Need For Oral Health Promotion Health And Social Care Essay
Aim Discuss need to promote oral health with reference to school going children while taking in consideration pre-scholars,primary and secondary school going students and educating their parents and teachers and discussing steps to be considered while planning promotional methods.
Oral health- a term commonly misunderstood for pretty teeth but in reality includes healthy teeth, gums, jawbone, supporting tissues. "Oral health is a standard of the oral and related tissues which enables an individual to eat, speak and socialise without active disease, discomfort or embarrassment and which contributes to general well-being" (World Health Organisation 1982.) It can also be said to be a mouth without any disease in its active form. But WHO (World Health Organisation) defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Thus it is impossible to exclude oral health from the well-being of an individual or can be said that according to the WHO’s definition to be healthy means to include oral health, which is an important aspect of health. Neglecting oral hygiene habits can lead to pain and discomfort for children. ‘Oral health care is not delivered to the same extent and is not given the same priority, perhaps because oral diseases are not as life-threatening as some other diseases are’ (Beiruti, 2005).Besides pain and discomfort, oral health impact’s an individual’s general health and can result in cardiovascular diseases and ulcers which will further result in various medical expenses and discomforts. Dental health affects an individual’s appearance and social well-being throughout their lifetime. According to the Manual of Health Education (1969) ‘the control of dental diseases and defects and the establishment of good oral hygiene are best accomplished during childhood. Children learn best by imitating adults around them. Thus it is important to educate the adults if an improvement is to be expected in the children.
According to the statistical survey done by WHO in 2005 to identify the number of disease, missing and filled teeth of children in their final year of primary schooling, average was higher when compared with countries like Australia and United Kingdom where similar oral healthcare system exists. In the similar survey by WHO, it was also observed that less than 52% children under the age of five were free of decayed teeth. In the year 2002 it was observed that average five year old had 1.83 decayed, missing or filled teeth (DMFT) but the statistical survey of 2004 showed that the DMFT has increased to 2.1 showing a growth of 0.27(Neuartha 2005). According to the World Oral Report 2003 presented by WHO ‘dental caries is still a major oral health problem in most industrialized countries, affecting 60-90% of school children and the vast majority of adults. It is also a most prevalent oral disease in several Asian and Latin American countries, while it appears to be less common and less severe in most African countries. In many developing countries, access to oral health services is limited and teeth are often left un-treated or are extracted because of pain or discomfort. Throughout the world, loosing teeth is still seen by many people as a natural consequence of ageing.’
In a research carried out in Australia by School of Dental Service (1999), it was observed that 53% school going children seen by DHSV had signs of Dental caries. The result also showed that the preschool children had a higher percentage (80%) of children with signs of dental caries. According to Dooland (1992), among those with dental caries signs, 30% of them were not receiving and only would visit a dentist in case of an emergency.
A survey has been conducted by Ministry of health in New Zealand in 2009 to collect information about the oral health of New Zealanders and various services used by them in regards to their oral health. A part of the survey also gets information on the oral health status, beliefs, attitudes, knowledge and practices of children, adults and older adults in New Zealand. Similar survey’s had been conducted in 1976 and 1988. The main aim for the collecting of this data is to describe the oral health of New Zealand children and adults, and on analysis the prevalence and severity of selected oral conditions. On the basis of this data a relationship to study and analyse the trends in general and oral health are established. This further leads to analyse oral health in the children within household, and also then analyse inequalities on the basis of age, gender, ethnicity, basic habits (smokers/ non-smoker; alcohol drinkers/ non-drinkers), socio-economic position etc. to access oral health services. A comparison is also done between the present and the past surveys to analyse the effectiveness of various programmes as being delivered and conducted since the last survey. This thus helps in improving oral health and healthcare system in an efficient and effective way. In the survey conducted in 2009 by Oral Health Services New Zealand in which approximately 2,000 adults and 1,000 children (under 15 years old) took part. The survey was designed in two parts- one part included the face to face interviews conducted by trained interviewers asking simple dental questions which was then followed by an simple dental examination by Qualified and Registered New Zealand dentist and the result of the survey conducted in 2009 will be published in December 2010 and then new strategies to promote and educate general public with oral heath will be put forward to overcome the oral health problem.
