Constituting Global Oral Health: Toward a Policy-Relevant and Action-Oriented Science.

Definitions can generate actionable consensus for a given subject matter by resolving important differences in philosophy and best practices and by streamlining activities for a stronger strategic direction. Interest in the global dimensions of oral health, a generally neglected area of global health, is growing; yet, no previously published research has defined the term ‘global oral health.’ As such, the Global Oral Health Interest Group of the Consortium of Universities for Global Health determined a need for an introductory definition of ‘global oral health’ to guide program planning, implementation, and evaluation. With the oversight of an expert senior Task Force for the Definition of Global Oral Health, we employed a mixed-methods approach using the more common expert consensus-building Delphi technique combined with the lesser utilized Q methodology. This approach allowed us to identify the interconnectedness of global oral health themes and integrate multiple, seemingly disparate, topics into a single streamlined concept. Our resulting definition is as follows: Global Oral Health aims for optimal oral health for all people and elimination of global health inequities through health promotion, disease prevention, and appropriate oral care approaches that consider common determinants and solutions and acknowledge oral health as part of overall health. The purpose of this short communication is to generate a narrative around our proposed definition of global oral health to support establishing guidelines and developing best practices for academic global oral health programs, policies, and practices that aim to achieve a goal of oral health globally.

To channel students' interest in global oral health and prepare them to respond adequately to the health effects of globalization as future practitioners, new courses in dental curricula may be needed. This article documents the results of Harvard School of Dental Medicine (HSDM)'s new course, Global Oral Health: Interdisciplinary Approaches. To the authors' knowledge, this is the first course of its kind in dental education. HSDM developed learning objectives for the course based on the literature, the training and experience of HSDM global health faculty, and the mission of the HSDM Global Health Initiative. Dental residents and public health students enrolled, and some dental students audited. The discussion-based critical thinking course examined the extensive relationship between oral health and global health, and concept development was determined by in-class participation. After taking the course, students' assessments of their global oral health knowledge increased on average 100 percent. Nearly all students reported that they were very likely to use the concepts of global oral health in their careers and that they would definitely recommend the course to others. This course model seems to have met the expectations of students and faculty, and its fundamentals appear to be readily transferrable to other dental schools.

Objectives: The present research indicates an increased interest in global health among dental students. We focused on developing our future dental practitioners with the skills and capacity to treat underserved populations as international experiences. Materials and Methods: This pilot explored the perspective of dental learners regarding global oral health knowledge who had experienced mission trips. Participants were assessed with a validated global oral health survey to understand their existing knowledge. Gaps in training were noted and a global oral health interactive module was created to address international community service learning approaches. Later, all students who intended to participate in a global oral health education or mission trip were administered the same validated pre-test. Finally, on the completion of mission trips or global oral health experiences, the same post-global oral health questionnaire survey was administered to assess knowledge gained. Results: Thirty-two dental students (Female = 18 and Male = 14) and learners who had completed mission trips to Jamaica and the Dominican Republic were invited to complete the pre-survey. Twenty-seven students completed the pre-survey in its entirety. About 41% (11/27) were not aware of developed and developing countries’ oral healthcare systems. Participant dental learners (56%) expressed limited cultural competency. They also expressed the lack of global health ethics (52%) awareness (knowledge). Conclusion: Results indicated that students benefited from a structured global oral health module, where their perspectives shifted positively. The results suggested that a shift from “mission trip” perspectives to a global oral health readiness is feasible as a student empowerment approach.

Dental schools need to produce graduates who are adequately prepared to respond to the complex needs and challenges of the increasingly diverse and interconnected world in which they will practice dentistry. To enhance discussions about the coverage of global oral health competencies in dental education, the aims of this study were to assess how global health education is currently incorporated into predoctoral dental training in the U.S. and which global oral health competencies are being covered. Surveys were emailed to all 64 accredited U.S. dental schools during the 2015-16 academic year. Respondents from 52 schools completed the survey (response rate 81%). The results showed that social determinants of oral diseases and conditions, how to identify barriers to use of oral health services, and how to work with patients who have limited dental health literacy were covered in the greatest number of responding schools' curricula. Key areas of global health curricula that were covered rarely included global dental infrastructure, data collection design, and horizontal and vertical programming approaches to health improvement. Despite current dialogue on the addition of global oral health competencies to dental curricula, only 41% of the responding schools were currently planning to expand their global oral health education. Based on these results, the authors conclude that it may be most feasible for dental schools to add recommended global oral health competencies to their curricula by incorporating didactic content into already established courses.

