childhood Caries
and preventative actions. The 2019 World Cavity-Free Future Day received an
overwhelming amount of support, making it the biggest yet. Numerous campaigns and activities took place, including:• The Canada/US Chapter had an article published online at BabyGaga.com – this is a website that receives
an average of 325 million views per month.
• Our Colombian Chapter took on a variety of activities, including supporting a ‘Tooth Brushing Day’ inschools, with over 115,000 students partaking in this simultaneously!
• Our Malaysia Chapter ran a toothbrushing awareness session with 3,700 primary school children (attended
by the Malaysian Book of Records Committee too!), various community engagement programmes, andfeatured heavily in the national media.
• Our Spanish Chapter hope to have reached almost 40,000 people through working with their General
Council to promote the awareness day amongst dental professionals.
• Our Chapter in India worked with Maulana Azad Institute of Dental Sciences (MAIDS) to screen approximately 35,098 patients at Mobile Dental Clinics between January-August 2019, during which, the messagesof World Cavity-Free Future Day were promoted. The Chapter also partnered with the Department ofSocial Welfare, Government of Delhi, and through this programme, over 365 patients in recreational homes
were screened and referred for treatment.
• A national-level event was held at the Bureau of Dental Health in Thailand with the Minister of Public
Health opening the ceremony. During the event, the #BabiesAreSweetEnough campaign’s key messages
were communicated.

The ACFF would like to thank everyone who got behind this crucial awarenessday, and to our Chapters across the world who worked tirelessly to promote theimportance of good oral health in so many communities.

From left to right: national mobile dental clinics (India Chapter),oral health awareness sessions (Colombia Chapter) and toothbrushing awareness session(Malaysia Chapter).

10WWW.ACFFGLOBAL.ORG

Cariology Curricula
Shaping the Future of Dental Education, Brescia – April 2019
The Alliance for a Cavity-Free Future opened proceedings at the American Dental Education Association(ADEA) and the Association for Dental Education in Europe’s (ADEE) third annual ‘Shaping the Future of
Dental Education’ conference on Thursday 25th April 2019 in Brescia, Italy. The ACFF pre-meeting workshop
entitled Building and Sharing the Global Future for Caries Education and Practice, aimed to redouble global
efforts to improve the situation of untreated caries in adults being the most common health burden, as demonstrated by The Global Burden of Disease Study (with untreated caries in children ranked sixth). The following
six areas were addressed during the course of the workshop:-1.

Dental Policy Labs – the concept, findings, and impact to-date of the Dental Policy
Labs were presented, before addressing the key issues and next steps, including
preparing the future dental and health workforce for delivering effective caries
prevention and tooth preserving caries care; providing appropriate care for boththose already in the dental system and those outside it, paying for health in dentistry and understanding the nature of future dental practice.

2.

Understanding CariesCare International – the “Practice version” of ICCMS™ launched by the ICDAS Foundation in June 2018. This implements the essential
elements of good practice across the “4Ds”:»»»»

Determine caries risk,
Detect and assess lesions;
Decide on a patient-appropriate care plan and
Do preventive and tooth maintaining CariesCare.

3.

Enabling caries education, practice and research using e-Health and cloud-based
integrated health records using the Colombian National Consensus as a Pilot
exercise.

4.

Building dental team and inter-professional capability in caries care by improving
communication between dental and other health / community teams in training
and beyond.

5.

Taking forward a specific version of the International Cariology Curriculum adapted for young children using the key elements of the IAPD Bangkok Declaration for
Early Childhood Caries as a framework.

6.

Expanding the Global Collaboratory for Caries Management to share and further
develop standardised resources to improve caries education, caries care and health.

