Results: The results indicate distinct contradictions in oral health promotion-related policy statements and decision-making. Only 50% of the 15 national health policy documents examined had statements on oral health or OHP. Two (17%) of the twelve provincial health policy documents reviewed made references to OHP. Fourteen provincial health managers (40%, n=35) indicated that their programmes included a viable OHP element of some kind.
Health policy development appears to follow an underlying vertical process despite efforts to project this process as an integrated effort. The health policy process also appears to be dominated by power, protection of professional interests and maintenance of autonomy. Potential opportunities to integrate health service delivery have not been adequately explored. Failure to translate policy rhetoric on OHP into pragmatic policy formulations or implementable strategies will continue to perpetuate health inequalities in South Africa. Conclusion: The study concludes that to successfully influence the processes of OHP requires more than simple, document-based policy reforms that are strong on rhetoric and good ideas, but have not achieved the widespread stakeholder support necessary to carry them through to funding and implementation. OHP strategies need to be re-assessed and re-structured so that real gains in dental public health can be attained.