Population Oral Health in Japan: Promoting Fluoride Mouth Rinsing Programs Using the Analytic Hierarchy Process Model—Pathway Determination

Abstract

Objectives: Firstly, to evaluate the factors and organizational structures which affect the decisionmaking processes for introducing fluoride mouth rinsing programs in Japan. Secondly, to better understand the structure of the processes required to develop a consensus model for public opinion on fluoride programs. Methods: 11 dental health services experts in Japan participated in this study. The AHP (Analytic Hierarchy Process) model was used to analyze and evaluate the factors and the organizational elements of the decision-making pathways and processes to the goal of “implementing fluoride mouthrinsing programs”. The first step in the AHP was to decide on the relative importance of each individual criterion in terms of sets of alternative proportions. Next, pair-wise comparison of the relative weight between each alternative target in each criterion was performed. A matrix of the alternative targets for each criterion was calculated and the characteristic vector and characteristic value were computed. Results: “power of enforcement”, indicating the influence of political will on health policy was the strongest criterion and its contribution rate was 56% toward municipal decision-making. As a final result, the “governor and council” was the main organizational target for advocacy of fluoride programs. “Safety” had the strongest influence on the public opinion and consensus development of fluoride programs. Conclusions: Using the AHP model, it was concluded that the power of political will of local government (the governor and the council) was most important in promoting fluoride programs in Japan. Reliable information on safety is a preceding factor necessary for residents to establish their support and consensus.