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Volume 32 , Issue 1
January/February 2017

Page 15


Editorial: Oral Health Redefined

Steven E. Eckert, DDS, MS


DOI: 10.11607/jomi.2017.1.e

When we think about health, it is not unusual for health to be perceived as an absence of disease. In that regard, health is a neutral condition, being neither positive nor negative. Certainly, an absence of disease is favorable in comparison to experiencing disease, but indifference is not an acceptable goal. Most people would prefer a condition that is better than average, a state of health that is not just one of no disease, but instead represents an overall state of well-being.

Health should be a positive grouping of physical and emotional factors that create a person who exhibits positive characteristics. By both objective and subjective measures, a “healthy” individual should look and feel well. Others will notice the physical benefits of health, while the individual will recognize the overall quality of life when health is present.

Recently, the FDI World Dental Federation introduced a redefinition of “oral health”.1,2 The new definition identifies many of the physical functions associated with people who perform physical tasks at a higher level than average. Likewise, psychologic health is often reflected in a positive sense of being “involved in the moment” while also having the capacity to plan for the future with a general sense of optimism.

Characteristics of oral health would include the ability to “speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex.” Traditionally, we have described this as patients with the ability to utilize their stomatognathic system to provide themselves with comfort, function, and esthetics. The new definition clarifies this classic description, which ultimately provides the clinician with numerous touch points to ensure achievement of the desired health.

The new definition also states that oral health is a fundamental component of health and physical and mental well-being; exists along a continuum influenced by the values and attitudes of individuals and communities; reflects the physiologic, social, and psychologic attributes that are essential to the quality of life; and is influenced by the individual’s changing experiences, perceptions, expectations, and ability to adapt to circumstances.

Considering this new definition, one wonders how the definition might affect the way that patients are treated. The treatment outcomes may be objectively evaluated through different testing mechanisms that have developed throughout the years. We feel relatively comfortable that we can evaluate chewing efficiency, tooth contacts, appearance, and even the effects on the patient’s quality of life if those patient perceptions are evaluated before and after dental intervention. Despite our ability to utilize such assessment mechanisms, we continue to struggle with the fact that subjective concerns on the part of the patient could be prioritized by the patient in such a way that the clinician simply fails to recognize the relative importance of one factor versus another. The new definition provides the clinician with a much more comprehensive list of items that need to be considered, but—and there is always a qualifier—the most important list of considerations is the one that the patient brings to the discussion, and a failure on the part of the clinician to understand those prioritized concerns of the patient could doom patient treatment.

The efforts of the FDI in establishing a new definition of oral health must be commended. Clearly, oral health is not an isolated set of outcomes from one region of the body, but instead is a comprehensive number of events/factors that contribute in a great way to overall patient health. This definition was created through the efforts of the “FDI’s vision 2020 Think Tank.” It would be difficult to estimate the amount of effort that was put into this new definition. The efforts have created a comprehensive description of oral health that provides a clear target upon which clinical dentistry may focus. Congratulations to the FDI as it brings clarity to its vision of “leading the world to optimal oral health.”

Steven E. Eckert, DDS, MS

Editor-in-Chief

REFERENCES

1. www.fdiworldental.org press release, September 6, 2016.

2. Glick M, Williams DM, Kleinman DV, Vujicic M, Watt RG, Weyant RJ. A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. J Am Dent Assoc 2016;147:915–917.


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