709. More than ten thousand private school children do not have access to the dentist's check

The Health Regulatory Entity (ERS) warns that more than 10,000 children are being excluded from the check-dentist program because they attend private schools. The alleged lack of equity in access to health care exists even in cases where children and young people are deprived of and have scholarships to attend colleges, Jornal de Notícias reports.
There is an unacceptable discrimination of those who make their choice for private education, says the director of the Association of Private and Cooperative Education, Rodrigo Queiroz e Melo, noting that of the 10,000 children without access to the dentist's check, about 1,000 have difficulties.
Despite the universal nature of this benefit, the Ministry of Health explains to the Jornal de Notícias that it has privileged the children of public schools and private social solidarity institutions (IPSS) as the most vulnerable and with the most clinical impact.
In 2017, more than 71,000 dental clinics were held in health centers, benefiting about 40,000 children and young people.

JE o JornalEconómico

708. PORTUGAL: More individuals report unmet needs in relation to oral health care

More individuals report unmet needs in relation to oral health care. Thus Portugal already has a total percentage of 15.7% (compared with 5.5% in the EU), with the lowest income group accounting for 28.8% (EU 10.4%).
The barriers to access to health care remain relevant in Portugal, and especially marked from the socio-economic point of view. An income-related social gradient has been observed for medical treatments in general, but above all a high degree of unmet need, with a marked socioeconomic gradient, in oral health, mental health and medicines. Compared to the rest of Europe, Portugal does not suffer from greater barriers to access, but these barriers are more marked from the socio-economic point of view, in particular with regard to financial constraints.

In this context, three notable and expected situations should be highlighted: iniquity in the use and access to oral health, mental health, and medicines. In these three fields, there are not only strong limitations in access, but these limitations disproportionately affect the poorest. In the case of oral health and mental health, this inequity is explained by the lack of provision of these services in the National Health Service, and the need to be largely satisfied through the private sector, that is, only accessible to those who have insurance or ability to pay.

In the case of oral health, attempts were made to mitigate this situation through check-dentist, to be able to use the private sector, but possibly this initiative failed to reduce inequity.

Thus, it will not be possible to improve access to certain care, nor to reduce catastrophic health expenditures without a determined action in S.N.S. (Portuguese national health service) in the field of oral health and mental health, and in improving access to medicines for the most deprived citizens.

 

RELATÓRIO PRIMAVERA 2017 DO OBSERVATÓRIOPORTUGUÊS DOS SISTEMAS DE SAÚDE

707. Dentistry in the SNS (National Health Service): an issue that is urgently solved

Urgent preventive medicine, informative, to address the small problems of today that will be enormous tomorrow. But can we continue to be a country that invests and does not reap the rewards?
This is a complex issue that must be tackled in a broad way. The ultimate goal is to ensure the access of the entire population to primary oral health care, without undermining the sustainability of state resources. Is it possible to do so? I think so. This will require a well structured plan that starts from scratch, evaluating all the hypotheses and not a project that starts already guided by a pre-established direction. By this I mean that the plan must begin by looking at the network that already exists, realizing if it is enough, and then yes, setting the course.

In a pragmatic way, we have to recognize that the means of the SNS are clearly insufficient and a large part of the population needs to be addressed which is not covered by subsystems or health insurance and does not have the financial resources to use the private sector . The problem is serious enough and requires urgent responses. It will not be possible to wait for the state to have the resources to create a network, nor does it seem to me the best solution.
It will be important to have the clairvoyance of realizing that the oral health problem in Portugal will only be quickly combated if the existing dental units are integrated into a future network, calling the dentists all to the discussion. I say well: everyone!

There is a need to optimize existing resources by listening to and integrating all dentists, not just large centers, since the reality in the less populated areas of the country is quite different from large urban areas. Taking advantage of the existing network will be a step that I consider vital to solve the serious public health problem that affects a significant part of the Portuguese population.
As we well know the public network of dental care in Portugal is so insufficient that would oblige investments of such order that would walk not for a global solution, but for such a slow and phased solution. Taking advantage of the existing network appears to be an act of intelligence in management. All on the basis of protocol services.

And what services would be provided? I believe that the best solution would be to invest in preventive medicine, with an annual check-up, co-responsible for the patient's oral health. The State should not assume costs arising from the patients' lack of care, but only ensure that users have access to consultations and information on oral hygiene care that avoid more serious problems - and therefore more costly for both parties.A preventive, informative medicine, to deal with the small problems of today that will be enormous tomorrow. Consultations where the patient can diagnose and treat, be directed to correct oral hygiene. This would prevent serious problems by also ensuring the correct use of public services in clinic cases where dental prostheses were implanted (which should obviously be reimbursed in the necessary cases, as in other areas of medicine).

