Suchergebnisse

OBJECTIVES: Review the meaning of 'health need', consider oral health inequalities and oral health promotion among people with HIV and outline methods to enhance coordination, standardization and dissemination of research efforts. METHODS: This workshop involved a brief introduction of each topic by an invited speaker followed by participant discussion. Participants were dentists and dental students attending the 7th World Workshop on Oral Health & Disease in AIDS RESULTS: A health need was regarded as a population's ability to benefit from care. Oral health inequalities called for both downstream and upstream health promotion. A community health programme to reach people with HIV infection in the community was described. Despite deploying community health workers to reduce costs, the programme required additional resources for comprehensive implementation. The Indian National AIDS Control Program exemplified coordinated efforts. Knowledge transfer can be achieved via educational, linkage and exchange and organizational interventions. Stakeholder engagement in a combination of all three types of intervention is the most effective. CONCLUSIONS: The discussion centred on the difficulties of Indian dentists who felt they did not receive sufficient revenue to treat patients with HIV. An opposing view approach treated all patients using universal standards of infection control. Dental regulatory bodies, professional organizations and governments may need to demonstrate leadership and advocacy for the oral health of people with HIV infection.

Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors—the so-called structural determinants of health—play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health–related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries (N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.