Purpose:The Global Health Starter Kit (GHSK) is an interdisciplinary, competency-based, open access global health curriculum covering global disease and demographic trends, Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), the connection between oral health and overall health, social determinants of health, and concepts of sustainable and ethical global health programs. In this study, we evaluate and describe barriers to and facilitators for using and implementing the GHSK curriculum across a variety of new users.Methods:This two-phase study uses the Roger’s Adoption Curve concept to standardize this evaluation and inform a strategic plan for continuing to move the curriculum across the chasm from early adopters to an early majority of global oral health educators and learners. We utilized a theoretical adoption framework to identify facilitators and barriers under the domains of innovation and curricular, educator and learner, and institutional and structural factors. Under qualitative Phase 1, five early adopter institutions were interviewed to elicit understanding of factors that contribute to adoption of the GHSK curriculum. Common themes identified were next used to create a Phase 2 quantitative survey for early majority subscribers of the GHSK (N = 27).Results:These qualitative and quantitative results showed an overall high satisfaction with the quality of the GHSK materials, but also effectively identified barriers to its adoption, including inexperience of faculty in teaching global oral health, a lack of awareness and marketing, and absence of global health accrediting requirements.Conclusions:By identifying the barriers and facilitators of GHSK curriculum integration, this study provides concrete and specific opportunities to improve its format, relevance, content, and delivery. This study outlines next steps to creating a standardized approach to successfully adopting competency-based global oral health teaching and learning.

Global health threats are also oral health threats

Oral health at a tipping point

The global oral health workforce

Dental education has seen increases in global health and international educational experiences in many dental schools' curricula. In response, the Consortium of Universities for Global Health's Global Oral Health Interest Group aims to develop readily available, open access resources for competency-based global oral health teaching and learning. The aim of this study was to develop and evaluate a Global Health Starter Kit (GHSK), an interdisciplinary, competency-based, open access curriculum for dental faculty members who wish to teach global oral health in their courses. Phase I (2012-17) evaluated longitudinal outcomes from two Harvard School of Dental Medicine pilot global health courses with 32 advanced and 34 predoctoral dental students. In Phase II (2018), the Phase I outcomes informed development, implementation, and evaluation of the open access GHSK (45 enrollees) written by an interdisciplinary, international team of 13 content experts and consisting of five modules: Global Trends, Global Goals, Back to Basics: Primary Care, Social Determinants and Risks, and Ethics and Sustainability. In Phase III (summer and fall 2018), five additional pilot institutions (two U.S. dental schools, one U.S. dental hygiene program, and two dental schools in low- and middle-income countries) participated in an early adoption of the GHSK curriculum. The increase in perceived knowledge scores of students enrolled in the pilot global health courses was similar to those enrolled in the GHSK, suggesting the kit educated students as well or better in nearly all categories than prior course materials. This study found the GHSK led to improvements in learning in the short term and may also contribute to long-term career planning and decision making by providing competency-based global health education.

Objectives:This study seeks to investigate to what extent are students conversant with global oral health initiatives and policies, students’ willingness to volunteer service at international setting or developing countries and the need for global oral health course in Nigeria.Methods:Final year dental students in two Nigerian Universities were surveyed for this study. The students voluntarily completed the global oral health information questionnaire in a classroom before a scheduled lecture. The collected data were analyzed using IBM SPSS Statistic 20.Results:All the final year students participated in the survey. All the students agreed that they need to be taught course on global oral health and would consider volunteering their dental skills and expertise in an international setting or developing country. Only 4.5% of the students knew the meaning of the basic package of oral care (BPOC) and none of the surveyed students could correctly name the three components of BPOC. Whereas only 18.2% could identify World Dental Federation and World Health Organization as the bodies that developed global oral health goals for the year 2000, none of the students could correctly list the three components of global oral health goals for the year 2000.Conclusion:This study concludes that a gap exists in the knowledge of students on global oral health matters and recommends that the curricula of schools be constantly reviewed in line with current trends in policies and practices.

