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Introduction¹

OVERVIEW OF THE WORKSHOP

According to the World Health Organization (WHO), oral health “contributes to overall health, well-being and confidence” (World Health Organization, 2022) and is essential to a person’s general health status. Yet oral health continues to be marginalized throughout the practice of health care, beginning with the way that providers are educated. This statement was communicated at the opening of the workshop by Isabel Garcia, the dean of the University of Florida College of Dentistry. The workshop, designed by a planning committee of experts, was intended to share ideas and experiences on public health approaches to oral health for interprofessional and transdisciplinary learning involving educators, health professionals, and community members. Titled Sharing and Exchanging Ideas and Global Experiences on Community-Engaged Approaches to Oral Health, the workshop took place on the afternoon of November 3, 2022, as an activity of the Global Forum on Innovation in Health Professional Education (forum membership can be found in Appendix B). The development of the workshop agenda was guided by a statement of task (Box 1-1). The full workshop agenda is provided in Appendix C. A list of planning

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¹ The planning committee’s role was limited to planning the workshop. This Proceedings of a Workshop was prepared by independent rapporteurs as a factual account of what occurred at the workshop. The statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine. They should not be construed as reflecting any group consensus.

committee members with biographical sketches can be found in Appendix D. While the workshop was primarily virtual, some of the speakers participated in person at the National Academies of Sciences, Engineering, and Medicine offices in Washington, D.C. This Proceedings of a Workshop is a mostly chronological summary of the presentations and discussions from the workshop.² In some instances, meaningful anecdotes from one portion of the workshop have been moved from their temporal location and grouped thematically to better illustrate deliberations on a topic.

Garcia and Mayumi Willgerodt, faculty in the Center for Global Health Nursing at the University of Washington, provided orienting remarks and introduced topics that would be discussed throughout the day, including data and evidence, policy and regulation, and interprofessional and transdisciplinary education and learning. Garcia told participants that the workshop was designed to provoke the consideration of oral health as a key

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² Presentations from the workshop are available at https://www.nationalacademies.org/event/11-03-2022/sharing-and-exchanging-ideas-and-experiences-on-community-engaged-approaches-to-oral-health-a-workshop (accessed April 20, 2023).

component of overall health. She underscored that “separating the mouth from the body has not served people well” when it comes to addressing their overall health needs. Willgerodt added that in addition to a broad focus on educating the future workforce to treat the “whole person,” the workshop would also discuss a unique population—infants—who do not yet have teeth. She then emphasized the importance of oral health across the lifespan and said the workshop would explore a prevention/promotion-focused model of oral health. These statements, shared during opening session, formed the foundation of the workshop.

As part of her opening remarks, Willgerodt provided an overview of the workshop that also set up the structure of this proceedings. The first half highlighted the roles of various health professionals in oral health and how they might work together to, in Willgerodt’s words, “ensure the entire person is cared for in mind, mouth, body, and spirit.” The second half focused on movement toward whole-person health promotion, prevention, and care, with an emphasis on underserved populations. Willgerodt also explained the workshop’s attention to the role of educators in the transformation of oral health care, noting that health professional educators prepare the future workforce so they are in a good position to work collaboratively with community members and leaders. Garcia encouraged the audience to consider oral health inequities that involve the underlying social determinants of health and spoke of the importance of oral health throughout the entire lifespan. She then described the overall mission of the workshop as being to “provide a foundation for discussing [the] concept of community engaged oral health and how we can apply it within, between, and across health professions.”

FRAMING THE WORKSHOP

Kaz Rafia, the chief health equity officer at CareQuest Institute for Oral Health provided the sponsor’s welcome, commenting that oral health has become siloed by tradition, general attitudes, and methods of funding. He said that oral health has traditionally been viewed as separate from general health and medical care, which poses many challenges for oral health promotion and has led to “critical, system-wide inequities and gaps in delivery and outcomes of care.”

Rafia then referred to WHO’s updated definition of health (WHO, 2022), which Garcia had described as taking into account psychosocial dynamics such as self-confidence as well as the importance of oral health. To fulfill his organization’s mission of building a future in which everyone can reach their full potential through optimal health, Rafia said, it is critical to appreciate the central role that oral health plays in overall health. Historically, he continued, the role of oral health in overall health

has been undervalued and overlooked, and he also spoke of inequities in access to oral health care and in the burden of oral disease. He described research from the CareQuest Institute, which found that Black Americans are 68 percent more likely to have unmet dental needs than white Americans. He spoke of the importance of addressing these inequities as well as of potential avenues of improvement in care and outcomes. Among the ideas he mentioned were the importance of integrating education and care between the medical and dental fields, the importance of integrating oral health into community health, and the benefits of advancing guidelines for integrating oral health into nursing and primary care. Rafia said that “meaningful system transformation towards [a system] that is more accessible, integrated, and ultimately more equitable demands collaboration and openness to learn from [international] paradigms . . . especially when it comes to movement towards training modalities that prioritize and invest in integrated education.” With these remarks, Rafia welcomed a global audience of educators, health professionals, community leaders, and other key stakeholders to the workshop and set the tone for what would be a comprehensive, data-focused discussion.