live mouth smart - world oral health day · speaking with your members or, for example, perceptions...
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Your guide to oral health policies
www.worldoralhealthday.org
MOUTH SMARTLive
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Your guide to using World Oral Health Day to advocate oral health policies Five calls to action for policymakers to help populations Live Mouth Smart
Introduction
Asaninternationally-recognizedcampaign,WorldOralHealthDay(WOHD)anditsbuild-upprovidesanexcellentopportunitytoadvocatepopulation-widemeasurestopreventoraldiseaseandpromoteoralhealth.Thisguide,whichhasprimarilybeenpreparedforFDImembernationaldentalassociationsbutcanbeusedbyanyonewithaninterestinoralhealthadvocacy,recommendspolicysolutionsandprovidesconcretemeasuresthatgovernmentsworldwidecanimplementtoprotecttheoralhealthoftheircitizens.Itisrecognizedthatpriorities,needsandchallengeswillvaryaccordingtogeographicalsettingtherefore,youmaychoosetoconcentrateyoureffortsononeparticularpolicycalltoactionoralternativelyadvocateallofthem.ThemainaimistoleveragethemomentumaroundyourWOHDcampaignstotargetgovernmentofficials,policymakers,publichealthauthorities,otherdecisionmakersorstakeholderssuchastheregionalofficesoftheWorldHealthOrganization(WHO)toaffectpolicychange.Inhigh-andmid-incomecountries,population-widemeasuresservetoreinforceoralhygieneofindividuals.Inlow-incomesettings,whereoralhygieneproductsarelackingornotwithinthemeansofthemajorityofpeople,population-widemeasuresareindispensable.
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ThisguidedrawsinspirationfromFDI’soralhealthatlasentitled‘TheChallengeofOralDisease–ACallforGlobalAction’1.YoucandownloaditinEnglish,FrenchandSpanishfromtheFDIWebsiteat:www.fdiworldental.org/oral-health-atlas.
Aboutthisguide
Thisguide:
• Providestheglobalcontextfororalhealthadvocacyandwhyitiscriticalfortheoralhealthcommunitytouniteinitseffortsinthefightagainstoraldisease
• OutlineshowWOHDcanbeleveragedforyouradvocacyeffortsanddetailsmeasuresthatcanbeimplementedunderfivespecificcallstoaction
• Showshowworkcanbefocusedarounddiseasesthatmaybeparticularlyprevalentinyourcountry
• Givestipsonrunninganeffectiveadvocacycampaignandhowtodealwiththemedia
TheWOHD2017‘LiveMouthSmart’campaignisoutlinedindetailinthecampaigntoolkitavailablethrough:www.worldoralhealthday.org
1 FDIWorldDentalFederation.TheChallengeofOralDisease–Acallforglobalaction.TheOralHealthAtlas.2nded.Geneva:FDI,2015.
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Global context for oral health advocacy Why the oral health community must unite in its efforts in the fight against oral disease Oraldiseasesaffect3.9billionpeoplegloballyandhaveasignificantimpactonindividuals,communities,healthsystems,economiesandsocietyatlarge.Consequencesoforaldiseaseonindividualsarebothphysiologicalandpsycho-social.Yetdespitetheirmagnitude,awarenessoforaldiseaseamongpoliticians,healthplannersandevenmembersofthepublichealthcommunityremainslow.Thisoftenleadstooralpublichealthinterventionstoberegardedasaluxuryratherthanafundamentalhumanright.Asaresult,althoughoraldiseaseisoneofthemostcommonnon-communicablediseases(NCDs)worldwideitdoesnotgetthenecessaryattention.However,thereisclearevidencethatoraldiseaseisnotinevitable,butcanbereducedorpreventedthroughsimpleandeffectivemeasuresatallstagesofthelifecourse,bothattheindividualandpopulationlevels.Urgentactionisneededtoavoidescalatingcoststogovernmentsandindividualsaswelltocontrolthegrowingdiseaseburden.FDI’svisionof‘leadingtheworldtooptimaloralhealth’requiresamovefromthecurrentpredominantcurativecaremodel,focusedonindividualclinicalpatientservices,towardspopulation-widepreventiveinterventions.Thischallengingparadigmshiftwillrequireaconcertedeffortfromallstakeholdersconcernedwithoralhealth.Itwillalsorequiretheforgingofnewpartnershipswithothersfromwithinandoutsidehealthcare.InternationaleffortstoreducetheburdenofotherNCDshaveshownthatsuchboldmovesarepossiblewithstrongleadershipandbroadpoliticalsupport.Itisnowtimetoensurethatoralhealthisintegratedintotheseefforts.
FDI’sVision2020advocacystrategy
FDIrepresentstheinterestsofourmemberdentalassociationsandtheoralhealthcommunitymorebroadly,atthegloballevelthroughitsVision2020advocacystrategy.WorkingwithUNagenciesincludingtheWorldHealthOrganization,internationalpartnerssuchastheWorldHealthProfessionsAllianceandtheNoncommunicableDiseaseAlliance(NCDAlliance),weensurethevoiceoftheoralhealthcommunityisheardwhenpoliciesareframedatthegloballevel.Byinfluencing
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theircontent,weaimtosupportourmembersnational-leveladvocacyeffortsandgivethemthestrongestbasisforpolicydiscussionswiththeirlocaldecision-makers.Itisonlybycombiningoureffortsatboththeglobalandnationallevelsthatwecansucceedinraisingtheprofileoforaldiseaseontheglobalhealthanddevelopmentagenda,aswellasensureeffectivepoliciesareimplemented.FDI’sneworalhealthdefinition
Oralhealthisakeyelementofoverallhealth.Individualssimplycannotbehealthywithoutgoodoralhealth.Therefore,integrationoforalhealthintoNCDpoliciesiscriticalandFDI’sneworalhealthdefinition2–whichpositionsoralhealthasanintegralpartofgeneralhealthandwell-being–isafirststepinhelpingtoachievethis.AsdefinedbyFDI,oralhealth:
Ismulti-facetedandincludestheabilitytospeak,smile,smell,taste,touch,chew,swallowandconveyarangeofemotionsthroughfacialexpressionswithconfidenceandfreefrompain,discomfortanddiseaseofthecraniofacialcomplex.
