Oral Health Promotion

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• Oral Health Promotion Health Education
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The concept of health(1)

• ??(health)
• ?????????????,?????????????????
• Health is a state of complete physical, mental,
  and social well-being and not merely the absence
  of disease or infirmity?
• World Health Organization (1946) Basic
  Documents, 5th ed. P. 1.

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Understand the concept of health(2)

• ????????????,
• ???????????????????????????,????,?????????????
• What this definition recognizes relevant to
  health care is that the terms physical,mental,and
  social ,conceptualize health according to
  human-system framework which invites a
  behavioural science-oriented approach to the
  study of health. Furthermore,it emphasizes the
  idea that health goes beyond the individual to
  include social,ecological and economic facets of
  health.

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The dimensions of health

• ????(inner circle)
• 6 ???
• ????(middle circle)
• ????(out circle)

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The concept of oral health(1)

• ?????(oral health) ???????????????????????????
• Teeth clean no caries cavities, no pains, gingiva
  with normal colure and no sign of bleeding.
• WHO 1981

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The concept of oral health(2)

• ????(Oral Health)????????????????????????????????
  ???
• Dental health is concerned with the functional
  efficiency not only of the teeth and supporting
  structures but also the surrounding parts of the
  oral cavity and or the various structures related
  to mastication and the maxilla-facial complex?
• WHO 1965

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The concept of oral health(3)

• ???????????????????,????????????????????,?????????
  ???????

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??????

• Oral Health Education

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??????Definition of Health Education

• Any planned combination of learning experiences
  designed to predispose,enable,and reinforce
  voluntary behaviour conducive to health,in
  individuals, groups, or communities.
• (Frazier,1992)

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??????Definition of Health Education

• ????(health education)??????????????,????????????
  ???????????
• Any combination of learning opportunities and
  teaching activities designed to facilitate
  voluntary adaptations of behaviour that are
  conducive to health?
• Green,L.W. National policy in the promotion of
  health, 1979

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???????????? The objective of dental health
education

• ????????????????????????????
• The ultimate objective of all planned dental
  health education activities is to obtain and
  maintain optimum dental and oral health status
  for all individuals throughout life.
• (WHO 1970)

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??????????? (1)Basic Concepts of Oral Health
Education

• ???????(Oral health education)???????????????????
  ????,???????????????
• ???????????????????????????????????
• Dental health education is an integral part of
  general health education,the achievement of
  dental health goals will require the application
  of principles and processes that are effective in
  other aspects of health education?
• (WHO,1970)

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??????????? (2)Basic Concepts of Oral Health
Education

• ???????????????????????????????

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???????????(3) Basic Concepts of Oral Health
Education

• ??????????????,?????????????,??????????????????
• Health education is not a substitute for a
  preventive serviceit is the educational
  component of such a service designed to develop
  understanding and acceptance of its value. (WHO
  1984)

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??????????? (4)Basic Concepts of Oral Health
Education

• ???????????????????????????
• ????????????????,????????????????????,??????????
  ??????,
• ???????????????????????????,??????,???????????????
  ?????????????
• 
  1978???????????

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??????????? Basic Concepts of Oral Health
Education

• the people have the right and duty to
  participate individually and collectively in the
  planning and implementation of their health
  care, Education concerning prevailing health
  problems and the methods of identifying,
  preventing and controlling them as the first of
  the eight recommended activities making up
  primary health care.
• WHO? Primary health care. Alma-Ata 1978.

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??????????? (5)Basic Concepts of Oral Health
Education

• ??????? educating with correct information
• ??????????????,??????????????????????????,???????
  ??????????(??????)????????????,??????????????

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??????????? (5)Basic Concepts of Oral Health
Education

• ????????????,???????????,??????????????,????????,?
  ???????????????
• Educational efforts using many different
  educational methods should be directed towards
  those associated with the programme, directly or
  indirectly, to ensure accurate knowledge and
  understanding,and to maintain interest and
  participation?
• (WHO,1984)

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? ????????? Health education principles

• ??????????????????
• Oral health education should be built into
  general health education programmes.
• (WHO, 1984)
• ??????????????????????????

