Community Oral Health Research Articles

Transforming Community Oral Health: My Journey as a Provider

Transforming Community Oral Health: My Journey as a Provider

Unmet Dental Care Needs of The Low-Income Elderly in South Korea: Applying the Andersen behavioural model.

Retirement reduces income and increases dental care needs for the elderly, but there are few studies on unmet dental care needs among the low-income elderly. This study aimed to identify actors associated with unmet dental care needs of low-income elderly people in South Korea. Secondary analysis of 2020 KNHANES data relating to 1,016 elderly individuals (65+) below median income. Unmet dental care needs were higher for women at 28.9% (p ⟨0.001), those with a middle school education at 28.5% (p ⟨ 0.05), individuals who rated their health as "poor" at 31.3%, those reporting feelings of depression at 44.8% (p ⟨ 0.001), individuals who rated their oral health as "poor" at 36.2% (p ⟨ 0.001), and those who experienced toothache at 37.2% (p ⟨ 0.001). In regression analysis women (Risk Ratio = 1.59, 95% CI 1.09-2.32), people with depression (RR = 2.29, 95% CI 1.01-5.15), those who perceived their oral health as "poor" (3.20, 95% CI 1.90-5.32) and those toothache (1.88, 95% CI 1.27-2.76) had higher unmet dental needs. Substantial unmet dental care needs exist among the low-income retired elderly. Comprehensive public oral health policies and community programs are needed for this population group.

Big Data in Epidemiology: Brave New World?

Epidemiology is experiencing a significant shift toward the utilization of big data for health monitoring and decision-making. This article discusses the recent example of the World Health Organization (WHO) global oral health status report and regional summaries, which faced criticisms due to its reliance on big data from the Global Burden of Disease (GBD) study. We address the arguments for and against the use of big data in epidemiology and provide an assessment of the value and limitations of big data epidemiology. Moreover, we provide recommendations as to how the oral health community should reconcile traditional epidemiologic approaches with big data and advanced data analytics. This Perspective article highlights the challenges of the current epidemiologic landscape, the potential of big data, and the need for a balanced approach to data utilization in epidemiology.

Determining the Phytochemical Properties and Antibiogram of Different Chewing Stick Plants on Selected Streptococcal Species Isolated from the Oral Cavity

Chewing sticks are small twigs obtained from plant stems, measuring 12-25cm long and tied in bundles of 5-10. These twigs have been used for oral hygiene for many years, even before the invention of toothpaste, mouthwash, and mouth sprays. This study aims to determine the phytochemical properties and antibiogram of different chewing stick plants on two streptococcal species isolated from the oral cavity. Streptococcus pyogenes and Streptococcus mutans were isolated from oral swabs of patients at Rivers State University Teaching Hospital and identified to the species level. The pure isolates were further tested against the antimicrobial effects of the aqueous and ethanolic extracts of four chewing stick plants: Vernonia amygdalina, Jatropha curcas, Massularia acuminate, and Phyllanthus mullerianus. Qualitative phytochemical screening and quantitative analysis were carried out on the plant stems to determine the presence of antimicrobials. The percentage of antimicrobials present in the plant stems ranged from 33.3% to 66.7%, with Jatropha curcas, Massularia acuminate, and Vernonia amygdalina exhibiting the highest percentages, and Phyllanthus mullerianus the lowest. The antibiogram of the isolates to conventional gram-positive antibiotics was determined by the disc diffusion method. Streptococcus pyogenes showed 75% sensitivity and 25% resistance to the antibiotics, while Streptococcus mutans displayed 50% sensitivity, 16.7% intermediate, and 33.3% resistance to the antibiotics. The investigation found that the ethanolic extract of Massularia acuminate has the highest zone of inhibition of 15.5 ±0.71mm at 100mg/ml, while Phyllanthus mullerianus exhibited the least inhibition at 8 ±0mm. The ethanolic extract of Jatropha curcas and Vernonia amygdalina showed little effect on the test isolates, with a range of 0-9.5±0.71mm. The aqueous extract ranged from 8±5.7 - 9.5±0.71mm at 100mg/ml, with Massulara acuminate exhibiting the highest and the lowest zones of inhibition. This finding indicates that Massularia accuminate has the ability to suppress the growth of dental plaque-forming Streptococcus mutans and Streptococcus pyogenes. Chewing sticks are more affordable and easily accessible, so they could be recommended in community oral health programs.