WWW.ACFFGLOBAL.ORG11

2019/20 Chapter Highlights
COLOMBIA

The Colombia Chapter have gone to great lengths to reach a number of communities throughout the country intheir campaigns and activities, and since launching their Facebook page, ‘Alianza por un Futuro Libre de Caries’
we’ve been able to follow their numerous achievements and innovation. During 2019, activities organised by the
Colombia Chapter, (or which they were heavily involved in) included:•
•
•
•
•
•

Intersectoral social care day in the municipality of Neira Caldas
Education on oral health for pregnant womenTranslation of resources from English to Spanish making them accessible to the Colombian community
Working with dental students at the Universidad Autónomade Manizales
Interventions for school children, teaching them how to brush
Visiting the indigenous shelter of San Lorenzo to share educational materials for children in the communities
to improve oral health• A huge event for over 1,000 children in Cali with activities based around oral health• Collaborative work, teacher exchanges, research and internships with the BUAP

JAPAN
17th February 2019: Annual general assembly in Tokyo			Reports on the financial situation and research activities in 2018 were presented, special
lectures were delivered, and the event was followed by a reception.
23rd-24th May 2019:	Symposium hosted by the Japan Chapter of the ACFF at the annual meeting ofJapanese Society of Oral Health in Shiga
			Professor Hanada hosted the annual meeting of the Japanese Society of Oral Health. The
Chapter organised a symposium with the aim of introducing its global and local activities
to this wider audience.
7th July 2019:		
			Open Conference in Tokyo
including a reception and series of lectures.

23rd September 2019: Members’ Conference in Tokyo			
including a reception and series of lectures.

12WWW.ACFFGLOBAL.ORG

2019/20 Chapter Highlights (cont’d)
PAN-EUROPE
Collaborative Council Meeting 2019
Members of the Pan-European Chapter were joined by select representatives from influential European dental
health organisations at the 2019 ACFF Collaborative Council Meeting in Frankfurt, Germany on Thursday 28th
February 2019. The meeting covered various topics with the introduction of new members, a review of 2018,
developments on the IAPD declaration and caries curriculum as well as updates on CariesCare Internationaland ICCMS™. Also discussed were patient perspectives and the COM-B model and ACFF’s plans for 2019 andbeyond were unveiled.

Collaborative Council 2020
ACFF held its 7th Pan-European Collaborative Council Meeting in Madrid on Friday 14th February 2020. The
ACFF would like to express a huge thank you to all attendees (from a variety of European oral health organisations and platforms) for contributing a wealth of knowledge across a broad range, and with such enthusiasm. It
was extremely useful to learn of the numerous developments taking place across Europe by our Pan-European
members and the significant progress being made towards achieving the ACFF Goals.

WWW.ACFFGLOBAL.ORG13

2019/20 Chapter Highlights (cont’d)
NORTH AFRICA/MIDDLE-EAST (NAME)
Over the past year, the North Africa and the Middle-East Chapter, led by Professor Ihsane Ben Yahya, haveorganised and attended numerous events to work with communities in order to improve oral health and promotea cavity-free lifestyle. Events have included: working to raise awareness with children in Tunisia, an ICDAS
workshop in Algeria, a promotional event at the University Dental Hospital in Casablanca, Morocco and a largescale event at the University Hospital Center Ibn Rochd in Casablanca, Morocco in which the Chapter teameducated their target group of children with leukaemia and lymphoma. In addition, the Chapter assessed over
1,900 patients during the World Cavity-Free Future awareness day, at the child and maternity units at Abderrahim Harouchi Children’s Hospital in Casablanca, Morocco.

Professor Ihsane Ben Yahya and the Chapter team worked tirelessly to ensure that the key messages from World
Cavity-Free Future Day reached a wide audience, and continued the momentum of related activities until
December 2019 when they visited the Hopital 20 Aout in Casablanca to support children with disabilities with
their dental health.

14WWW.ACFFGLOBAL.ORG

2019/20 Chapter Highlights (cont’d)
SPAIN
On Friday 7th June 2019 in sunny Madrid, the spring meeting of SESPO (Spanish Society of Epidemiology andOral Public Health) incorporated the launch of the new ACFF Chapter in Spain. The SESPO team welcomed
Professor Nigel Pitts, ACFF Global Chairman to give a presentation on the ACFF, and to commit to the development of a Spanish Chapter of the ACFF. The SESPO team, led by Dr Jesus Rueda Garcia, was joined by the
Spanish Minister of Health and the President of the Council of Dentists of Spain to discuss the future of dentistryin Spain. The Chapter will be working on setting their focused goals and forming their committee over the
coming months, with a strong drive to draw together networks operating across Spain to improve oral health andensure a preventive focus is placed on high-level discussions within the health arena.
Thank you also to our Spanish Chapter and SESPO who joined us for the morning session of the Pan-European
Collaborative Council Meeting 2020, and to Javier Cortés for his presentation to the Council on the advancements they have made within Spain towards implementing the Core Curriculum in Cariology for undergraduate
dental students.