Good management of scarce resources will be the way to find a global solution and not a phased solution. Good management not only of financial resources, but also of human resources. Portugal, with recognized merits in training, has also been an exporter of dentists. The question is: can we continue to be a country that invests and does not reap the rewards? Why not find a way to integrate students who finish their courses in vocational internships?These internships, duly paid, would last for one year. This dental medicine would allow that, at the end of this complementary training, these professionals were better prepared to carry out their activity. These stages and this provision of oral health services to the population would take place in the existing private units, as long as they fulfill the previously established requirements. In this integrated plan, Hospital Dental Medicine should be, above all, aimed at treating urgent situations and not cases of negligence on the part of the patient.

In short, and so that the Oral Health of the Portuguese does not remain hostage to subsystems and health plans, it is necessary to look at what we have in a transversal way and find a solution that allows integrating what already exists, also responding to surplus physicians dentists.

João Espírito Santo, Diretor Clínico, Clínica Medical ArtCenter    

706. ARS / Algarve puts dentists at the service of the population

The Regional Health Administration (ARS) of Algarve announced that, from today, Monday, 13, dentists were placed at the service of the population in the three Groupings of Health Centers in the region. The placement of dental professionals is part of the investment of the National Health Service in the area of oral health that, by the end of 2017, will integrate the specialty in 59 Health Centers nationwide, stressed the institution in a statement.
In an initial phase, the ARS / Algarve has three dentists and their dental assistants at the Barlavento Health Centers Group (ACES) in Portimão; in ACES Central, in Faro; and ACES Sotavento in Tavira. But the number of professionals in the area and the number of locations may grow during the year 2018, admits ARS.

In a meeting with the board of directors of ARS / Algarve, the regional coordinator of the Algarve Oral Health Program, executive directors and clinical directors of ACES, dentists and dental assistants, the guidelines were drawn up on how these new services work, which have the capacity to cover, at an early stage, users with risk factors and other situations that the family doctor considers to be clinically justified.
The referral of the users to the consultations of dental medicine is done through the family doctor. It thus increases the responsiveness of the National Health Service (NHS) in the Algarve to universal and equitable needs, taking into account the most vulnerable groups, says ARS / Algarve.

The institution stresses that there will be progressive access to oral health care in primary health care to guarantee access for people with chronic conditions to oral health care and to evaluate the oral health situation of people with the various pathologies defined and followed in the SNS.
To date, if there is a need to perform apical x-rays, dentists can do so because the cabinets are equipped with intraoral x-ray equipment. The reinforcement of primary health care in the region brings another novelty: from the beginning of December, the Algarve SNS provides for the first time in the ACES, a direct digital orthopantomograph for the execution of panoramic radiological images (digital orthopantomography) - previously possible only in the private health universe - which are available in the ARS / Algarve image filesystem. 

Consultations in the primary health care of the three ACES of the ARS / Algarve will be able to carry out the following interventions: dental medicine consultation, urgent consultation, definitive direct restoration in composite resin and cement, permanent and deciduous tooth extraction and supra - periodontal maintenance treatment, gingivoplasty and gingivectomy, drainage and sealing of fissures.

Região Sul

705. Natural teeth missing to almost 70 percent of Portuguese (video in Portuguese)

CopyRight @ RTP Notícias

704. Pilot project of dentists in health centers reached more than 16 thousand users

The DGS reports that the 13 health centers in the initial phase of the project received 16,760 patients in 25,640 dental clinics. The new policy strategy in this area thus addresses the lack of dental medicine in the NHS, seeking to recover from the backwardness which, in comparison to other European countries, is particularly evident in Portugal given its large number of partial or total edentulous .Continuing the strategy initiated with the dental checks, which the Secretary of State says has been particularly relevant for population groups such as children, the elderly and pregnant, the pilot project "Dentists in Primary Health Care" obtained in the first 13 units that the ruler considers very interesting results. This assessment results from two perspectives: on the one hand, that of the users, who recognize that this service was really necessary and among which there were people who had not been to the dentist for 20 years, and on the other hand, of the satisfaction of the dentists who worked where they knew they really made the difference.

As for the balance of this performance, the DGS reports that the 13 health centers of the initial phase of the project received 16,760 users in 25,640 dental clinics. With the exception of cosmetic care, which are not covered by the program, these patients were, in turn, subject to a total of 28,900 basic treatments and 20,270 complementary procedures. If the universe of analysis is extended to the 11 health centers that integrated the program in a second phase of the process, the total accounting includes 32,882 users and 56,824 consultations until the 30th of September.According to the Deputy Secretary of State for Health, the involvement of municipalities such as Arouca, which, before health centers without dental equipment, were willing to pay the necessary investment - in the specific case of this municipality, involved more than 37,000 euros. It is not the responsibility of the autarchy to assume this expense and that is the difference between politicians, Fernando Araújo said.

