Common Risk Factor Approach Research Articles

Improving oral health and malnutrition: Common Risk factor approach

Improving oral health and malnutrition: Common Risk factor approach

Exploring medical and dental practitioner perspectives and developing a knowledge attitude and practice (KAP) evaluation tool for the common risk factor approach in managing non-communicable and periodontal diseases

BackgroundThe Common Risk Factor Approach (CRFA) is one of the methods to achieve medical-dental integration. CRFA addresses shared risk factors among major Non-communicable Diseases (NCDs). This study aimed to explore the perspectives of dental and medical practitioners concerning CRFA for managing NCDs and periodontal diseases and to create and validate a tool to evaluate the Knowledge, Attitude, and Practice (KAP) of medical and dental practitioners in relation to utilization of CRFA for management of NCDs and Periodontal diseases.MethodsThis research employed a concurrent mixed-method model and was carried out from January 2021 to February 2022, focusing on medical and dental practitioners in South India. In the qualitative phase, online interviews were conducted with dental and medical practitioners, recorded, and transcribed. Thematic analysis was applied after achieving data saturation. In the quantitative phase, a KAP questionnaire was developed. The sample size was determined by using the G power statistical power analysis program. A sample size of 220 in each group (dentists and medical practitioners) was estimated. Systematic random sampling was used to recruit the potential participants. The data obtained through the online dissemination of KAP tool was analysed and scores were standardized to categorize the KAP.ResultsQualitative thematic analysis identified four major themes: understanding of common risk factors, risk factor reduction and disease burden, integrating CRFA into clinical practice, and barriers to CRFA. In addition, thematic analysis revealed seventeen subthemes. For the quantitative phase, standardization was applied to a 14-item KAP questionnaire for medical practitioners and a 19-item KAP questionnaire for dental practitioners. The total KAP score for medical practitioners in the study was 21.84 ± 2.87, while dental practitioners scored 22.82 ± 3.21, which indicated a high level of KAP regarding CRFA. Meta integration of qualitative and quantitative data identified eight overarching themes: four were concordant, three were discordant, and one theme provided the explanatory component.ConclusionThe study’s structured, validated questionnaire showed that both medical and dental professionals had a high knowledge of CRFA. However, they were not appreciably aware of the risk factors that are shared between NCDs and periodontal disease. Both groups were interested in the idea of using CRFA in integrated medical and dental care.

Childhood adversity, perceived social support, and depressive symptoms among pre-abortion Chinese women

BackgroundUnintended (unwanted) pregnancy is a sexual and reproductive health issue with psychosocial consequences for the individual, their family, and society. However, the relationship between social support and related mental health issues, like depression and the effects of childhood adversity, is poorly studied. This study aims to explore the connections between childhood adversity, perceived social support, and depressive symptoms in pre-abortion women (women who have decided to have an abortion) in a clinical setting, based on the common risk factor approach and social support theory.MethodsA total of 299 pre-abortion Chinese women 18–45 years were recruited in a hospital in Shantou, China. Hierarchical linear regression analyses were employed to examine the relative effects of childhood adversity and sources of social support on depressive symptoms, controlling for sociodemographic influences.ResultsThe results show that 37.2 percent of participants reported at least one adverse experience in childhood. More than half of the respondents were at risk for depression. Results of regression analysis showed that childhood adversities were negatively associated with depressive symptoms before sources of social support were entered into the model. However, when the sources of perceived social support were added, the effect of childhood adversity was not significant. Perceived social support explained the additional 15 percent variance in depressive symptoms. Additionally, being married (β = -.12, p < .05) and number of siblings (β = .13, p < .05) were significantly related to depressive symptoms.DiscussionPre-abortion women are at risk of mental health problems. Peer and familial social supports can alleviate the influence of childhood adversity on depression among pre-abortion Chinese women. Strengthening the role of various sources of social support can help to improve the mental health conditions of pre-abortion women.

Childhood dental caries and obesity: Opportunities for interdisciplinary approaches to prevention.

