Dynamics and links between politics, policies and programs: The case of water fluoridation program in Korea

Public oral health programs are the basic component for improving oral health in any community. It should be posted as public oral health policies. The policies must be integrated by the health politics. The politics are triggered by the demand of the public. So they are circulating and hierarchical.

Politics: In Korea, the first and only administrative organization for oral health in the central government was established in December 1997. Since the establishment of the Division of Oral health, five major public oral health programs were planned. Through the Health Promotion Act passed in 1996, public oral health programs gained a legal foothold for the budget. Policies: National Oral Health Goal by 2010 was settled and age specific oral health objectives were established. Programs: To prevent dental caries, community water fluoridation (CWF) was the main public oral health program in urban areas. Real situation: CWF began in Korea as a pilot program in 1981 in Jinhae and in 1982 in Chungjoo. CWF increased dramatically up to 15% (6 million) in 2004, from 2% (0.8 million) in 1997; it decreased to 8% (3.3million) in 2006. Anti-fluoridationists have increased since 1998 and their efforts to discontinue the CWF were effective. Finally, Chungjoo, the pioneering model of water fluoridated city, interrupted CWF in 2006.

Oral health is a low priority for policy-makers, legislators, advocacy groups and much of the general public. More support is needed to develop and sustain coalitions on oral health.