In its initial phase, the pilot project "Doctors Dentists in Primary Health Care" was implemented in the health centers of Alenquer, Arruda dos Vinhos, Azambuja, Cartaxo, Costa da Caparica, Fátima, Lourinhã, Mafra, Moita, Montemor-o -Novo, Portel, Rio Maior and Salvaterra de Magos.
The second stage also included Arouca, Castelo de Paiva, Celorico de Basto, Cinfães, Damaia, Estremoz, Faro, Freixo de Espada a Cinta, São João da Pesqueira, Moimenta da Beira and Tabuaço.

Already, until the end of 2017, the third phase of the project will extend to the Alfandega da Fé, Algueirão, Bragança, Cacém (Olival), Carnide, Carrazeda de Ansiães, Carregal do Sal, Castelo Branco (Izeda), Macedo de Cavaleiros, Matosinhos (Leça), Miranda do Douro, Mirandela, Mogadouro, Monte Pedral, Moscavide, Odivelas, Ovar, Paço de Arcos, Portimão, Porto (Aldoar, Barão de Nova Sintra e São João), Póvoa de Santo Adrião, Queluz, Santa Comba Dão, São João da Talha, Santo António de Cavaleiros, Tavira, Torre de Moncorvo, Torre de Dona Chama, Vila Flor, Vimioso, Vinhais and Vouzela.

PÚBLICO 

703. Only half of the dentist's checks issued by ARS (Alentejo) were used

A recent study on oral health was presented, which indicates that 45 percent of Portuguese children with six years old have dental caries. A high number at a time when the dental check and the existence of hygienists in hospital are already acquired. The "Diário do Alentejo" wanted to know how our children's mouths went and learned that although there are still problems, the number of children with oral health problems has been decreasing.
In Alentejo, and although we are still not meeting the goals set by the World Health Organization for 2020 (80 per cent of children at 6 years old free of cavities), between 2000 and 2014, the evolution is notorious , 3 percent to 67.4 percent).

In the third National Study of Prevalence of Oral Diseases, which aimed to evaluate the prevalence and needs of dental treatment in Portuguese children and adolescents, with the purpose of outlining strategic programs promoting oral health throughout the country, it was concluded that despite the problems being smaller than in previous years, there is still a large group of children, 12 years old, in our country, with problems (47 percent have dental caries). This number increases in the age group of 18 years, with 67.6 percent of young people with cavities.Delmira Regra, an oral hygienist, oral health manager at the Beja Health Center, in an interview with the "Diário do Alentejo", reports that the oral health service of Ulsba (Local Health Unit of Baixo Alentejo), which has four hygienists for 13 municipalities, has been following some national programs to promote and educate children and young people in public schools in this area of ​​health. At this moment we continue to work with all the directives of the General Directorate of Health and the National Program for the Promotion of Oral Health (PNPSO). Since 2014 we have applied fluorine varnishes in accordance with guideline nº 013/2013 of the Directorate-General for Health (2013), which defines for the biannual application of fluoride varnish in children under the age of seven and who attend the garden -childhood.

The National Program for the Promotion of Oral Health and the Information System for Oral Health are two of these programs. In the first case, the already famous dentist's checks are included. In this regard, from 2009 to this part the government issues this type of checks, intended for school-age children. The first check is assigned at the age of seven, the second at 10, and the third at the age of 13. Each child can be counted on more than one check per school year if his or her situation so requires.
According to data provided by the hygienist, citing the General Directorate of Health, in the Regional Health Administration of Alentejo, almost 3,000 (2 977) checks were issued to children aged seven years. It turns out that only 1 552 were used. In the case of the second check, assigned to the 10 years, 4 144 checks were issued and 1,785 were used, and the third check (13 years) was delivered 3 655 checks and only used 1 648.

The same has happened with the reference for recourse to an oral hygienist. That is, in the 7-year age group, 1,036 children were referred for this type of follow-up, but only 742 presented at the consultation. In the next age group, 10 years, 267 children were selected, but only 162 benefited from the consultation and the treatments. The 13-year-old children, selected for follow-up by an oral hygienist, were 683, but only 379 benefited from the consultation.
For Delmira Regra: as we can see, the utilization rate of the documents that allow treatment and prevention is below expectations, however there is always room for improvement, and we will do our best to reach the goal of 100 percent.  