Furtherattributesrelatedtothedefinitionstatethatoralhealth:
• Isafundamentalcomponentofhealthandphysicalandmentalwell-being.Itexistsalongacontinuuminfluencedbythevaluesandattitudesofindividualsandcommunities
• Reflectsthephysiological,socialandpsychologicalattributesthatareessentialtothequalityoflife
• Isinfluencedbytheindividual’schangingexperience,perceptions,expectationsandabilitytoadapttocircumstances
Thedefinition,raisesawarenessofthedifferentdimensionsoforalhealthandemphasizesthatitdoesnotoccurinisolation,butisembeddedinthewiderframeworkofoverallhealth.FDIencouragesitsmemberassociationstoadoptthisnewdefinitionandisnowdevelopingameasurementtooltohelpdefineindicatorsbywhichtomonitororaldiseasestatus.ThisnewtoolisplannedtobelaunchedatFDI’sWorldDentalCongressinSeptember2017andinthespiritof‘whatgetsmeasured,getsdone’willallowforassessmentofindividualandpopulationneedsatanationallevel,andinevitablyinformanddriveoralhealthpolicies.
2 FDI’snewdefinitionoforalhealth.FDIWorldDentalFederation,2016(http://www.fdiworldental.org/oral-health/vision-2020/fdis-definition-of-oral-health.aspx,accessed20January2017).
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Yournationalcontext
Foryourcountry-levelactivities,youwouldbewelladvisedtocollectsomenationalfactsandfigurestoillustrateandbackupyouroralhealthadvocacy.Thesemightbe:
• Scientific:drawnfromapeer-reviewedarticleinanational,regionalorinternationalscientificjournalfocusingonyourcountry
• Observational:forexample,theresultsofanationalsurveyamongdentistsbyyournationaldentalassociationonthespecificfieldoforalhealthyouwanttohighlightinyourcampaign
• Anecdotal:ifyoudon’thavefactsandfiguresorsurveyresults,youmayhaveevidencefromspeakingwithyourmembersor,forexample,perceptionsoforalhealthderivedfromaspecialWOHDdentalclinicyousetuptogivefreedentalcheck-upsin2015or2016
Notethatbothpolicymakersandthepublicliketoknowwheretheystandcomparedtoneighbouringcountries.Anycomparativeinformationwouldthereforebeausefulpartofyourcampaign.
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HarnessingthepowerofWOHD2017–LiveMouthSmart
TheWOHD2017‘LiveMouthSmart’campaignempowerspeopletotakecontroloftheiroralhealth–throughoutlife–sotheycanenjoyahealthy,functionalmouthfromchildhoodintooldage.Bylivingmouthsmartpeopleunderstandthemeaningofgoodoralhygieneandhowtoavoidoraldisease.However,theburdenoforaldiseasecanonlybetrulyaddressedbyindividualactioncombinedwithpopulation-widepreventionstrategies.Forthat,strongadvocatesareneededsothatthevoiceoftheoralhealthcommunityisheardwhenpoliciesarebeingframed.TheeffectivenessofyourWOHDcampaignscanbesignificantlyheightenedifaccompaniedbychangesatthepolicylevelthatfacilitatehealthyliving.Aperson’sabilitytoLiveMouthSmartthroughahealthydietandavoidingexposuretotobaccoorexcessiveuseofalcohol,inassociationwithgoodoralhygienehabitsisgreatlyinfluencedbytheenvironmentinwhichtheyliveandwork.Therefore,weinviteyoutouseWOHDasaplatformtoadvocatepoliciesthatfosterhealth-promotingenvironmentsthatfacilitateoralhealthwithinyourcommunity,countryorregion.
Theroleofadvocacy
Advocacyaimstoinfluencedecisionswithinpolitical,economicandsocialsystemsandinstitutionsandtranslateawarenessintoaction.Youcanmakedirectorindirectapproachestolegislatorsonoralhealthissuesandusemanydifferenttoolstodeliveryouradvocacycallstoaction.Theonesmostsuitabletoyourneedswilldependonyournationalcircumstances,prioritiesandresources,butinclude:
• In-personmeetings• Telephonecalls• Membershipofspecificcommittees
andworkinggroupsinvolvedindraftinglegislation
• Workshops• Pressreleases• Directmailcampaigns• Letters/charters
• Publiccallstoaction• Newsletters• Campaigns• Factsheets• Informationsessions• Books/scientificjournals/articles• Website• SocialMedia–e.g.Twitterand
FacebookAsprofessionalassociationsworkinginthefieldofhealth,nationaldentalassociationsrepresentpractitionerswithdirectaccesstopatientcare,patientservicesand,ultimately,thepublic.Itisthisproximitythatplacesyouinauniquepositiontoadvocatepositivechangeinthehealthcaresystem.
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Whenyoucarryoutoralhealthadvocacy,youarenotonlyraisingawarenessoftheburdenofdiseasebutalsopresentingsolutionstokeypeoplewiththepowertomakepoliciesthatfurtherthecause.
