Oral health, a public health issue in 2023: Reflections and actions of the ASPBD / La santé orale, un enjeu de santé publique en 2023 ­ Réflexions et actions de l'ASPBD

The first Dental Public Health Day, in 2001, was not only the starting point for the creation of the Association des Acteurs de la Santé Publique Bucco-Dentaire (ASPBD), but also for the recognition of this specialty in France, even though it had already been recognized by the American Dental Association as early as 1950. Every year, the ASPBD organizes a national oral health day. The ASPBD brings together the vast majority of French odontologists and academic researchers in the field, as well as other French-speaking academics. Throughout the year, we work to bring together the dental and non-dental worlds, mainly the institutional and non-profit sectors with users, freelancers, and employees, the World Health Organization, and the French Public Health Society. This is in keeping with the partnership approach taken by the association for the past twenty-two years. Our aim is to bring together all the actors concerned to work toward integrating oral health into all health policies and health promotion and prevention schemes. We believe it is vital to provide oral health training for medical and paramedical staff, as well as for those working in education and outreach. Likewise, we are working to ensure that prevention is organized on a territorial level, involving local people as closely as possible and focusing on their needs. This is why we are actively involved in the fight against social and territorial inequalities in health, oral health being a strong indicator of these inequalities.

La première Journée de santé publique dentaire, en 2001, a été non seulement le point de départ de la création de l'association des Acteurs de la santé publique bucco-dentaire (ASPBD), mais aussi celui de l'identification en France de cette spécialité, alors qu'elle était déjà reconnue comme telle par l'Association dentaire américaine dès 1950. L'ASPBD organise, depuis annuellement une journée nationale de santé publique bucco-dentaire. L'ASPBD rassemble la grande majorité des odontologistes, enseignants-chercheurs hospitalo-universitaires français, mais aussi les autres hospitalo-universitaires francophones. Nous œuvrons tout au long de l'année à faire travailler ensemble le dentaire et le non-dentaire, principalement le monde institutionnel et associatif avec les usagers, les libéraux et les salariés, l'Organisation mondiale de la santé et la Société française de santé publique. À l'image du binôme qui préside chacune de nos journées depuis vingt-deux ans. Notre association a pour vocation de rassembler tous les acteurs concernés pour œuvrer à l'intégration de la santé orale dans toutes les politiques de santé et dispositifs de promotion de la santé et de prévention. Nous pensons qu'il est indispensable de former à la santé orale tant les personnels médicaux et paramédicaux que ceux de l'éducation et de l'animation. De même, nous agissons pour que la prévention s'organise à l'échelon territorial, au plus près des populations en fonction de leurs besoins. C'est le sens de notre participation active à la lutte contre les inégalités sociales et territoriales de santé, la santé orale étant un marqueur fort d'inégalités sociales de santé.

[Oral health of users of psychoactive substances]. / Santé buccodentaire des usagers de substances psychoactives.

This article reminds you that, whatever the psychoactive substance in question, it is not one that has repercussions on the oral health of its user. This affects both the tooth, the periodontal and oral mucosa. Drug addicts, especially those engaged in polydrug use, represent the population at the largest risk for oral cancer. Of all the factors, smoking is by far the largest risk. The alcohol has a synergistic effect with the tobacco, so that the combined effect is more than multiplied. Preventing risks of these products is possible through good oral hygiene and lifestyle, preventive care and followed by a regular dentist. Regaining self-esteem, however, should be one of the key dimensions of social reappropriation through his body.

[Oral health of users of psychoactive substances]. / Santé buccodentaire des usagers de substances psychoactives.

The oral health of drug users is increasingly part of the medical universe of caregivers. For too long, the place of oral health in the "good living" was very thin. The mouth of a patient interests very few people, and still less the person himself who begins to worry that very late. His entourage has a lot of other reasons for concern and the dentist is infrequently associated to support teams in a global approach to public health, and a fortiori as caregiver.

Caries experience in the primary dentition among French 6-year-olds between 1991 and 2000.

BACKGROUND: There are few national caries preventive policies for children in France. Various surveys suggest that in the late 1980s, oral health of the 6-year olds in France was poorer than in those of other European countries. In Val de Marne (a Department just east of Paris) a public dental service was established in 1991. A programme to inform preschool staff about dental diseases was commenced and volunteers brought oral health information to parents and health professionals. Periodical monitoring of primary tooth caries of 6-year olds was planned. AIM: The aim of the study was to evaluate changes in primary tooth caries in 6-year olds over the 10 years of the programme. METHODS: Participating 6-year olds, randomly selected, were examined in schools by dentists. Clinical data were collected (WHO criteria). Sociodemographic data were collected through questionnaire. Statistical analysis involved comparison of mean values, variance analysis and chi-square test for categorical variables. RESULTS: The proportions of children with caries experience were, 38.9%, 30.6% and 22.2% in 1991, 1995 and 2000 respectively (P < 0.01). The dft index decreased from 1.74 to 1.39 and 1.05 respectively. About 75% of children with dental caries remained untreated. Children of non-European native parents or belonging to low socioeconomic families remained those most affected by dental caries in 2000. CONCLUSION: Dental caries in 6-year olds improved between 1991 and 2000 in Val de Marne but caries remained a socially inequitable disease. Most children did not have access to dental care. The situation requires changes to the dental care provision system.