FROM THE ARCHIVES Celebrating the Year of Oral Health: Changing Public Expectation and Challenges for the Profession

Robert J. Collins, DMD, MPH Assistant Surgeon General & Chief Dental Officer U.S. Public Health Service

Article reprinted from the Joural of the American College of Dentists Fall/Winter 1994, Volume 61, Number 2

Abstract

The year 1994 was designated as the Year of Oral Health by the World Health Organization. The remarkable progress in oral health achieved in the United States over the past several decades is cause for celebration; however, the gains have not been equitably distributed and many challenges remain if good oral health is to become a reality for all Americans.

Members of the dental profession in general, and Fellows of the American College of Dentists in particular, have a responsibility to be aware of not only the health of our individual patients but also the oral health of the public as a whole. Many opportunities to improve dental practice on the individual and community level exist. By taking action to better meet the overall oral health needs of society, the dentist can increase professional satisfaction, improve the health of the public, and enhance the status of the dental profession.

As has been its custom since 1950, the World Health Organization (WHO) holds an annual celebration of World Health Day by focusing on a particular global health issue. World Health Day (WHO) is acknowledged on April 7 each year - the day of the formal adoption of the official constitution of the WHO. The theme for WHO in 1994 was Oral Health for a Healthy Life. Many communities in the United States and around the globe held events celebrating the progress made in pursuit of the benefits of good oral health, while acknowledging the need to do more to extend those benefits to all sectors of society.

This year, the WHO, in cooperation with the Federation Dentaire Internationale (FDI) went beyond just a single day’s acknowledgment and declared all of 1994 as the Year of Oral Health. This joint declaration provides an unparalleled opportunity to raise the public consciousness regarding oral health. In the U.S. activities related to World Health Day and the Year of Oral Health are supported, in part, by the American Association for World Health (AAWH), which serves as the U.S. Committee for the WHO. Recognizing that global health is improved through local action, the AAWH provides resource materials (1) to assist communities in coordinating activities. For several years the rallying cry for the annual AAWH campaigns has been “Think globally, act locally!” The American Dental Association and many other professional organizations are acknowledging the Year of Oral Health during their annual meetings and at other planned events.

Professional and public involvement in the Year of Oral Health can perhaps best be captured by two words: Celebration and Challenge.

Progress in Oral Health

There is much for both the public and the profession to celebrate in this Year of Oral Health. The oral health of the public in the United States has never been better. Largely due to increases in exposure to fluoride, the prevalence of tooth decay in school children has declined substantially over the past two decades (2) Advanced periodontitis afflicts a relatively small proportion of adults (3). Edentulism is clearly on the decline(4). A recent national survey indicates patients appear to be satisfied to a large degree with their dentists(5). Dental insurance coverage and the use of professional services also has been increasing. Although health expenditures as a percent of the Gross Domestic Product (GDP) have been rising, dentistry as percent of health expenditures has been declining(6). In spite of these and other gains, however, many challenges remain.

Remaining Challenges

Health Status

Oral diseases remain among the most ubiquitous of those facing Americans. More than 50 percent of children 5 to 17 years of age, and over 80 percent of 17-year old children, have experienced some dental decay. Not surprising, but perhaps more disturbing, is that the burden of oral disease is not distributed equitably. About 75 percent of the caries in children is found in only 25 percent of the population(6)

Higher oral disease levels are found in minority and low income populations. For example,