The global complexities of oral health
Comparison of estimated global case numbers for selected noncommunicable diseases.
Dr Bradley Christian, an external contributor to the report, says, 鈥淭he global burden of oral diseases and their associated inequalities are alarming and at a tipping point. Without immediate action the burden on individuals and communities could become unmanageable鈥�.
The report emphasises the importance of the social and commercial determinants of health and the need for a common risk factor approach to addressing disease burden. It reveals opportunities and challenges in engaging stakeholders to accelerate progress towards universal coverage for oral health and provides country oral health profiles based on the most updated oral health indicators to enable evaluation and monitoring.
The WHO are in the final stages of two more significant projects: the听听and accompanying Monitoring Framework, where a key strategic action is the integration of oral health into primary health care with a听. In collaboration with the WHO, Dr Christian is leading a systematic review,听Effective strategies to integrate oral health into primary care, which will enable countries to translate the action plan into practice.
Ranking of most prevalent conditions per World Bank country income level.
Work in Timor and Fiji
Poor oral health is a complex and intractable problem. It fundamentally shapes the qualities of everyday life, the capacity for basic needs to be met, and it introduces mortality amongst groups of otherwise healthy individuals. It is not a matter of having clean teeth or teaching people to clean their teeth regularly to improve oral health; it is a fundamentally social, cultural and economic formation, manifest in the undulations of class, ethnicity, geography, gender and many more aspects of biography.
In a current project led by听Professor Michele Ford听补苍诲听Professor Woosung Sohn, the team depart from the understanding that oral ill-health is not simply the result of 鈥榩oor choices鈥�, 鈥榣ow education鈥� or 鈥榠rresponsible behaviour鈥� 鈥� or even a lack of access to oral health professionals or nutritious food. It is a product of a complex constellation of economic, social and cultural factors that shape the behaviour and experiences of individuals and their communities.
Oral health reflects exposure to markets, access to formalised education, parenting modelling and cultural standards. Patterns in oral health are intergenerationally mediated; situated in (local) parenting customs, which are situated within broader societal and cultural customs. The result is many local habits are in place before we have agency over our oral health practices.
Given these dynamics, it is perhaps unsurprising that medically driven models have failed to address the problem.
Comparison of edentualism by education attainment in different populations (in percentage of edentulous population).
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Comparison of edentualism by education attainment in different populations (in percentage of edentulous population). (Click to enlarge.)
With Professor听Woosung Sohn听as the oral health lead, the team aim to identify these factors by mapping the political economy of oral health in Timor-Leste, focusing on the factors that shape the context in which individuals and communities make their choices about consumption and preventative practices, as well as treatment. They will examine the oral health beliefs that underpin the choices that individuals, families and communities make about consumption patterns and oral health practices.
In Fiji, Dr Christian and Professor Woosung Sohn are working with Fiji National University鈥檚 Dental School to explore a collaboration on population oral health education and research.听
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