Promoting Oral Health

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Promoting Oral Health

A toolkit to assist the development, planning, implementation and evaluation of oral health promotion in New Zealand

Citation: Ministry of Health. 2008. Promoting Oral Health: A toolkit to assist the development, planning, implementation and evaluation of oral health promotion in New Zealand. Wellington: Ministry of Health.

Published in February 2008 by the

Ministry of Health
PO Box 5013, Wellington, New Zealand

ISBN 978-0-478-31268-3 (online)

HP 4518

This document is available on the Ministry of Health’s website:


Contents iii

1 Introduction 1

2 Health Promotion and Oral Health Promotion 2

3 Oral Health Promotion at the Strategic Level 3

Looking beyond the health sector 4

4 Developing an Effective Oral Health Promotion Programme 5

Designing an oral health promotion programme: step by step 5

Outcome 11

5 Using the Ottawa Charter as a Framework for Oral Health Promotion 12

Building healthy public policy 12

Creating supportive environments 13

Strengthening community action 14

Developing personal skills 15

Re-orientating health services 16

Case study: an example of the Ottawa Charter in action 18

6 Using Other Health Frameworks for Oral Health Promotion 19

Te Pae Māhutonga 19

Oral health promotion using Te Pae Māhutonga 20

Case study: an example of Te Pae Māhutonga in action 21

7 Monitoring and Evaluation 22

Monitoring 22

Evaluation 23

Putting it all together 24

8 References and Bibliography 26

Effectiveness of oral health promotion and action plans 27

1 Introduction

Promoting oral health is one of the seven key action areas of Good Oral Health for All, for Life: The Strategic Vision for Oral Health in New Zealand (Ministry of Health 2006b). This toolkit will help you make this happen. It is a practical guide for the design, delivery and evaluation of programmes that promote oral health.
It is written for policy makers from all sectors, planners and funders of oral health services, health promotion practitioners, oral health professionals, teachers, and anyone else with an interest in, or responsibility for, promoting oral health in New Zealand.
This toolkit works through the steps involved in developing a comprehensive oral health promotion programme, from understanding the strategic context through to researching and selecting interventions, analysing resources, planning implementation and ultimately evaluating the final programme.
This toolkit does not provide a review of the evidence for oral health promotion interventions. A number of evidence-based reviews have been undertaken internationally and are listed in the bibliography at the end of this document.
This toolkit uses the Ottawa Charter as the framework for many of the examples shown here. However, it is important to note that the Ottawa Charter is not the only health promotion model that you can use to design an oral health promotion programme. Other models, such as Te Pae Māhutonga, may be more useful as you design programmes that are relevant for Māori, Pacific peoples and some other non-European populations. These other models are discussed later in the toolkit.
Developing a health promotion programme of any kind can be an ambitious task. However, it is our hope that this toolkit, and the resources listed in it, will make the task more manageable.

2 Health Promotion and Oral Health Promotion

Health promotion is a strategy for improving the health of a population by providing individuals, groups and communities with tools to increase control over and improve their health and wellbeing.
Health promotion moves beyond the traditional treatment of illness and injury by centring its efforts on the social, physical, economic and political factors that influence health. Health promotion has the potential to be particularly effective in improving the oral health of a population, given the complex interplay of factors that underlie good oral health.
Good oral health is achieved through a combination of optimal biological, social, behavioural and environmental factors. Oral health promotion therefore is any planned effort to build public policies, create supportive environments, strengthen community action, develop personal skills or reorient health services in ways that will influence these factors. The following are all examples of effective oral health promotion:

  • promoting healthy eating

  • teaching effective oral hygiene practices

  • facilitating early access to preventative dental services

  • promoting use of topical fluorides.

Oral health promotion should be based on the principles of the Ottawa Charter, which suggest that the population, not just those individuals at risk, needs to be involved in directing action towards the causes of ill health. This is particularly important in New Zealand where the principles of partnership, participation and protection should also guide thinking when planning a programme or intervention. Oral health promotion will be successful when the population is empowered, rather than compelled, to achieve oral health.

3 Oral Health Promotion at the Strategic Level

Promoting oral health is one of the seven action areas identified in Good Oral Health for All, for Life (Ministry of Health 2006b) that are considered key to achieving the oral health vision. Improving and maintaining oral health through prevention and promotion is regarded as one of the most effective ways to achieve oral health over the long term. Promoting oral health, particularly in childhood, is likely to have benefits across the life course as healthy environments and behaviours early in life have been shown to decrease the risk of oral disease in later years.
However, oral health promotion also sits within a wider strategic context – the principles of which guide the actions of the health sector and the development of health promotion programmes.
The New Zealand Health Strategy provides an overarching framework for the health sector. Improving oral health is one of the 13 population health objectives for the Ministry of Health and District Health Boards (DHBs). Other key national strategies and policy documents include:

  • Primary Health Care Strategy

  • He Korowai Oranga: Māori Health Strategy

  • Whakatātaka Tuarua: Māori Health Action Plan 2006–2011

  • Health of Older People Strategy

  • New Zealand Disability Strategy

  • Pacific Health and Disability Action Plan

  • Reducing Inequalities in Health.

There are also a number of issue-specific strategies. Examples of issues-specific strategies relevant to oral health include:

  • Healthy Eating – Healthy Action: The Ministry of Health’s strategic approach to improving nutrition, increasing physical activity and achieving healthy weight for all New Zealanders (see Ministry of Health 2004c)

  • Clearing the Smoke: A Five-year Plan for Tobacco Control in New Zealand 2004–2009: The Ministry of Health’s tobacco control programme to reduce levels of tobacco consumption and smoking prevalence, inequalities in health outcomes, Māori smoking prevalence to at least the same level as non-Māori and exposure to second-hand smoke for all New Zealanders (see Ministry of Health 2004b)

  • Well Child/Tamariki Ora: The Ministry of Health’s framework of integrated health education and promotion, health protection and clinical assessment and family or whānau care and support.

Tools to assist with implementing the strategies and evaluating the potential impact of initiatives also exist. These include:

  • The Health Equity Assessment Tool

  • Whānau Ora Health Impact Assessment.

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