As director of the WHO Collaborating Centre for Oral Health Inequalities and Public Health, Prof. Richard Watt is well positioned to understand the extent of the global public health challenge presented by non-communicable oral diseases and the role that dental hygienists and their associations can play in reducing this burden. A presenter at last week’s 13th International Symposium on Dental Hygiene, Prof. Watt recently discussed this topic and related matters with Dental Tribune International.
Prof. Richard Watt. (Image: Richard Watt)
Prof. Watt, how can dental hygienists promote oral health policy change and implement WHO’s draft global strategy on oral health?
Over the last two years, WHO has had many opportunities to address global oral health, and a raft of documents are coming through that will highlight how oral health services and policies can be changed for the better. One of these documents will be the global oral health action plan, which is currently being formulated. It will have a consultation period set to commence in the near future. This is an example of how, through their international and national organisations, dental hygienists can come together, provide their input and really influence how these global oral health policies are developed and implemented.
Dental hygienists can really take the lead on prevention. There are many opportunities for them to promote and influence oral health policies individually within their local communities and also, perhaps most importantly, collectively in their national and international organisations.
In your view, is there a way in which dental hygienists can put these policies into practice at the patient level?
I think there is, though it depends on the working arrangements and the level of autonomy experienced by dental hygienists in different countries. Overall, they play a pivotal role in prevention at the individual level through interventions such as promoting plaque control and effective hygiene, encouraging the cessation of smoking and providing dietary support. All of these measures are linked to the prevention of non-communicable diseases, both oral and otherwise. As we know, there is a link between oral health and conditions such as diabetes, obesity and heart disease.
In general, dental hygienists are ideally placed to perform this kind of preventive role and to provide guidance on achieving behavioural change. Indeed, their education and training often means that they have more knowledge of preventive oral health strategies than dentists do.
What role can the dental hygienist–patient relationship play in encouraging this preventive approach to oral health?
Again, it’s something that depends on circumstances, but dental hygienists should have time to discuss and implement prevention, whereas this may not be possible for dentists, who often deal with complex clinical cases. To help dental hygienists best achieve this, they should be given proper training so that they’re able to confidently deliver up-to-date, evidence-based advice on prevention in the clinical setting.
“It’s clear that there are many different levels at which dental hygienists can become involved in oral health policy change”
The International Federation of Dental Hygienists and the European Dental Hygienists Federation released a joint statement earlier this year on WHO’s draft global strategy on oral health, stating that cross-sectoral collaboration between the oral health workforce and teachers, nurses and public health workers is necessary for all groups in a population to be reached. Do you feel there is a need for this kind of collaboration if global oral health issues are to be truly addressed?
Yes, without question. Dental hygienists have not only a clinical role interacting with their patients in dental practices but also a role in the broader community where they need to better understand what factors influence patients’ oral health. The health advocacy role that hygienists play can be really important at the community level and can help facilitate collaboration and oral health promotion between the dental team and other agencies and sectors.
It’s clear that there are many different levels at which dental hygienists can become involved in oral health policy change. This provides the opportunity, in my opinion, for a challenging and ultimately rewarding career.
When we talked in September 2020, you discussed how the pandemic had highlighted opportunities for reform in dentistry. Two years later, do you believe that there are any areas in which dental reform has taken place? Is there still potential for it?
The potential for reform in dentistry is definitely still there, but whether it’s actually happened is debatable. One thing that we didn’t predict is that, owing in part to the pandemic, a global recession is occurring, and this is leading to high levels of inflation and major financial problems. As a result, public spending is being squeezed dramatically, and this, unfortunately, has meant that many dentistry reforms have been put on the back burner for the time being.
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