Fiveoralhealthpolicycallstoaction
Theoralhealthcommunitywantspolicymakersto:1. Integrateoraldiseasesintopoliciesaddressingnon-communicablediseases(NCDs)and
generalhealthmorebroadlytosecurehealthandwell-beingthroughoutlifeKeymessage:Youcan’tbehealthywithoutgoodoralhealth.Oralhealthisoneofthemainpillarsofoverallhealthandwell-beingand,giventhesharedriskfactorswithotherNCDs,shouldbeintegratedintopoliciesaddressingthem.
2. Implementcost-effective,evidence-basedpopulation-wideoralhealthpromotionmeasuresKeymessage:population-basedpublichealthinterventionssuchasmeasurestoaddressaffordableaccesstofluorideandreducesugarconsumptioncanpositivelyinfluenceoralhealthoutcomesanddecreasecoststotheindividualandtotheeconomy.
3. Recognizethatoralhealthisabasichumanrightandessentialtomaintainingagoodqualityoflifebyprovidinguniversalhealthcoverageandimplementingpoliciesthataddresssocialdeterminants
Keymessage:broaderintegrativepoliciesthattakeaccountofcommonriskfactorsandtherootdeterminantsofhealththroughan‘oralhealthinallpolicies’approach,willresultinequitableapproachestopromotingbetteroralhealthandgeneralhealth.
4. Prioritizesurveillance,monitoringandevaluationoforaldiseasesandrecognizethatthisis
anintegralpartofroutineepidemiologicaldatacollection
Keymessage:oralhealthdatamustbeintegratedintonationaldiseasesurveillance.Monitoringriskfactorsandoralhealthneedsisfundamentaltodevelopingappropriateinterventionsandprogrammesaswellastoevaluatingtheireffectivenessforlong-termpositivehealthoutcomes.
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5. LeverageWorldOralHealthDayon20MarchtopromoteoralhealthandsupporttheworkofnationaldentalassociationsKeymessage:WorldOralHealthDayisaninternationally-recognizedcampaignthatprovidestheidealplatformforgovernmentstoworkwithnationaldentalassociationstounderstandtheircountry’soralhealthchallengesandlaunchpoliciesthataddressoraldiseasesatalocal,nationalandregionallevel.
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Call to action 1 Integrate oral diseases into policies addressing non-communicable diseases and general health more broadly to secure health and well-being throughout life
Oraldiseases,likeallotherdiseases,shareawiderangeofriskfactors.Some,suchasage,sexandhereditaryconditions,areintrinsictotheindividualandcannotbechangedormodified.Others,whicharesubjecttobehavioursandlifestyle,areconsideredtobemodifiableriskfactors,becauseindividualactionandmodificationofaparticularhabitorbehaviourispossible.Inreality,thischangemaybedifficulttoachievewithoutadditionalsupportiveinterventions.OraldiseasesareasignificantNCDwithuntreatedtoothdecaybeingthesinglemostprevalentandpreventabledisease,andoralcanceramongthe10mostcommoncancers.Themodifiableriskfactorsoforaldiseasesincludeanunhealthydiet,particularlyonehighinsugar,tobaccouse,andunhealthyalcoholconsumption.ThesekeyriskfactorsarealsosharedwithmostoftheothermajorNCDs.Henceadoptingacommonriskfactorapproachandfullyintegratingoralhealthintopopulation-wideNCDpreventionandhealth-promotionstrategiesshouldbeencouraged.KEYMESSAGE:Youcan’tbehealthywithoutgoodoralhealth.Oralhealthisoneofthemainpillarsofoverallhealthandwell-beingand,giventhesharedriskfactorswithotherNCDs,shouldbeintegratedintopoliciesaddressingthem.
Unhealthydiet,particularlyonehighinsugar
Rationale
• Sugarisaleadingriskfactorfortoothdecay• Untreatedtoothdecayisthemostcommonchronicdisease,duetoexposuretosugarand
otherrisks,thelackofeffectivepreventionandlimitedaccesstoappropriateoralhealthcare• Toothdecayisprincipallycausedbysugarconsumptionandcanlargelybepreventedby
reducingsugarintake,appropriatefluorideuseandpromotinggoodoralhygiene
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• Thehighestlevelsoftoothdecayarefoundinmiddle-incomecountries,wheresugarconsumptionisontheriseandhealthsystemsarenotabletoprovideappropriatepreventionoraccesstooralhealthcare
• Theconsequencesofuntreatedtoothdecay,particularlyforchildren,arenegativeimpactsonnutritionandgrowth,lossofdaysinschoolandatwork,reducedoverallproductivityandsignificantimpactsonqualityoflifeandsocialinteractions
• Reducingsugaraspartofahealthydietpromotesbetteroralhealthandcontributestoreducingtheriskoforaldiseases,obesity,diabetesandotherNCDs
• Population-widestrategiesandpoliciestoreducesugarconsumptionaspartofahealthydiethavethehighestpotentialtopromotebetteroralhealthandpreventotherNCDs
Campaignfor:
• Highertaxationonsugar-richfoodandsugar-sweetenedbeverages• Transparentfoodlabellingforinformedconsumerchoices• Limitingthemarketingandavailabilityofsugar-richfoodsandsugar-sweetenedbeveragesto
childrenandadolescents• Provisionofsimplifiednutritionguidelines,includingsugarintake,topromotehealthyeating
anddrinking• Strongregulationofsugarinbabyfoodsandsugar-sweetenedbeverages• Banningunhealthyfoodfromtheschoolenvironment• Regulationofadvertisingandsponsorshipoffoodmanufacturers• Promotingnaturalandindigenousproductswithgoodnutritionalvaluesovertheuseof
processedfoodthroughintegratednutritioncounsellingUseFDI’s‘Apracticalguidetoreducesugarsconsumptionandcurbtheepidemicofdentalcaries’tohelpdevelopyoursugarstrategies3.