Dental caries and obesity are prevalent and preventable chronic childhood diseases. Evidence shows a strong connection between these two diseases, with overlapping common risk factors, including diet as a key driver of risk. Dental professionals are well-positioned to perform nutritional counseling and obesity prevention in dental clinic settings, but training and clinical integration remain key challenges. This paper highlights the potential for leveraging the common risk factor approach (CRFA) framework and its principles to reduce the impact of childhood dental caries and obesity. Strategies and methods are provided to integrate meaningful didactic and clinical training experiences in dental academia, and the need to include effective and evidence-based nutritional counseling techniques in dental settings is also described. Additionally, the potential for integrating CRFA and engaging health care providers across the spectrum of care, including primary care settings, to reduce the prevalence of these diseases in pediatric populations is highlighted. Finally, theauthors propose future directions for multidisciplinary research to advance the scientific knowledge in this area and to inform effective and comprehensive interventions for dental settings.

Association between frailty and oral health services use in Brazilian older adults.

To assess the association between frailty and oral health services use in Brazilian older adults. This cross-sectional study analysed the baseline data from the Longitudinal Study on Brazilian Ageing (ELSI-Brazil) representative of Brazilians aged 50 or over. The outcome was oral health services used in the year prior to the interview. The main exposure variable was Frailty defined by the frailty phenotype. Age, skin colour, wealth, sex, education, type of service, health insurance, number of teeth and self-perceived oral health were included as covariates. Prevalence ratios (PR) with their respective 95% confidence intervals (CI) were estimated using Poisson regression with robust variance. 8405 individuals were included in this study. The prevalence of frailty was 7.5%. Regarding frailty status, the prevalence of dental service use was 47.0%, 48.5% and 4.5% for robust, pre-frail and frail individuals, respectively. Frail individuals had a 7% higher prevalence of not using dental (PR: 1.07; 95% CI: 1.01-1.13) than robust individuals. Frailty was independently associated with not using oral health services. Given the complexity of the determinants of dental service use, frailty adds another dimension to be examined in older adults. Public health strategies considering a common risk factor approach should be endorsed.

Prevention of caries and obesity in children with immigrant background in Norway- a study protocol for a cluster randomized controlled trial

BackgroundImmigrants are known to experience greater socioeconomic stress and poorer well-being and to suffer more from lifestyle- and diet-related disorders than native populations. There is also evidence that children of immigrant parents are at greater risk of diverse health problems than their host country cohorts. The aim of this study is to apply and evaluate the efficacy of an early life intervention program among parents/children with immigrant background to prevent childhood caries and obesity, thereby improving the children’s general health, oral health, and quality of life.MethodsThis is a study protocol for a cluster randomized controlled intervention follow-up study. In phase I of the study, the primary care health centers in the municipality of Bergen, Norway were randomly allocated to intervention or control groups. The intervention was carried out using the motivational interviewing technique and the common risk factor approach. The intervention group received guidance on diet/oral hygiene and the control group received standard care information. Parental knowledge and children at age 3 and 5 years old will be assessed in a prospective phase II follow-up study compared to native Norwegian controls. The primary outcome will be evaluation of change on parental oral health related knowledge and attitudes. The secondary outcome will assess the impact of the intervention on children’s caries -, body mass index- and oral health related quality of life.DiscussionCollaboration between dental public health and primary health care personnel on the common risk approach motivational intervention offers opportunities to address key dietary behaviors that may prevent obesity and dental caries. Providing sustainable preventive measures decreases the burden of diseases and consequently reduces health inequalities, particularly among at-risk children.Trial RegistrationThe study is registered as a clinical trial (ClinicalTrials.gov Identifier: NCT05758454: 7 March 2023). Ethical approval has already been granted by the Regional Ethical Committee (REK) (2015/ 27,639 /REK vest) and Sikt – Norwegian Agency for Shared Services in Education and Research (Reference number 778825).

It is Time to Consider Biophysical &amp; Psychosocial Political Model for Prevention of Oral Diseases through Common Risk Factor Approach (CRFA)

It is Time to Consider Biophysical &amp; Psychosocial Political Model for Prevention of Oral Diseases through Common Risk Factor Approach (CRFA)

Tooth loss severity and core and non-core food consumption among older Brazilian adults.

