The case for integrating oral health into primary health care

Severe disparities in oral health and inequities in access to oral health care exist globally. In New Zealand, the cost of oral health services is high. Physician services and medicines are heavily subsidised by the government -- however, in contrast, private financing, either as out-of-pocket payments or as private insurance, dominates dental care. Consequently, the use of services is often prompted by symptoms, and services are mostly oriented towards relief of pain. The high cost of dental care with insufficient emphasis on primary prevention of oral diseases, poses a considerable challenge for providing equitable access to health care as laid down by the Alma-Ata Declaration on Primary Health Care (PHC). While improving oral health is one of the health objectives of the New Zealand Health Strategy, providing accessible and affordable oral health services does not feature prominently in the current Primary Health Care Strategy. This paper discusses current knowledge regarding oral health in relation to general health and health care strategies and frameworks, in order to highlight that oral health care is an important component of primary health care. The authors also propose that oral health care should be integrated into primary health care in New Zealand. This could be achieved by placing oral health within the broader framework of PHC as encapsulated by the Alma-Ata Declaration and the New Zealand Primary Health Care Strategy.