Oral Health Promotion and Education

Health" State of complete physical, emotional, and social well-being, not merely the absence of disease or infirmity" (WHO) 1940 (Russell, 1975)

In the 1970's and 1980's the health definition expanded to other components which were included: intellectual, environmental, and spiritual health

individual's health ??!!! Is it individual's responsibility ??? Or Does society have some part to play in it???

Its a shared responsibility

The individual is responsible for the conduct of his life

Goals for Oral Health These goals were developed after a great deal of discussion, and with the strong involvement of the WHO

As global goals, they are intended to stimulate individual countries to either adopt them as they are for their own goals, or to modify them for their own circumstances

Global Goals for the Year 2000 (WHO and FDI in 1981) per cent of 5-6-year-olds will be caries free 2- The global average will be no more than 3 DMF teeth at 12 years of age per cent of the population should retain all their teeth at the age of 18 years 4- A 50 per cent reduction in present levels of edentulousness at the age of years will be achieved. 5- A 25 per cent reduction in present levels of edentulousness at the age of 65 years and over will be achieved.

Midcourse reviews found that some progress had been made toward most goals, although disparities were growing between some minority groups and the main population in some areas. As a result, new sub objectives were established for Native Americans in the reduction of edentulous persons, and for African-Americans in the prevention of oropharyngeal cancer

1990s were proceeding to establish health goals for the nation for the year 2010; including goals for oral health. The nature of these goals depended to a large extent on progress made toward the Healthy People 2000 goals

Global Goals for the Year 2020 (FDI, WHO & IADR ) 1- To minimize the impact of diseases of oral and craniofacial origin on health and psychosocial development, giving emphasis to promoting oral health and reducing oral disease amongst populations with the greatest burden of such conditions and diseases. 2- To minimize the impact of oral and craniofacial manifestations of systemic diseases on individuals and society, and to use these manifestations for early diagnosis, prevention and effective management of systemic diseases

Goals without a program to achieve them are no more than wishful thinking

The ultimate goal is: The optimization of health Health promotion addresses individual responsibility while preventive services can be fulfilled by health providers (Healthy People, DHEW. 1979)

Health Promotion It is any combination of health education, and related organizational, political, and economic intervention designed to facilitate behavioral and environmental changes conducive to health Health education is an important part of health promotion Defined as any combination of learning opportunities designed to facilitate voluntary adaptations of behavior that are conducive to health

Health promotion and health education (in general) have been described as the mechanisms that connect: 1-Prevention activities; 2-Policy development; and 3- Community-Based Health Promotion Programs implementation, maintenance, and evaluation

1-Disease prevention Focuses on protecting as many people as possible from the harmful consequences of a threat to health (e.g., through immunizations)

2-Policy development Governments should have policies in place that promote health and do not interfere with people's lives, but give them the freedom to make informed choices on their health behavior

Governmental action in other area often means legislation Such steps represent the organizational, social, economic, and environmental supports basic to the development of healthy behaviors e.g. use of seatbelts and safety helmets, and immunizations for children

As an example in the oral health area, legislation that mandates or permits water fluoridation, and the statutory basis for school dental programs in some countries, are both organizational aspects of oral health promotion

3- Community-Based Health Promotion Programs A comprehensive, systematic, coordinated approach to affecting long-term health behavior change by influencing the community (cultural) norms through education and community organization

The goal of the Community- Based Health Promotion Programs is to encourage people, through lifestyle changes, to improve their overall health and well being

Community-based health promotion's focus is on basically healthy people Health promotion needs to reach people before they are symptomatic, and at a time when changing health behaviors can prevent illness, disability and death.

Community-based health promotion targets the whole community Changing habits may begin at the individual or family level, but maintaining change relies on reinforcement and approval at the community level

Community-based health promotion aims at effective public participation: People need to be involved in the decision- making process, coming together to determine the appropriate strategies for their community Involving all segments of the community in the planning and implementing of programs insures cooperation and coordination and is a key to the success of health promotion efforts

The Community-based health promotion strategies require action at many levels through: 1- Providing people with health information (education) 2-Developing opportunities for people to make and practice healthful choices 3-Encouraging those choices through community support and provide economic and other incentives and policies that promote healthy choices

The mass media, especially television, are frequently used in promotional programs in oral health, for sensitization and publicity purposes ( National campaign in Finland 1980s, 54% to 65% not effective )

The (ADA), for example, launched a television campaign in the mid-1980s to increase patient visits among adults over age 30, mostly by presenting the health benefits of regular dental care

One problem in defining a role for mass media in oral health promotion is that: evaluation carried out by market researchers, accustomed to dealing with commercial advertisements, is often "process" evaluation, which stops short of detecting outcomes, made the evaluation of the effects uncertain

Use of more than one medium is likely to better promote health messages One campaign that involved both television and printed material found that the television spots were the least well remembered and that the printed material, which demanded active involvement of participants at home, was more effective in improving oral health knowledge