There is no community that has not been affected by oral diseases. It is the responsibility of dental health specialists to evaluate the oral health status of the communities they serve, and based on the feedback, design and develop effective strategies and models to ensure that the oral health needs are met.
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My particular interests pertaining to the dental profession lie in the application of the biopsychosocial model and contrasting it with the dominant biomedical one. The purpose of this paper will be to introduce the biopsychosocial model in the context of dentistry and illustrate its effectiveness in curing and preventing oral diseases. I also gravitate towards prevention of oral diseases, and various prevention strategies that had been undertaken in various studies. The essay will attempt to discuss and describe prevention strategies angling towards the dental area. Finally, the essay will focus on the implementation of physiological models in curing oral diseases.
The dominant model of disease which is to this day practiced by many practitioners is biomedical (Engel, 1977). The biomedical model puts forward deviation from the norm of the biological variables entirely neglecting the social, psychological, and behavioral factors of the disease. The biomedical model proved successful with the help of dramatic technological advances made in the 20th century (Trilling, 2000). The 20th century praised the use of the biomedical model and identified bacteria and viruses as the root of many diseases. Other models were regarded as supernatural forces or practices having nothing to do with medicine (Trilling, 2000). This has led to a generation of practitioners adhering blindly to biomedical models choosing to ignore other concepts and modern theories.
In my area of expertise, I would seek to depart from the dominant biomedical model the fundamental concept of which “requires the disease to be dealt with as an entity independent of social behavior” (Engel, 1977). Contrary to this model, I believe that social, behavioral, and psychological framework needs to be brought into a sharper focus when examining a patient.
The philosophy of the biomedical model comes at the expense of depersonalization of patient care and doctor-patient relations (Trilling, 2000). Unfortunately, the drawbacks and shortcomings of the biomedical model are still not apparent to the major part of the medical community. My views are in line with the statement that “the lack of consideration of the illness, and the medicalization of life problems without addressing the patient’s life story, and fragmentation of the medical care do not fully meet patients’ needs (Trilling, 2000). The shortcomings of the biomedical model resulted in the emergence of the Biopsychosocial Model that is becoming increasingly popular nowadays.
Based on the biopsychosocial model, the doctor needs to take into account the patient’s psychological and sociological factors which lead to the emergence of the disease. Clinical studies provide ample reason to substantiate a statement that external stresses may complicate, and even cause a disease (Trilling, 2000). In my medical practice, I would primarily address the questions of the health-consequences, immunological dysregulation, or other stress-related causes. Rather than curing the disease itself, it is essential for a practitioner to ascertain that stress and positive changes in immunological sphere may prevent the disease in the first place.
Dental health is an integral part to general health and well-being. Dental practitioners need to realize that oral diseases are closely connected with the overall development of a person, and therefore, it is essential that oral diseases be effectively addressed since childhood. Children who suffer from oral diseases are 12 times more likely to have restricted-activity than children with healthy mouths (Kwan et el., 2005). Dental practitioners need to think globally and see the big picture, rather than focusing on a medical cause of the disease. It is a recorded fact that children with oral health diseases lose in total 50 million of school hours each year, resulting in poor performance at school and later in life (Kwan et el., 2005).
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I believe that any successful prevention strategy or a model enhancing and promoting oral health needs to originate from school. Oral health strategies need to be adopted and reinforced throughout the school years; beliefs and attitudes cultivated in schools are more likely to be adhered to in adult life. Taking this into account, health education and advice given by medical practitioners may be viewed as a solid prevention tool aimed at eradicating the disease at its incipient stage.
It is true that many oral health problems may be prevented from the onset. However, both parents and teachers in many countries have superficial knowledge regarding prevention of the oral diseases. With this in mind, there is a strong need to provide patients with oral health knowledge during medical encounters. The information given to patients by dental professionals will allow them to effectively manage their oral health routine. Dental practitioners have predominantly employed the biomedical model of curing a disease with a focus on causes of the disease. It has been suggested that this model is largely ineffective (Yevlahova & Satur, 2009).
The use of the biopsychosocial model will allow dental professionals to cover a broader context and look at the areas such as economic, political, social, and environmental. These factors combined form the so-called social determinants of health (Yevlahova & Satur, 2009). Based on the biopsychosocial model, the causes of the disease should not be underpinned merely by biological factors. Social determinants, as well as cultural and social circumstances in which people live in also need to be taken into account.
Psychological models of behavior change may also be instrumental in tackling oral diseases. There exists a magnitude of various models, although not all of them are effective, especially, when applied to dentistry. The systematic review of the physiological models of behavior change found that the Health Belief Model (HBM) may successfully be applied to dental care (Yevlahova & Satur, 2009). The HMB focuses on a person’s understanding of the threat emanating from the health problem. The advantages of avoiding the threat and factors complicating the decision are presented to the patient. The research showed that psychological approaches applied to dentistry resulted in positive changes such as improved plaque score, as well as improved patient-reported flossing and brushing (Yevlahova & Satur, 2009). The HBM has been found as one of the effective approaches in forming health-seeking behaviors. The model has been used successfully in a wide range of areas, including diabetes, drug abuse, alcohol, and others. The HBM presents potential for developing an effective approach to be applied in the field of oral health.
Summing up, a successful dentistry practice, in my opinion, needs to be based on the three pillars. The first one is a biopsychosocial model which gives a dental professional a much deeper patient insight. The second one is a prevention strategy that needs to be cultivated from school years instilling the health-seeking behaviors in children. The last, but certainly not the least, is the use of various physiological models in relation to dentistry. Many may be recommended, however not all are effective. The research findings put Health Belief Model, along with others, as the one used most effectively in dentistry.
Engel, G. L. (1977). The Need for a New Medical Model: A Challenge for Biomedicine. Science, 196(4286), 129-136.
Kwan, S., Petersen, P. E., Pine, C. M., & Borutta, A. (2005). Health-promoting schools: an opportunity for oral health promotion. Bulletin of the World Health Organization, 83(9), 677-685. Web.
Trilling, J. S. (2000). Selections from Current Literature Psychoneuroimmunology: validation of the biopsychosocial model. Family Practice, 17(1), 90-93.
Yevlahova, D., & Satur, J. (2009). Models for individual oral health promotion and theireffectiveness: a systematic review. Australian Dental Journal, 54(3), 190-197. Web.