‘Despite hundreds of studies involving thousands of individuals, we know remarkably little about how best to promote oral health’ (Kay & Locker,1997). A different approach is required at this stage to promote oral health and to get general public’s mind diverted towards the importance for the need of this promotion by improving oral health status and reducing the burden of oral disease. Major aim of this promotion will be to provide a longer life to the healthy disease free teeth. It is also important to inform the public about the affordability and access to quality oral health services at the initial stage of oral disease and also need to educate them about long term consequences and expenditure as a result of the ignorance in the initial stage of oral diseases.
There is also need to be asked that are the parents of school going children with bleeding gums aware that the bleeding gums are actually a symptom of a gum disease. General public is also unaware that the bleeding gums while brushing teeth is due to the presence of germs in the mouth (Rowland Healthcare, 1997).
Among various methods that can be used to promote the oral health Croucher (1993) suggested that the dominant approach should expert led, and individually orientated, featuring persuasive behaviour changing communication, based around the knowledge, attitudes and behaviour concept. While using this approach few important points need to be considered such as not to use the blame game and thus not make individual or parents feel guilty of their ignorance.
The British Association for the Study of Community Dentistry and the Department of Health (2007) have formulated and delivered a guide for patients, Delivering Better Oral Health: An evidence-based tool kit for prevention, which provides best possible advice to patients. The main emphasis in this information is given to the simplicity of the language used along with a consistent langrage provided to the patients to avoid any confusion regarding the procedure and the importance of oral health. This toolkit want to provide the guide to the general public irrespective of the fact whether they are risk of oral diseases in the future or not and it is also a guide to the patients at risk and are at greater risk and who require more intensive actions for the oral diseases due to any medical conditions. This pack has a lot of relevant information but is still lacking effective procedure in delivering all the information in a sequential and sustained manner.
All above mentioned stats suggests that there is a need to discuss promotional values and methods used to promote oral health with reference to school going children while taking in consideration both primary and secondary school going kids. According to WHO (1987) ‘main aim of dental health promotion is to improve dental health through a voluntary change in patient’s dental behaviour, attitude, thinking and knowledge.’
A common shortcoming of many dental health education programmes is that they are not coordinated with the general health programme (Gochman, 1973). Dental health programmes are needed to be embedded within the curriculum to teach importance of oral health to the students. (Dental Health, 1974). Students need to know the importance of keeping their teeth and gums clean and healthy. They also need to learn the short and long term consequences and how it will be affecting their life in the future. Students must be informed about various associated problems and the also the triggers that can lead to various oral diseases and complications Like Smoking and alcohol’s effect on the teeth. One of the best ways to pass this message to the children is to pass it on through the curriculum and led by teachers. Catherman (1967) suggests that teachers can be motivated and stimulated to become effective tools in teaching dental health education in the classroom by proper training and acquisition of the relevant knowledge.
Besides the teachers, the parents are also needed to be educated as the first schooling starts at home. In the later years of schooling, it is the responsibility of the parents to reinforce the teaching provided to the children by the teachers in the school. Parents are second role models, which are followed by the children. According to Rayner (1970), parents are the strongest influence on a young child’s life and there is a direct association between parent’s personal practices and the child’s behaviour. It is also a known fact the habits that are formulated and are maintained in early years of childhood remain with an individual throughout life. To promote oral health the parents need to informed about it as in vital in promoting to the children.
