Lois K. Cohen

Attributes of an ideal oral health care system

OBJECTIVES The sense of urgency concerning the inadequacies of the current U.S. oral health care system in better preventing oral diseases, eliminating oral health disparities, and ensuring access to basic oral health services has increased in recent years. This paper sought to articulate the attributes that an ideal oral health care system would possess, which would be consistent with the principles of the leading authorities on the publics health. METHODS The authors reviewed policy statements and position papers of the World Health Organization, The Institute of Medicine, The American Public Health Association, Healthy People 2010 Objectives for the Nation, and the American Association of Public Health Dentistry. RESULTS Consistent with leading public health authorities, an ideal oral health care system would be have the following attributes: integration with the rest of the health care system; emphasis on health promotion and disease prevention; monitoring of population oral health status and needs; evidence-based; effective; cost-effective; sustainable; equitable; universal; comprehensive; ethical; includes continuous quality assessment and assurance; culturally competent; and empowers communities and individuals to create conditions conducive to health. CONCLUSIONS Although there are some attributes of an ideal oral health care system on which the United States has made initial strides, it falls far short in many areas. The development of an oral health care delivery system that meets the characteristics described above is possible but would require tremendous commitment and political will on the part of the American public and its elected officials to bring it to fruition.

The UN High-level Meeting on Prevention and Control of Non-communicable Diseases and its significance for oral health worldwide

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Communication and patient motivation in preventive periodontics.

PERIODONTAL disease is a major chronic disease which ha;s received little public health attention. The National Health Survey has reported that one of four American adults who still have their teeth has destructive periodontal disease; about two of four have gingivitis (1). Past early middle age periodontal disease is the major contributing cause to tooth loss. Further, it is an insidious disease which often has an asymptomatic early course, and it is extremely common among children. Public health dentistry has been almost exclusively concerned with controlling caries. Altlhough thalt goal has not yet been achieved, the road to conquering caries seems direct-through promotion of universal fluoridation of community water and widespread use of topical fluorides and therapeutic den;tifrices. These measures have the potential to reduce caries incidence by two-thirds. Thus, the time is ripe to attack periodontal disease, the other major destroyer of good oral health. The following discussion concerning communication and patient motivation in preventive periodontics presents some findings from recent dental and social research, identifies leads for preventive periodontal programs, and points out areas in which further research is indicated.