673. In Portugal, half of the elderly population does not have a single tooth

The data are from the Non-Governmental Organization (NGO) Mundo a Sorrir, within the scope of the Door-in-Door Smiles project which, for about four years, promoted the improvement of oral health indexes. This project helped to reduce the risk of periodontal infections and oral pathologies, as well as the prevention of infections or diseases associated with dental prostheses in the elderly. The project was innovative in Portugal and Europe, was born in Porto in 2012 and joins the new Porto4Ageing consortium, created under the recent application of the Porto region to the classification of European Reference Site in the Area of Active and Healthy Aging.

According to the dentist, founder of the NGO Mundo a Sorrir, Miguel Pavão, the great majority of the population believes that tooth loss is a natural and inevitable consequence of age, a misconception that derives from the examples we have of elderly relatives and friends . The main causes for this phenomenon are the culmination of little investment in oral health and health, associated with a reduced oral hygiene care routine. Miguel Pavão also says that oral health in the elderly is a neglected problem that negatively influences the quality of life of the elderly and has negative repercussions on general health. It is clear that poor oral health has consequences in interpersonal relationships. People with a healthy mouth are people with a higher self esteem. That is why projects such as Door-to-Door Smiles are so necessary and we must continue to bet on this target population, since the more than 15,000 beneficiaries and 300 institutions covered by the project demonstrate that we can not stop and, in this sense, we are preparing A new application for this purpose.

Through a preventive and formative approach, the project aimed at raising awareness and awareness that aging does not mean a decrease in well-being. Miguel Pavão explains that oral health in the third age consists of maintaining healthy teeth and adjacent structures, maintaining health, function and esthetics in their fullness and that provides well-being and quality of life to the individual. These objectives were achieved through health promotion actions, oral screening for the elderly, training of professionals, referral for interventions, monitoring of injuries and fitting of prostheses, among others.

In 2012, the Smiles Door-to-Door Project received the 1st Place in the CIS-Porto award, after its implementation in Porto. A year later, in 2013, Mundo a Sorrir expanded the project to mainland Portugal, having been awarded the 1st place in the BPI Seniors award. In 2014, it received support from the Calouste Gulbenkian Foundation and the company VOCO GmbH.
The World Health Organization (WHO) estimates that, by 2025, the age group comprising individuals aged 65 and over is the one with the highest growth. WHO also warns that millions of elderly people around the world are not receiving the oral care they need due to the lack of awareness of governments about this problem.

O JornalDentistry 

672. Dental doctors defend new oral health program in Madeira

The Madeira delegation of the Order of Dental Physicians defended today in Funchal that the Regional Government must resume the program of information and promotion of oral health, due to the increase in the number of children with dental caries.
We have to invest in the field of information and promotion of oral health, not only in schools, but also in informing parents. We can not lose what we did for 15 years in the schools of the region, said the president of the delegation of the Dentists Doctors, Gil Alves, after a meeting with the regional secretary of Health, João Faria Nunes.

The oral health promotion program in the Autonomous Region of Madeira is suspended and the Dentists' Association recognizes that, if it is resumed, a new methodology should be applied, not for lack of human resources, but financial resources.
Gil Alves stressed that there is an increase in the index of diseases, especially caries and gum disease, and regretted that the committee, created by the former Regional Government, in the context of early intervention in the diagnosis of oral cancer, has not continued.

We see, in our clinical practice, children of 3 and 4 years old with lesions of the dental caries disease, Gil Alves warned, emphasizing: we are constrained to be only treating the disease and not prevent it from arising.
The president of the delegation of Madeira of the Order of Dental Doctors also said that the regional secretary was receptive to concerns, and even communicated that he will appoint a dental professional to assist in the implementation of oral health measures in the Region.

Dnoticias.pt 

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Oral health programs should be done taking into account available resources. The National Health Service should include the physical, human and financial means to integrate oral health in health centers and family health units. Over the past thirty years, the private sector has not yet contributed to solving the problem of unequal Portuguese access to oral health care and has used public resources in a very dubious manner in the final results obtained.It is the responsibility of the public authorities to integrate oral health into the National Health Service and guarantee equal access for all Portuguese to oral health care. For example, one can not continue to allow a person to assume risk behavior and Contracting certain diseases and thus having privileged access to oral health care; It is necessary to put an end to this discrimination so negative for so many millions of Portuguese.  

671. PORTUGAL: There are only 20 dentists for all hospitals and health centers

Every year, between 500 and 600 dentists are trained on average in Portugal. But for those who leave college, the options are basically two: private medicine or emigration. Oral health is still a very limited public service reality. About 20 dentists work in health centers. That is, one for every half million users. For the first time a government has assumed that this is a priority and by the end of the year they have started pilot experiments with dentists in primary health care. The proposal of the Order of Dentists was delivered yesterday to the Ministry of Health.

Of the 20 dentists working for the National Health Service (SNS in portuguese), the majority are in the Lisbon and Tagus Valley region, six in the cluster of health centers in the north, two in the center and one in the Algarve. The pilot project is designed to meet the needs of an economically disadvantaged and chronically ill population. But in the future, what is wanted is that these basic care, such as derangement, devitalization, extraction of teeth or prostheses, can reach all by the public service.

This is what a large part of the population needs and which are the most sought after care. We welcome the initiative of the Government, which to be realized is a huge advance in the access to basic oral health care. It will meet the requirements of the SNS in the equity of access, says to the Orlando Orlando Monteiro da Silva, canon of the dentists. So far, a portion of the population - pregnant women, children and young people, elderly people with solidarity and HIV patients - have had access to these care through the dental check, which is important to maintain, as it has had considerable health gains, Says the baston. Last year, 545,000 dental checks were issued and 413,000 were used. In March, the project will be extended to 18-year-olds. In an interview with DN Henrique Botelho, coordinator of the Reform for Primary Health Care, explained that this is a project that will continue.

The World Health Organization recommends one doctor dentists for every 2500 inhabitants. Portugal more than meets the eye, but only in the private sector, where there are more than five thousand clinics: one dentist for every 1236 inhabitants. The country has 8500 dentists registered in the Order and another 1200 are working out of the country, mainly in England (59%) and France (12%). But does the offer translate into care? More than 50% of the population does not have access to basic care. An important part can not afford them and health insurance that guarantees this specialty is expensive, he says, considering there must be a dentist doctor by health center and in the larger ones more than a professional.

Since its inception the SNS has never had oral health care. First there were not many professionals, then it was a political option, possibly it was thought that it was not fundamental. There is the realization that it is a specialty that is not cheap, that you need financial resources to equip the spaces. It is regrettable that there is equipment in primary health care that has never been used, he regrets.

For Rui Nogueira, president of the association of family physicians, having dentists in health centers should be a top priority, suggesting two ways of doing this: one is dentists in the health centers, the other is conventions with the offices And ensure direct access. We have to ask ourselves if this is an easy service to install and maintain? A convention system can guarantee a faster response and with less costs. In the more peripheral and isolated health centers we could have the service. The two solutions can work together. The doctor also says that it would be essential to have oral hygienists in all health centers.

Another priority, says Orlando Monteiro da Silva, are dentists in public hospitals to team with the stomatologists, a specialty that has 167 professionals working in the SNS. More than 80% are over 50 years old. It is necessary to think in the long term in mixed teams if we want to give a multidisciplinary coverage. We need to have teams in hospitals to treat trauma, operated patients, hemophiliacs, deep patients who need anesthesia for dental treatments, oral cancer, he says.

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