Evidence in Oral Health Promotion—Implications for Oral Health Planning

摘要

I have explored the debates on evidence-based oral health promotion and examined the practicality of promoting oral health care within a whole system (social, cultural, and environmental) approach. The use of evidence-based decision-making in health services and planning is a viable mechanism to identify optimal health benefits; however, barriers to the effective adoption of evidence-based health practice, including barriers that apply to oral health promotion, have been identified. Evidence-based oral health promotion highlights the importance of examining health promotion activities within a defined social context—a departure from the focus on improving study designs and research methods. Thus, the basis for evidence in health activities is grounded in social and organizational systems. This could contribute to sustainable health efforts. The emergence of evidence-based health care practice has gained considerable popularity in recent years. The use of evidence-based decision-making in health services and planning is seen as a viable mechanism to identify optimal health benefits to the population in question. 1,2 However, the role and value of evidence in health promotion and oral health promotion, particularly the nature and quality of evidence, has also been the subject of substantial debate. 3 Oral health care should involve initiatives directed toward promoting and supporting oral health self-care practices within appropriate general health strategies that respond to the prevailing social, economic, and environmental influences on health and well-being. Oral health promotion activities include oral health education, additional fluoride uptake, nutrition guidance, and fissure sealant applications. 4–6 The appropriate practice of evidence-based health promotion, and by analogy oral health promotion, requires high-quality available evidence, considerations of local values, and the availability of resources. 4 However, population health requires more than evidence-based health care. Research rarely determines policy but rather is used to support policy decisions. Evidence in health promotion, therefore, needs a focus beyond the health care system. There is a need to examine the social, cultural, economic, and environmental context of the whole social system, not merely health promotion activities. 7,8 I have explored the debates on evidence-based oral health promotion, and I have examined the practicality of promoting oral health care within a whole system (social, cultural, and environmental) approach.