This parent teacher involvement for the promotion of young children, their role modelling, their teaching the importance of oral health and consequences for ignoring oral health will eventually show better result during the later stages of life. It is on an individual to learn about dental health on its own paces but it is worth trying to promote healthy teeth and gums. Importance of regular brushing and eating a proper diet and their link to both dental health and oral health can lead to future with health conscious individuals in the near future. There should be an emphasis on educating adults so that they become aware of health needs not only for themself but also for the younger generation. They also need to be informed about the determinants of Oral Health so that they can differentiate between good and bad oral health.
But the major question that is still answered is that how to promote oral health so that it is reached to every individual and that we can save the humanity form losing their healthy teeth till they die. We can use various methods to promote the oral health but whichever technique we use we need to make sure that the language used in promotional material must be easy to understand and must be free of meta-languages and technical terms. To reach the promotional goal, the instructions and the activities must be appropriate and relevant to the particular targeted group with clear aims and objectives in front. While organising the promotional material the social and the psychological characteristics of the targeted group must be kept in mind. Major emphasis must be on laid to educate the individuals about the importance of healthy and balanced diet. A list of healthy food and the food to be avoided must be presented to the public along with the long and the short term effects of those eatables. Information on how to clean their teeth effectively and what type of paste and brush is to be used and when to change their brush etc. must be given. Public should also be taught to visit the dentist on regularly and how these regular visits can save them in the near future (Blinkhorn 1998).
The material presented must not only be simple but also should be able to grasp the attention of the targeted audience. The audience must be forced to think about its importance and must be able to relate it to themselves. Besides its information it should be able to inform the general public about various easily available helping agencies and so series of informative contact number, emails, website and other sources to collect more information must be presented to the general public. It is essential to inform the general public about various oral health programs both at national and community base are provided to the public and implementation guidelines for these programs are also clearly presented for the public to view. The various audio-visual aids must be able to increase audience’s interest and understanding and will be able to communicate the message in a clear and concise way. To promote the oral health various aids can be used for example pamphlets and leaflets, Flannel boards, picture study, posters, motion pictures, slides, advertisements for television, radio and on the internet, discussion blogs must be set-up and public must be encouraged to use them, help blog with dentists or dental therapists or nurses to answer their questions immediately must be organised, various camps to provide a free general opinion about their oral health must be organised and then must be educated about importance of oral health in detail in those camps, talk shows related to health should be arranged both on mass media and face to face in community centres and other ethical and religious gatherings.
But by providing information and promoting oral health this business is not stopped. Various dental health education programs to be implemented on national basis must be well planned. Roles and responsibilities of health and other bodies in promoting oral health care will be discussed and the preventive strategies and techniques to make this program a success must be pre-planned. After the initial phase has completed an assessment on the effectiveness of these programs must be conducted and this must include on few important aspects such as what went right and what went wrong, what could have been done to improve it and what factors needed to be changed and why; and what other things must have been added to make the program a bigger success.
According to an article published in the British Dental Journal (2006), there has been some improvement in the oral health of the children and the adolescent but still there is a long road ahead. Same article also pinpointed that a dental health promotions are very important at this particular phase when lollies and drinks with huge amount of sugars are becoming an essential part of our diet. It is the time for us to promote oral health and prevent diseases and thus must expand our ideas to plan activities and also to design various programs that will be utilised to promote oral health. We need to make the general public aware that oral healthy is not just clean teeth but has a wider meaning and includes diseases and disorders which will affect the social health as well as psychological and general well-being of individuals. The public needs to be aware that the oral diseases are mainly related to our day today habits, lifestyle behaviour like excessive use of alcohol, intake of tobacco etc. along with poor choice of diets and are often associated with other health problems. As said prevention is better than cure thus an early detection of various oral health diseases will not only save us from more severe and complicated diseases but will also save us a lot of money in future by reducing the burden of different diseases and disorders that affect our face, teeth, gums and mouth and affecting our social wellbeing and psychological health (Hammam 2003). As we are waiting for the survey done in 2009 and result scheduled to be available in December 2010 we must pre-plan on how to improve the oral health of New Zealanders and eliminate health disparities.