The "E-UKGM" Model as an Effort to Improve the Quality ofRecording and Reporting Community Oral Health Efforts (UKGM) in Community Health Centers

UKGM is a dental health service activity carried out by the community through guidance from the health center. The obstacle to the implementation of UKGM is that the recording and reporting applied so far at the Community Health Centers is still manual. In the Bulukumba Regency area, recording and reporting of UKGM activities is still carried out manually, reports on UKGM activities are combined with other health reports, and there is no data on ongoing actions from the results of examinations on UKGM activities. Efforts are needed to improve the quality of recording and reporting of UKGM at Community Health Centers based on information systems. Objective: To prove that the E- UKGM model is effective as an effort to improve the quality of UKGM recording and reporting atCommunity Health Centers. Methods: Research and Development with Pre-experiment one Group Pretest-Posttest Design research design. The research sample was TGM working at the health center totaling 20 people who were given the E- UKGM model . Data collection techniques are interviews and questionnaires. Data were processed with non- parametric tests. Results: The expert validation test of the E-UKGM model obtained an average of 82% with a very feasible category and r> 0.726. The recording and reporting mechanism, and the quality of data and information improved after being given the E-UKGM model compared to the previous p-value of 0.000 (p<0.05). Conclusion: The application of the E-UKGM model is effective in improving the quality of recording and reporting UKGM at the Community Health Centers.

The Impact of the COVID-19 Pandemic on Pattern of Antibiotic and Opioid Prescriptions by Dentists in Alberta, Canada.

After the shutdown of most dental services during the COVID-19 lockdown, the oral health community was concerned about an increase in prescribing opioids and antibiotics by dentists due to patients' limited access to dental offices. Therefore, the objective of this study was to investigate the impact of COVID-19 pandemic on the pattern of antibiotic and opioid prescriptions by dentists in Alberta, Canada. Data obtained from the Tracked Prescription Program were divided into antibiotics and opioids. Time periods were outlined as pre-, during-, and postlockdown (phase 1 and 2). For the number of prescriptions and average supply, each monthly average was compared to the corresponding prelockdown monthly average, using descriptive analysis. Time series analyses were conducted using regression analyses with an autoregressive error model. Data were trained and tested on monthly observations before lockdown and predicted for during- and postlockdown. A total of 1.1 million antibiotics and 400,000 opioids dispense were tracked. Decreases in the number of prescriptions during lockdown presented for antibiotics (n = 24,933 vs. 18,884) and opioids (n = 8892 vs. 6051). Average supplies (days) for the antibiotics (n = 7.10 vs. 7.55) and opioids (n = 3.92 vs. 4.05) were higher during the lockdown period. In the trend analyses, the monthly number of antibiotic and opioid prescriptions showed the same pattern and decreased during lockdown. The COVID-19 pandemic altered the trends of prescribing antibiotics and opioids by dentists. The full impact of COVID-19 pandemic on the population's oral health in light of changes in prescribing practices by dentists during and after lockdown warrants further investigation.

Bridging the evidence-to-practice gap: exploring dental professionals' perspectives on managing oral health during pregnancy in Tasmania, Australia.