To investigate the association between tooth loss severity and core and non-core food consumption in the older Brazilian population. We analysed data from 20756 people aged 60years or older who participated in the 2019 Brazilian National Health Survey. The average consumption days a week of core (8-item) and non-core (4-item) foods were the outcomes, measured using a Food Frequency Questionnaire. Tooth loss severity was the main exposure, using a four-category ordinal variable: mild (1-12 teeth missing), moderate (13-22), severe (23-31) and edentulous (all 32). Sociodemographic, tobacco smoking, use of dental prosthesis, difficulty in chewing and systemic conditions were among the covariates. Linear regression models estimated the association between tooth loss and food consumption. Almost two-thirds of participants had moderate or worse levels of tooth loss. Older adults with more severe tooth loss reported an overall lower consumption of core and higher non-core foods than those with mild tooth loss. Worse tooth loss severity was associated with lower consumption of vegetables and/or legumes and fruits, and higher consumption of beans, artificial fruit juices and confectionery. Older Brazilian adults with more severe tooth loss are consuming lower core and higher non-core foods. Our findings reinforce the importance of the common risk factor approach to tackle the adverse effects of tooth loss on diet.

Assessment of Common Risk Factors of Non-Communicable Diseases (NCDs) and Periodontal Disease in Indian Adults: An Analytical Cross-Sectional Study.

Risk factors that predispose individuals towards major non-communicable diseases (NCDs) and periodontal disease (PD) often co-occur in the same individual. The common risk factor approach (CRFA) for controlling the risk factors associated with NCDs and PD ensures that modifying a few risk factors has an incredible impact on regulating many chronic conditions. To apply CRFA to NCDs and PD, it is essential to quantify the common risk factors of these conditions. The proposed hospital-based analytical cross-sectional study aims to assess the proportion overlap of risk factors that are common or shared between NCDs (cardiovascular diseases (CVD) and diabetes mellitus (DM) type 2) and PD. The risk factors for PD and NCDs will be estimated in subjects aged 18 years and above, diagnosed with NCDs (DM type 2, CVD) or PD. This will be a non-directional study. The dependent variables analyzed will be PD and NCDs (DM type 2, CVD). The explanatory variables that are assessed will be: age, gender, address, occupation, access and affordability of care, familial pattern, family size, insurance, socioeconomic status, obesity, tobacco usage, physical activity, alcohol consumption, food frequency, stress, and oral hygiene. The research is expected to provide data which will aid in the development of advocacy initiatives to implement CRFA for PD and NCDs.

Global status of oral health provision: Identifying the root of the problem

AbstractDental health is deeply rooted in the primary care of an individual such that an individual's overall health status and behaviours may be determined by their oral health status. Oral diseases are a major cause of morbidity and are among the most prevalent diseases worldwide. Despite the risk these diseases pose to global health, they remain a largely neglected facet of healthcare. In this article, we discuss why predominantly preventable oral diseases persist with high prevalence and suggest how to address the global oral disease epidemic. People living in rural areas are particularly disadvantaged, due to insufficient oral care in remote locations, lack of transport and an overall under‐resourced health care infrastructure. In cases where oral health programmes exist, they are usually directed only at certain groups. Dental tourism has been increasing in popularity over the last two decades. Eastern Europe has become one of the leading destinations for patients seeking dental care across borders. However, negative findings regarding the quality of dental procedures in these destinations have been highlighted in many studies, with some pointing out that only a small fraction of patients received sufficient quality, and that only very simple dental treatments were actually evaluated as cost‐effective. Low‐income countries are hindered not only by lack of dentists, but by lack of public health initiatives such as fluoridation of water and toothpastes. The integration of oral health into medical education and primary care could improve the common risk factor approach between the specialties and improve preventative measures and screening for better patient outcomes and reduction in cost of care.

Strengthening Behavioral Patterns Impacting COVID-19 Vaccination and Oral Health Amidst the Looming Third Wave Scenario—Need of the Hour!

