Journal of Oral Hygiene & Health
Open Access

Oral health plays a fundamental role in overall health, influencing nutrition, speech, self-esteem, and the risk of systemic diseases such as diabetes and cardiovascular conditions. Despite its significance, oral health often remains a neglected aspect of primary healthcare policies. Many countries continue to separate dental services from general medical care, limiting access and increasing health disparities [1].

This review explores how oral health is addressed in primary care policies in five selected countries. It aims to identify best practices, challenges, and opportunities for improvement by examining government policies, healthcare models, and the role of primary care providers in oral health promotion [2]. Through this analysis, the study provides insights into strategies for better integrating oral health into primary healthcare systems globally.

Methods

This study employs an integrative review methodology, synthesizing findings from policy documents, government reports, and academic literature. The selection criteria included:

• Countries representing diverse healthcare models (public, private, and mixed systems).
• Availability of oral health policies within primary care frameworks.
• Published literature from 2015 to 2024 to ensure relevance.

The five selected countries for this review are:

1. United Kingdom – A publicly funded National Health Service (NHS) with universal access.
2. United States – A mix of private insurance and public programs like Medicaid.
3. Canada – A publicly funded healthcare system with limited dental coverage.
4. Australia – A hybrid model with government-funded dental programs.
5. Sweden – A strong public healthcare system with integrated dental care.

Data were extracted and analyzed thematically to identify key trends, policy strengths, and areas for improvement.

Discussion

Integration of Oral Health in Primary Care Policies

• United Kingdom: The NHS provides basic dental care, but accessibility issues persist. Oral health is included in public health strategies, yet preventive care remains underfunded.
• United States: Oral health policies are fragmented, with Medicaid offering limited coverage. Private insurance dominates, leading to disparities in access.
• Canada: While healthcare is universal, dental services are largely excluded, requiring private insurance or out-of-pocket payments. Recent policy discussions aim to expand public dental care.
• Australia: Government-funded dental programs target children and low-income groups, but wait times for services can be extensive.
• Sweden: A model for integration, Sweden includes preventive and routine dental care within its healthcare system, reducing inequalities in access.

Barriers to effective oral health integration

Common challenges among the selected countries include:

• Lack of funding and prioritization – Many governments underfund dental services within primary care.
• Workforce limitations – Shortages of dental professionals, particularly in rural areas, affect service delivery.
• Insurance and affordability issues – Many individuals lack adequate dental coverage, leading to untreated conditions.
• Limited provider training – Primary care providers often lack sufficient training to address oral health concerns.

Best practices and lessons learned

• Sweden’s universal coverage model demonstrates that integrating dental care into primary health systems can improve accessibility and reduce disparities.
• The UK’s public health approach to oral health education and prevention highlights the importance of early intervention.
• Australia’s targeted government-funded programs for vulnerable populations show the impact of strategic public funding [3-10].

Conclusion

This review highlights significant variations in how oral health is incorporated into primary care policies worldwide. Countries with well-integrated dental care, such as Sweden, achieve better oral health outcomes, while those with fragmented policies, such as the United States, face disparities in access and affordability.

To improve oral health integration in primary care, the following recommendations are proposed:

1. Strengthen policy frameworks to include oral health as a fundamental component of primary care.
2. Increase public funding for preventive and routine dental services.
3. Enhance interdisciplinary collaboration between dentists and primary care providers.
4. Expand workforce training to equip primary care professionals with basic oral health skills.
5. Implement universal or subsidized dental coverage to reduce financial barriers.

By adopting these strategies, countries can work toward a more inclusive and effective oral healthcare system, ultimately improving population health outcomes.

Acknowledgment

None

Conflict of Interest

None

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