Tobaccouse
Rationale
• Tobaccouseinallformsisharmfultohealth,includingoralhealth• Globally,tobaccouseistheleadingpreventablecauseofdeathanddisease,includingoral
conditions 3 Apracticalguidetoreducesugarsconsumptionandcurbtheepidemicofdentalcaries.FDIWorldDentalFederation,2016(http://www.fdiworldental.org/media/98541/sugar_toolkit-fdi-2016.pdf,accessed20January2016).
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Campaignfor:
• Policiestostrengthentobaccocontrolsuchasprotectingpeoplefromtobaccosmoke• Policiestohelpquittobaccouseandwarnaboutthedangersoftobacco• Highertaxesontobaccoproductstoreduceconsumption• Bans,orenforcingbans,ontobaccoadvertising,promotionandsponsorship
Harmfuluseofalcohol
Rationale
• Harmfuluseofalcoholisamajorriskfactorformorethan200diseases,includingoralcancerandperiodontaldisease
• HarmfuluseofalcoholmustbeaddressedaspartofacomprehensiveapproachtoNCDsCampaignfor:
• Raisingtaxesonalcoholicbeveragestoreduceconsumption• Implementingandenforcingeffectivemeasuresthatregulatealcoholavailability• Strictzero-tolerancepoliciesfordrinkdriving• Regulating,reducingorbanningalcoholadvertisingandpromotion
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Call to action 2 Implement cost-effective evidence-based population-wide oral health promotion measures FDIhasrecognizedtheroleofpopulation-widestrategies,notablyfluoride,insupportingself-careandprevention,andthuspromotingoralhealthandfunctionality.Goodoralhygiene,areductioninconsumptionofdietarysugars(seeCalltoaction1),andtheregular,appropriateuseoffluoridearekeyelementsofeffectivetooth-decaypreventionstrategies.Fluoridehasbeenusedforover70yearsinthepreventionoftoothdecay.Alargebodyofscientificevidencedemonstratingitseffectivenessinpopulation-widestudiessupportsitsuse.However,theevidenceisstillevolvingandvariesfordifferentmodesofdelivery.Theeffectoffluorideislocal(topical)onthetoothsurface:inhibitingbacterialacidproduction,stoppingenameldemineralization,enhancingremineralization(repair)andimprovingenamelresistancetofutureacidattacks.Fluoridecanreachthetoothsurfaceinmanyways:itcanbeaddedtowater,saltormilkaspartofcommunityinterventions;beprofessionallyappliedorprescribedasgel,varnishortablets;orcomprisepartofself-careintoothpasteandmouthrinses.Theevidenceforthesefluoridationmethodsvariesfromverystrongtoweak,sothatthechoiceofthemostsuitablefluoridationstrategydependsonmanyfactors,includingtheevidenceofeffectiveness,thesettingandtheresourcesavailable.Fluoridesaresafeandeffectiveifappliedatrecommendedlevels.Sodium-fluorideispartofWHO’smodellistofessentialmedicines,andaccesstofluorideshasbeenrecognizedasapartofthebasichumanrighttohealth.Thepotentialforreducinginequalitiesinthetooth-decayburdenthroughuniversalaccesstofluoridesfordentalhealthislargelymissedthroughabsenceofpreventivenationalfluoridepoliciespromotingavailability,affordabilityoruseoffluorideproducts,andmandatingwater,saltormilkfluoridation.
KEYMESSAGE:population-basedpublichealthinterventionssuchaspoliciestoaddressaffordableaccesstofluorideandreducesugarconsumptioncanpositivelyinfluenceoralhealthoutcomesanddecreasecoststotheindividualaswellastheeconomy.
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Preventionoftoothdecay:fluorides
Rationale
• Theconsequencesofuntreatedtoothdecay,particularlyforchildren,arenegativeimpactsonnutritionandgrowth,lossofdaysinschoolandatwork,reducedoverallproductivityandsignificantimpactsonqualityoflifeandsocialinteractions
• Theuseoffluoridesforthepreventionoftoothdecayissafe,efficientandhighlycost-effective.Increasedeffortsarerequiredtopromoteaccessanduseofappropriatefluoridestoachieveuniversalaccess
• Fluoridetoothpasteishighlyeffectiveinpreventingtoothdecay.Itissafeandreadilyavailable,butgreatereffortisrequiredtoimproveitsaffordabilityandqualitytoensureuniversalaccess
Campaignfor:
• Universalaccesstoaffordableandeffectivefluoride• Removaloftaxationandtariffsonfluoridetoothpasteandpassonsavingstothe
consumer• Increasingtaxationoftoothpasteswithoutfluoridetodiscouragetheiruse• Enforcingequitypricing–differentialpricesfordifferentpopulations,dependingon
purchasingpower• Promotinggenericcompetitionandlocalproduction,whileensuringqualitystandards• Improvingcapacitiesofnationalfoodanddrugadministrationsforbettermonitoringof
toothpastequality• StrengtheningandenforcingtheregulationsofISO11609
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Call to action 3 Recognize that oral health is a basic human right and essential to maintaining a good quality of life by providing universal health coverage and implementing policies that address social determinants Thesocialdeterminantsofhealtharethecircumstancesintowhichpeopleareborn,grow,live,workandage.Thesecircumstances,whichlargelydeterminethebehaviourspeopleadoptandthechoicestheymake,areinturnshapedbyawidersetofforces:economics,socialpolicies,education,politicsandmanymore.Theunequaldistributionofallthesedeterminingfactorsaccountsforthepersistingandgrowingglobaldifferencesinhealthstatusanddiseaseburden.Theseinequalitiesingeneralandoralhealthwithinandbetweenpopulationsmustbeaddressedbypolicymakersandthoseinpublichealth.Prevailinginterventionsthatfocusonmodifyinghealthbehavioursandlifestylechoiceshaveonlylimitedsuccessandhavebeencriticizedbecausetheyignorethewidersocialinfluencesthatdeterminethesechoices.Onlyabroaderintegrativestrategythattakesaccountofthecommonriskfactorsandtherootdeterminantsofhealthwillresultinequitableapproachestopromotingbetteroralhealthandgeneralhealth.Oraldiseaseshaveconsiderableimpactintermsoftreatmentcostsandproductivitylosses.LinkingandintegratingoralhealthwiththeSustainableDevelopmentGoals(SDGs)iscrucialforbetterprioritizationoforaldiseasesinthecontextofglobalpublichealthanddevelopment.KEYMESSAGE:broaderintegrativestrategiesthattakeaccountofcommonriskfactorsandtherootdeterminantsofhealththroughan‘oralhealthinallpolicies’approach,willresultinequitableapproachestopromotingbetteroralhealthandgeneralhealth.
