Department Epidemiology and Health Promotion, WHO Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of Dentistry, New York University, New York, NY, USA.
Global Health Center, Geneva Graduate Institute for Policy Studies, Geneva, Switzerland.
J Dent Res. 2021 Mar;100(3):221-225. doi: 10.1177/0022034520979830. Epub 2020 Dec 9.
The coronavirus disease 2019 (COVID-19) pandemic revealed a lack of consensus on the concept of essential oral health care. We propose a definition of essential oral health care that includes urgent and basic oral health care to initiate a broader debate and stakeholder alignment. We argue that oral health care must be part of essential health care provided by any health system. Essential oral health care covers the most prevalent oral health problems through an agreed-on set of safe, quality, and cost-effective interventions at the individual and community level to promote and protect oral health, as well as prevent and treat common oral diseases, including appropriate rehabilitative services, thereby maintaining health, productivity, and quality of life. By default, essential oral health care does not include the full spectrum of possible interventions that contemporary dentistry can provide. On the basis of this definition, we conceptualize a layered model of essential oral health care that integrates urgent and basic oral health care, as well as advanced/specialist oral health care. Finally, we present 3 key reflections on the essentiality of oral health care. First, oral health care must be an integral component of a health care system's essential services, and by implication, oral health care personnel are part of the essential health care workforce. Second, not all dental care is essential oral health care, and not all essential care is also urgent, particularly under the specific risk conditions of the pandemic. Third, there is a need for criteria, evidence, and consensus-building processes to define which dental interventions are to be included in which category of essential oral health care. All stakeholders, including the research, academic, and clinical communities, as well as professional organizations and civil society, need to tackle this aspect in a concerted effort. Such consensus will be crucial for dentistry in view of the Sustainable Development Goal's push for universal health coverage, which must cover essential oral health care.
2019 年冠状病毒病（COVID-19）大流行揭示了人们在基本口腔卫生保健概念上缺乏共识。我们提出了一个基本口腔卫生保健的定义，其中包括启动更广泛辩论和利益相关者协调所需的紧急和基本口腔卫生保健。我们认为，任何卫生系统所提供的基本卫生保健都必须包括口腔卫生保健。基本口腔卫生保健涵盖了最普遍的口腔健康问题，通过在个人和社区层面上商定的一组安全、高质量和具有成本效益的干预措施来促进和保护口腔健康，预防和治疗常见的口腔疾病，包括适当的康复服务，从而维持健康、生产力和生活质量。默认情况下，基本口腔卫生保健不包括当代牙科所能提供的所有可能干预措施的全部范围。在此定义的基础上，我们构想了一个基本口腔卫生保健的分层模型，其中整合了紧急和基本口腔卫生保健以及高级/专科口腔卫生保健。最后，我们提出了关于口腔卫生保健基本性的 3 点思考。首先，口腔卫生保健必须是卫生保健系统基本服务的组成部分，因此，口腔卫生保健人员是基本卫生保健劳动力的一部分。其次，并非所有的牙科护理都是基本口腔卫生保健，并非所有的基本护理也都是紧急护理，尤其是在大流行的特定风险条件下。第三，需要制定标准、证据和共识建立过程，以确定哪些牙科干预措施应纳入基本口腔卫生保健的哪个类别。所有利益相关者，包括研究、学术和临床界以及专业组织和民间社会，都需要共同努力解决这一问题。鉴于可持续发展目标推动普及全民健康覆盖，必须包括基本口腔卫生保健，因此，这种共识对于牙科来说至关重要。
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