Poor oral health is associated with adverse health, social and economic consequences for pregnant women. While dental professionals promote good oral health within the dental practice context, more broadly, women in the antenatal period face poor oral health outcomes. Therefore, this study explored dental professionals' perceptions of their role in managing the oral health of pregnant women and identified the barriers and facilitators to improving maternal oral health. This study employed a descriptive qualitative method utilizing semi-structured interviews. Convenience and snowball sampling were used to recruit 13 dental professionals from Tasmania, Australia, comprising dentists (n = 10), oral health therapists (n = 2) and dental therapist (n = 1). Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis. Three major themes were constructed from the interviews: (1) dental professionals' oral health care of women during pregnancy; (2) perceived challenges to maternal oral health; and (3) proposed strategies to improve maternal oral health. Findings suggest dental professionals' competence in maternal oral health, but that several barriers, such as dental care access and maternal factors, hinder oral health outcomes. To address these barriers, oral health policies that support interprofessional collaboration, professional training and evaluation of existing community oral health programmes are needed. © 2024 Australian Dental Association.

Community-based dental education in Iranian dental schools

BackgroundCommunity-based dental education (CBDE) has been an essential advancement in dental education in recent decades, enhancing it in many aspects. This study aimed to determine the characteristics and improvements of CBDE in dental schools in Iran.MethodsIn the present descriptive study, an electronic questionnaire, including 18 “yes/no”, “multiple choice”, and “short answer” questions about the nature and extent of CBDE and students’ experience in CBDE, was used. In early 2021, the questionnaires were mailed to the deans of all 43 dental schools in Iran under the supervision of the Council for Dental Education of the Iranian Ministry of Health and Medical Education. Reminder calls were made after 6 and 12 weeks. Dental schools that did not follow the CBDE program were excluded. The responses were analyzed descriptively.ResultsThirty-six dental schools completed the questionnaire (response rate: 84%). Seventeen schools (47%) reported having CBDE in their dental program. Sites lacking a well-equipped dental setting were the most used out of all extramural sites. The number of weeks dedicated to CBDE ranged between 1 and 20 (median: 4). The most common dental procedures practiced in extramural sites were pediatric dentistry (100%), restorative dentistry (71%), and dental examination (59%). The student-to-supervisor ratio in CBDE ranged between 3 and 15 (median: 5). In most schools (65%), the staff involved in directing CBDE were Community Oral Health PhDs.ConclusionsAn increasing number of Iranian dental schools have integrated CBDE into their undergraduate dental curriculum. The characteristics and extent of this educational strategy vary widely among dental schools. CBDE can be more effective by making positive changes in dental programs.

Increase in dental hygienists’ competency and self-directed capacity after capstone-designed class on community dental hygiene

Objectives: This study aimed to verify the effect on students’ competency and self-directed capacity after a capstone-designed teaching method with community dental hygiene class. Methods: The study participants were 34 dental hygiene students taking a 4-year community dental hygiene course at a university located in City C. The research tool consisted of 52 questions on major competency and 20 questions on self-directed capacity. Results: After the capstone design class, overall dental hygienists’ competency increased (p<0.05), and competencies of clinical dental hygiene and community health promotion showed a high increase (p<0.001). As a result of analyzing the increase in dental hygienists’ competency according to self-directed learning ability, the group with low self-directed capacity showed high improvement in clinical dental hygiene competency and community oral health promotion competency. Conclusions: This study confirmed that the capstone-designed community dental hygiene class improved students’ competency and self-directed capacity, and suggests that it is an excellent teaching method for training competencies required for future society.

Pediatric Oral Health Online Education for Rural and Migrant Head Start Programs in the United States.

Children living in rural and migrant areas in the United States disproportionately suffer from poor oral health. Additionally, there continues to be a shortage of pediatric dentists practicing in rural/migrant areas. The purpose of this formative research study was to assess whether staff, teachers and families from rural/migrant Head Start/Early Head Start (HS/EHS) programs in California were receptive to oral health online education workshops conducted by pediatric dental residents who were assisted by bilingual (English and Spanish) community oral health workers (COHWs). Our findings suggest that partnering pediatric dental residents with bilingual COHWs to educate HS/EHS teachers, staff and parents on oral health care in rural/migrant areas could result in a rewarding experience for pediatric dentists that might lead them to practice in these communities upon graduation from their residency program. Furthermore, the positive feedback received from the teachers, staff and parents who participated in the workshops indicates they were receptive to receiving oral health information related to oral health literacy from the dental providers and COHWs. COHWs can help increase access to oral health care by serving as a bridge between families and providers by relaying information in a cultural, linguistic and sensitive manner.