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Socialdeterminants
Rationale
• Thegeneralandoralhealthofwholepopulationsarelargelydeterminedbysocialfactorsandtheirinteractionwithasetofcommonriskfactors,namelysugar,tobacco,alcoholandpoordiet
• Systematicallyincludinghealthandoralhealthinallpoliciescanhelptoreducenegativeeffectsonhealthequityofpolicydecisionsinothersectorsandcancontributetoincreasingsynergiesforbetterhealthstatusofpopulations
• Measurestoreduceexposuretoriskfactorstohealthandoralhealthareakeyresponsibilityofgovernmentsinthecontextofprotectingpopulationsandimprovingtheirqualityoflife
Campaignfor:
• Policiesandapproachesaimedat:o Reducingpovertyo Increasingsocialinclusiono Improvingthegenerallevelsofeducationandemploymento Reducingbarrierstohealthcareo Promotingaffordablehousing,safewaterandsanitationo Protectingminorityandvulnerablegroupsforsustainableimprovedhealthandoral
healthstatus• Thesystematicinclusionofhealthandoralhealthinallpoliciestoreducenegativeeffects
frompolicydecisionsmadeinothersectorsonhealthequityandcontributetoincreasingsynergiesforbetterhealthstatusofpopulations
• Maximizationofopportunitiestoworkeffectivelyacrossdisciplinesandsectorstoreduceinequalitiesinsocialdeterminantsandpeople’shealth
• Resourcestobetargetedtoaddresshealthinequalitiesandsupportthosewiththegreatestandmorecomplexneedstoreduceinequalities
• Measurestoreduceexposuretoriskfactorstohealthandoralhealththroughtheregulationofunhealthyfoodsandthereductionoftobaccoandalcoholuse
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Oralhealthanddevelopment
Rationale
• LinkingandintegratingoralhealthwiththeSDGsiscrucialforbetterprioritizationoforaldiseasesinthecontextofglobalpublichealthanddevelopment
• ItwillbeimportanttorelateoralhealthsystematicallytotheobjectivesoftheSDGs,theirindicatorsandtargetsfromtheoutset.Thiswillprovideaframeworkforthesystematicinclusionoforalhealthcareinstrengtheninghealthsystems,topromoteoralhealthcareandpreventioninthecontextofuniversalhealthcoverage;andtomakestrongadvocacyargumentsforcross-sectoralintegrationoforalhealthinsustainablehumandevelopment
• UniversalHealthCoverageisanincreasinglyrecognizedconceptaimingtoensureaccesstobasicprimaryhealthservicesforall
Campaignfor:
• ImplementationoforalhealthstrategiestoberecognizedasbeingofcriticalimportanceiftheSDGsaretobemet
• Universalaccesstoprimaryoralhealthcare,coveringatleastreliefofpain,promotionoforalhealthandmanagementoforaldiseases,includingtoothdecay
• BasicoralhealthcareasanintegralpartofUniversalHealthCoverage• Increasedfocusonimplementationandhealth-serviceresearchtoevaluateexisting
UniversalOralHealthCaremodelsandtoguideevidence-basedpolicydecisionsfornewones
• Strategiesthatencourageearlydetectionofdisease
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Call to action 4 Prioritize surveillance, monitoring and evaluation of oral diseases and recognize that this is an integral part of routine epidemiological data collection Despitethewidespreadnatureoforaldiseases,reliable,standardizedglobaldataarelimitedandthereareseriousgapsinrecentepidemiologicaldata,particularlyinlow-andmiddle-incomecountries.Thisislargelybecauseoralhealthdataarenotintegratedinnationaldiseasesurveillance.Thus,generalawarenessoforaldiseasesamongpolicymakers,healthplannersandthehealthcommunityatlargeremainslow.Existinginterventionstopreventandcontroloraldiseasesaretoooftenregardedasanexpendableluxury,ratherthanasafundamentalhumanrightforeveryone.Consequently,alargeproportionoftheglobalburdenremainsunattended,andoraldiseasesreceiveonlyalowallocationofresourcesforsurveillance,prevention,careandresearch.Collectingdataonhealthisacomplexundertakingthatrequiresanappropriateandagreedindicatorframework,aswellasahealthsystemthatincludesreliablesurveillancesystemsandabilitytoreportdataregularly.Moreover,politicalsupporttoallocatesufficientresourcestostatisticalanalysisandcommitmenttotransparencyforopenaccessisrequired.Muchprogresshasbeenmadeincollectingdataongeneralhealthandhealthsystemsperformance.Yet,allareasofdatacollectionrelatedtooralhealth,oralhealthsystemsandoralhealthprogrammeperformancearesignificantlylaggingbehind.FDI’sneworalhealthdefinitionisafirststeptounitetheglobaloralhealthcommunityundercommonlanguagewhenreferringtooraldisease.Thenextstep,whichisunderway,istoprovideameasurementtoolbywhichtomonitorprogress.Theseindicatorswillaidoraldiseasesurveillanceatnationallevels.KEYMESSAGE:oralhealthdatamustbeintegratedintonationaldiseasesurveillance.Monitoringriskfactorsandoralhealthneedsisfundamentaltodevelopingappropriateinterventionsandprogrammesaswellastoevaluatingtheireffectivenessforlong-termpositivehealthoutcomes.