Still according to data provided by this health professional, the number of children, up to six years old, without dental caries has been increasing from year to year. In 2000, only 30.3 percent were caries-free Alentejo children. In 2002/2006 this number rose to 59.5 percent and in 2013/2014 the percentage was around 67.4 percent. In the latter case, this is higher than the national average, which is 54.4 per cent.
Another encouraging fact has to do with the number of cases of children who at age 12 already showed oral health problems. In 2000, in the Alentejo, 5.49 percent had problems, while the national average was 2.95 percent. In 2005/2006 the number decreased to 1.77 percent, and in 2013/2014 it is around 0.75 percent, below the country average of 1.18 percent and already well below the targets set by the World Organization for 2020, which is 1.5 per cent.

The Oral Health Service of ULSBA has existed since October 1994 and, for this oral hygienist, in public health, the results are not immediate. One must know how to expect and work on promotion and prevention in an innovative way. This is what we have done here, always with the agreement and support of the various health coordinations that have passed through our district.
At the beginning, the work was about stimulating and increasing the interest of our target population with playful educational spaces, such as the Tooth Fair, in 1999 and 2001, where children were invited through the school to participate with posters about this theme. During the week of activity they participated in games, watched small plays. As a reward there was exposed fruit and were invited to take what they liked.

In 2002, with the financial support of the Calouste Gulbenkian Foundation, the Lion Project was started in Aljustrel. The objective of this project was to determine if brushing, when carried out at school with fluoridated paste and supervised by teachers, twice a day would be effective in reducing the incidence of dental caries.This was followed by the project Smile in Motion, which won the Missão Sorriso prize, which aimed to implement good oral health practices among children.At this moment we are working on a play, which has as protagonists the Lidador, emblematic figure of Beja, the Legend of Beja with his monster snake and bull and oral health, which will be presented next year to the children of the 1st. Primary school cycle. On the other hand, we hope to hold next year the Oral Health Days and the importance of peers, which will target parents, teachers, nurses, doctors and oral health professionals.Text Natacha Lemos
Diário do Alentejo

* * *

Unfortunately the public bodies linked to oral health in Alentejo work extremely poorly. In the middle of the XXI century, half of the available dental checks are not used. Some questions are put to the ARS of the Alentejo: why is only half of the checkers used? Where does the money from check - dentists go that is not used? Why are not there campaigns that allow the use of 100% of the checkers?
This situation is neither justified nor contemplated. Problems of incompetence are very easy to solve; just put the right people in the right places and this would not happen in Portugal. Someone has to be held accountable for what is happening.

702. Oral oral health in Extremadura (Spain)

About 45,000 children under the age of six can benefit from the next year of free dental assistance in the region. They will be added to the around 100,000 that already have this service, which is offered until the 15th birthday.
The Extremadura Health Service plans to extend the Infant Dental Assistance Plan of Extremadura (Padiex) as of January 1 to influence prevention efforts.

The Padiex offers dental assistance to children between the ages of 6 and 15 who are entitled to healthcare under the SES. It was born in 2005 and its implementation was gradual, starting with children of 6 and 7 years until in 2013 it was applied to all ages contemplated in the plan.

The financing is public and the provision of services is mixed, shared between the 32 dentists of the public system and the nearly 300 dentists in the private sector who have the corresponding SES authorization. In this case, the dentists receive a payment for each patient that they attend in their consultations.

The Padiex includes two types of treatments. Basic, which includes reviews (at the discretion of the professional but at least one a year), assistance in dental emergencies (mainly trauma), extractions, oral health education (brushing and cleaning techniques) and preventive treatments (fluoridation and placement of sealants, among other techniques). But it also includes special actions, such as attention to incisors and canines in case of trauma and endodontics (destruction of the nerve), as well as the reconstructions that the latter entail.

Only orthodontics, prostheses and treatments of temporary or milk parts (except for extractions and emergency care) are left out of the program. According to the latest data from the National Institute of Statistics, as of January 1 of this year there were 105,000 minors between the ages of 5 and 14 in the region, who would be part of the plan's target group in 2017, since care begins in the exercise in which they are met 6. Below that age there were 45,000, which will be those who join the program in 2018.

The SES indicates that the extension of the service will be assumed from the public network. That is, the 45,000 children would be served by the 32 dentists, although in practice it is expected to reach mainly children of 5 and 4 years. A large increase in costs is not expected. The budget for the program is 1,980,000 euros.
The extension of the Padiex aims to influence prevention, for which additional attention will be given to education on issues such as healthy habits, oral health and periodic reviews, especially indicated for the little ones. We have to ensure that the treatments carried out in the consultations are more preventive than curative, indicates the SES.
Among other issues, it will try to alleviate the problem of early childhood caries, since it is estimated that 31% of children at five years have decay in the primary dentition.