AbstractAim The current review aims to ascertain the scope and depth of the behavioral patterns impacting COVID-19 vaccination and oral health as well as recognize the rates of acceptance and hesitancy of coronavirus disease 2019 (COVID-19) vaccine.Background The COVID-19 vaccination drive is a decisive factor in the control and termination of the COVID-19 pandemic. Concerns about vaccine hesitancy are growing worldwide and it has been thus declared as one among the top 10 threats in 2019 by the World Health Organization; thus, addressing the obstacles and expediters of vaccines will be fundamental in initiating and effectively implementing the interventions to accomplish extreme vaccine coverage.Review Results The vaccine utility is not merely reliant on the efficacy and the safety of the vaccine. The major factor is the vaccine acceptance among the general public of all the sectors of the society. Trust in public authorities, adverse effects, phobias, community influences affect the vaccine acceptance rate tremendously. With an evolving third peak of the COVID pandemic, the affinity toward availing COVID vaccine has increased but the hesitancy rate among individuals still persists.Conclusion The large variations in vaccine acceptance and hesitancy rates can impact the efforts put forth in eliminating the disease. Thus public health policies can enable development of effective approaches to overcome the hesitancy related to COVID-19 vaccine thereby increasing its uptake and facilitating smooth functioning of the vaccination drives which could help conduit the existing gaps.Clinical Significance Involvement of dental health professionals in vaccination campaigns is vital for the enforcement of common risk factor approach wherein focus can be shed on both general and oral health wellness.

Common Determinants of Dental Caries and Obesity in Children: A Multi-Ethnic Nested Birth Cohort Study in the United Kingdom.

The article examines the common determinants of childhood dental caries and obesity. Longitudinal data from the Born in Bradford cohort study (BiB1000) (n = 1735) and dental data (dental general anaesthetics (GA) and oral health survey 2014/15) (n = 171) were used to test a framework on the social determinants of childhood dental caries (decayed, missing, filled teeth (dmft) index) and obesity (body mass index (BMI)). The BiB1000 data were collected at pregnancy week 26–28 and after birth at 6, 12, 18, 24 and 36 months. The determinants were demographics, wellbeing, socio-economic status (SES), dietary behaviours and physical activity behaviour of the children. Missing data were accounted for through multiple imputation (MI). The framework was tested through structural equation modelling. Overall, the model fit was adequate. No alcohol consumption of the mother after giving birth, higher frequency of child drinking sugar-sweetened beverages, emotional and behavioural difficulties of the child and being male were directly associated with both BMI and dental caries. Caregivers uninvolved or indulgent feeding style were associated with higher BMI and less dental caries. Social deprivation was associated with lower BMI and higher dmft. Five determinants were directly associated with BMI only. Fifteen indirect paths were significant for both child dental caries and BMI. The findings suggest common determinants for both childhood obesity and dental caries. Common risk factor approach seems appropriate for planning future health promotion programmes.

Individual social capital and dental pain in older adults.

To investigate the association between the structural and cognitive dimensions of social capital and dental pain in Brazilian adults aged 50years and over. This cross-sectional study conducted individual assessments of 6154 Brazilians aged 50years or older. Four individual variables based on structural and cognitive dimensions of social capital were assessed. We used hierarchical logistic regression models to estimate the odds ratio for dental pain with individual structural and cognitive social capital variables adjusted for associated factors. The model followed hypothetical pathways linking social capital to oral health. Cognitive social capital was associated with dental pain. Participants who did not trust their neighbourhood had a 28% greater chance (OR, 1.28; 95% CI, 1.02-1.60) of dental pain than those who did. Elements of cognitive dimension of social capital, particularly trust, reciprocity and support, as part of a common risk factor approach, should be considered when planning oral health promotion and preventive activities for older people.

Common Risk Factor Approach to Limit Noncommunicable Diseases and Periodontal Disease-The Molecular and Cellular Basis: A Narrative Review.