INDIA
The India Chapter released a newsletter in 2019 that contained a wealth of information about their advancements
and achievements. Amongst these, included:• The ASHA Training Programme (Accredited Social Health Activist) involving members of the Chapter
training 549 ASHA workers between January-August 2019. The training covered raising oral health awareness and improving timely referrals with a focus on maternal oral health. The ASHA Family Programme has
also been introduced, providing ASHA workers and family members with dental services (560 people havebeen screened, and 459 have received treatment through this programme).
• Mobile Dental Clinics Initiative – the Chapter, in collaboration with the Maulana Azad Institute of Dental
Sciences (MAIDS) have provided mobile dental clinic services to integrate with ongoing national healthprogrammes and partners. There are now six clinics and 28 staff working under the initiative, and approximately 35,098 patients were screened between January-August 2019 with treatment services being provided
to almost 56% of those screened (19,654). This project was nominated among six finalists at the Federationof Chambers of Commerce and Industry – Healthcare Excellence Awards 2019 (FICCI Healthcare Awards2019) and awarded a ‘Special Jury Mention’ under the Social Initiative category.
• Teacher Training – The Chapter have launched a programme and have now trained 478 teachers on oral
health for children. A Parent-Teacher Orientation Programme was also introduced, with 22 sessions delivered for 189 parents, and via this, 54 patients were also screened and referrals made.
• School Awareness Campaign – this covered approximately 1856 school children across three district regions in Delhi, and the school principals signed a memorandum to include dental health in health awarenessprogrammes and teachers to promote routinely in school.
• Project AMMA (Geriatric Oral Health Care Promotion) – partnered with the Department of Social
Welfare, Government of Delhi, and through this programme over 365 patients have been screened andreferred for treatment.
• Oral Healthcare for Cadets – more than 2500 cadets were screened in 2019.

WWW.ACFFGLOBAL.ORG15

Impact
The ACFF, is a key part of the Global Collaboratory for Caries Management, and is recognised by King’s College London’s Service to Society initiative as one of its “Big Ideas” inhelping King’s and its Partners to “Serve to shape and transform”, in order to “Make theworld a better place”. Recent Impact highlights include making a range of changes to help
the varied beneficiaries listed below:
Implementation activities around key research findings in cariology have informed new EU and US/International
curricula, changing the training of future dentists
ACFF, in collaboration with King’s College London, have now convened two caries-focussed workshops on
Shaping the Future of Dental Caries Education jointly with the European and US Dental Education Associations (ADEE and ADEA) in 2017 and 2019 to help implement cariology curricula, including: the EuropeanCore Curriculum for Cariology, ICCMS™ Guidance and International Caries Curricula (including the US
version). Alongside this, complementary developments adopting the Guidance in undergraduate professional
dental education for dental caries in Malaysia, Japan and Brazil, ACFF and the Global Collaboratory for Caries
Management have substantially changed the training of future dentists and hygienists, promoting prevention andpreservation of tooth tissue in clinical decision-making, as opposed to excessive drilling and filling.
By following this guidance in its various forms around the world, Patients receive care which is more personalised, patient-centred, risk based, preventive and minimally interventive. Evaluations in a number of countries
have shown that this style of care is preferred by both dentists and patients to conventional, restorative-dominated, approaches.
Facilitating the integration of clinical and dental public health approaches to caries prevention and management
through advocacy using common synthesis of research evidence in many countries.
King’s College London-led research and global evidence have directly led to advocacy for the integration of theclinical dental practice and dental public health aspects of caries prevention and management worldwide throughclose collaboration with the ACFF. The King’s/ACFF approach is ’globally driven, locally delivered’ (“Glocal”)
in order to maximise adoption and impact and we now work with 193 Chief Dental Officers around the world,
providing resource materials for their joint website and reporting annually on progress to the “CDOs/Dental
Public Health Section” of the FDI.
Governments and Health Departments/Payers
Great impact and momentum has been seen, resulting directly from the three Dental Policy Labs. In response to
demand from the participants, a ‘King’s/ACFF Policy Lab Network’ has been developed to continue dialogue
and share good implementation practice. Impacts achieved to date include:• Being approached by CDO Wales to work with the Welsh Government, who urgently wanted to take forward the outcomes of the 2nd Lab. A sub-group from this Policy Lab on Payment Systems were invited andfunded to meet with government planners in Cardiff to form a group to directly advise on policy planning for
NHS Wales.
• “As a result of the Dental Policy Labs -all potential “Office of CDO England” projects now have to haveboth a systematic review and a health economics assessment before they are considered”.
• Soon after the 2nd Policy Lab, the French NHS entered into an 18 month structured negotiation and have
now agreed (with the Dental Trade Unions and the Government) a funded, nation-wide, Policy experiment
which will use both the ICCMS™ Guide and 4D caries management model from CariesCare International,
combined with the payment model developed by the 2nd Policy Lab. This national experiment will involve
500 dental practitioners in two French regions and 10,000 of their patients aged between 18 and 21 years
old; it is the first of its kind in France, and will be for three years initially, before being adapted, refined androlled out wider.
• In Belgium – where dental hygienists have just been recognised, the Government are now using the 2nd
Policy Lab Report model to pay dentists and hygienists

