There’s much more to having healthy teeth and gums than brushing and flossing. Oral health is central to one’s overall health and quality of life. As Daniel McNeil, a clinical health psychologist, puts it, “oral health is a mirror of overall health.”
The intersection of oral health and behavioral and social sciences is highlighted in a newly-released international consensus statement, authored by McNeil, a researcher in both the West Virginia University School of Dentistry and the Eberly College of Arts and Sciences Department of Psychology.
The statement, supported by a 12-person committee comprised of experts from around the world, aims to advance the application of behavioral and social sciences to promote oral health globally. The article is published in the Journal of Dental Research.
“When people think about dentistry, they tend to think about dentists and hygienists and brushing and flossing,” McNeil said. “That is vital to maintaining and restoring oral health. But what influences oral health behaviors is also important. It’s about what we eat and drink, and how we can prevent tobacco use and vaping. It’s about being comfortable and not fearful about getting dental care, having Medicare or Medicaid or other dental insurance to pay for preventive dental services twice a year, and having the time to take off from work for a dental visit. And, it is about having dental offices that are accessible, and a system of care that integrates oral and overall health.”
The article grew out of a three-day international Behavioral and Social Oral Health Sciences Summit in 2020 organized by McNeil that included more than 400 registrants and stakeholders, representing 54 countries, who endorsed a consensus statement resulting from the meeting.
According to McNeil, a key takeaway from the Summit and the Consensus Statement article is that we must work together across disciplines and across the world to promote optimal oral health and prevent dental, oral, and craniofacial diseases and conditions.
“Optimizing oral health and healthcare globally requires active engagement with the behavioral and social sciences,” McNeil said. “Working together across regional and national boundaries over the globe, we can more fully realize the potential of behavioral and social sciences in regard to their essential role in oral health. Uniquely positioned to help advance racial, cultural, and other equity in oral health, behavioral and social sciences must be integrated into the education, training, and mentoring of all oral health clinicians and researchers.”
Another main point of the consensus statement is to urge the adoption of innovative, technology-based methods. As one example, McNeil and a WVU doctoral student developed a method in which a person who has a high level of dental fear uses a smartphone to watch dental-related videos a few times a day on their own time leading up to a dental visit, which helps to dispel fears and uncertainties about what happens during dental treatment.
“We demonstrated that over a two-week period, a person’s anxiety was reduced,” he said. “We need to capitalize on evolving technologies like apps and smartphones to increase the scope of what we’re doing.”
Joining McNeil as a Summit co-organizer and co-first author is one of his former doctoral students and WVU alumnus, Cameron Randall, now a faculty member at the University of Washington.
WVU’s influence on behavioral and social sciences in oral health is long-standing, said McNeil, who has researched behavioral dentistry here for more than 20 years.
“Historically, WVU has had an imprint on this topic area,” he said. “The University has also encouraged me and others to engage in transdisciplinary work to meet the unique juncture of oral health needs in the state.”
Since 2000, McNeil has served as a principal investigator of the Center for Oral Health Research in Appalachia, a collaboration among researchers at WVU, the University of Pittsburgh and the University of Michigan. COHRA has explored factors that contribute to the burden of dental problems and oral health disparities in West Virginia and across Appalachia. The National Institute of Dental and Craniofacial Research—a division of the National Institutes of Health—funds the initiative.
“One of the hallmarks of the Center has been its interdisciplinary approach to promoting oral health and preventing oral disease,” McNeil said. “We work with dentists and dental hygienists, physicians, psychologists and people in industry, health departments and school systems. We have to take an interdisciplinary approach involving different disciplines and systems because, unfortunately, we have oral health disparities and inequities and we must address them.”
McNeil cited one example of a broad, system-wide effect on oral health in West Virginia. In 2021, the state Legislature made available a $1,000 Medicaid benefit to individuals to promote oral health.
“It’s not just an individual behavior,” he said. “It’s a bigger part of the system.”
McNeil also hopes the consensus statement will leave an impact on oral health not only in other nations spanning the globe, but for marginalized groups that need improvements to access and care the most.
“The consensus statement makes clear that we’ve got to include all groups, particularly the marginalized, minoritized and oppressed,” he said. “Hopefully, this will help promote cross-fertilization of ideas and practices. For instance, what can we learn about the sugar tax in the U.K. that could have implications in the U.S.? What’s happening in developing countries? What we learn in rural Appalachia can also have implications in rural Australia or Africa.
“We have great hopes to create and continue this worldwide conversation about behavioral and social sciences in oral health.”