ABSTRACTIntroduction:The link between periodontal disease and noncommunicable diseases (NCDs) has been the subject of major research over the past several years. The primary objective of this review is to understand the cellular and molecular components that link common risk factors (exposure) in adult patients (population) with periodontal disease and other NCDs (outcome). The secondary objective is to interpret from existing literature the possibility of identifying the molecular plausibility of the Common Risk Factor Approach (CRFA).Materials and Methods:A literature search was performed in PubMed/MEDLINE, CINAHL, Web of Science, and Google Scholar for all published articles pertaining to the molecular and cellular basis of the risk factors between periodontal diseases and major NCDs. Data from all randomized and nonrandomized clinical trials, cross-sectional studies, case-control, cohort studies, literature, and systematic reviews were included.Results:Periodontal pathogens, stress, obesity, smoking, and dietary factors are some of the common risk factors between periodontal disease and NCDs.Conclusion:Understanding the molecular and cellular link of common risk factors between NCDs and periodontal disease would ensure the application of CRFA. The CRFA implies that controlling the risk factors associated with NCDs can have an incredible positive impact on regulating many chronic conditions, which would extend to periodontal health also.

Oral health academics\u2019 conceptualisation of health promotion and perceived barriers and opportunities in dental practice: a qualitative study

BackgroundOral diseases place a significant burden on individual and population health. These diseases are largely preventable; health promotion initiatives have been shown to decrease the disease rates. However, there is limited implementation of health promotion in dentistry, this could be due to a number of factors; the ethos and philosophy of dentistry is focused on a curative, individualised approach to oral diseases, confusion around health promotion as a concept. Oral health academics are well placed to implement health promotion, training of these professionals needs to include prevention, as training influences dental practice. However, there is a little understanding about how oral health academics (dental professionals who educate dental and oral health students) view health promotion. The aim of this exploratory study is to understand how oral health academics conceptualise health promotion and perceive the barriers and possible opportunities for health promotion implementation in dental practice.MethodsNominal group technique (NGT), a highly structured face-to-face meeting, was conducted with 24 oral health academics to explore how they conceptualize health promotion and the barriers and opportunities for health promotion in practice. An additional 4 questions were emailed to oral health educators after the NGT meeting to gather additional data, 6 oral health academics were involved. The data was analyzed using thematic analysis.ResultsThree board themes were identified: “Knowledge, ideas and concepts of health promotion”, “Challenges to health promotion”, “Opportunities for health promotion practice”. The oral health academics in this study discussed health promotion in a holistic way, however, health education and behaviour change were mentioned more than other aspects of health promotion. The structure of dental practice specifically the curative approach that underpins dentistry and the lack of funding, and value placed on health promotion could act as a challenge to health promotion being implemented in practice. There has been a shift towards prevention in dentistry, however the participants acknowledge there needs to be a change in the curative culture of the profession. Collaboration with other health professionals and using a common risk factor approach were the identified opportunities for health promotion practice.ConclusionsOral health academics have a holistic understanding of health promotion, but still focus more on behavioural approaches which is common within dentistry. For a change to occur in health promotion practice a change in the structure, curative approach and funding model of dentistry is required. Collaboration with other health professionals is an opportunity to be capitalised on. Training of future dental professionals is the perfect place to start to implement the changes and opportunities for health promotion presented in this paper.

Oral hygiene practices, its associated factors and evaluation of oral health education package among 6-8 grade students of bajrabarahi municipality, Lalitpur