16WWW.ACFFGLOBAL.ORG

Media Coverage
3

INTERVIEW

Dental Tribune Japan Edition | 9/2019

カリオロジーのトレンドを知る「世界のう窩なくす」を目標に独自の活動を展開するACFF日本支部

By Dental Tribune Japan「2026 年以降に誕生する子供たちは生涯をとおしてう窩を作らない」を地球規模でのゴール

料通信アプリ「LINE」を応用して健康情報を送り、家族や親戚の教育を行うプロジェクトでシステムに取り入れたいと考えています。ICCMS™のいいとこす。私は母子手帳を活用する

ろは、eラーニングのシステムをなど、行政と一緒に進めてほししっかりつくっていて、「4 つのDから入りましょう」と示していいと考えています。

2 つ目のプロジェクトは、新大阪大学大学院歯学研究科口腔分子感染制御学講座

一般社団法人ACFF日本支部 理事長︵歯科保存学教室︶教授

林 美加子に設定し、2010 年に発足した国際非営利組織である ACFF（Alliance for a Cavity Free Future）。
潟大学の野 杁由一郎先生の2018 年2月に、一般社団法人 ACFF 日本支部が発足し、独自のプロジェクトを展開しています。そこで、日本支部の理事長を務める大阪大学教授の林美加子先生に、グローバルな ACFF 「高齢者の根面う蝕の謎に迫る」というものです。野杁先生の設立趣旨や活動、日本支部の活動についてお伺いしました。

（はやし・みかこ）専門は歯科保存学。1961生まれ。1987年大阪大学歯学部卒業。
1997年同大学大学院歯学研究科博士課程（歯学）修了。英国マンチェスター大学客員研究員、大阪大学大学院歯学研究科准教授を経て、2012年から教授に就任。2015年から
同大学歯学部附属病院副院長を兼務。歯科保存学教室で、「基礎研究の臨床への展開」と「エビデンスの創出を目指す検証的臨床研究の推進」を柱に据えた研究に取り組む傍ら、2018年にはACFF日本支部を設立し、「う窩のない未来」の実現を目指し、独自のプロジェクトを展開している。

て、これを日本の臨床、教育のることです。この4 つのD とは、

DETERMINE（決定）、DETECT（検出）、DECIDE（決断）、DO（実行）です。

の一番の業績は、根尖性歯周さらに 4 つのエレメントがあ日本支部の活動目標と活動フォーカス炎が治らないのは、根尖孔外り、1はリスクアセスメント、2にバイオフィルムが出ていくとは診断する、3は情報を統合す日本支部の主たる活動目標

