• Methods of oral health promotion
• Approaches in oral health promotion
• Oral health promotion in action
• Role of health professionals in oral health promotion
• Common risk factor approach in oral health promotion
• The World Health Organization (WHO) defined health as not merely the absence of disease, but a state of
complete physical, mental and social well-being (WHO, 1946)
• WHO defined oral health as: a state of being free from chronic mouth and facial pain, oral and throat
cancer, oral sores, birth defects such as cleft lip and palate, periodontal (gum) disease, tooth decay and
tooth loss, and other diseases and disorders that affect the oral cavity
• Oral health promotion aims to prevent oral health disease before it occurs or to reduce the impact of oral
health disease. This is done through a variety of strategies or community-based programs that aim to
improve and maintain population oral health.
• According to WHO, Health promotion is “The process of enabling
the individuals and communities to increase control over the
their health, representing a mediating strategy between people and
personal choice and social responsibility for health to create a
• Health promotion represents a mediating strategy between people
personal choices and social responsibility to create a healthier future.
5. METHODS OF ORAL HEALTH
• Determinants of health
• Working in partnership with the range of agencies and sectors
• Adopting a strategic approach to promote the health of the population.
6. Major determinant of health
The following are factors that can enhance or impair health and they
• Human biology ; age, sex, hereditary factors
• Health care organization
• Personal beliefs and lifestyle factors
• Environmental factors: includes the Socio-economic, political,
such as poverty, poor housing, unemployment referred to as the
• Social determinants of health (SDOH) are the conditions in the
learn, work, play, worship, and age that affect a wide range of
outcomes and risks.
7. • Source: Adapted from Watt and Fuller
Economic, political and environmental conditions influence the social and
community context, which in turn affect oral health-related behaviour and oral health.
8. Working in partnership
Partners in oral health includes the following
• Health professionals e.g. doctors, health visitors, pharmacists, district
• Education services: Teachers, school governors, parents
• Local authority staff e.g Carers, planning departments, social
• Voluntary sector: Age concern, pre-school learning alliance, Terrence
• Commerce and industry Food retailers, food producers, advertising
• Government, local, national and international: National: education
9. Adopting a strategic approach to promote the health of the
Going by the determinants of health, three strategies for addressing
1. Medical approach ( to address the health care organization)
2. Behavioral approach ( lifestyle)
3. Socio-environmental approach
10. Medical approach
• The medical approach focuses on diseases and is concerned with
induced damage to the body so essentially focuses on the body with
community. (this is a curative approach)
• E.g Treating someone for dental caries by restoring carious teeth
the other teeth
11. Behavioural approach
• The behavioural approach (lifestyle changing approach) focuses on the personal behavior of the person
and stresses healthy behavior and lifestyles
• Examples;Do not smoke, brush twice daily, reduce sugar intake, don’t snack in between meals.
12. Socio-environmental approach
• Socio-environmental approach incorporates elements of the medical and behavioral models and focuses
on the social-economic, physical environment, personal health practices as well as the nature and
distribution of health services.
13. APPROACHES IN ORAL HEALTH PROMOTION
The practice of health promotion can operate in several different ways, depending upon the philosophy and
skills of the practitioner and the setting of the activity:
• Aim: Reduction in disease levels, in which medical/ dental professionals take the lead. Interventions such
as screening tests or clinical activities such as immunization are used.
• Limitations – does not address underlying causes of disease
14. Behaviour change
Aim : Encourage individuals to take responsibility for their health and adopt healthier lifestyles.
• Assumes that provision of information will lead to sustained change in behavior.
• The desired change in lifestyle are determined by the professional and largely imposed on the patient
Aim: To provide individuals knowledge and skills and attitudes to make informed choices about their health
It provides individuals with choices.
Largely expert led and ignores a wide range of factors that determine the patients attitude towards a
• Aim: To assist people in identifying their own concerns and priorities and in developing the confidence
and skill to address these issues.
• Individuals and communities identify their problems and seek solutions for the same.
• Aim: To change the physical, social and economic environment to promote health and well being.
• Requires change in policy and political support.
• Lobbying and policy planning need to be done.
16. ORAL HEALTH PROMOTION IN ACTION
The first International conference on health promotion held in 1984 in Ottawa Canada published a set of
guiding principles referred to as “the Ottawa Charter” which has 5 key areas:
• Build Healthy Public Policy
• Create Supportive Environments
• Develop Personal Skills
• Create Supportive Environments
• Reorienting Health Services
17. Build Healthy Public Policy
• Dental professionals can play a role in this by raising awareness among policy makers of the importance
of good oral health by advocacy and by involving communities in initiatives to promote oral health.