As indicated by María Dolores Zapata, director of oral health programs at SES, what is intended is to educate so that cavities do not appear later. For example, he notes that many parents do not promote brushing between their children until their baby teeth fall. He also points out that the current diet, with lots of sugary products, does not help. We will try to change the chip. Zapata points out that it will try to reach as many children as possible, for which pediatricians will be asked during the reviews to take care of the referral to the dentists.  

The proposal will allow investing in preventive treatments at an early age, which in the long run will mean savings in more expensive interventions. As a result of our good preventive work, the children of our community should require less and less curative treatments, explains the SES.For professionals the measure is a success. José Álvarez, dentist of the Ortodental Clinic of Almendralejo, affirms that Padiex is very beneficial for the oral health of those under 15 years of age, since it allows access to treatments for people who lack resources. More serious pathologies are avoided in the adult stage, which in addition to be corrected require more expensive treatments.As shown, Álvarez points out that some molars with very pronounced grooves can be corrected at an early age with sealants. Otherwise, they will be more prone to accumulate dirt, which will lead to plaque formation and later decay. If they are not treated, it will be necessary to do an endodontics and, in the long run, you can lose the tooth and require an implant. A small expense at the beginning would have avoided a large outlay at the end.

Regarding the extension of the plan to children under 6 years of age, José Álvarez points out that everything that is to promote or inculcate prevention is positive. At an early age, brushing techniques can be taught more easily to children and parents, who sometimes do not give importance to the first problems that arise because they are milk teeth.

Hoy   

701. More than 70 oral hygiene products analyzed by Infarmed

More than 70 cosmetic oral hygiene products, including toothpaste and elixirs, which are subject to microbiological quality analyzes by the National Medicinal Products Authority (INFARMED), are within the authorized amounts, according to a report by that entity. According to the report released today by Infarmed, the market supervision and cosmetic products aimed at analyzing the maximum levels of fluoride, preservatives, whitening substances and microbiological quality.

The chemical and microbiological analyzes of the 76 products, including 67 toothpastes, revealed that the values obtained were lower than the maximum permitted levels, complying with legal limits, it is revealed. INFARMED explains that the chemical analysis focused on three types of substances: fluorine, triclosan and hydrogen peroxide.

If the analyzed products had values above those allowed, burns and tooth sensitivity (in the case of hydrogen peroxide), possible induction of antibiotic resistance (triclosan, in continuous exposure) and possible tooth enamel damage could occur (fluor, in continuous exposure), is underlined. Regarding the microbiological quality analyzes, INFARMED explained that these are performed according to the place of application of the cosmetic product - such as the mucous membranes - or the intended audience, namely children and babies. The laboratory analysis of these products consisted of evaluating the presence of bacteria and fungi, reports INFARMED, adding that high microbial contamination could cause a high risk of infections.

INFARMED informs that it has selected the area of oral hygiene for supervision due to the increase in the supply and demand of this type of products. The Authority annually defines the areas to be monitored on the market for cosmetic products, with the highest potential risks to public health, including products intended for populations at risk (infants and children) or research on banned substances, as a priority.

TVI24   

700. Check-dentist: what it is, how it works and who has the right

Created in 2009, the National Oral Health Promotion Program began by covering children and young people up to the age of 16 who attend public schools or private social solidarity institutions (IPSS). Subsequently, it was extended to pregnant women, the elderly, people infected with HIV, children and young people of 7, 10 and 13 years of age with special health needs.
In 2018 an electronic oral health report will be made available, a measure included in the Simplex + program. This document will be made available on the SNS portal. From then on, dental checks will also be issued digitally, arriving to the users by sms or e-mail. The number of checks that each group of beneficiaries is entitled to is defined by the Ministry of Health. The purpose of this measure is to avoid the loss of checks and to increase the use of checks.

Who can benefit from dental checks?
- Children up to 6 years of age in a situation considered to be serious, taking into account criteria such as pain and degree of infection in temporary teeth, a dentist's check may be assigned per year;

- Children attending public schools or IPSS (private institutions of social solidarity): at 7 and 10 years of age they are entitled to 2 dental checks, for an equal number of consultations. At the age of 13, 3 consultations are planned. The first check is provided through the school and the following by the dentist. To young people with 15 years of age who have been beneficiaries of the PNPSO and following their treatment plan at the age of 13, a dental check may be awarded per school year;
- Children and young people of 7, 10 and 13 years of age with special health needs, such as those with mental illness, cerebral palsy, trisomy 21, among others, who have not yet been covered by PNPSO;

