Defining oral health: a new comprehensive definition

The accompanying editorial¹ introduces a new definition of oral health approved by the FDI World Dental Federation at the September 2016 Annual World Congress in Poznan, Poland. The key components of this broad definition are inclusion of the full range of activities that involve the craniofacial complex, a focus on oral health as a component of health, and the importance of oral health for achieving good quality of life. Further, the definition will change over the life course of the individual, acknowledging the cumulative nature of oral/dental disease. The working group that developed this new definition should be congratulated for their efforts, and the FDI acknowledged for its role in stimulating the larger Vision 2020 initiative².

The new definition includes five domains can modify oral health, including genetic predisposition, the social environment, physical environment, health behaviors and access to care. The definition also emphasizes the complexity of oral health, which on the level of the individual is modified by age, cultural context, income, experience, expectations and personal adaptability.

Definitions are important, and this new, comprehensive definition of oral health serves as a new starting point, and a directional vector for actions that will promote the importance of oral health in the larger context of health care, provide a message to government agencies that are responsible for oral health policy, and lead to a better understanding by the lay public about what is meant by oral health.

This definition can be viewed from different perspectives. It highlights the importance of a fully-functional oral cavity and craniofacial complex, emphasizing that anatomical components contribute to function. However, measuring “oral health” under this comprehensive definition is a challenge, and potentially includes quantitative measures (i.e. periodontal status, salivary flow), qualitative measures (i.e. impact on quality of life) and summative activities (i.e. chewing, smiling). One critical next step is defining the practical application of the definition, as well as expected changes that occur with age. Standards should be developed for different age groups, as the definition will change over the life course.

This new definition of oral health is noteworthy for its vision and breadth. It sets a high bar, and in a world where dental serves are often not readily available, it will be a challenge to use this definition effectively. Further, the definition should be particularly impactful for older adults (traditionally defined as 65 years of age and older). With increased tooth retention globally³, and the demand for oral health care services by older adults expected to grow, the definition can serve to emphasize that oral health care for older adults does not begin when a person reaches a certain age. Rather, older adult oral health depends upon an emphasis on prevention at an early age, and availability of oral health care services if disease develops.

Application of this definition is particularly important for the FDI. Representing dental associations and dentists across the globe, and focused on improving oral health care for all, the new definition of oral health can be a unifying banner that places a new emphasis on oral health, while also allowing comparison of the oral health status of different populations in disparate communities.

In sum, an excellent beginning.