Oral health is a leading indicator of general health, happiness, and life quality. Dental caries, periodontal (gum) disease, tooth loss, oral cancer, oro-dental trauma, and congenital abnormalities are all covered under this umbrella term. The leading noncommunicable illnesses share modifiable risk factors with most oral diseases and disorders (cardiovascular diseases, diabetes). Tobacco use, alcohol usage, and poor diets high in sugar are among the risk factors, all of which are on the rise globally. There is a proven relationship between oral and general health. For instance, diabetes has been associated with the development and progression of periodontitis. The burden of oral diseases and other noncommunicable diseases can be reduced through public health interventions by addressing common risk factors. The World Health Assembly approved a resolution on oral health in 2021 at the 74th World Health Assembly. The Resolution recommends "a shift from the traditional curative approach towards a preventive approach that includes promotion of oral health within the family, schools, and workplaces and includes timely, comprehensive, and inclusive care within the primary health-care system" (WHO, 2022). According to the Resolution, oral health should be firmly incorporated into the noncommunicable disease agenda, and oral health-care measures should be included in universal health-care programs. Oral health care is treated as a distinct entity in the Canadian health-care system. Every province recognizes some dental care as medically necessary and "targets oral health care resources to marginalized groups, using different methods and varied health and social service provisions." The federal government covers a portion or all the cost of oral health care for veterans, refugees, and eligible Indigenous peoples, and every province recognizes some dental care as medically necessary and targets oral health care resources to marginalized groups using different and varied health and social service provisions. Oral disease prevention is crucial and possible. Preventive techniques that are evidence-based, simple, and cost-effective do exist, but they must be vigorously pushed and adopted.
The social ecological model views health as a whole and considers a variety of elements that can influence it. This comprehensive definition of health, enshrined in the World Health Organization's 1947 Constitution, encompasses physical, mental, and social well-being (World Health Organization, 1947). According to the social ecological model, health is influenced by interactions between individuals, groups/communities, and their physical, social, and political surroundings. The social ecological model acknowledges the intricate role of context in the development of health problems as well as the success or failure of efforts to treat these problems. In its most basic form, the social ecological model is the concept that one item has an impact on another. The basic premise of this theory is that one event influences another, and that existence does not occur in a vacuum, but rather in relation to changing circumstances. This model can be used by oral health professionals, researchers, and community leaders to identify variables that contribute to poor health at various levels and to build oral disease preventive and oral health promotion strategies that include action at those levels. Rather than simply improving individual oral health behaviors, this strategy focuses on combining ways to transform the physical and social settings (CTSA, 2011). This new emphasis on community engagement can encourage health professionals, community leaders, and policymakers to imagine new opportunities as they face new challenges.
The Social Ecological Model identifies health as being influenced by interactions between individuals, communities, and the physical, social, and political environments. Additionally, the social ecological model considers the entire ecological system in which growth occurs to be considered when it comes to health (Crawford, 2020). Individual and personal factors such as age, education, income, and health history are included in the model's initial level. The second level, relationship, encompasses a person's closest social circle, such as friends, partners, and family members, all of whom impact and contribute to a person's experiences. The third level, community, looks at the areas where individuals have social ties, such as schools, businesses, and neighborhoods, and tries to figure out what makes these places healthy. Finally, the fourth level considers the broad socioeconomic variables that influence health. Cultural and social standards, as well as health, economic, educational, and social policies, all contribute to the creation, maintenance, or reduction of socioeconomic disparities across groups.
By using the social ecological model, we can enable community-engaged partnerships to identify a comprehensive list of factors that contribute to poor oral health and develop a broad approach to oral health problems that involves actions at many levels to produce and reinforce change. Some of the examples at different levels include:
Individual: Educational programs can be conducted to help people make wise choices to brush regularly, follow routine dental checkups, floss daily, use mouthwash and improve nutritional intake.
Interpersonal relationships: Working with local dental clinics to encourage referral discounts and benefits. Providing free samples of fluoride containing toothpastes and mouth washes. Encouraging use of protective equipment when doing sports and travelling on bicycles and motorcycles (to reduce the risk of facial injuries).
Community: Create dental camps and work with community groups to introduce healthy oral habits and preventive methods. Work with local dental clinics to promote free dental screenings and checkup. Community health promotion using oral health advertisements. Equal distribution of oral health professionals.
Society: Advocate for the passage of regulations for dental insurance and benefits. Regulation of tobacco, areca nuts and alcohol consumption. Legislations regarding community water fluoridation.
The ecological perspective is a valuable framework for comprehending the wide range of factors that influence one's oral health. It's a paradigm that can help provide a holistic view of the elements that influence specific oral health behaviors, such as social determinants of health. As a result, ecological frameworks can be utilized to incorporate elements from various theories and models, resulting in the development of a holistic health promotion, oral disease prevention program and policy approach. By putting long-term commitment to all stages and levels of ecological model, we can get the necessary modifications and synergy to promote long-term oral health improvement.
References:
Crawford, M. (2020). Ecological Systems Theory: Exploring the Development of the Theoretical
Framework as Conceived by Bronfenbrenner. Journal of Public Health Issues and Practices, 4(2), 2–7. https://doi.org/10.33790/jphip1100170
CTSA Community Engagement Key Function Committee Task Force on the Principles of Community Engagement. (2011).Retrieved from https://www.atsdr.cdc.gov/communityengagement/pce_models.html
World Health Organization. (n.d). Oral Health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/oral-health
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