- Young people of 18 years, provided they have been beneficiaries of PNPSO and concluded the treatment plan at the age of 16;- From the age of 65, those who receive the solidarity supplement for the elderly benefit from 2 annual checks to treat the teeth;- Pregnant women in the National Health Service receive 3 consultations, which can occur up to 60 days after delivery. They will be assigned by the family doctor;-In the case of HIV patients, the program provides for 6 checks. The first is assigned by the family doctor and the rest by the dentist. Checks also cover HIV patients who have already been covered by PNPSO and have not been receiving treatment for more than 24 months;- High-risk patients (eg those who have had tumors, smokers and heavy drinkers) or suspected mouth injuries are entitled to two annual diagnostic checks of € 15 each and, if necessary, another two for the biopsy (each check for 50 euros). The process of assigning the check is triggered by the family doctor;

Where can you use it?
Check-dentist can be used in any dentist doctor, in private dental clinics or clinics. They do not have any restrictions regarding the area of residence of the user, and can be used anywhere in mainland Portugal. Consult the list of participating dentists on the General Health Directorate page.
The scope of use of check-dentist provides for the promotion of oral health, prevention and treatment of oral diseases. In the use of the dental check, for each beneficiary group and in the scope of treatment, there is a set of specific acts of their own. In particular, in the case of children, the program only covers the treatment of definitive teeth, except in the dental check for children under seven years.

Jornal Económico   

699. The importance of dental medicine in the National Health Service (SNS)

Since the 1980s, when I finished my degree in Dentistry, I hear about the importance of having dentists to provide oral health care at the National Health Service (SNS in portuguese). By that time, all those who had just finished their dental school were immediately working. All! Those who were very good students, the average and even the less skilled. We could all get to work. And all, or almost all, in the private exercise of the profession.But this abundance of work and the ease with which we settled in the professional world did not prevent the first leaders of the Professional Association of Dental Practitioners (APMD) from striking to see the political power of the time how important it was to entry of dentists into the public health service so that they could, broadly speaking, have access to oral health care. From the first moment that the maximum leaders of the APMD, in that time led by Professor Doctor João Carvalho, did everything to obtain this objective. It should be noted from the above that it was not because we had difficulty working, but because we could not be indifferent to the fact that a large percentage of the population, much more than today, does not have the economic capacity to access the offices and to private clinics.

A question of justice, enshrined in the Constitution of the Portuguese Republic: The right to health protection is carried out through a universal and general national health service and, taking into account the economic and social conditions of the citizens, is free. Guarantee the access of all citizens, regardless of their economic condition, to the care of preventive medicine, curative and rehabilitation.Unfortunately, since its inception, dental medicine has been excluded from the National Health Service. It was therefore quite natural that since 1991, when the APMD was created, this issue was part of the concerns, struggles and negotiations with the guardianship It's been over 25 years. It was not because of lack of commitment or lack of will of dental practitioners and their leaders that, with the exception of a few cases scattered throughout the Continent and the reality of Madeira and the Azores, oral health remained outside the public service.

It was because the politicians, the decision makers at this level, never wanted to take the step forward and always preferred to postpone the decision, making use of a wide variety of excuses to do so. I want to emphasize, as it is true and for justice, that all the staff members, secretaries-general and leaders of the APMD and the OMD have always defended and always beat each other to change this state of affairs. Only the political class, first, did not listen to us and then, when it began to hear us, was postponing the resolution of the problem.
And so it was in January 2016 when the Secretary of State Assistant and Health, Professor Fernando Araújo, announced the intention of his Government to create the conditions for dental medicine to enter the SNS. To this end, he proposed to dialogue with the OMD, in order to reach the much desired presence of dentists in the SNS.

The solution proposed by the Government in April last year did not meet our demands, as is well known. For this reason, it unanimously decided that the Governing Board of the OMD did not sign with the Government the protocol that defined the conditions of the 2016 pilot project and that led to the entry of 13 colleagues in other health centers to provide primary oral health. However, by not having signed the protocol, the Board of Directors of the OMD also wanted to keep the doors open for dialogue so as to be heard and to contribute to improving the conditions of care provided, should the Government decide, as it happened, to extend the pilot project, after the first year.Would another position be responsible? Could we seriously sulk and closed this door that had just opened? Even if it did not open as we all wanted? Indeed, some improvements have been achieved from the first to this second model of oral health care delivery in health centers: the contracts to be established are preferably from one to two years, from 13 health centers to more than 50, the geographical area it is no longer just Lisbon, Tagus Valley and Alentejo to cover the North, Center and South of the country, the salaries of the dentist and dental assistant are improved, etc. ...

We are all aware that the present conditions are not yet desirable and that there is much more to do. Nobody could expect that, after more than 25 years without anything very relevant having happened, immediately, in a year or two, if all the conditions we desired for the professional practice of dental medicine within the NHS were reached.
The recent decision of the Government to form a working group, which aims to create the conditions to reach the dental medicine career in the SNS, should concentrate our efforts in a serious and responsible way, continue to beat us for such important desiderato . I would remind you that the electoral program with which the current OMD board has presented itself to elections, this point, referring to the public service in the SNS, is one of the priorities.

