The Changing Definition of Oral Health

The FDI World Dental Federation (established in Paris in 1900 as Fédération Dentaire Internationale) is the world's leading organization representing the dental profession.  It serves as the principal representative body for over one million dentists worldwide, and it's membership includes over 200 national dental associations and specialist groups from over 130 countries.  Last week, the FDI launched a new definition of ‘Oral Health’ – positioning it as an integral part of general health and well-being – at its Annual World Dental Congress, which happened to be held in my native Poland. The definition was adopted by over 200 national dental associations.

Before we get to the new definition, it is interesting to note that “Oral Health” has been defined by several different organizations in vastly different manners.

World Health Organization Definition of “Oral Health”

In 2008, the World Health Organization, part of the United Nations, defined oral health as “a state of being free from chronic mouth and facial pain, oral and throat cancer, oral sores, birth defects such as cleft lip and palate, periodontal (gum) disease, tooth decay and tooth loss, and other diseases and disorders that affect the oral cavity.”  This is a highly clinical definition dealing only with mechanical function in the oral cavity and diseases of the oral cavity and surrounding structures.

ADA/Surgeon General Definition of “Oral Health”

In 2014, following the first ever report of the US Surgeon General on Oral Health, the ADA defined Oral Health as “a functional, structural, aesthetic, physiologic and psychosocial state of well-being and is essential to an individual’s general health and quality of life.”  It is interesting that this definition adds the (a) aesthetic, (b) psychosocial and (c) interrelation to the patient’s overall health to the definition.

New FDI Definition of “Oral Health”

Now, just last week, the FDI has modified the definition to reflect a more holistic approach to oral health.

As defined by FDI, oral health:

• Is multi-faceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex.
• Is a fundamental component of health and physical and mental wellbeing. It exists along a continuum influenced by the values and attitudes of individuals and communities;
• Reflects the physiological, social and psychological attributes that are essential to the quality of life;  
• Is influenced by the individual’s changing experiences, perceptions, expectations and ability to adapt to circumstances.

Why the new definition?  In an email from Poland, Dr. Michael Glick, who was on the committee that advanced the new definition, explained why the old definition needed to be changed. “The old definition lacked a theoretical framework that made assessment and evaluation of oral health hard to measure,” he said. “Furthermore, this new definition moves dentistry from treating disease to treating a person with disease. The new definition uses language that resonates with language commonly used in the healthcare realm — words and concepts that healthcare professionals across disciplines can understand and use.”

David Williams, Ph.D., a professor at Barts and The London School of Medicine and Dentistry at Queen Mary University in London commented, “With this new definition, we want to raise awareness of the different dimensions of oral health and emphasize that oral health does not occur in isolation, but is embedded in the wider framework of overall health.”

It is clear that Oral Health is more than just mechanical use and freedom from oral disease—especially given the huge amounts of data that suggest there is an interrelationship between all types of diseases and oral health.   From my standpoint, it is an interesting development in the understanding of the importance of oral health to overall health and happiness, from a physical, social, and psychological perspective.

Keep smiling, 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121