Breaking the bamboo ceiling and de-bunking the model minority myth.

Leadership roles must incorporate representation from all involved individuals for the resulting decision-making process to reflect the interests and expertise of a diverse organization. Many resources have rightly focused on developing historically underrepresented racial and ethnic(HURE) leaders. Though numbers of Black and Hispanic dental school deans have increased, more work is needed for these and other HURE groups such as American Indians. Asians are not classified as HURE. As an aggregated group they have robust presence in the dental workforce in North America, the United Kingdom and Australia. The assumption is they are fine, so the group is ignored. Previous research indicates Asians are almost invisible in leadership roles in dentistry, and while the "Glass Ceiling" phenomenon for women persists, Asian women face even greater obstacles to leadership. This paper explores cultural factors contributing to the "Bamboo Ceiling", such as Confucian values emphasizing collectivism and deference to authority. It examines challenges faced by Asian women at the intersection of gender and race. The impact of the "Model Minority Myth" compounds these challenges, leading to overlooking diverse needs. The importance of dispelling these harmful myths is underscored. This paper provides strategies to combat them, urging proactive efforts from minorities and management. By shedding light on the "Bamboo Ceiling" and the "Model Minority Myth", this paper aims to reassess existing norms, current policies and procedures pertaining to equitable representation and leadership opportunities for Asian women in academic dentistry, community oral health, research, and in dental corporations.

Debating: effective and satisfactory learning method in dentistry

BackgroundEducation in the modern world of health needs diverse methods of learning and teaching. The traditional education model has limited capacity for developing abilities such as critical thinking, problem-solving, and reasoning skills. Therefore, improving the quality of teaching–learning processes requires implementing educational innovations in the classroom and evaluating them. This study aimed to determine the impact of the debate teaching method on improving the abilities of general dentistry doctoral students.MethodsThe research was a semi-experimental study with pre-tests and post-tests to measure the knowledge and abilities of students. The study included 60 dental students who completed the fall 2022 session of the Community Oral Health (COH) 2 practical course. This course, one of three practical components within the Community Oral Health curriculum, aligns with the educational framework of general dentistry. Challenging topics on which there is no consensus in dentistry were chosen for the debate. The descriptive statistics indicators include an independent t-test and variance analysis test with a significance level of 5%. Were used to analyze the data.ResultsThe results of the study showed that the average total knowledge (P < 0.001), 'perception of critical thinking skills (P < 0.001), expression power (P < 0.001), reasoning skills (P = 0.003), interpretation and Information analysis power (P < 0.001), the ability to find and use scientific databases (P < 0.001) and the ability to analyze and evaluate evidence (P < 0.001) increased significantly after intervention in students. 95% of students agreed/strongly agreed that this method enhances their ability to answer people's questions. From an instructor’s point of view, students had 93.1% of the ability to reason and analyze information after intervention and 88.5% of the ability to think critically.ConclusionThe results of the study showed that the use of debate in the classroom is an effective way to present content. The process of evaluating data-driven arguments promotes higher-level cognitive skills and teaches students about the knowledge base and the use of scientific databases.Trial registrationRegistration date: 21/11/2022, Registration number: IRCT20141128020129N3.

A Healthy Mouth for All: involving community oral health workers to serve as a link between vulnerable groups and dental professionals.

