March 2006

Objective: This study explores the evolution of conceptual frameworks and models of health and disability to construct an explanatory model of oral health. Results: The International Classification of Impairments, Disabilities, and Handicaps adopted by the WHO is based largely on social role theory and a utilitarian tradition portraying disablement as a negative and socially unacceptable consequence of impairment. It has been the major conceptual influence on the construction of psychometric tools for dentistry. However current views of chronic disease are refocused on the influence of coping strategies used by people to prevent or limit disability and handicap. Consequently, the WHO adopted the International Classification of Functioning, Disability and Health (ICF) as an alternative description of health and health-related states based on an existentialist view of the body, the person and society. In addition, an ethnographic exploration has identified three major domains of oral health – oral hygiene, comfort and general health - that dominate the opinions of people with oral impairments. Conclusions: Application of the framework and language of the ICF to the major domains of oral health provides the basis for a new biopsychosocial model of oral health, function and disablement. Key words: Dentistry; disability; international classification of functioning; model of health; oral health; quality of life.