465. Newspaper interview i Orlando Monteiro da Silva (Part 2: Analysis of the interview /2)

For the president of the Dental Association, the State has to provide health care but ensure they are provided, regulated and funded. From this perspective, it seems that the OMD argues that health care should be provided for contracting of services by third parties and financially supported by our taxes, it is an option, as many others. Course will have both positive and negative aspects. However, we must remember that in thirty years, the state built a vast and comprehensive network of public health services, both in quantity and in quality, so it would be more logical to promote a competition full of care between health offer the public sector and private sector provision, leaving the option to patients / clients, but this is what would be the best logic: we would all gain and the existing equipment would be properly monetized. We can not stop now profitable public investment made ​​by the state over the past thirty years and delivers it to companies or groups that target the private economic profit at the expense of exploitation of patients / customers.

For the dentist-check program, it is a desperate makeup mounted by the Ministry of Health in order to partially fill one of the biggest weaknesses created by the wrong policies followed in the area of ​​oral health by various governments over the past thirty years, using the check-dentist to retain patients / clients at the expense of misery and poverty of those who have to resort to their use seems at least a ridiculous statement. Loyalty should be directed, rather, the quality of services provided.

It is a question: how was it possible to accept the OMD program when asked 80 euros for each dental check and its value was set at 40 euros? After all, did the treatments performed by each dentist-check would be identical if the cost was twice the current? Are pressing issues that the interview does not give insightful response.

Pernicious remains the relationship between a large proportion of dentists and insurance companies, without the OMD requires an ethical order to safeguard the oral health of patients / clients; pure aberration, as might be expected, the reimbursement of ADSE in treatment costs of oral health.

(Continued)

464. BRAZIL: Dentists are so against fluoride in water

The Brazilian Dental Association (ABO) protest against the draft law 297/2005, authored by Senator António Carlos Valadares (PSDB-SE), which limits the use of fluoride in preventing tooth decay for topical application and prohibits the addition of substance in water, food and beverages.

The proposal repeals Law No. 6050 of May 24, 1974, which provides for the fluoridation of water supply systems when there is treatment plant, and is being reported in the Social Affairs Committee (CAS) by Senator Flávio Arns (PT -PR).

The organization rejects the justifications presented by the parliament. Valadares points to the existence of data that contradict the thesis that the systemic intake of fluoride is effective in the prophylaxis of dental caries and that numerous other studies also show the huge occurrence of dental fluorosis.

The congressman also said that there is consensus among experts that the prophylactic action of fluoride is due especially to its topical application and that it makes sense, therefore, require an entire population to ingest a toxic element in public water supplies or food and beverages in which it has been routinely added.

Method and cost effective - According to the ABO system fluoridation public water supply can reduce up to 60% the incidence of cavities. Official statistics confirm the validity of the measure. The Ministry of Health says that between 1986 and 1996, fell by 53% in caries prevalence in children 12 years of age caused by the policy of fluoridation.

Fluoride is indicated by more than 150 science and health organizations, including the International Dental Federation (FDI), the International Association for Dental Research (IADR), the World Health Organization (WHO) and Pan American health Organization, and since that is offered to the public in appropriate dosages and concentrations, poses no risk to people, says the president of ABO.

WHO and IDF advocate fluoride - According to the World Health Report 2003 WHO Oral, dental caries remains a major health problem in most industrialized countries, affecting 60-90% of schoolchildren and the vast majority of adults. Also according to the document, the addition of fluoride to the water, where technically feasible and culturally acceptable, has substantial advantages in public health.

In November 2000, in Paris (2000), the FDI approved the Report on Fluoride and Tooth. The paper concludes, based on extensive scientific evidence that the substance is used properly and with appropriate concentrations to prevent tooth decay, fluoride is safe and effective.

The report indicates that dental fluorosis can be caused by excessive ingestion of fluoride during the pre-eruptive development of teeth, but that levels of fluoride used to prevent tooth decay, the opacity or fluorosis only occurs in a relatively small proportion of the population.

According to the report, these symptoms are very mild in general and especially of aesthetic interest. According to the IDF, since the intake levels are carefully monitored, fluoride is considered a measure of public health more important for maintaining oral health.

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463. Newspaper interview i Orlando Monteiro da Silva (Part 2: Analysis of the interview /1)

The interview given by the president of OMD (Dental Association) Jornal i assume peculiar importance, representing a value - added valuable and urgent need for urgent that the country is experiencing in relation to discuss the sustainability of the SNS (National Health Service ) and, framing it, the way forward regarding the oral health in our country. In this context, the interview concerning various issues that currently influence oral health in Portugal and shows various scenarios for the future, on the other hand, raises questions that deserve urgent resolution by the political power.

Understand that reflection is the interview as a further contribution necessary to broaden the discussion, to seek consensus and ensure for the future, access to oral health care to all Portuguese. The contribution is minimal, other contributions to the discussion will always be - welcome.

The president of OMD says that the Constitution should not allude to a national health service tend to be free, by calling attention to the need for a certain degree of economic participation in the use of health services, it is an urgent need to go much further this issue - the parties represented in parliament and government have the absolute moral duty to implement measures to create mandatory insurance, in health, for citizens and assuring them of an addition to the expenses that eventually every citizen will have throughout his life.

Fiscal policy can and should be used to encourage savings; happens that the current government, by limiting tax benefits in relation to spending on health is directly contributing to the Portuguese divest part of the savings in promoting their own health and, indirectly , is another major factor in the sustainability of the drastic reduction in national health service.

It is then with user fees that will get funding that are lost due to wrong policy to fiscal policy, user fees represented one of the gravest violations of discrimination between people in access to medical care, because nobody chooses to be sick.

The president of OMD is absolutely right when he says that the national health service is centralized and decisions are taken by a small group of people, this is truly a remarkable defect of health policies in Portugal - half a dozen people stuffed in cabinets and often away from the difficulties of everyday life that we are professionals of national health services face in the field, are able to take, sometimes absurd options and sink the country's coffers without providing any accounts there or be held accountable.

For example, in the area of oral health and in previous post, where they are shown to stop millions of euros of oral health programs that should have been spent on medical care.

It is urgent to implement accountability to all appointments to intermediate and higher national health service, lack of positive praise and promotion, lack of accountability negative results and subsequent demotion or removal from office.

Says the president of OMD is need to reorient the national health service to prevent, in fact, perhaps tens of billions of euros could be saved annually by implementing a national health service more preventive. Also the application of a real public policy for prevention of oral health may contribute to the reduction in the medium and long term, the weight of household budgets spent on dental treatment. There is courage and assume that this is possible, not piece accountability to citizens when there is no education for this purpose.

After all, the Government and the national health service responsibility for the health of the general population, it is for them to help people make better decisions for your health.

(Continued)