It is really important to ensure that, even for the most disadvantaged and the poorest, there may be, within the NHS, dental clinics where primary oral health care is provided. We know that this process will take time to bear fruit. Let us not create false expectations. We want to hear all the social bodies of the OMD. We count on the collaboration of all the dentists; we will want to hear the whole class in a public consultation on this matter.

Portuguese dentists are needed, with a dignified career, in the National Health Service. The Portuguese population deserves, and needs, that this happens.
Dr. Pedro Pires, Vice-Chairman of the Board of Directors of OMD
O JornalDentistry

698. Supermarkets with oral medicine consultations (2nd part)

Dental dentists against Dr. Wells opening
António de Sousa says he is ashamed

Following the news of the opening of a network of clinics of dental medicine and aesthetic medicine by the giant Sonae, several dentists have shown their dislike in social networks. The dentist António de Sousa was one of them and said to be ashamed because when it embraced the profession it was by love to the same one and not by the clothes Prada or by the cars of range. Here is the opinion of the dentist:

Embarrassed
Mr President and the other leaders of the Order of Dentists (OMD in portuguese language), and you and a large part of your staff have been responsible for the OMD for 16 years, it is my colleagues who are responsible for the shame I feel as a dentist. When I embraced the option for this profession 30 years ago I did it for the same taste; it was not the second or third option, it was even the first.

I did not do it for Prada clothing or high-end cars, but for the taste of dental art, for independence as a worker that I can have in this profession. The cars, the clothes, the houses, the trips are the consequence of the commitment that we can have in our work and this profession until a certain height allowed to ambition a good quality of life.

Even with the dental buzzword it is expensive, it was a profession respected by the population; respect from your medical colleagues is another story. This year marks many levels of reaching the lowest point in dentistry. It is not the excess of professionals that justifies the sorry state to which the art has arrived. The only justification I find is in the social bodies of the OMD. Everything that is happening was predictable, and you and your peers did nothing to prevent it.

When the Competition Authority finished the price list, you did nothing to get around the problem that arose. In due time the guidelines for the various dental treatments should have been created; these guidelines associated with the nomenclature table would allow the manual of good medical practices, with this and with the costs imputed to the accomplishment of each medical act, it would be easy to institute processes for dumping to the agents who notoriously made announcement to clinics near free.

On the other hand, the emergence of dental clinics in commercial spaces should have awakened a glimpse of the future for them and realize that this would be the foreseeable path of some economic groups.

Avoid this situation? Simple, dear sirs. It's called a code of conduct. The existence of a code of conduct for the dental practitioner and the activity of dental medicine would make it possible to regulate the practice of the activity. Furthermore, if they had implemented positive certification of dental clinics in a timely manner, based on the codes of conduct and the law regulating the activity, the fellow clinic owners could apply for this certification to the OMD; this would be a complementary and voluntary process to all the certifications we need. In this certification process, among other things, the conditions given to the colleagues who practice it will be taken into account.

The existence of clinics certified or recommended by OMD would make a difference in the market. It is the role of the Order that you direct regulate the medical-dental activity and is the guarantor of good clinical practices for the population that we serve.
With good service, surely we dentists would also be well, is not it dearer gentlemen?

You are responsible for what have been happening systematically with clinics linked to economic groups, which have had the end that we all know.
You have not fulfilled the role that the State delegates to the Order; regulate and ensure quality medical-dental service to the population.
It's late today. Any action that may be taken will have no effect.

That is why I am ashamed to be a dentist in an order led by you. The announced massive opening of clinics by the country's biggest economic agent embarrasses me, Mr President, and my fellow Members. I do not like to feel compared to a Worten appliance or a travel agency.It embarrasses me that colleagues are joining this and other groups as clinical directors, further reducing the good name that our profession deserves. If you were aware of these situations, today these economic groups would have serious difficulties in hiring clinical directors and it would be impossible to obtain certification from the OMD. You could argue that they could open the clinics, because the general law allows it, but it would not be the same thing.As a dear and illustrious colleague, we are all brothers and sisters, but no dear sirs, I am not the brother of the one who let the profession get there, nor am I the brother of clinical directors who are ultimately responsible for what is happening.It is the market to work, you may argue, but it is a market without any rule entirely your fault. It is this market that will absorb the surplus of dentists, but it only absorbs because you have allowed it; without eggs no omelettes are made, and as many clinics as they can open, if there were regulations these eggs would be very expensive.Lastly, I would like to know whether the more than 100 colleagues on the governing bodies of the OMD, many of whom are in this group, are continuing to review this OMD policy. Do not also have colleagues ashamed of the state we have reached?

