|LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 4 | Page : 1029-1030
Dilemmas in oral health care during the Covid-19: Prevention and public health promotion as focus of care
Sukhvinder Singh Oberoi1, Shibani Grover2, Shabina Sachdeva3, Sweta Rastogi1
1 Department of Public Health Dentistry, ESI Dental College, Indraprastha University, Rohini, New Delhi, India
2 Conservative Dentistry and Endodontics, ESI Dental College, Indraprastha University, Rohini, New Delhi, India
3 Department of Prosthodontics, Faculty of Dentistry, Jamia Milia Islamia, New Delhi, India
|Date of Submission||08-Apr-2021|
|Date of Acceptance||05-Jun-2022|
|Date of Web Publication||10-Feb-2023|
Dr. Sukhvinder Singh Oberoi
Flat No. 20, Triveni Apartments, H-Block, Vikaspuri, New Delhi - 110 018
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Oberoi SS, Grover S, Sachdeva S, Rastogi S. Dilemmas in oral health care during the Covid-19: Prevention and public health promotion as focus of care. J Datta Meghe Inst Med Sci Univ 2022;17:1029-30
|How to cite this URL:|
Oberoi SS, Grover S, Sachdeva S, Rastogi S. Dilemmas in oral health care during the Covid-19: Prevention and public health promotion as focus of care. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2023 Apr 1];17:1029-30. Available from: http://www.journaldmims.com/text.asp?2022/17/4/1029/369476
The COVID-19 pandemic has sharply brought into focus the need to re-examine oral health systems given that virtually every aspect of healthcare delivery has been impacted by the outbreak including oral health care delivery. It can be argued that COVID-19 has completely altered the care landscape with not only new challenges and threats, but also new opportunities. Likewise dentistry and oral care delivery should not be left behind as the entire health delivery systems morphs and evolves along with the times. We need to protect the integrity of our health care system by having a more focus based approach catering to all segments of the society and in line with the public health care approach.
The COVID-19 has impacted the health service delivery, especially the public health-care system which is already overburdened. Populations vulnerable to COVID-19, including those in low socioeconomic groups, minority groups, older adults, low-literacy individuals, those in rural areas, and the uninsured are also at increased risk for oral disease and associated systemic health problems. Populations at higher risk for many chronic diseases are similar to those at higher risk for developing oral diseases. Common risk factors include stress, poor diet, alcohol and tobacco use, substance misuse, behavioral health issues, domestic violence, and poverty. Many of these factors have been heightened during the pandemic. These and other social determinants of health lead to both exacerbation of chronic disease and poor oral health outcomes.
A review and re-organization of oral health systems is thus overdue. There is need to ensure equitable and improved access to oral health care with a focus on improving population health outcomes. There is need for increased policy discussions on oral health care, research and innovation, monitoring, and surveillance. The primary health care model could provide a viable vehicle to facilitate political commitment from planning to implementation through local legislative efforts.
Even when the oral health-care services are getting opened, there is still a lot of dilemmas in the mind of oral health professionals in provision of the services. This situation has given us a picture of the unforeseen factors affecting the health care system which should open our eyes to such kind of crisis in the future.
The COVID-19 pandemic has led to more severe socioeconomic and cultural disparities and consequently lead to even more disparities when oral health is concerned. Research suggests a strong association between oral health conditions like erosion, caries, and periodontal disease and mood conditions like stress, anxiety, depression, and loneliness. There are other potential connections downstream between COVID-19 and oral health. With the COVID-19 pandemic's impact on mental health, pandemic-related increases in oral health risk factors, and anticipated declines in per capita dental visits, increasing integrated practice and referrals between dental providers and behavioral health providers will be prudent.
Promotion of oral health care should not be the responsibility of just the health system. From an organizational perspective this requires a shift from health practitioner focus to oral health promotion within a social setting. Oral health self-care can be reinforced at multiple settings such as crèches, schools, workplaces, etc. Oral health action could include efforts to modify oral health behaviors through oral health education, dietary counseling, individual skills development (such as proper toothbrushing and flossing) and access to additional fluoride uptake. In addition, awareness programmes to control risks to oral health such as nutrition intake, tobacco cessation, reduction in alcohol consumption, and avoidance of dental trauma should be considered.
The importance of oral health to overall health as a whole emphasize the need for inclusion of dentistry in the planning, as a part of the response team and effectively dealing with the public health emergency. Our oral health-care delivery systems have to refocus more upon the oral health needs of the native population and higher priority has to be set upon the rural, underprivileged, needy groups, such as those with many morbidities.
Hence, a more committed focus is required for the prevention of commonly occurring oral diseases and promoting the healthier behavioral practices. Isolated individual interventions directed toward modifying specific oral health-related behaviors have not been successful in achieving long-term changes in behavioral practices. It highlights the importance of preventive health care and a refocusing on the public health care as one of the primary targets for strengthening to keep the disease burden at the lowest level.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Elster N, Parsi K. Oral health matters: The ethics of providing oral health during COVID-19. HEC Forum 2021;33:157-64.
Stennett M, Tsakos G. The impact of the COVID-19 pandemic on oral health inequalities and access to oral healthcare in England. Br Dent J 2022;232:109-14.
Singh S. Public Oral Health Care During COVID-19: Time for Reflection and Action. Front Med. 2021;8:610450.