A questionnaire study was conducted among dental students in Central India. The study population included 264 dental students, who voluntarily completed a questionnaire, comprising of 16 close ended questions. There were 9 questions to judge knowledge and 5 questions for attitude assessment towards global oral health course. Two additional questions were included to assess the willingness to volunteer in international setting; and also, to assess dental student's perspection on global oral health course. Chi Square test was used to compare between categorical variables. Analysis of Variance (ANOVA) was used to compare mean of knowledge and attitude scores. P value of ⩽.05 was considered significant for all statistical analysis. Eighty seven percent of the surveyed students (222) stated that they would consider volunteering their dental skills as a future dentist in international setting. Majority of the students in the present study were not aware about the global oral health status (99.2%) and theoral health care systems of industrialized and emerging economies (99.2%), had not been trained to serve underserved population (68%), had not been trained in global health ethics (70.1%) and none of the students had been trained for cultural competence in addressing international oral health issues (100%). Most of the dental students were not aware, that, WHO created basic package of oral care (63%) about the primary health care strategy (59.5%) and about the role and functions of FDI (66.7%). The majority of students expressed a desire to volunteer their professional services in international settings. However few students knew about WHO's BPOC or FDI'S role in global oral health. The findings indicate a need for global oral health course among dental students in Central India.

Oral health is vital to overall well-being but faces significant global challenges, necessitating reform in dental education. Global oral health education empowers professionals to address these issues, promoting global competencies,s and preventive approaches. The objective was to map scientific articles that approach global oral health education, its practical reality, and curricular inclusion in undergraduate dental programs. This study is a scoping review following the Joanna Briggs Institute’s approach, with searches in databases such as PubMed and SciELO using the keywords “global health” and “education, dental,” along with the Boolean operator AND. After excluding studies outside of the scope of the research and duplicate articles, 26 articles were selected for analysis. Among the analyzed articles, the need to further discuss the following topics was observed: trends and challenges in global dental education, oral health inequalities and the need for global approaches, and the integrating global health into the dental curriculum. The reviewed studies highlight the importance of adapting curricula to global needs, emphasizing the integration of oral health into global health policies and the promotion of interprofessional competencies. The review underscores the need to internationalize dental education and prepare future dentists to address oral health inequalities, with global partnerships and interprofessional collaboration being essential for the success of these initiatives. The conclusion shows that global oral health education should include preventive and interdisciplinary approaches, preparing professionals for global challenges. This requires integrating global health competencies into curricula and promoting international collaborations in dental education.

The FDI World Dental Federation is a federation of 157 dental associations in 136 countries, representing more than 900 000 dental professionals worldwide. Its main roles are bring together the world of dentistry, represent the dental profession on a global level and stimulate and facilitate the exchange of information across borders. The idea of forming an international dental federation was first discussed at a meeting of the Copenhagen Dental Society, held in Copenhagen in 1894. In 1900, during a congress in Paris, the Federation dentaire internationale (FDI) was created in order forward dental education. As one of the two oral health-related nongovernmental organizations in official relations with WHO, the FDI has a long history of collaboration with the Organization, which is based on the FDI's mission to promote optimal oral and general health for all peoples. Key activities of the FDI Policy-making In order contribute the development and dissemination of policies, standards and information related all aspects of oral health care around the world, the FDI issues policy statements that set out current thinking on various issues related oral health, the practice of dentistry and dental public health. These declarations, which are based on evidence where possible and are also the results of consensus among groups of experts, are disseminated oral health professional organizations worldwide and serve as templates for national policy formulation. Representation Acting on behalf of its member associations, the FDI is the global voice of dentists and other oral health professionals. The legal framework of the practice of dentistry and other professional issues are elements of the FDI's representative functions with WHO, the United Nations and the European Union. The FDI protects the interests of its member associations and promotes the formation of professional organizations in countries where there are none. Adherence the FDI and access the support of the international family of health professionals helps such organizations develop and strengthens their role at the national level. Advocacy Focus on the gaps and inequalities in oral and general health status is a major public health activity of the FDI, which promotes appropriate policies, education and technology. The reduction of risks health--such as tobacco use and high sugar intake--are on the FDI's agenda for action, as well as the promotion of fluorides prevent dental decay. Interaction The Annual World Dental Congress organized by the FDI is a major event aiming at information sharing between all stakeholders in international oral health. It is also a major source of income for the Federation. The official relations with WHO and other international organizations are of crucial importance for implication in consensus building, advocacy and policy formulation at the highest international levels. A strong, comprehensive set of ethical guidelines governs these relations, and is important safeguard the independence and credibility of the FDI. Achievements in FDI-WHO collaboration Global goals for oral health In 1981, the FDI and WHO jointly established global goals for oral health for the year 2000 (1). During the following decades most high-income countries reached or even exceeded these goals, but for many low-income countries they remain a remote aspiration. A joint working group composed of the FDI, the International Association for Dental Research (IADR) and WHO developed new goals for oral health for the year 2020 (2), whose focus draws on the experience and evaluation of the previous goals and acknowledges the recognition of oral health as an integral part of general health. The new goals also encourage a broader view of oral health and indicators by including other diseases and conditions as well as dental caries. …

