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Oral Health Promotion – in a Nutshell

Amelia Seselja
Oral Health Promotion Consultant and Contributing Author

As dental professionals, we see first-hand the impact that poor oral health has on an individual; it can cause pain and discomfort, disrupt sleep, as well as an impact on their ability to eat, and to socialise. The impact of poor oral health does not only affect individuals, but it trickles on to impact our community through reduced school attendance and work productivity (sick days/carer days).

Poor oral health also places a substantial burden on the Australian health care system. In fact, oral diseases are among the most common chronic health conditions in Australia and are contributing to the rising rates of health care costs. For example, in 2015-16, an estimated $9.9 billion was spent on oral health with many of these costs associated with oral diseases, many of which are preventable.

Oral Health Promotion (OHP) examines how we (and I stress the word we) reduce this burden of disease and ensure all Australians can enjoy and maintain good oral health throughout their lives.

There is not one simple solution or strategy and the truth is, OHP is not easy, and it does not happen overnight.  Rather, coordinated actions across different levels are required. Also, responsibility must be shared amongst a range of stakeholders, including government, industry, community, dental professionals, and individuals. We all play a role in OHP.

Prevention is always better than a cure and OHP focuses on early intervention and prevention rather than treating disease; otherwise known as primary prevention. OHP is guided by the same principles of health promotion– our goal is how to make the healthy choice the easier choice.

Poor Oral Health

Poor oral health also places a substantial burden on the Australian health care system. In fact, oral diseases are among the most common chronic health conditions in Australia and are contributing to the rising rates of health care costs.

The Ottawa Charter for Health Promotion

→  Build Healthy Public Policy

→  Create Supportive Environments

→  Strengthen Community Actions

→  Develop Personal Skills

→  Reorient Health Services

Implementing strategies at a population level (upstream) enables us to assist the greatest number of people within our community and ideally stop them from developing disease in the first place.

“Oral Health Promotion (OHP) examines how we (and I stress the word we) reduce this burden of disease and ensure all Australians can enjoy and maintain good oral health throughout their lives.”

Figure 1.  Upstream-Downstream approaches
Oral Health Promotion: Defining Intervention Strategies

Source: McKinley JB. A case for refocusing upstream-the political economy of illness. Processing of the American Heart Association. Conference on applying behavioural sciences to cardiovascular risk: 1974. P.7-17

UPstream / UNIVERSAL
  • Focus on government policy and structural change, funding, healthy settings, inter-sector relationships, mass media
  • Build a fence to stop people falling in
MIDSTREAM / SELECTIVE / TARGETED
  • Change lifestyle and behavioural risks
  • Community Development, multiple intervention strategies, allied health links and training
  • Teaches survival skills
Downstream / Individual / Personal
  • Focus on personalised prevention, disease treatment and management
  • Provide ambulance service

The reason OHP is complicated is that there is a range of complex factors that affect oral health. These factors include social, economic and lifestyle determinants. Furthermore, understanding the social determinants of oral health is essential in OHP, as these factors directly impact a person’s ability to achieve good oral health outcomes.

Figure 2.
The determinants of oral health

Source: Draft National Oral Health Plan 2013- 2017

Successful OHP recognises this range of factors and incorporates these into strategies to improve oral health. Furthermore, there is an intrinsic link between oral health and general health; many of the lifestyle risk factors associated with general chronic disease also contributes to oral disease; these are known as common risk factors. For example, poor diet i.e. (high in free sugars) is a risk factor for tooth decay as well as obesity and diabetes. Therefore, by implementing strategies such as policies that aim to reduce sugar consumption so that oral health may improve, we are also aiming to improve general health outcomes – integrating oral and general health strategies means OHP is more efficient.

 

Settings and partnerships

An integrated approach is a key principle in OHP. This involves working across a diverse range of community settings such as childcare, schools, aged-care, workplaces and sporting institutions. Working within a diverse range of settings ensures oral health can be addressed at all life-stages. Furthermore, forming partnerships provides the opportunity to integrate oral health into other areas of practice and policy ensuring that oral health is addressed within other sectors.

 

The role of Dental Professionals in OHP

As dental professionals, we are normally treating disease (working downstream) and our ability to work upstream can be limited.

However, we should see our role as oral health advocates in the communities and organisations in which we work. As a group we can play a key role in advocating at a national level, for example, working with our peak bodies to promote the importance of fluoridated water and the need for better food labeling and government funded dental schemes such as the Child Dental Benefits Scheme.

At a local level, we can coordinate local oral health promotion initiatives to raise awareness and educate those in our community about oral health.  Remember oral health education is a strategy of OHP. There are many initiatives that you and your team can do to be oral health advocates.  These initiatives do not need to be in the dental setting, engaging with your community and making partnerships within other settings is key to OHP.

Depending on the size of the practice or organisation you work in, you may like to create an oral health promotion working group- here you can agree on local initiatives to get involved in.

For example, you may volunteer with a local sporting club or school rugby team and be the emergency dentist/ dental practice (during the sporting season). You can use this opportunity to educate parents, players and coaches on dental first aid as well as the importance of wearing a custom-made mouthguard. You could even do an education session about the importance of hydrating with water over sugary sports drinks.

Within your practice or clinic, you may wish to organise parent education sessions – for example many parents are unaware their child should be having their first dental visit by age one. By reaching out to a local ‘mums and bubs’ group you can provide advice on the importance of establishing a dental home and answers questions, such as when to start brushing their child’s teeth. You might even like to organise some oral health take home information and packs.

You may wish to visit and provide an education session at your local aged-care facility and educate staff on the oral issues that older people can experience and how their team can assist in maintaining the oral health of residents.

Remember there are also several key dates across the year that you can dedicate to OHP. Create an oral health promotion calendar and get involved in days and weeks such as World Oral Health Day, Dental Health Week and World Cavity Free Future Day.

AMELIA SESELJA

Amelia is the Oral Health Promotion Consultant for the Australian Dental Association (ADA).  She graduated from the University of Queensland with a Bachelor of Oral Health and is in her final year of completing her Master of Business Administration through Flinders University. Amelia has a diverse range of experience working alongside specialists and general dentists providing care for patients, as well as lecturing students.

Amelia works closely with ADA’s Oral Health Committee to oversee and deliver a comprehensive range of oral health promotion campaigns and projects, including Dental Health Week, and Chairs the ADA’s Oral Health Working Group.  Amelia works closely with the Australian Dental Health Foundation to develop and implement oral health programs to assist those who are most disadvantaged in our community through unique corporate social responsibly projects.  

Amelia is passionate about advancing the oral health of all Australians through advocacy and awareness of oral health issues and leading a collaborative approach in oral health promotion. 

 

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PERSONAL + CAREER DEVELOPMENT

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