いうことを初めて見つけたこと

る、4はどのようにマネジメン

は、「生涯にわたって効果的なです。また、これまで高齢者にトしていくかというもので、こう蝕マネジメントを促進する」

多発している根面う蝕は、口腔れを日本の現状に合わせていことです。そこでは、患者、教に露出している部分のみに発こうと考えています。

育者、研究者および行政に携生し、歯周ポケットの中には発わるすべてが、「う蝕は予防で生しないと考えられていまし

きる疾病であるが、幼児から高た。しかし、このプロジェクト

齢まで生涯にわたってリスクにでは仮説を立てて臨床サンプさらされる」ことを、強く認識するように活動することです。
これらを実現するために、次の 3 つに活動のフォーカスを当てました。
まずは妊婦さん、あるいは
母親教育をもっと充実させた

国際チャリティーに興味ある臨床医は参画を

ACFF日本支部では研究プロ

ルを使い、根面う蝕の発生部

ジェクトを行いたいと考えてい位や原因となる細菌を特定すますので、一般社団法人としてる予定です。

始めました。日本支部は 4 人の

3 つ目は、鶴見大学の花田信

理事と、正会員は 100 人に限定

弘先生の「理想的なオーラルフにしていますが、現在の会員数

ローラとは何か」というもので、先端的な遺 伝子解 析技術をい。次に、ICCMS™（International

使って、人のあるべきオーラル

Caries Classification and Management

フローラを探求します。つまり、は 50 人ほどです。また賛助会
員（企業）は 14 社で、活動趣旨にご賛同された企業から賛助金をいただいています。

う窩がない未来を目指し
世界の28地域で活動グする取り組みが浸透する環

System™）がヨーロッパでカリオ

長寿の健康な細菌叢は何かが

この他、先ほど挙げた 4 つの境を整えることです。

ロジーのマネジメントシステム

分かっていないため、それを遺プロジェエクトには、リサーチ

ACFFは「う 窩 が な い 未 来

ACFF の最 初のチャプターとして確立しているため、それ伝子を見て検索するのです。

ワーキングメンバーが組織さを目指そう」という、国際的な（支部）は、2011年 5月にコロン

を日本の歯学教育に導入する

4 つ目は 私 が 進 め て い る

れており活動しています。これチャリティーです。ポイントはビアで発足し、その後メキシように、歯学部、学術団体、行「ICCMS™ 翻訳プロジェクト」では、プロジェクトに自ら手を挙「う蝕」ではなく
「う窩」
。つまり、

コ、ブラジル、ベネズエラが政に働きかけていきたいと考す。これは国際的学会組織がげた方には、資金を支援して、キャビリティーフリーの撲滅、を実現可能なゴールとして設定しています。

続きました。2012 年には中国、えています。もう一つは高齢中心となり、日常臨床における2013 年はヨーロッパ、2014 年

者で、ACFF の本部は子どものう蝕の診断とマネジメントにつには急成長して支部が増え、ことを中心に据えていますが、

いて、17 年にわたり議論を重調査・研究を実施していただ
くというものです。現在、国際チャリティーに参画していただ2010 年、イギリスのロンドン

2018 年 2 月 に 27 番 目 と し てねた成果を ICCMS™として包ける臨床医を募集していますで発足し、4 つの大きな目標を日本支部が登録されました。

防するために、う蝕罹患に関す括的で詳細な具体案を提唱し（カコミ参照）。

設定し、活動を行っています。

2019 年にはスペインが加わり、る実態調査を行い、効果的なています。世界でもこれが認知

1 つ目が、2026 年 以降に 生

現在 28 地域で活動しています

まれる子どものキャビティーフ

が、その地域はさらに広がりつリーを達成すること。2 つ目が、つあります。

「モダン・カリオロジー教育の浸透」。すなわち、歯科でよくいう「削って、填めて、請求する」ということではなく、生物学的に回復可能な歯質は大切

各支部の活動は、①専門家の教育、②公衆衛生に関する
教 育、③ 口 腔 保 健 の 不 均 衡

我々は高齢者の根面う蝕を予踏み出したばかりですが、積極的に我が国のう蝕に関わる問療の臨床や教育に取り入れる

題の解決を図り、これまでに達可能性や方策について、ワーク成したう蝕マネジメントをモデ予防法を探索することにしました。

②国内外の学術団体との連携、ショップなどを開催して議論すルケースとして、世界に発信し③年次総会の開催、④会員のることを計画しています。そしていきたいと考えています。

