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Get Your Shoes On...! A Response from a Practicing Dentist240 Central Park South, New York, NY 10019; lwscpw{at}aol.com There is a story about a man who kept a centipede as a pet. One day, he told his pet that they were going to take a walk. After a period of waiting, the man became impatient and called out to the centipede, "What's taking you so long?" The centipede replied, "Wait a minute! I’m putting my shoes on." In the year 2000, the Surgeon General of the United States released a report entitled "Oral Health in America" that presented a comprehensive assessment of the status of the nation's oral health. It identified the relationship between oral health and general health and well-being, assessed the manner in which oral health is promoted and maintained, and presented an analysis of the actions needed to enhance the oral health of the American people. This report calls for a National Oral Health Plan to "improve quality of life and eliminate health disparities". The principles upon which the NOHP is to be based require an intensification of the awareness of the public, the policymakers, and the large family of health care providers that oral health is an integral part of general health. It calls for a commitment to support the research necessary to design the protocol for elimination of the health disparities that the report identifies. Most important, the NOHP requires an "effective health infrastructure" which would allow Americans to achieve the optimum level of oral health desired. It is much easier to design a plan than to implement it. The NOHP, if it is to come to fruition, will require the participation of all levels of society, including public and private resources of funding and organization, as well as the support of other communities of interest and the public. This daunting task must be accomplished through coalitions and partnerships that bring together organizations and individuals who share the commitment to the common goal. But without the support of the oral health workforce, organizational structures alone cannot achieve success. As pointed out in the Surgeon General's Report, the public health capacity in this country is not adequate to provide the services necessary to satisfy the need. Thus, ultimately, it must fall to the private oral health workforce to involve itself in addressing the dental needs of the American public. Every day, in dental offices around the country, dentists and their staffs reach out to the public, educating them about the importance of their oral health and encouraging them to transmit that message to their families and friends. Each dental office is a repository of information that would be invaluable in developing the database so badly needed as resource material for clinical research. Dentists and allied professionals have continually shown the willingness to participate in programs directed at improving oral health and must be included in the process. Including the practicing dental team in the process will not only provide a large competent workforce, but will also enhance the professional life of every individual participating. Every dental office must be part of any effort to provide optimum oral health to the American public and thus to improve quality of life throughout the country. The 2001 Future of Dentistry Report developed by the American Dental Association identifies the many challenges that the dental profession faces in achieving the same goals and contributing to the effort to ensure that every American has access to the dental care he or she needs and wants. As a stimulus to the creation of partnerships and discussion of the issues, the FOD Report makes broad-based recommendations about areas that dentistry must enter in the next decade. Drawing on input provided from diverse communities of interest and experts from varied areas of the dental profession, the report identifies the enormous complexity of the problem. Discrepancies in the make-up and distribution of the dental workforce, inadequacies in the structure for funding dental services in underserved communities, and the shortfall in workforce and finances for the education and research communities are all areas of concern which must be addressed if an adequate infrastructure for the effort is to be ensured. Encouraged by these two reports, many organizations have committed themselves to entering the arena and are anxious to be of help. But without centralized leadership and the broad-based support of the large population of dentists and allied dental personnel, the good intentions will be relegated to symposia and meetings in which the issues are debated, but from which action is not forthcoming. The Future of Dentistry report, supported by a resolution passed by the 2001 American Dental Association House of Delegates, suggests the development of structured interaction among the ADA, the American Dental Education Association, the National Institute of Dental and Craniofacial Research, and the American Association for Dental Research. By joining together in discussion about concerns that affect all of these important communities, better understanding of the complex cross-cutting issues will be achieved. Unless all interested parties come together at the table, the people who are in need of services which could be provided to improve their oral health may be forced to assume the fate of the owner of the centipede...waiting an inordinate amount of time for the many diverse organizations, all dedicated to the best interests of the public they serve, to get their shoes on and start moving forward. It is time for all to tie their laces and join together in the common effort to take advantage of what the Surgeon General identifies as "opportunities for all health professions, individuals and communities to work together to improve health" and to implement a program that "integrates oral health into overall health". The time for debate and discussion is at hand, but the march forward to achieve the desired goals must follow. REFERENCE
Journal of Dental Research, Vol. 81, No. 3,
156 (2002)
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