Oral health is recognized as equally important in relation to general health. Proper oral hygiene is the fundamental basis of the common risk factor approach to prevent the oral diseases. Dental caries is the common oral pathology that remain widely prevalent among all populations throughout the lifespan. The school years cover a period that runs from childhood to adolescence. These are influential and receptive stages in people’s lives when lifelong sustainable oral health related behaviors, as well as beliefs and attitudes, are being developed. Children may also be equipped with personal skills that enable them to make healthy decisions. So school may be considered as an ideal setting for conducing successful health programs. This study provides important information to identify the oral hygiene practices and aims to implement the oral health education package among school students. The objective of the study is to identify the status of oral hygiene practices, its associated factors, and evaluate the effectiveness of oral health education package in improving the practices on oral hygiene among the students of 6-8 grade of Bajrabarahi Municipility of Lalitpur District. The school based action research was conducted among the students of grade 6-8 of Bajrabarahi Municipality. The study was completed in three phases. The phase I was Baseline study Phase, this phase was conducted to identify the status and gaps on oral hygiene practices. Phase II was the package development phase, from the findings of the baseline study the intervention package on oral hygiene was developed. Phase III was implementation phase, in this phase the implementation and evaluation of health education package on oral hygiene practices was done. Baseline study was conducted in total 5 secondary private school of Bajrabarahi Municipality which was selected randomly and all the students of class 6-8 were selected as a study population. Quantitative technique was used for the data collection the self-administered questionnaire was employed to collect the information from the students. Cross sectional study design was applied for the baseline study. Data entry and analysis was done on SPSS 21 version Study reveals that 100% of the respondents brush their teeth daily. Only 37.6% of the student brush their teeth twice a day. Majority of the student use toothpaste and toothbrush to clean their teeth. 54% of the respondent change their toothbrush more than 6 month. Among the participants 23.9% followed the appropriate technique of brushing. 55% of the participant used to rinse their mouth after major meal and 45% rinse their mouth only after major meal. Only 20.2% of the participant used to visit dentist every 6 month. Regarding the status of oral hygiene practice more than fifty percent of the participant have below average practice on oral hygiene (55.8%). Regarding knowledge only 36.1% participants have knowledge on proper techniques of brushing. 85.2% have above or equal average knowledge on oral hygiene. The education level of the mother and perceived barrier was found significantly associated with oral hygiene practice. The second phase of the study was package development phase. In this phase package on oral hygiene was developed according to the information obtained from the baseline study. From the baseline findings the package was developed on proper technique of brushing. Package was developed by analyzing the methods media and content. The third phase of the study was to implement and evaluate of the oral health education package. Package was implemented in 2 school among those 5 school where the baseline was conducted and remain 3 school were considered as control school. From the analysis of comparison between intervention and control group the oral health education package was found to be effective in changing knowledge, belief and practice among the student in the intervention group.

The association of periodontal diseases with metabolic syndrome and obesity.

Periodontitis is a multifactorial chronic inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth-supporting apparatus. Globally, it is estimated that 740 million people are affected by its severe form. Periodontitis has been suggested to be linked to obesity and metabolic syndrome. Obesity, defined as excessive fat accumulation, is a complex multifactorial chronic inflammatory disease, with a high and increasing prevalence. Metabolic syndrome is defined as a cluster of obesity, dyslipidemia, hypertension, and dysglycemia. Obesity, metabolic syndrome and periodontitis are among the most common non-communicable diseases and a large body of evidence from epidemiologic studies supports the association between these conditions. Extensive research has established plausible mechanisms to explain how these conditions can negatively impact each other, pointing to a bidirectional adverse relationship. At present there is only limited evidence available from a few intervention studies. Nevertheless, the global burden of periodontitis combined with the obesity epidemic has important clinical and public health implications for the dental team. In accordance with the common risk factor approach for tackling non-communicable diseases, it has been proposed that oral healthcare professionals have an important role in the promotion of periodontal health and general well-being through facilitation of healthy lifestyle behaviours.

Strategies for the prevention of periodontal disease and its impact on general health in Latin America. Section III: Prevention.

Dental plaque removal and the understanding of risk factors, risk indicators and social determinants are important components in the prevention of periodontal disease. Periodontal diseases and dental caries are largely preventable conditions, but require a "common risk factor approach" with non-communicable diseases with the purpose of improving their prevention and control, and positive impact on health. The aim of this consensus was to identify the evidence and gaps in periodontal prevention in Latin American, and to propose individual and collective recommendations for the population, health professionals, dental practice and government. The prevention of periodontal diseases in Latin America has mainly been focused on oral hygiene instruction, use of toothbrushes and interproximal devices, but in some patients, it is necessary to use adjuncts to these measures, such as antimicrobial and/or probiotic products that are backed by broad scientific evidence. Some evidence has shown that there are inadequate knowledge, attitudes and practices among patients, dentist and other health professionals. The prevention of periodontal diseases and caries should be adopted as a healthy lifestyle routine, because of their local and systemic effects. Recently, new empowerment strategies have been proposed in order to generate behavioral changes. Periodontal diseases can often be prevented, or controlled by joined efforts between government health systems, scientific associations, universities, health professionals, private companies and communities. In conclusion, the relations between periodontal diseases, caries, healthy lifestyles and NCD's offer an ideal opportunity to change Latin American prevention strategies at both the individual level and population levels.

