What is dental public health?
What is dental public health, and why is it important?
Dental public health is a unique discipline that is formed by a marriage of the broad fields of dentistry and public health, with a strong emphasis on prevention of oral diseases and ensuring provision of adequate preventive and treatment services among vulnerable groups.
It's important because oral health is essential to overall health and wellbeing. Despite significant improvements, oral disease is still highly prevalent in all populations, and more importantly, is a disproportionate burden to certain disadvantaged or vulnerable population groups.
Dental public health is distinguished from other disciplines of dentistry in its pursuit to serve the community as a patient rather than the individual. It aims to improve oral health at a population level with a strong emphasis on the prevention of oral diseases, and the provision of adequate preventive and treatment services to the entire population.
What do dental public health specialists do?
Dental public health has traditionally focused on disease prevention (e.g. fluoride and oral health education) and providing oral healthcare services to the most vulnerable populations. While these are still major concerns, dental public health has a much wider scope and practice.
At the highest level, dental public health is concerned with improving the dental care delivery system, effective and efficient payment systems, and cost-benefit and cost-effectiveness of different services and delivery models, to assure effective and sustainable dental services for all.
This wide and complex scope of dental public health practice increasingly demands a wide range of advanced knowledge, skills, and experience in dental, behavioural, public health, education, social, and political sciences from dental public health workers.
Dental public health practice often includes advocating for and providing services for vulnerable and disadvantaged communities.
What are the key challenges for population-level prevention in oral health?
There are too many! Just to list a few:
Since the discovery and implementation of fluorides (community water fluoridation, fluoride toothpaste, and fluoride rinse, gel, and varnish) we haven’t had such a breakthrough in prevention at a population level.
There are several promising preventive measures including pit and fissure sealants, but its uptake at dental practices is very low. It is, in part, because the dental care delivery system in Australia is designed to incentivise dental professionals to provide treatment rather than focus on prevention.
Like many other chronic diseases, prevention of oral disease require changes in behaviour and lifestyle which pose significant challenges at a population level. For example reduction of high sugar intake, a common risk factor for dental caries as well as obesity and diabetes.
Another challenge is changing demographics – for example, increasing elderly population who are retaining more of their teeth and an increase in migrants and refugees. These changes pose specific challenges and call for different strategic approaches in prevention.
Above all others, one of the most important challenges to population-level prevention in oral health is the separation of the mouth from the rest of the body. Health systems alienate dental care from overall disease prevention, and this is a key challenge dental public health experts are trying to overcome.
Professor Woosung Sohn is the Chair of Population Oral Health at the University of Sydney School of Dentistry.
As a dental public health expert, what are you hoping to achieve in the field?
The overarching goal of dental public health is to positively impact the oral health of local, national, and global populations, particularly the disadvantaged, underserved, and vulnerable, through excellence and innovation in research, education, and service.
I am particularly aspired to achieve this goal by addressing the challenges listed above through research innovation and education, and the translation of science to dental practice and the community.
To support this, I have worked closely with colleagues at Sydney Dental School, Sydney School of Public Health, and wider Faculty of Medicine and Health to design an innovative masters program in dental public health that will produce graduates with the knowledge and skills to advance research and practice in this growing field.
The program is set to commence at the University of Sydney in 2021, and once accredited will be the first approved program in Australia to meet the standards for specialist registration with the Dental Board of Australia.