Alliance for a Cavity Free Future

Alliance for a Cavity Free Future
Stop Caries NOW for a Cavity-Free Future
An Oral Health Resource


Health Promotion

Description and use:

Health promotion is the process of actively engaging individuals and providers, assuring access to the necessary health information and tools, and facilitating a conducive environment to enable people and their communities to gain control over their health. As defined by the World Health Organization (WHO) [1] this process involves the establishment of initiatives that are “empowering, participatory, holistic, equitable, sustainable and use multistrategies.[2]

Oral disease and chronic systemic disease share many common risk factors, so an integration of oral disease prevention and health promotion with general health and chronic disease prevention education should be considered a primary communication strategy.[3] Schools can be useful stage for integrated oral and general health promotion, with the benefit of reaching audiences of school children with varying levels of age and socio-economic status. Furthermore, input from health care professionals is key to ensuring quality control and the incorporation of preventive services. Health promotion aimed at intervening in common oral and systemic risk factors should take priority. The effects would be mutually beneficial to oral health and allow for oral health to be an integral part of systemic disease interventions.

Health promotion should be employed to educate individuals, health professionals, and policymakers regarding the influence of social and environmental determinants of oral disease, and access to dental services. Strong evidence exists of an association between childhood experience of socio-economic factors and adult health.[4] Caregiver oral health literacy problems have been associated with poor oral health behaviors and dental outcomes in early childhood.[5, 6] Moreover, stress induced biologic responses due to adverse socio-economic conditions such as increased cortisol levels may lead to alterations in dental pathology and increase poor oral health outcomes.[7] Lead and tobacco smoke have each been independently associated with increased risk of dental caries.[8-13] Interventions aimed at reducing socio-environmental risk factors of chronic disease can simultaneously lead to benefits in oral health outcomes. Support for such interventions on a community level is necessary and can be achieved through including oral health in targeted general health promotion programs. A systematic review of the impact of oral health promotion on cardiovascular outcomes was inconclusive and calls for more research in the area.[14]

Poor oral health has an impact on the quality of life in the population.[15] Health promotion programs should aim to bridge the gap between the perceived need and the real need for prevention and better access to oral health services. Programs may focus on prevention of disease in developed countries while developing countries might focus on health promotion through the combined establishment of programs, services and policies. For example, many developing countries have limited access to individual oral health care and use of preventive technologies. Hence, oral health promotion is needed on a community level with increased awareness of environmental and behavioral factors. The population-based promotion of fluoridated toothpaste in Cambodia and introduction of salt fluoridation in Laos are two such examples. One example of a health promotion school program is the Brighter Smiles Africa [16] initiative undertaken jointly by several partners in Uganda and Canada. The intervention-based model included daily at-school tooth brushing, in-class health education, topical fluoride application for a subset of higher risk children, routine data collection and regular program evaluation. Using a different approach to health promotion, China has conducted “Love Teeth Day” (LTD) a yearly nationwide health promotion campaign since 1989. The campaign provides oral health services, oral health promotion through mass media, festivals and special activities to raise oral health awareness.[17]