This editorial first published in the Journal of the American Dental Association presents the new definition of oral health.
Discusses why a new definition of oral health was a necessary part of the FDI World Dental Federation's Vision 2020.
Presents a companion framework for the new definition of oral health.
This article first published as an editorial in the Journal of the American Dental Association presents the FDI World Dental Federation's universal definition of oral health. This new definition was approved in September 2016 and developed as as part of the FDI's advocacy and strategic plan – Vision 2020.
On September 6, 2016, a new definition of oral health was overwhelmingly approved by the FDI World Dental Federation General Assembly. This was a key part of the organisation's advocacy and strategic plan – Vision 2020.1 The definition, together with a companion framework, creates an opportunity for the profession to reflect on what oral health encompasses and what the implications are of this definition for clinical practice and oral health policy. But why was a new definition needed?
Although oral health has been recognised for millennia to be an essential component of overall health and well-being, it has not been clear whether oral health has meant the same thing for different components of our profession and for our stakeholders. And if we are uncertain as a profession what we mean, how can we explain ourselves clearly to our patients, other health care professionals, policy makers, and those others we seek to collaborate with and inform? A common definition can bring stakeholders together to advocate for the importance of oral health; to influence and shape parameters of care, health policies, research, education, and reimbursement models; and to shape the future of our profession. During the creation of FDI's Vision 2020,1 it became evident that there was a need for a universally accepted definition of oral health, one that conveys that oral health is a fundamental human right and that facilitates the inclusion of oral health in all policies. To accomplish this goal, the FDI charged a newly created think tank with producing such a definition.
A definition was needed that included the full scope of health and well-being and, ultimately, one that could be agreed on by all. Traditionally, oral health has been defined as the absence of disease. This definition fails to account for a person's values, perceptions, and expectations. Furthermore, existing definitions of oral health mostly lack a theoretical framework that can be used to address all of the domains and elements that are part of oral health. The new definition acknowledges the multifaceted nature and attributes of oral health (Box 1). Alongside the proposed concise definition, a companion framework was developed to describe the complex interactions among the three core elements of oral health (disease and condition status, physiological function, and psychosocial function), a range of driving determinants (elements that influence and determine oral health), moderating factors (factors that determine or affect how a person scores his or her oral health), and, finally, overall health and well-being (Figure 1). (A powerpoint version of the new definition of oral health and its accompanying framework can be downloaded at http://www.fdiworldental.org/oral-health/vision-2020/a-new-definition-of-oral-health.aspx.)
In addition to the creation of a theoretical framework, there are several other advantages associated with adoption of this new definition of oral health. The new definition:
Echoes definitions used by the World Health Organisation (WHO), national dental associations worldwide, and many other organisations and is, therefore, not a revolution but an evolution of existing definitions
Moves dentistry from treating disease to providing care and support for oral health
Uses language that resonates with language commonly used in the healthcare realm—words and concepts that health care professionals across disciplines can understand and use
Raises awareness of the different dimensions of oral health and emphasises that oral health does not occur in isolation but is embedded in the wider framework of overall health.
FDI represents more than one million dentists through its more than 200 national dental associations in more than 130 countries; it represents dentistry at WHO and is a member of the World Health Professions Alliance and the Supporters Consultation Group of the Non-Communicable Disease Alliance.2 The creation of this new definition of oral health and the accompanying framework is intended to be used by all stakeholders and builds on the WHO's Commission on Social Determinants of Health report.3 Accordingly, patients, practicing dentists, academicians, researchers, politicians, third-party payers, industry partners, and medical providers were consulted and included in the creation of the definition.
Efforts are under way to assess and measure this new definition of oral health, and work in the United States has started, as demonstrated by the American Dental Association Health Policy Institute.4 We now have a definition of oral health that will enable a conversation that creates a common understanding when addressing the needs of people and communities and when making the case for the importance of optimal oral health for all. Let's get started.
BDJ Editor's note: The in brief and abstract sections of this article have been added by the BDJ Editor and were not part of the original JADA article.
ORCID Number. Michael Glick: http://orcid.org/0000000342365385.
Glick M, Monteiro da Silva M, Seeberger G K et al. FDI Vision 2020: shaping the future of oral health. Int Dent J 2012; 62: 278–291.
World Dental Federation. FDI in brief. Available online at http://www.fdiworldental.org/about-fdi/fdi-in-brief/fdi-in-brief.aspx (accessed October 2016).
World Health Organization. Commission on Social Determinants of Health: final report. Available online at http://www.who.int/social_determinants/thecommissionfinalreport/en/ (accessed October 2016).
American Dental Association Health Policy Institute. Oral health and well-being in the United States. Available online at http://www.ada.org/en/science-research/health-policy-institute/oral-health-and-well-being (accessed October 2016).
'This editorial, published in JADA, Vol 147, issue 12, 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, 915917, doi: 10.1016/j.adaj.2016.10.001 © ADA (2016) is reprinted from The Journal of the American Dental Association, with permission from the American Dental Association to help disseminate the new definition of oral health to as broad an audience as possible'. Editorials represent the opinions of the authors and not necessarily those of the American Dental Association.
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Glick, M., Williams, D., Kleinman, D. et al. A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. Br Dent J 221, 792–793 (2016). https://doi.org/10.1038/sj.bdj.2016.953
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