1238 Journal of Dental Education ■ Volume 72, Number 11 A Global Oral Health Course: Isn’t It Time? Asef Karim, D.M.D., M.P.H.; Ana Karina Mascarenhas, Dr.P.H.; Shafik Dharamsi, Ph.D. Abstract: This article examines current global oral health initiatives to underserved dental populations and assesses the level of familiarity with these initiatives among dental students. The World Health Organization (WHO)’s basic package of oral care (BPOC) is described, as well as successes and difficulties in global oral health initiatives. A survey was conducted of third-year dental students at a North American dental school to determine their familiarity with global oral health initiatives set out by the WHO and the World Dental Federation (FDI). The majority of the surveyed students (87 percent) expressed interest in volun- teering their professional services in international settings. However, none of the surveyed students knew about the BPOC or the FDI’s role in global oral health. The findings indicate that predoctoral dental public health courses in dental schools ought to include a course on global oral health to expose students to global oral health issues and equip them with interventions like the BPOC so they can provide better care to globally underserved dental populations. Dr. Karim is in private practice in Vancouver, British Columbia; Dr. Mascarenhas is Professor and Director, Division of Dental Public Health, Goldman School of Dental Medicine, Boston University; and Dr. Dharamsi is Assistant Professor, Department of Family Practice, Faculty of Medicine, and Associate Director, Centre for International Health, University of British Columbia. Direct correspondence and requests for reprints to Dr. Asef Karim, 4981 Earles Street, Vancouver, British Columbia V5R 3R7, Canada; 604-868-8493; drkarim@live.ca. Key words: global oral health, international oral health, primary oral health care, basic package of oral care, World Dental Federation (FDI) Submitted for publication 2/26/08; accepted 7/20/08 T here are vast differences between developed and developing countries in oral health status and in the availability, access, and affordability of oral health services. 1,2 The World Health Organization (WHO) and World Den- tal Federation (FDI) are helping to bridge this gap by encouraging developing countries, international dental aid organizations, and dental volunteers to incorporate the basic package of oral care (BPOC) as a guiding framework for the delivery of oral health services. The BPOC, which includes oral urgent treat- ment (OUT), affordable fluoride toothpaste (AFT), and atraumatic restorative treatment (ART), can be delivered by locally trained health workers using some basic instruments. The effort to standardize a global approach to improve the condition of under- served dental populations could be enhanced if the dental education community adopted and advocated the BPOC principle. This article proposes that dental training institutions and universities in both developed and developing countries ought to consider introducing a dental public health course with a focus on global oral health into predoctoral dental curricula. Set within a framework of primary oral health care (POHC) principles that advocate the development of dental programs that are simple, effective, and inexpensive and involve local people (Table 1), a course on global oral health would focus on the global burden of oral disease and the health care policies and interventions that can be used to address it. Such a curricular addi- tion can help future dental professionals to contribute more competently to international oral health issues with increased awareness, sensitivity, knowledge, and skills. Global Burden of Oral Disease Oral health is an important component of gen- eral health and indicator for quality of life. Despite the recognition of oral health as a human right, indi- viduals throughout the world, particularly the poor and socially disadvantaged in developing countries, suffer greatly from oral disease. 1 Among the condi- tions they face are caries, gingivitis and periodontal disease, tooth loss, oral cancer, HIV-AIDS-related oral disease, facial gangrene (Noma), dental erosion, dental trauma, and dental fluorosis. 1-3 In addition to these clinical manifestations of oral disease and the associated detrimental impacts on health, the sociobe- havioral ramifications of compromised oral health include oral dysfunction leading to malnutrition, facial disfigurement, time lost from work or school, and social isolation. 4,5 The factors that contribute to this burden of oral disease include poverty, a high illiteracy rate, compromised oral hygiene habits, lack of oral health education and promotion, and lack of access to timely, affordable oral health services. 6 Fur-