Your guide to oral health policies

www.worldoralhealthday.org

MOUTH SMARTLive

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.

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.

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

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).

Yournationalcontext

Foryourcountry-levelactivities,youwouldbewelladvisedtocollectsomenationalfactsandfigurestoillustrateandbackupyouroralhealthadvocacy.Thesemightbe:

• Scientific:drawnfromapeer-reviewedarticleinanational,regionalorinternationalscientificjournalfocusingonyourcountry

• Observational:forexample,theresultsofanationalsurveyamongdentistsbyyournationaldentalassociationonthespecificfieldoforalhealthyouwanttohighlightinyourcampaign

• Anecdotal:ifyoudon’thavefactsandfiguresorsurveyresults,youmayhaveevidencefromspeakingwithyourmembersor,forexample,perceptionsoforalhealthderivedfromaspecialWOHDdentalclinicyousetuptogivefreedentalcheck-upsin2015or2016

Notethatbothpolicymakersandthepublicliketoknowwheretheystandcomparedtoneighbouringcountries.Anycomparativeinformationwouldthereforebeausefulpartofyourcampaign.

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.

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.

5. LeverageWorldOralHealthDayon20MarchtopromoteoralhealthandsupporttheworkofnationaldentalassociationsKeymessage:WorldOralHealthDayisaninternationally-recognizedcampaignthatprovidestheidealplatformforgovernmentstoworkwithnationaldentalassociationstounderstandtheircountry’soralhealthchallengesandlaunchpoliciesthataddressoraldiseasesatalocal,nationalandregionallevel.

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

• 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).

Campaignfor:

• Policiestostrengthentobaccocontrolsuchasprotectingpeoplefromtobaccosmoke• Policiestohelpquittobaccouseandwarnaboutthedangersoftobacco• Highertaxesontobaccoproductstoreduceconsumption• Bans,orenforcingbans,ontobaccoadvertising,promotionandsponsorship

Harmfuluseofalcohol

Rationale

• Harmfuluseofalcoholisamajorriskfactorformorethan200diseases,includingoralcancerandperiodontaldisease

• HarmfuluseofalcoholmustbeaddressedaspartofacomprehensiveapproachtoNCDsCampaignfor:

• Raisingtaxesonalcoholicbeveragestoreduceconsumption• Implementingandenforcingeffectivemeasuresthatregulatealcoholavailability• Strictzero-tolerancepoliciesfordrinkdriving• Regulating,reducingorbanningalcoholadvertisingandpromotion

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.

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

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.

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

Oralhealthanddevelopment

Rationale

• LinkingandintegratingoralhealthwiththeSDGsiscrucialforbetterprioritizationoforaldiseasesinthecontextofglobalpublichealthanddevelopment

• ItwillbeimportanttorelateoralhealthsystematicallytotheobjectivesoftheSDGs,theirindicatorsandtargetsfromtheoutset.Thiswillprovideaframeworkforthesystematicinclusionoforalhealthcareinstrengtheninghealthsystems,topromoteoralhealthcareandpreventioninthecontextofuniversalhealthcoverage;andtomakestrongadvocacyargumentsforcross-sectoralintegrationoforalhealthinsustainablehumandevelopment

• UniversalHealthCoverageisanincreasinglyrecognizedconceptaimingtoensureaccesstobasicprimaryhealthservicesforall

Campaignfor:

• ImplementationoforalhealthstrategiestoberecognizedasbeingofcriticalimportanceiftheSDGsaretobemet

• Universalaccesstoprimaryoralhealthcare,coveringatleastreliefofpain,promotionoforalhealthandmanagementoforaldiseases,includingtoothdecay

• BasicoralhealthcareasanintegralpartofUniversalHealthCoverage• Increasedfocusonimplementationandhealth-serviceresearchtoevaluateexisting

UniversalOralHealthCaremodelsandtoguideevidence-basedpolicydecisionsfornewones

• Strategiesthatencourageearlydetectionofdisease

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.

Surveillance,monitoringandevaluation

Rationale

• Separatenationaloralhealthsurveysarecomplexandcostlytoconduct,andhencenotprioritized

• Thepersistinggapsindataontheprevalenceoforaldiseases,andtheirburdenandseverityindifferentpopulations,meansthatawarenessofthesignificanceofthesediseasesispoor

• Lackofgoodinformationcreatesabarriertoprioritizingtheirpreventionandtreatment,andlimitsthedevelopmentofeffectivepublichealthresponses

• Monitoringriskfactorsandoralhealthneedsisfundamentaltodevelopingappropriateinterventionsandprogrammesandtoevaluatingtheireffectiveness

Campaignfor:

• Oralhealthanddiseaseindicatorstobeincludedsystematicallyinregulardiseasesurveillanceandepidemiologicalmonitoring,includingdataontherelatedriskfactors

• Cancerregistriestobestrengthenedtocoveroralcancereffectively• Monitoringofnoma,orofacialtraumaandcongenitalmalformationstobeimproved• Collecteddatatobemadeuniversallyaccessibleandcompiledinrepositories,sothatthey

areavailableforresearchandinformedpolicydecision-making

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

• 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

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

• 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

• 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

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.

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.

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

yourtargetjournalisttoseewhattheythink.Rememberthat,unlikepressreleases,articlesaremoreconversationalandareusuallyopinion-led.Besuretoconcludewithastrongfinish/calltoaction.Thingstoavoid:

• Long,repetitivesentences• Badjokes• Medicalorscientificjargon• Assumingthereadersknowasmuchasyoudoaboutthetopicyou’redescribing

Butdon’tforget:

• Alwaysbeaccurate–andusespell-check• Keepitsimpleandconcise• Keeptothewordcount• Stayontopic• Meetthedeadlinethatyouagreedwiththejournalist

MANAGING EDITOR

Charanjit Jagait

EDITORIAL REVIEW & SUPPORT

Christopher Simpson

Claudia Marquina

DESIGN & LAYOUT

Gilberto D Lontro

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