Oral health policy and programmatic implications: lessons from ICS-II

Department of Health Service, University of California, Los Angeles 90095, USA.

The conceptual model used in the ICS-II USA Ethnicity and Aging project helps to identify who among the elderly should be targeted for oral health promotion initiatives and the kinds of initiatives most likely to promote positive oral health outcomes. Outcomes have been measured in this study as perceived by the individual and as clinically assessed by the oral epidemiologists. For policy purposes, achieving both types of outcomes is important. A typology of oral health promotion priorities is used to rank the diverse racial-ethnic groups. In the analysis, groups with both low perceived and low evaluated oral health status receive highest priority. By these criteria, the older Native American populations have the highest priority, followed, in order, by Hispanics, African-Americans, and non-Hispanic Whites. Policy implications of the empirical analyses presented in earlier articles are discussed by use of the conceptual model and the typology of oral health promotion priorities. Having a usual source of care and/or regular dental visits appears to be a promising avenue for the promotion of better-perceived oral health status among most older ethnic groups. Improved oral hygiene practices, as represented by both regular toothbrushing and dental floss use, promote better clinically evaluated oral health status among many older ethnic groups.