Introduction: The linear graded relation between (oral) health and socio-economic status (SES) is well-established and seen in all countries, including Belgium. Regarding oral health care for socially vulnerable groups, there are important barriers on both the supplier and the user sides. The program 'Ieders Mond Gezond ('Healthy Mouth for All') aims to minimize the gap between underprivileged people and dental professionals by involving employees or volunteers of poverty- or other welfare organizations as Community Oral Health Workers (COHW's). This paper aims to present the design of a two-year longitudinal study investigating the program's effect on participants' oral health status, attitude toward dental care, and healthcare consumption.&#x0D; Methods: During a one-year feasibility study, employees and volunteers from welfare organizations followed a validated one-day educational program to learn how to support and assist underprivileged families in oral care. After the training, oral screenings were organized in the local organizations to screen the participants on current oral health status and oral health behavior. A process evaluation was performed by interviewing the COHW's on the referral process and access to dental care.&#x0D; For the two-year longitudinal study, cluster randomization will be performed. First, 15 out of the existing 60 primary care zones in the Dutch-speaking region of Belgium will be randomly selected. All local welfare organizations in these zones will be asked to be involved in the study. They will have to appoint COHW's who will follow the one-day educational program, after which they can individually coach their clients in their preventive and curative oral health care path. After the training, oral screenings will be organized within the local organizations to find and screen participants on the primary outcome variables: current oral health status and oral health behavior. These outcome variables will be assessed yearly to evaluate evolutions, collecting quantitative data through oral examination and a self-administered questionnaire. Furthermore, the COHW's and participants will be interviewed annually to determine their attitudes toward oral health care and dental professionals. Data analyses will include linear mixed model analyses (continuous variables) and generalized mixed model analyses (dichotomous variables) to evaluate changes over time. &#x0D; Results and discussion: During the feasibility study, 26 COHW's were trained, and 37 screenings were organized. In total, 467 persons were screened, of which 277 (59%) were referred to a local dentist. Besides the organized screenings, the COHW's referred 149 other clients to a local dental professional. Of all referred participants, 43% ended up seeing a dentist.&#x0D; The longitudinal study should show to what degree evolution can be seen in oral health behavior and care consumption of the participants over a two-year time period. After obtaining ethical approval, clinical data will be gathered between August 2023 and July 2025. The results will contribute to knowledge about the impact of involving community oral health workers on oral health, oral health behavior, and access to oral health care of underprivileged individuals.

Oral Health Care and Multidisciplinary Knowledge at the Volunteering Work in Peru: an Experience Report.

People in lower-income societies are facing significant challenges in accessing primary oral health care during their entire lives. Nongovernmental organizations (NGOs) have facilitated the provision of dental services by outreach program volunteers to low-and middle-income countries. Volunteering programs worldwide create a positive new experience between the students and professionals who are able, available, and with the initiative to help others, their objective primarily is to give some relief to those involved in the approximately more than 4 billion people worldwide who have a small or no access to basic dental care. Peru is one of the places in Latin America that needs attention when it comes to oral health care. The highest level of caries disease was biostatistically found in Cuzco. A lack of information regarding oral hygiene could explain this high prevalence of caries in Peru, concluding that the cities around the country of Peru need volunteering intervention. This study is classified as an experience report and a description of a dental volunteer program event. The proscript author has experienced an entire volunteering work in dentistry as an academic dental medicine student. All the activities developed were localized in the city of Cusco in the center of public health named Centro de Salud Clas Wanchaq, promoting oral health actions daily and being able to put into practice the techniques learned before in Brazil. Conclusively, in terms that express the ethical considerations in community oral health, it is necessary to discuss an overview of community oral health from an ethical perspective, including the importance of equity, human rights, and social justice in providing oral health care.