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Surveillance,monitoringandevaluation
Rationale
• Separatenationaloralhealthsurveysarecomplexandcostlytoconduct,andhencenotprioritized
• Thepersistinggapsindataontheprevalenceoforaldiseases,andtheirburdenandseverityindifferentpopulations,meansthatawarenessofthesignificanceofthesediseasesispoor
• Lackofgoodinformationcreatesabarriertoprioritizingtheirpreventionandtreatment,andlimitsthedevelopmentofeffectivepublichealthresponses
• Monitoringriskfactorsandoralhealthneedsisfundamentaltodevelopingappropriateinterventionsandprogrammesandtoevaluatingtheireffectiveness
Campaignfor:
• Oralhealthanddiseaseindicatorstobeincludedsystematicallyinregulardiseasesurveillanceandepidemiologicalmonitoring,includingdataontherelatedriskfactors
• Cancerregistriestobestrengthenedtocoveroralcancereffectively• Monitoringofnoma,orofacialtraumaandcongenitalmalformationstobeimproved• Collecteddatatobemadeuniversallyaccessibleandcompiledinrepositories,sothatthey
areavailableforresearchandinformedpolicydecision-making
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Call to action 5 Leverage World Oral Health Day on 20 March to promote oral health and support the work of national dental associations
Drivingpublicawarenessonoralhealthissuesgoeshand-in-handwithinitiativesaimedatchangingpolicy.Populationsneedtobeempoweredtomakeinformedchoicesandgovernmentsneedtotakeresponsibilityandsafeguardtheoralhealthoftheircitizensbyimplementingeffectivepolicies.WOHDprovidestheidealplatformfordecision-makerstocollaboratewiththeirnationaldentalassociationandbeguidedontheoralhealthchallengesfacedbytheircountryaswellasmapoutsolutionstogether.Oralhealthprofessionalsarekeystakeholdersandadvisorstogovernment,andnationaldentalassociationscanhelpamplifytheirmessagesandsupportpolicyimplementation.Combatingtheoraldiseaseburdenwilltakeawhole-of-societyandwhole-ofgovernmentapproachandWOHDshouldbeleveragedtoeducateasmanypeopleaspossibleonhowtoprevent,treatandmanageoraldisease. Theoraldiseaseburdencanonlytrulybeaddressedbyindividualactioncombinedwithgovernment-driven,population-basedpreventionstrategies.
KEYMESSAGE:WorldOralHealthDayisaninternationally-recognizedcampaignthatprovidestheidealplatformforgovernmentstoworkwithnationaldentalassociationstounderstandtheircountry’soralhealthchallengesandlaunchpoliciesthataddressoraldiseasesatalocal,nationalandregionallevel.
Whytheneedfororalhealthawarenesscampaigns
Rationale
• Oraldiseasesaffect3.9billionpeopleworldwide,withuntreatedtoothdecay(dentalcaries)impactingalmosthalfoftheworld’spopulation(44%),makingitthemostprevalentNCD
• Globally,between60–90%ofschoolchildrenandnearly100%adultshavetoothdecay,oftenleadingtopainanddiscomfort
• Severeperiodontal(gum)disease,whichmayresultintoothloss,isfoundin15–20%ofmiddle-aged(35–44years)adults
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• Severeperiodontitisanduntreatedtoothdecayintheprimaryteeth(milkteethorbabyteeth)areamongthetop10mostprevalentofallconditions.Combined,theseconditionsaffect20%oftheglobalpopulation
• Globally,about30%ofpeopleaged65–74yearshavenonaturalteeth,aburdenexpectedtoincreaseinthelightofageingpopulations
• Oraldiseaseisassociatedwithsignificantpainandanxiety,aswellasdisfigurement,acuteandchronicinfections,eatingandsleepdisruption,andcanresultinanimpairedqualityoflife.Indevelopingcountries,thisisexacerbatedduetothelackofpaincontrolandtreatmentnotbeingreadilyavailable
• Oralconditionsarethefourthmostexpensivetotreat.IntheUnitedStatesalone,US$110billionarespentyearlyonoralhealthcare.IntheEuropeanUnion,annualspendingonoralhealthcarewasestimatedat€79billionintheyears2008-2012,whichismorethanthemoneyinvestedinthecareofcancerorrespiratorydiseases
• Oralhealthisessentialtomaintaininggeneralhealthandwell-being
Campaignfor:
• Governmentstorecognizethelackofawarenessonoraldiseaseandimplementpoliciesthat
helptopreventandmanagethem• Investmentinpreventiontohelpreducecoststotheindividualaswellastheeconomy• Policymakerstoworkwithnationaldentalassociationstodefinestrategiestoaddressthe
growingoraldiseaseburden• GovernmentofficialstoshowtheirsupportforWOHDeventsorganizedbythelocal/national
dentalassociationanduseitasanopportunitytocommunicatetheircommitmenttoaddressingoraldisease
• Decision-makerstolaunchpoliciestocombatoraldiseaseonWOHD
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Disease-specific action Prioritize diseases that are particularly prevalent in your country Thefivecallstoactionhighlightedabovefocusontakingabroadapproachtoaddressingtheoraldiseaseburden.However,youmaychoosetotakeadisease-specificapproachandconcentrateyouradvocacyeffortsonadiseasethatisparticularlyprevalentinyourgeography.