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? ????????? Health education principles

• ?????????????????????
• Every available preventive oral health procedure
  includes educational components.
• (WHO, 1984)

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? ????????? Health education principles

• ??????????????????????
• ????????????????????????????????????????
• Education of a variety of different target
  groupspolicy-makers,food manufacturing
  industry,all health care providers,parents,school
  personnel,primary health care workers,programme
  participants, and school students.
• (WHO, 1984)

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? ????????? Health education principles

• ??????????????,??????,???????????
• Educational materials should be designed to gain
  or focus attention, to provide new knowledge, to
  facilitate interpersonal and group discussion,
  and to reinforce or clarify prior knowledge and
  behaviour. Materials such as leaflets, news
  releases, posters, films, and slides series are
  appropriate educational aids. (WHO, 1984)

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? ????????? Health education principles

• ????,??????????????????
• In all community and school-based settings, oral
  health instruction should be consistent and
  compatible with scientific knowledge as well as
  with the local culture, the educational system,
  and social goals.
• (WHO, 1984)

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????????the methods used in community health
ducation

• ??????????????
• divided into the following four broad categories
• 1. ????(one-to-one communication)?
• 2. ???????????????????(group presentations of
  information and group discussion and
  decision-making)

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????????the methods used in community health
education

• 3.??????(disseminating information through mass
  communication channels, including the use of
  pamphlets, posters, newspaters, newsletters,
  rediao and television.)
• 4.??????(community organizational strategies)
• ?????????,????????

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????????

• Oral Health Education Programme

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??????????? Objective of the oral health
education programmes

• ??????????,????????????,?????????
• ?????????????????
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• ?????????
• ??????????
• ??????????????

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???????? Oral health goal

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• ????
• ????
• ???????
• ?????????

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????????? Evaluation

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• ??????? (?????????)

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????????? Evaluation

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???????????? Evaluation

• ???????????????
• ????????????,??????????????
• ????????????,?????????????,?DMFT,CPITN?
• ??????????????????,??????????????????????

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???????????? Evaluation

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• ???????????????,???????????????????,??????,?????
  ??

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??????

• Oral Health Promotion

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??????? The origins and development of health
promotion (1)

• Invest highly ---- After the 2nd World War
• Ensuring access to health services facilities
  (hospital primary care) for those in need
• The National Health Service (UK, 1948)
• Universal publicly managed health insurance
  schemes (Canada, 60s-70s)
• Legislation ---- health-related resources (USA)
• Medicaid and Medicare ---- readily available to
  the old and poor
• (Green Kreuter, 1990)

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??????? The origins and development of health
promotion (2)

• Resource development ---- After the 2nd World War
• The original assumption
• Better access to high-quality health service
  inevitably led to better health. ?
• The challenging assumption
• Spending more money on health services will have
  limited impact on the health of the population.

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??????? The origins and development of health
promotion (3)

• The facts
• ???????????????????
• the provision of free health care did not in and
  of itself eliminate the health gap between the
  wealthy and the poor.
• ?????????????????
• The mortality morbidity vs socioeconomic status
  ---- inversely

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??????? The origins and development of health
promotion (4)

• The consequence
• ??????????
• Cost containment policy
• ???????????????,????
• The role of health education in promoting
  self-care and reducing utilization of services

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??????? The origins and development of health
promotion (5)

• ????????(??????)
• New forms of medical practice (health maintenance
  organizations)
• ??????????????????
• Professionals were paid for prevention

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??????? The origins and development of health
promotion (6)

• ?????The major health problems of modern
  populations, particularly the poor, were and
  continue to be chronic degenerative diseases
• Expensive to manage but could not be cured
• Could be prevented by changes
• in personal behaviours
• in social and physical environments

