March 2019

Volume 36, Issue 1

Editorial ‘No simple solutions, no single ingredient’: Systems-orientated approaches for addressing Wicked Problems in population oral health

Authors: Sarah R Baker
doi: 10.1922/CDH_BakerMarch19editorial02


A Wicked Problem is a problem that is impossible or difficult to solve partly because of its multi-component nature and its interconnection with other problems (Rittel & Webber, 1973). There are many Wicked Problems in the field of population oral health; tooth decay being one. Tooth decay is a function of biology (destruction of our tooth enamel); a function of our physical environment (availability, advertising and accessibility of sugar sweetened foods and drinks, availability of dental services); a function of our social environment (norms of oral hygiene and sugar consumption vary by socio-economic strata, country, and cultures); a function of us as individuals (dietary habits, visiting the dentist, oral health beliefs, toothbrushing, use of fluoride, dental anxiety, income); and a function of politics (our city, region and national policies on oral health education, tax on sugar sweetened drinks, water fluoridation, dental payment systems). The ‘Wicked Problem of tooth decay’ therefore involves multiple factors, none of which occurs in a vacuum. There therefore seems little point then in studying them in a vacuum or intervening in a vacuum. Yet, we continue to do so. We have become adept at describing gradients in tooth decay according to income, education or occupation (‘socio-economic inequalities’) or documenting changes in tooth decay over time (‘is caries prevalence better now than 10 years ago’?) or calculating odds associated with individual risk factors (‘lower self-efficacy = worse caries experience’).


Other articles in this issue

Article Pages Access
Editorial ‘No simple solutions, no single ingredient’: Systems-orientated approaches for addressing Wicked Problems in population oral health 3-4 Download
Dental Public Health in Action: The use of the NICE ten step model to conduct an oral health needs assessment in South Yorkshire and Bassetlaw 5-8 Download
Caries-preventive efficacy of a supervised school toothbrushing programme in Northland, New Zealand 9-16 Download
Socioeconomic Variation in the association between Malocclusion and Oral Health Related Quality of Life 17-21 Download
Low rates of dental attendance by the age of one and inequality between local government administrative areas in England 22-26 Download
The relationship between body mass index and oral health status among Saudi adults: a cross-sectional study 27-32 Download
The acceptability of fluoride varnish and fissure sealant treatments in children aged 6-9 delivered in a school setting 33-38 Download
Interventions to reduce socio-economic inequalities in dental service utilisation – a systematic review 39-45 Download
Embarrassing realities: The portrayal of dentistry in reality tv ‘dentertainment’ 46-54 Download
Systems science and oral health: Implications for Dental Public Health? 55-62 Download
The Boundaries between Caries and Periodontal Diseases. What are the Implications for Education in Dental Public Health? Proceedings of EADPH/SESPO Pre-Congress Workshop held on Wednesday, 17 October 2018 at The Centro Cultural Sa Nostra Congress Cen 63-86 Download


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