Oralcancer
Oralcancerisacommoncancerworldwide,andthetypicalpatientisamiddle-agedman.InsomecountriesinSouthAsiaoralcanceristhesecondmostfrequentcancerformenandisthemostcommoncauseoftheirprematuredeath.
Rationale
• Oralcancerisamongthe10mostcommoncancersworldwide• Reducingtobaccoandalcoholconsumptioncanlargelypreventit• Survivalratesarelowcomparedtoothercancersduetolatedetectionandthecomplexities
ofappropriatecare• Survivalratescanbeimprovedwithearlydetection• Theimpactonqualityoflifeforthosewhosurvivethediseasecanbehigh
Campaign for:
• Reducingthemainriskfactors(tobaccouseandexcessivealcoholconsumption)• Earlydetectiontoimprovetreatmentoutcomesthroughtimelyreferralforspecialistcare• Screeningofpatientswithriskfactorssuchassmokingorhighalcoholconsumption,where
thereisgoodevidenceforitseffectiveness(generalpopulationscreeningisnotrecommended)
• Availabilityofeffectiveandappropriatespecialistcare• Accesstotreatmentthroughinclusionoforalcancercareinuniversalhealthcoverage,the
strengtheningofhealthsystemsandacomprehensiveapproachtorisk-factorreductionmayhelpinaddressingtheseinequalities
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• Integrationoforalcancerinroutinediseasesurveillanceusedforothercancers,includingspecializedoralcancerregistries
• Strengthenedcapacitiesinoralpathologyandhistologicaldiagnosis
Noma
Rationale
• NomamainlyaffectschildreninSub-SaharanAfrica• Itisarapidlyprogressive,destructiveandfrequentlylethaldiseaseofpovertyandneglect
Campaignfor:
• Measurestoincreaseawarenessofnoma• Comprehensivemeasuresthatcontributetoreducingpoverty,malnutritionandother
environmentalandbehaviouralriskfactorsofnomaforchildren• Measurestostrengthenearlydetectionofnomacasesbasedonintegratedcommunity
healthstrategies• Rapidandappropriateprimarycareforpatientswithearlystagesofnoma• Referralofpatientswithadvancednomatospecialistcare• Measurestostrengthenintegratedsurveillancesystemsthroughdocumentationand
reportingofnomacases
Congenitalanomalies
Rationale
• Cleftlipand/orpalate(orofacialclefts–OFC)arethemostfrequentbirthdefectsofthefaceandmouth,creatingaheavyburdenintermsofmortality,disability,qualityoflifeandfinancialcost
Campaignfor:
• MeasurestostrengthennationalregistriesforbirthdefectsandOFC,astheyarecrucialforplanningservicesandevaluatingprimarypreventiveinterventions
• Combinedeffortsinessentialhealthcare,primarypreventionandeducationtoimproveaccesstocareforchildrenwithOFC
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• AmorecomprehensiveapproachforNGOsinvolvedincareforOFC,whichgoesbeyondprimarysurgeryservices
• MeasurestoensurethatprimarypreventiontakesaccountofgeneticandenvironmentalfactorsifthecausesofOFCaretobeaddressedeffectively
• Measurestoensurethatprimarypreventionandessentialsurgeryservicesforbirthdefects(includingOFC)areavailableinthecontextofintegratedhealthcare
• Improvedmonitoringofcongenitalmalformations
Oraltrauma
Rationale
• Oraltraumaiscommonandcanbepreventedbyimprovingpublichealthpoliciesandraisingawarenessofrisksrelatedtoviolence,sportsandroadsafety
Campaignfor:
• Measurestoenforceregulationstoincreaseroadsafetythroughthemandatoryuseofseatbelts,childseats,motorcycleandbicyclehelmets,andthepreventionofdrunk-driving
• Implementationofappropriatestrategiestoreduceviolenceandbullyingatschool• Measurestoenforcethemandatoryuseofhelmetsormouthguardstoimprovesafetyfor
contactsports• Measurestostrengthentheroleofdentistsindiagnosingtraumaasaresultofviolenceand
childabuse• Measurestoensureappropriateemergencycareforimprovedpost-traumaresponse• Improvedmonitoringoforofacialtrauma
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Tools to get you started How to run an effective advocacy campaign and deal with the media
Runninganeffectiveadvocacycampaign
Tocarryoutaneffectiveadvocacycampaignonaspecificissueitiscrucialto:Define:whattheultimategoalyouwanttoachieveisForexample,definewhichofthecallstoactionyouwanttofocusyoureffortson.Youmaydecidetoimplementstrategiesforallfiveofthemoralternativelychoosetoprioritizeonlyoneortwoofthem.Decide:whatpolicy/priority/actionyouwishtopromote,influenceorchangeAttheoutset,itisbetternottobetooambitious:youshouldreadthisguideanddecidehowtoapplyittoyournationalpriorities.Identify:whomakesthedecisionyouaretryingtoinfluenceandthetimelineforthedecisiontobemadeThesewouldincludegovernmentministersandtheiradvisers,inparticularMinistersofHealthandChiefDentalOfficersbut,giventhe‘whole-of-government’focus,headsofotherdepartments,parliamentarians(includingmembersoftheopposition)businessleadersandotheragenciesthatimplementpolicy.Formalliances:withothergroupswithsimilarinterestsWhoarethepartnersyoucouldworkwithtobemoreeffective?Contactinghealthprofessionnationalassociationscouldbeastart,aswellasothergroupssuchasprofessionalandpatientassociationsinthefieldoforalhealthandpublichealth.Getthefacts:thismeansbeinginpossessionofthedataandfactstosupportyourcase‘Facts’canbeobjective(e.g.evidence-baseddata);however,theycanalsobesubjective(e.g.publicappraisalsof,e.g.publicawarenesscampaigns)orpatients’perceptionsoflivingwithoraldiseasesorpoordentalcare.Statementsofpolicyorbestpracticecanalsobeusedtosupportyourarguments.