の是正、④学際的協力、⑤地研修会、講演会の開催、⑤ホー域のプログラム、⑥ ICDAS/

ムページによる情報提供、⑥口にしていこうという考えや、教ICCMS™ の推進、という6 つの腔保健・歯科医療に関わる諸育を浸透させていくことです。

アプローチがあります。

団体との連携、の 6 つです。

3 つ目が、口腔と全身の健康状

ACFF のユニークなところ態を視野に、世界あるいは地は、これらに関することであれ

正会員・賛助会員を募集中！
ACFF日本支部は、設立の経緯・設立趣旨・研究プロジェクトにあることを目的に、活動期間は基本的に2018年から2027年までの10年間と日本支部独自の4つのプロジェクト

域での、う蝕発生の不均衡をば支部は何に取り組んでもよ是正するために、幅広い組織といことです。目標の達成に向け

リサーチプロジェクトの 1 つ

協力して活動することです。4て、自分たちの状況や健康の

目は、コーク大学 PhDの西真

つ目は、2020 年までに、ACFF

状態、経済状態、患者さんの思紀子先生による「Okuizoméプの地域のメンバーが一体とな考などに合わせて活動を推進

ロジェクト」です。生後 100日

り、包括的かつ地域に適したうするよう、裁量が与えられていの時に、その子の生涯の健康蝕予防およびマネジメントのます。

を祈り、家族や親戚が集まってシステムと、それをモニタリン

日本支部は、まだ第一歩をされていますので、まずは翻訳をして、我が国のう蝕予防・治

具体的な活動としては、①リサーチプロジェクトの実践、行われる「お食い初め」に、無し、正会員は100名に限定しています。それはスピーディーな意思決定と、研究成果の達成を目標としているからです。
臨床医を対象にした正会員の会費は、年間20万円です。ぜひご賛同、ご参画をお願いします。
また、団体・企業にも趣旨・活動にご協力いただきたく、賛助会員としてのカテゴリーを設けています。賛助会員の会費は年間10万円です。

一般社団法人ACFF日本支部 事務局（学際企画株式会社内）
TEL：03-3981-7281（代表） 050-5530-1160（IP電話）
FAX：03-3981-7284

E-mail：acff@gakusai.co.jp

URL：http://www.acffjapan.org/(Clockwise from top left: Australia’s ‘Bite Magazine’ published an article around World Cavity-Free Future Day, The Japan Chapter featured in the
Dental Tribune and approximately 20,000 copies were issued, the Pan-Europe Chapter had articles on World Cavity-Free Future Day published in
the Dental Tribune and Dentistry Today magazines as well as having a story featured on the King’s College London website, the Canada/US Chapter
featured on the ‘Baby Gaga’ website that draws an average of 325 million views per month, the India Chapter featured in national newspapers including‘The Times of India’ and a number of partner organisations including the IAPD promoted the key messages of the day).

Our Malaysia Chapter featured on Buletin Utama (below left) national news which attracts approximately 5.3 million viewers per show, and Prof. Dr.
Rahimah Abdul Kadir was also interviewed in the ‘hello DOKTOR’ magazine (below right).

WWW.ACFFGLOBAL.ORG17Thank you!
The ACFF would like to thank the Global Expert Panel, all of our Chapter teams and ourmembers for their continued involvement, commitment and support.
We also gratefully acknowledge the continuing CSR support to the ACFF Charity fromMarsha Butler and the team at Colgate-Palmolive.

(Above photograph taken at the Expert Panel in Washington, 4th October, 2019).

Contact Us
If you wish to contact any of our local Chapters, please contact our Global Office on the details below,
and we will put you in touch with your local team.
The Global Office is based within the Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College
London, UK.

Alliance for a Cavity-Free Future
Floor 17, Tower Wing
Guy’s Hospital
LondonSE1 9RT
Tel: +44 207 848 8481

admin@acffglobal.org
www.acffglobal.org@ACFFGlobal
ACFF Global