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Scannapieco, F. , R. B. Bush, and S. Paju. 2003b. Periodontal disease as a risk factor for adverse pregnancy outcomes. A systematic review. Annals of Periodontology 8(1):70-78. Shipler, D. 2004. Working poor: Invisible in America. Westminster, MD: Alfred A. Knopf. Skillman, S. , M. P. Doescher, W. E. Mouradian, and D. K. Brunson. 2010. The challenge to delivering oral health services in rural America. Journal of Public Health Dentistry 70(Supp. 1):S49-S57. Slavkin, H. , and B. J. Baum. 2000. Relationship of dental and oral pathology to systemic illness.

2007. Oral health—fact sheet No. 318. who. html (accessed February 17, 2011). Williams, M. , T. Davis, R. M. Parker, and B. D. Weiss. 2002. The role of health literacy in patient-physician communication. Family Medicine 34(5):383-389. Copyright © National Academy of Sciences. All rights reserved. Advancing Oral Health in America 2 Oral Health and Overall Health and Well-Being A number of factors influence oral health status and may act as obstacles to improving the oral health of the nation. Patients and health care professionals need to understand the importance of oral health, especially its connection to overall health, and apply that knowledge in practice.

Copyright © National Academy of Sciences. All rights reserved. Advancing Oral Health in America 13 SUMMARY The Importance of Strong Leadership Compared to previous HHS efforts to improve oral health, the OHI 2010 involves many more HHS agencies and programs at multiple levels. The NOHI further calls for each agency to involve individuals at the staff level, a strategy that veterans of previous initiatives have said can be helpful. However, this also presents the challenge of organizing and directing multiple agencies that are highly autonomous and may not always act in concert.

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