Community dentistry and oral epidemiology
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Community Dent Oral Epidemiol · Oct 2012
Social determinants of oral health inequalities: implications for action.
For over 30 years, the WHO has been advocating an integrated approach in chronic disease prevention. The concept of the common risk factor approach (CRFA) highlighted shared risk factors for chronic conditions including oral diseases has provided the basis for closer integration of oral and general health promotion activities. ⋯ The narrow and restricted interpretation of the CRFA is a serious threat to developing effective action to address oral health inequalities. Based upon the WHO conceptual framework on the social determinants of health inequalities, an overview will be presented of a range of actions that could be implemented to tackle the social gradients in oral health outcomes.
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Australia has a complex history of providing public dental services to its communities. From the early days of Colonial settlement, the provision of dental care to the Australian public has largely been driven and influenced by organized groups and associations of dentists. The Constitution of Australia, under Section 51 xxiii A, allows for the Commonwealth to provide for medical and dental services. ⋯ A new paradigm for public dental services in Australia requires strong Commonwealth leadership, as well as the commitment of State and Territories and the organized dental profession. The National Health and Hospitals Reform Commission provided the most recent scenario for a radical change in mission. This paper canvases the competing roles of strategic, functional, and structural issues in relationship to social network and policy issues, which must be recognized if Australians truly seek to reform public dental services.