Strategies for oral disease prevention and health promotion
Oral health within WHO strategic directions
The latter part of the twentieth century saw a transformation in both general health and oral health unmatched in history. Yet, despite the remarkable achievements in recent decades, millions of people worldwide have been excluded from the benefits of socioeconomic development and the scientific advances that have improved health care and quality of life. The past decade has been a time of significant change in international health. The understanding of the causes and consequences of ill health is changing. The social, economic, political and cultural determinants of health are significant and it may be argued that better health can be achieved by reducing poverty. Moreover, health systems, including oral health systems, have roles to play. Systems are becoming more complex and people’s expectations of health care are rising dramatically. In many countries, the role of the state is changing rapidly, and the private sector and civil society are emerging as important players. In developing countries in particular, a growing number of development organizations, private foundations and nongovernmental organizations are becoming active in the health sector.
WHO's goals are to build healthy populations and communities and to combat ill health. Four strategic directions provide the broad framework for focusing WHO's technical work, which also have implications for the Oral Health Programme.
- Reducing oral disease burden and disability, especially in poor and marginalized populations.
- Promoting healthy lifestyles and reducing risk factors to oral health that arise from environmental, economic, social and behavioural causes.
- Developing oral health systems that equitably improve oral health outcomes, respond to people's legitimate demands, and are financially fair.
- Framing policies in oral health, based on integration of oral health into national and community health programmes, and promoting oral health as an effective dimension for development policy of society.
In accordance with WHO overall priorities, the Global Oral Health Programme has adopted the following priorities and strategic orientations.
Strategies and approaches in oral disease prevention and health promotion
The threat of noncommunicable diseases and the need to provide urgent and effective public health responses led to the formulation of a global strategy for prevention and control of these diseases, endorsed in 2000 by the Fifty-third World Health Assembly (resolution WHA 53.17).
Priority is given to diseases linked by common, preventable and lifestyle related risk factors (e.g. unhealthy diet, tobacco use), including oral health.
High relative risk of oral disease relates to socio-cultural determinants such as poor living conditions; low education; lack of traditions, beliefs and culture in support of oral health. Communities and countries with inappropriate exposure to fluorides imply higher risk of dental caries and settings with poor access to safe water or sanitary facilities are environmental risk factors to oral health as well as general health. Moreover, control of oral disease depends on availability and accessibility of oral health systems but reduction of risks to disease is only possible if services are oriented towards primary health care and prevention. In addition to the distal socio-environmental factors, the model emphasizes the role of intermediate, modifiable risk behaviours, i.e. oral hygiene practices, sugar consumption (amount, frequency of intake, types) as well as tobacco use and excessive alcohol consumption. Such behaviours may not only affect oral health status negatively as expressed by clinical measures but also impact on quality of life.