Prevention and control of oral diseases via "Common Risk Factor Approach"

People are generally more aware of infectious diseases, cardiovascular diseases, trauma and other fatal diseases rather than oral diseases. In fact, the oral disease as a whole is ranked the third among the chronic diseases of human beings. There have been accumulating evidences that oral health plays a significant role in general health and quality of life. There is a wide recognition that oral health shares common risky/pathogenic factors with other Non-Communicable Diseases (NCD). Oral microorganisms may cause dental caries and periodontal diseases, and they may also cause atherosclerosis and heart diseases, thus these usually end up to chronic diseases. On the other hand, unhealthy diet, physical inactivity, tobacco and alcohol consumption, psychological stress, poor sanitation, accidents and a sedentary lifestyle contribute to both oral diseases and a number of general chronic diseases. Oral health cannot be dealt with in isolation from other health issues. That is why the WHO recommended the "Common Risk Factor Approach (CRFA)" for oral health promotion. In this article, the authors give essential interpretation of CRFA and make suggestions on preventing and controlling oral diseases via CRFA.

Workshop: NCDs prevention through integrated approaches: reducing obesity from individuals to populations

Abstract Non-communicable diseases, the slow motion disaster, represent one of the main global threats to health in the 21st century. Overweight and obesity are major risk factors for a number of chronic diseases and obesity has nearly tripled since 1975. Obesity can be prevented through healthy food, healthy lifestyle and anti-obesogenic environments. Effective multidisciplinary and intersectorial approaches are needed now more than ever and public health strategies should tackle the social determinants of health through the adoption of a common risk factor approach, which start from the mouth to reach the rest of the body. This applies to preventive actions, investments and advocacy with the government and the food industry. This workshop aims to discuss challenges and leverages to increase integrated approaches to prevent NCDs through healthy nutrition, focusing on the need to tackle the body as a whole as well as providing the skills necessary to understand and play the power game related to food and food industry. The workshop will start with a critical analysis of the key actions and debates at the global level, focusing afterwards on the sugar-sweetened beverage (SBB) laws and the need to re-legitimate the mouth as an integral part of the body to increase the effectiveness of prevention. The country case of Italy will give an important perspective from a country that has always been associated to the healthy Mediterranean diet but has reverted the trend in the last few years, especially among children. The debate will then lead to an analysis of the effective approaches, which can be applied to fight the obesity trend with a special focus on government roles and wrestling with industry. The obesity prevention strategies as described above will be analysed through the Global Charter for the Public’s Health (The Charter) lens, a joint effort of WFPHA, multiple stakeholders, as well as the WHO, which has been developed to provide a comprehensive, clear and flexible framework to adapt today’s public health to its global context. The implementation of The Charter functions and services, through a flexible approach, paves the path to reverse the obesity trend and facilitate the development of effective measures through multidisciplinary and intersectorial partnerships and effective laws. An integral part of the process is leadership from inside and outside the health sector along with people, communities, organizations, governments, concerned corporates and citizens. This workshop will provide delegates with the information, examples and skills necessary to understand and play an active role in the “food power game” through the adoption of common risk factor approach and increased advocacy skills by applying The Charter in Europe and globally. Key messages Integrated and multidisciplinary approaches, including the common risk factors approach, and effective advocacy with governments and concerned corporates are key elements to prevent obesity and NCDs. The Charter is the flexible and innovative framework to be applied from the communities up to their governments, at national and international levels to prevent diseases such as obesity and NCDs.