The FDI World Dental Federation is a federation of 157 dental associations in 136 countries, representing more than 900 000 dental professionals worldwide. Its main roles are bring together the world of dentistry, represent the dental profession on a global level and stimulate and facilitate the exchange of information across borders. The idea of forming an international dental federation was first discussed at a meeting of the Copenhagen Dental Society, held in Copenhagen in 1894. In 1900, during a congress in Paris, the Federation dentaire internationale (FDI) was created in order forward dental education. As one of the two oral health-related nongovernmental organizations in official relations with WHO, the FDI has a long history of collaboration with the Organization, which is based on the FDI's mission to promote optimal oral and general health for all peoples. Key activities of the FDI Policy-making In order contribute the development and dissemination of policies, standards and information related all aspects of oral health care around the world, the FDI issues policy statements that set out current thinking on various issues related oral health, the practice of dentistry and dental public health. These declarations, which are based on evidence where possible and are also the results of consensus among groups of experts, are disseminated oral health professional organizations worldwide and serve as templates for national policy formulation. Representation Acting on behalf of its member associations, the FDI is the global voice of dentists and other oral health professionals. The legal framework of the practice of dentistry and other professional issues are elements of the FDI's representative functions with WHO, the United Nations and the European Union. The FDI protects the interests of its member associations and promotes the formation of professional organizations in countries where there are none. Adherence the FDI and access the support of the international family of health professionals helps such organizations develop and strengthens their role at the national level. Advocacy Focus on the gaps and inequalities in oral and general health status is a major public health activity of the FDI, which promotes appropriate policies, education and technology. The reduction of risks health--such as tobacco use and high sugar intake--are on the FDI's agenda for action, as well as the promotion of fluorides prevent dental decay. Interaction The Annual World Dental Congress organized by the FDI is a major event aiming at information sharing between all stakeholders in international oral health. It is also a major source of income for the Federation. The official relations with WHO and other international organizations are of crucial importance for implication in consensus building, advocacy and policy formulation at the highest international levels. A strong, comprehensive set of ethical guidelines governs these relations, and is important safeguard the independence and credibility of the FDI. Achievements in FDI-WHO collaboration Global goals for oral health In 1981, the FDI and WHO jointly established global goals for oral health for the year 2000 (1). During the following decades most high-income countries reached or even exceeded these goals, but for many low-income countries they remain a remote aspiration. A joint working group composed of the FDI, the International Association for Dental Research (IADR) and WHO developed new goals for oral health for the year 2020 (2), whose focus draws on the experience and evaluation of the previous goals and acknowledges the recognition of oral health as an integral part of general health. The new goals also encourage a broader view of oral health and indicators by including other diseases and conditions as well as dental caries. …

In November 2022, the World Health Organization (WHO) launched the first Global Oral Health Status Report (GOHSR) that describes the status of oral health care in the 195 member states. In the present editorial, we summarize the key findings of the GOHSR report and discuss the successes and pitfalls of the suggested remedy strategies. The WHO GOHSR report that is available online was used to summarize and discuss in the present editorial. The report highlights that globally close to 3.5 billion people suffer from oral diseases, with South-East Asian and Western Pacific countries having the highest caseloads. Key issues that have led to the unproportionally high-rise in the caseloads include political, socio-economic, familial, and historical experiences of the communities, ever-growing power, and sophistication of targeted commercial advertisements, negligent attitude of the policy planners and insurance companies, and lack of funding in oral health research and instrumentalization of proper surveillance tools. Global strategies for improving dental health needs to be tailored for each country given the logistical and financial challenges with self-care and regular dental hygiene proving to be the most effective factors in preventing dental diseases.