Measuring oral health—How can the International Classification of Functioning help?

Abstract

There is need for a theoretically-informed, contextualised approach to measuring oral health from a multi-disciplinary perspective that goes beyond the commonly used clinical indices and sociodental measures. This commentary aims to discuss the potential for the WHO's International Classification of Functioning, Disability and Health (ICF) to provide a model for the development of indicators for oral health. It is suggested that the ICF might provide both a theoretical model and an operational classification for indicators of oral health. The ICF model states that human experience of physical, cognitive and social functioning is universal, and thus can be described and qualified. Human function is given social and environmental context within the model at both an individual and population level. The ICF can capture data regarding oral health and function at the physiological level (e.g. chewing) but also at the social level (e.g. sharing meals). It is able to capture aspects of preventive behaviour (e.g. caring for teeth) but also aspects of social facilitation (e.g. economic self-sufficiency) or ability to fulfil a social role (e.g. remunerative employment). It also includes aspects of social environment, such as health care services or political, economic and legal systems. Case studies are given as examples of the potential use of the ICF in the oral health domain. Examples are also given of the first steps that have been made towards operationalisation of the ICF in data collection and oral health research. The challenges of encompassing such a comprehensive model into a practical oral health measure are discussed.

Oral health inequalities and disability: Closing the gap

“…shows the ICF model (reproduced from ref 5). The ICF classification lists body structures, body functions, activities and participation, and environmental factors.…”

Intersection of the iADH undergraduate curriculum in special care dentistry and the association of Canadian faculties of dentistry competencies framework

“…Functional models recognize that impairment may be related to physical, medical, or cognitive conditions, but defines disability as a limitation in activity and/or restriction of participation within a given physical, social, and attitudinal environment 17 . The adoption of the World Health Organization's International Classification of Functioning, Disability, and Health (WHO‐ICF) 18 allows educators, researchers, and clinicians to teach, measure, and evaluate disability through this functional approach 19–21 …”

“…17 The adoption of the World Health Organization's International Classification of Functioning, Disability, and Health (WHO-ICF) 18 allows educators, researchers, and clinicians to teach, measure, and evaluate disability through this functional approach. [19][20][21] The need for Canadian dental students to be adequately trained in SCD has been articulated for over a decade 2,3,22 ; however, there are no defined competency requirements for Canadian dental students in SCD. In 2012 the International Association for Disability and Oral Health created a predoctoral dental curriculum that used the functional model of disability as its basis.…”

Does education in special care dentistry increase people's confidence to manage the care of a more diverse population?

“…The International Association for Disability and Oral Health (IADH) describes SCD as dentistry for those with a disability or activity restriction which directly or indirectly affects their oral health 1 . This may include but is not limited to people with intellectual, sensory or physical impairments, those with mental health issues, complex medical conditions and frail older people 2 .…”

“…The International Association for Disability and Oral Health (IADH) describes SCD as dentistry for those with a disability or activity restriction which directly or indirectly affects their oral health. 1 This may include but is not limited to people with intellectual, sensory or physical impairments, those with mental health issues, complex medical conditions and frail older people. 2 Any combination of these special healthcare needs (SHCN) may leave a person unable to maintain their own oral hygiene, make attending a dental surgery particularly difficult or even increase their risk of oral disease based on a pre-existing condition.…”