Promoting periodontal health--effective programmes of education and promotion.

A realistic aim for a preventive programme is to reduce dental plaque to levels compatible with rates of progression of periodontal disease which will allow functional and aesthetically and socially acceptable dentitions to be maintained throughout life. Since tooth cleaning is mainly influenced by socialization, and most people do brush their teeth, the objective of health education is to improve the effectiveness of oral hygiene behaviour. However, most dental health education programmes, whether directed at individuals or groups, are based upon an incorrect concept. Instead of attempting to change the commonly used scrub technique, encouragement should be given to use the scrub method more effectively. Oral health should be integrated with programmes dealing with general hygiene and grooming; a diversity of approaches and maximal participation by the community, individuals and professionals should be encouraged. The dentist/hygienist-centred strategy is not likely to be effective in reducing periodontal disease at a community level. Social and educational strategies directed at groups are more likely to be useful. Programmes should concentrate on educating significant individuals in the community, educating educators and educating the dental team. The programme should be continuous and low key and refrain from victim-blaming exhortations to clean teeth with devices of questionable usefulness.