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??????? The origins and development of health
promotion (7)

• The historical research of McKeown
• improvements in health of over the past 200 years
  were the product of rising standards of living,
  improvements in the social and physical
  environment in sanitation and water supplies.
• (1979)

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??????? The origins and development of health
promotion (7)

• Tuberculosis
• The mortality from tuberculosis declined by 90
  before chemotherapy and BCG vaccination became
  available.
• host resistance
• The improved environment decreased exposure to
  infectious diseases and increased host resistance
  to microorganisms.

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??????? The origins and development of health
promotion (8)

• New approach to population health health
  promotion
• Rejects much of the philosophy on which health
  service provision has been based.
• Involves the prevention of diseases and behviour
  change through health education
• And goes far beyond them

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????? New Public Health

• ????????????1978
• ?????????1986
• ?????????????1988
• ????????1991

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???????Defining health promotion

• ? ?????????,????????????????????????,????????????,
  ??????????????????????

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????????? The development of oral health
promotion

• 1990s----
• The discipline of oral health promotion has
  therefore emerged as a means of improving oral
  health based upon the principles of the New
  Public Health movement?

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????????? The development of oral health
promotion

• A core element of oral health promotionthe
  recognition of
• The importance of the determinants of oral health
• the need to reduce oral health inequalities

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????????? The development of oral health
promotion

• Contemporary oral health promotion seeks to
  promote oral health by improving both
• The ways people live ????
• The condition of living that are relevant to oral
  health ????

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??????? the determinants of health

• ???? ???????????????????
• ??????? ?????????????????????????
• ???????? ????????????????????????????,??????,???
  ????
• ?????? ????????????????????,?????????1/5

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???????????? Risk Factor Approach
WHO 2003
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?????????????

• ???????????? building healthy public policy
• ???????????????? creating supportive environments
• ???????????????? developing personal skills
• ?????????? reorienting health services
• ???????? strengthening community action
• Ottawa Charter for Health
  Promotion(WHO 1986)

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? ???????Principles of Health promotion(1)

• 1??????,??????,?????????????????
• Health promotion involves the population as a
  whole in the context of their everyday lives
  rather than focusing on people who are sick or at
  risk for specific diseases.

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? ???????Principles of Health promotion(2)

• 2?????????,?????????
• It is directed towards action on the determinants
  of health and requires close cooperation between
  many different sectors of society.
• 3?????????,???????????,??????????????????????
• It combines many different approaches and
  requires organizational change, community
  development and local activities to identify and
  remove health hazards.

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? ???????Principles of Health promotion(3)

• 4??????????????,????????????????????????
• Health promotion aims at effective and concrete
  public participation and requires that
  problem-defining and decision-making life skills
  be developed further in individuals and
  communities.

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? ???????Principles of Health promotion(4)

• 5?????????,?????????????,?????????????????????
• While it is an activity in the health and social
  fields, it is not a medical service health
  professionals have a special contribution to make
  in the areas of education and advocacy.
• WHO 1984

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? ????????????

• ???? Community strategies
• ?????? Professional strategies
• ???? Individual strategies
• WHO 2003

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??????Community strategies(1)

• Community-wide health promotion interventions
• Community water fluoridation, salt fluoridation
• School-based fluoride mouthrinse,

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??????Community strategies (2)

• fluoride tablet programmes
• School-based or school-linked dental sealant
• programmes, oral hygiene programmes, screening
  and referral

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???????? Professional strategies

• Patient education and counselling on risk factors
• Professional plaque control
• Topical application of fluorides
• Provision of dental sealants
• Individualized recall schedule

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?????? Individual strategies

• Self-care practices
• Oral hygiene measures
• Toothbrushing, flossing,
• traditional cleaning, dentifrice
• Self-applied fluoride use
• Self-initiated use of dental services

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