Oral health literacy strategies focused on community-based learning

Abstract Background Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. The objective of this work is to present the strategies under development in the community, focusing interventions of oral health literacy by the application of community-based learning models in the central region of Portugal. Methods At the Faculty of Dental Medicine of the Universidade Católica Portuguesa (Viseu, Portugal), various community oral health projects have been developed focusing on oral health literacy promotion among the most vulnerable population, with the goal of achieving acceptable levels of empowerment towards adequate oral health behaviors. One of the main strategies consists in the application of the Service-Learning methodology that has allowed the identification of community needs and the active participation of dental medicine students in community interventions and scientific research in oral health. Results Innovative oral health community strategies should be performed to improve oral health literacy within the most vulnerable risk groups of society, specifically oriented to a community-based learning model. Service-Learning is an educational approach where the student learns specific soft skills, collaborating directly with a social institution and society “outdoors” and engages in reflection activities to deepen their understanding of what is being taught. Conclusions One of the main strategies to incorporate the health professional in social responsibility and direct contact in community is by experiencing Service-Learning programs during their training phase. It is important to highlight that health-related degreeś curriculum should favor community-based learning as a successful and engaging learning model that addresses both professionalism and humanism. Key messages • Community-based learning projects can be developed in order to work with and for the community contributing, simultaneously, for the development of soft-skills among future oral health professionals. • Public health strategies should be performed to improve oral health literacy within the most vulnerable risk groups of society, specifically oriented to a community-based learning model.

Rural Zambian Oral Health Transition: A Long-Term Retrospective Examination of an Outreach Program's Progress and Impact.

This study aimed to (a) describe an annual prevention-focused, community-based oral health outreach program in rural Zambia, (b) assess its oral health outcomes using demographic and oral health variables, and c) identify milestones resulting from program activities. A retrospective analysis of demographic and oral health data from a single site between 2007-2014 and 2018-2019 was conducted. Demographic variables included sex and age, while clinical outcomes encompassed pain, untreated caries, and treatment urgency. Bivariate and multivariable analyses were performed, adjusting for sex and age categories. Information on community development was obtained from the Ministry of Health and local community representatives. Data from 5,791 subjects were analyzed. The prevalence of pain, untreated caries, and highest treatment urgency category decreased consistently across year categories. Both bivariate and multivariable analyses showed statistically significant differences in clinical outcomes between year categories (p < 0.001). In addition, the percentage of male participants and younger age categories increased during the study period. Key program milestones included the installation of two boreholes for clean water, the development of a local community oral health volunteer program, the establishment of an educational pipeline by the Dental Training School for residents, and the construction of a maternal/oral health center with district and ministry oversight. The observed decrease in treatment urgency scores, presence of pain, and untreated caries are consistent with the prevention-seeking behavior of program participants. The increasing participation and changing demographic patterns over time suggest a growing demand for oral health services among males and younger individuals. The positive oral health outcomes and development of a maternal child/oral health facility exemplify a program design aligned with community needs and appropriate care delivery.

Determinants Impacting the Use of Antibiotics Among Patients Visiting the Dental Clinic at Kampala International University Teaching Hospital in Bushenyi-Ishaka Municipality, Western Uganda

The primary objective of this investigation was to identify the factors influencing the usage of antibiotics among patients seeking care at the Dental Clinic within Kampala International University Teaching Hospital, situated in Bushenyi-Ishaka Municipality, Western Uganda. The study employed a cross-sectional hospital-based survey, gathering data between February and July 2022. This design enables the collection of specific parameters at a single point in time. Analyzed data was presented through tables and figures, illustrating frequencies and proportions. For continuous variables, univariate analysis was conducted, presenting measures of central tendency (such as mean, median, and mode) and measures of dispersion (like range, interquartile range, and standard deviation) for various independent variables. The study revealed that financial constraints were cited by patients and health center nurses as a significant factor causing delays in seeking dental care and occasionally resulting in non-attendance at the dental department. From interviews, patient-related factors emerged, including knowledge about oral health services, awareness of services offered in dental clinics, perceived necessity, fear, anxiety, and access to oral health services. Consequently, the study recommended an enhancement in oral health education initiatives, particularly leveraging media channels, due to a shortage of community oral health personnel. The aim is to extensively educate the population about preventing oral diseases and the appropriate timing for seeking oral health services, enabling individuals to make well-informed decisions regarding their oral health. Keywords: Antibiotics, bacterial infections, Dental Clinic, Oral health.

Positive impacts of oral health services provision by a student-led primary care clinic to an Australian rural indigenous community.