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Devise:appropriatetacticsTherearenumerousapproaches:securingaplaceintheworkinggroup/committeechargedwithnationalimplementation;ensuringallocationofa‘civilsociety’seatinpublichearings;ensuringpresenceinthepolicyreviewprocess;directcontactswithministers,parliamentariansandprovidinginformationanddevelopingcontactsamongmembersofthemedia.
Dealingwiththemedia
GettingstartedForanyonelookingtoengagewithjournalists,butisunsurehowtostart,thenthissectionoftheguideisforyou.Ifyouhaveenoughresources,thenitwouldmakelifeeasiertohireanexperiencedpublicrelationsagency.However,weknowthatsuchasolutionisnotalwayspossibleforourmembers,sowehopethatthefollowingguidancewillproveuseful.Ifyouwanttoestablishmutuallybeneficialmediarelationships,makesureyoumakeagoodfirstimpression.Forinstance,findoutwhichjournalistshavewrittenrelevantstoriesbycarefullysearchingonlinenewssites.Wheneverpossible,trytoavoidblindlysendingoutpressreleasesandotherinformationwithoutcheckingfirsttoseeifyou’retargetingtherightpeople.Journalistsreceivemanyemailsandphonecallseveryworkingday,mostofwhichareignoredbecausetheyareeitherirrelevantoruninteresting.PreparingpressreleasesForbeginners,thebestwaytowriteapressreleaseistoadoptthe5Wsrule–What?Who?Where?When?Why?ThefirstfewparagraphsofeverypressreleaseshouldprovideinformationconcerningthefirstfourWs.ThefifthW–Why–shouldfollowafterwards,thencontinuethestorybyprovidinganyotherrelevantinformation.Anexampleofthe5Wsapproach1.Whatisyourstoryabout?E.g.yourdentalassociationiscallingonyourcountry’sgovernmenttosupportthepreventivemodeloforalhealthcarebasedonthecommonriskfactorapproachtoNCDs.2.Whereisthishappening?Givedetailsofyourlocalinitiative,i.e.areyoulaunchingapolicyreportthoughanevent?Ifso,giveinformationonthetime,place,venueofwherethisistakingplace.
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3.Whoisinvolved?Mentionanylocalstakeholdersthatareinvolvedi.e.MinisterofHealth,DentalSchools,RegionalWHOOfficeetc.orothersisterorganizations.4.Whenisthishappening?E.g.agovernmentcampaignonnutrition,tobelaunched[date]butremember,ifyoucanissueapressreleaseonthesamedaythatotherimportantannouncementsordevelopmentsoccur,youwillhaveabetterchanceofgainingjournalists’attention.5.Whyisthishappening?(Adaptandusethekeymessageslistedforeachcalltoactiondependingonyourareaoffocus).Otherpointstorememberwhenwritingpressreleases:
• Includeaquotefromoneortwopeople(butnomore),toprovideahumanperspectiveonthestory
• Keepyourpressreleaseshort–trytofityourstoryonto1.5sidesofA4maximum(anddouble-spacethetextsoit’seasytoread)
• Makesureyouaddcontactdetails(phoneandemail)atthebottomofthepressrelease
WritingopinionarticlesLocalnewspapers,tradepressandagrowingnumberofwebsitescanprovideopportunitiesfordentalprofessionalstosubmitstoriesforpublication.However,beforeyouputfingerstokeyboardorpentopaper,itisimportanttoknowthepurposeofwhatyouarewriting,sothatyouunderstandthestoryandforwhomyouarewriting.Thekeyrequirementsforanyarticleare:
• Topicalandrelevantstory-e.g.healthpromotionanddiseasepreventiontocutpublichealthexpenditure
• Astrongheadline• Aninterestingintroduction• TheFiveWs(Whatisthisstoryabout;Whoisinvolved,WhenandWherearethings
happening;Whyisthishappening?)• Demonstrateyourexpertize–asdentalpractitioners,whatinsightscanyouprovidethat
otherscannot?Onceyouhavepreparedstronganswersforalltheserequirements,eithertelephoneoremail
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yourtargetjournalisttoseewhattheythink.Rememberthat,unlikepressreleases,articlesaremoreconversationalandareusuallyopinion-led.Besuretoconcludewithastrongfinish/calltoaction.Thingstoavoid:
• Long,repetitivesentences• Badjokes• Medicalorscientificjargon• Assumingthereadersknowasmuchasyoudoaboutthetopicyou’redescribing
Butdon’tforget:
• Alwaysbeaccurate–andusespell-check• Keepitsimpleandconcise• Keeptothewordcount• Stayontopic• Meetthedeadlinethatyouagreedwiththejournalist
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MANAGING EDITOR
Charanjit Jagait
EDITORIAL REVIEW & SUPPORT
Christopher Simpson
Claudia Marquina
DESIGN & LAYOUT
Gilberto D Lontro
©2017 FDI World Dental Federation
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Ihsane Ben Yaya
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