• Policies are made at International level , National level , Local level
• Examples are economic and regulatory activities such as taxation. These policies provide a legislative
framework for environmental change
18. Create Supportive Environments
• Ensuring that the physical and social environments in which we live maximizes the possibility of leading
healthy lives. Environments which “make the healthy choices the easy choices”.
• Controlling sale of sweets within school premises, providing drinking water in schools and fruits in school
• Fluoridation of water.
• For smoking: designating smoke free areas
• Providing tooth brush and paste
19. Developing Personal Skills
• This aspect involves providing information, health education, coaching and enhancing life skills to enable
the people make choices which promote health.
• Without knowledge, individuals cannot be expected to make intelligent decisions about their oral health or
in the case of decision makers, for the oral health of their constituencies.Personal skills to support life can
be learned at home, school and community settings
• Examples : Chair-side intervention aimed at improving oral hygiene has been found to be effective as well
as dietary counseling, School health education, Use of media, Chair side smoking cessation Raw et al
(2013) – brief intervention of less than 3 minutes can help 2% of smokers to give up successfully and a
further 6% will benefit by referral for more intensive counseling and nicotine replacement therapy.
20. Strengthen Community Actions
• This is to increase the ability of communities to recognize and change those aspects of their physical and
social environment that are hazardous to health.
• Communities should be involved in planning health interventions for it to be successful. Also it is essential
to build competencies and skills among community members.
21. Reorienting Health Services
• Health services have traditionally been more concerned with curing diseases than promoting health. The
formal health care system needs to expand its activities beyond the previous clinical services and adopt a
more preventive focus.
• It also requires that oral health is fully integrated into general health promotion in primary care settings
23. ROLE OF HEALTH
PROFESSIONALS IN HEALTH
• This involves educating politicians, community leaders and other influential individuals such as representatives of
the media in order to influence political decisions that have a bearing on the health of the population.
• It involves the provision of health education/information, teaching people the skills they need in order to use the
health information effectively in order to achieve control of the determinants of their health.
• This is one of the most important functions of health professionals with respect to health promotion.
• involving other agencies in health promotion
• Education services: teachers, principals, ministry
• Local government services, NGOs, Industries
• Federal government
25. COMMON RISK FACTOR
APPROACH IN ORAL HEALTH
• The concept of CRFA is that promoting general health by controlling a small number of risk factors may
have a major impact on a large number of diseases at a lower cost, greater efficiency and effectiveness
than disease specific approaches
• Most common NCDs share many risk factors with oral diseases. In 2011, a high-level meeting of the
United Nations General Assembly on NCDs urged the world to recognize that oral, eye and renal diseases
“pose a major health burden for many countries and that these diseases share common risk factors and
can benefit from common responses to non-communicable diseases”
26. • Many of these risk factors are behaviour and lifestyle related and are therefore preventable and Preventive
strategies based on CRFA will exert a favourable effect not only on a single disease but also
simultaneously on several conditions
• For example, tobacco use is estimated to be the underlying cause of over 90% of oral cancers and it is
also linked to aggravated periodontal tissue breakdown, poor oral hygiene, and premature tooth loss.
• Diet, plaque and smoking are also cause of dental caries, periodontal diseases, oral mucosal lesions and
• Clearly these are causes that are common to a number of other chronic diseases or NCDs
Why is health promotion important?
• Health promotion improves the health status of individuals, families, communities, and the nation.
• Health promotion enhances the quality of life for all people.
• Health promotion reduces premature deaths.
• By focusing on prevention, it reduces the costs (both financial and human) that individuals, employers,
families, insurance companies, medical facilities, communities, nation would spend on dental treatment.
• Promoting oral health in Africa: A manual for oral health managers in the WHO African Region. Brazzaville:
WHO Regional Office for Africa; 2016
• What is health promotion: College of public health, University of Georgia
• Jane M. Pratt, Oral health education and promotion, pocket dentisty https://pocketdentistry.com/6-oral-
• Rogers JG. Evidence-based oral health promotion resource. Prevention and Population Health Branch,
Government of Victoria,Department of Health, Melbourne, 2011.
30. • Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and
Health Promotion. Retrieved [date graphic was accessed], from
• Raw et al, smoking cessation Contemp Clin Dent 2013;4(4):493-499
• Watt RG. Emerging theories into the social determinants of health: implications for oral health promotion.
Community Dent Oral Epidemiol 2002;30:241-247