This study aimed to determine whether oral health services provision by a dental student clinical outplacement embedded within a Community Controlled Health Service positively impacted a rural Indigenous community and to explore the nature of these benefits. Aggregated and de-identified 2017, 2018 and 2019 student-led clinic services provision data were retrospectively analysed. The change in services mix over time was measured. Rural outplacement clinic operational costs to the university were estimated. Government-funded local public dental clinic waiting list and services provision data were used to identify any student clinic establishment effect. The student-led clinic services mix shifted over time from mainly acute care for toothache towards prevention of disease and tooth restoration, indicating an improvement in patient oral health and correspondingly reduced system costs. Imputed value of 2017-2019 student-led clinic services provision totalled almost AUD$1 million. Government public clinic waiting list times decreased after full establishment of the student-led clinic, indicating decreased pressure on the public system. The Community Controlled Health Service and university partnership improved community oral health care access, its timely delivery and simultaneously provided valuable human capital development from the student training experience. The student-led clinic's targeted Indigenous community showed oral health improvement over time. © 2023 Australian Dental Association.

Geospatial Analysis of Dental Access and Workforce Distribution in Kenya.

One of the major factors affecting access to quality oral healthcare in low- and middle-income countries is the under-supply of the dental workforce. The aim of this study was to use Geographical Information System (GIS) to analyse the distribution and accessibility of the dental workforce and facilities across the Kenyan counties. This was a cross-sectional study targeting dental professionals and their practices in Kenya in 2013. Using QGIS 3.16, these data were overlaid with data on population size and urbanization levels. For access measurement, buffers were drawn around each clinic at distances of 2.5, 5, 10 and 20 km, and the population within each determined. Nine hundred six dental professionals in 337 dental clinic locations were included in the study. Dentists, community oral health officers (equivalent to dental therapists) and dental technologists comprised 72%, 15% and 12%, respectively. Nairobi county with 100% urbanization and >4000 people/km2 had 43% of the workforce and a dentist to population ratio of 1:9,018. Wajir with an urbanization level of 15% and 12 people/km2 had no dental facility. Overall, 11%, 19%, 35% and 58% of the Kenyan population were within 2.5, 5, 10 and 20 km radius of a dental clinic respectively. Maldistribution of dental workforce in Kenya persists, particularly in less urbanized and sparsely populated areas. GIS map production give health planners a better visual picture of areas that are most in need of health care services based on population profiles.

Global public health must end the neglect of oral health

Abstract Oral diseases are among the most common health problems and constitute major public health challenges across countries and health systems worldwide. The main diseases dental caries, severe periodontal disease, oral cancer and toothlessness affect populations everywhere and show significant social gradients - poor, disadvantaged, rural, or otherwise vulnerable groups suffer from a much higher burden, while at the same time having more difficulties to access prevention and care. Similarly, low- and middle-income countries have the highest prevalence of oral diseases while their healthcare systems are ill-equipped to address the challenges. Due to the predominant clinical care model of dentistry that favours an interventionist approach requiring costly technology provided by a dentist, many health systems and large population segments are not able to afford even basic oral health care. Moreover, oral health has been largely absent from the global health arena for the last 20 years leading to faltering political priority and attention. This has changed recently with the convergence of several initiatives of global relevance, supported by advocacy of the wider oral health community. Following the first ever paper series on oral health in The Lancet, a Lancet Commission on Oral Health was established in 2019, which sparked a group of WHO member states to embark on a remarkable policy development process dedicated to oral health. We now have a Global Strategy for Oral Health and will soon have a Global Action Plan complemented by a comprehensive Monitoring Framework. In addition, work on defining Best Buys in Oral Health and other supportive workstreams are under way. The presentation will provide an introduction and overview to these global policy guidance frameworks that are shaping a new reform agenda for oral health as part of NCDs, Universal Health Coverage and the SDGs towards 2030. Particular implications for public oral health in Europe will be discussed.