Saúde Oral

        

697. Supermarkets with oral medicine consultations (1st part)

The retail unit of Sonae - Sonae MC - wants to reinforce its commitment to health and wellbeing with the opening of 75 dental and aesthetic clinics in the next eight years. The first space Doctor Wells, the name chosen for the network of clinics, was inaugurated this Friday, May 19, at the Colombo Shopping Center in Lisbon.
The first clinic is made up of a team of 25 employees, 15 of whom are physicians. The space includes six medical offices (three dental, two aesthetic and a mixed), a sterilization zone and a waiting room. It operates every day from 9am to midnight, with the possibility of making appointments until 10pm.

The Sonae group wants to open five new clinics later this year, one in Gaia and another in North Shoping, with the remaining locations being studied by the group. By 2018, Sonae wants to open 10 new stores and reach the 75 clinics scattered from north to south of the country. In the area of dentistry, Doctor Well's clinic offers implantology, prosthodontics, orthodontics, dentistry, oral surgery, endodontics, periodontology and oral hygiene services.
The strategy is not just about growing in numbers. The inclusion of other specialties, such as ophthalmology, is being studied as well as the internationalization of the concept in the long term.

During the press conference that took place during the opening of the new clinic, Inês Valadas, Sonae MC manager, said that there is an opening in this market to create a strong brand, not excluding the hypothesis that the growth could go through the acquisition of existing clinics. It was also advanced that one of the strategies of the clinics will go through prices and solutions of accessible payments, as well as agreements with the insurers of the networks Multicare and AdvanceCare.
Beneficiaries of the Well's Health Plan benefit from a direct discount of up to 40% on consultations in the Doctor Well's network, plus a credit of 15% of the amount paid for consultations on Continente Card.

Saúde Oral

696. First Iberian Congress on Preventive and Community Oral Health

https://www.facebook.com/CongressoIberico/

695. Only in Portugal: One million dentist checks left unused

Nearly one-third (27%) of dentists' checks issued since 2008 were not used, according to data published Monday, March 20, by Jornal de Notícias. Of the 4.3 million vouchers launched in the last eight years under the National Program for Oral Health Promotion, there were 1.14 million that were eventually wasted.

Quoted by the newspaper, the president of the Order of Dentists, Orlando Monteiro da Silva, said that it is a shame that the checks are not harnessed to the maximum, stressing that the need exists, but does not always turn into demand. Dentist's checks can be used in private clinics or clinics, and there is no restriction on the area of residence of the user. Pregnant women, elderly people who receive the solidarity supplement and children and young people under the age of 16 are the main beneficiaries of this measure, which a year ago was extended to 18 years if they had already been users.
According to the data provided by the Dental Physicians Association, 69% of the beneficiaries during the past year were children and young people, while pregnant women accounted for 19% of the total of more than 544,000 dentists' checks issued in 2016.

Jornal de Negócios 

* * *

The reality of the facts reveals the oral health policy of the governments in Portugal. By saving 1,140,000 checkers, governments in recent years have saved tens of millions of euros at the expense of oral health of Portuguese children and adolescents. An aberrant and atrocious crime that reflects the real interest of the government and the Directorate General of Health in effectively promoting true oral health for all children and adolescents in Portugal by subtracting more than one million checkers.

The question is simple: how many children and grandchildren of all ministers who have passed through the Ministry of Health and Education, Members of the Parliament or senior officials of the Directorate General of Health in the last ten years did not have access to health care oral? Children and young people without rights are the first to feel the contempt that governments have for oral health. If the rulers had any interest, all the dentist's checks would have been used; unfortunately this is not the interest of the government or the Directorate - General for Health. 

694. March is the month of oral health

To mark World Oral Health Day, which is celebrated on March 20, Colgate, in partnership with the Portuguese Association of Oral Hygienists, will promote the 17th edition of the "Oral Health Mission" during the months of March and April . The objective is to raise awareness of the importance of oral health and the adoption of good oral hygiene practices by promoting the 4 steps: brushing with fluoride toothpaste at least twice a day, use of elixir, use of dental floss and regular visit to the dentist / hygienist.Since the year 2000 Colgate has been promoting this event and in these 17 years more than 130,000 dental check-ups have been offered. This year, the leading brand in oral hygiene has returned to the street, and for more days, the itinerant van that will not only be in Lisbon and Porto, but also in Coimbra, offering free dental check-ups and making personalized advice on the oral habits of oral hygiene professionals. These check-ups will also take place in national hypermarkets, from north to south of the country. There are also the possibility of forty Portuguese people taking advantage of € 100 in dental treatments. To do this, just go to the Colgate website - www.colgate.pt - and participate in the quiz by answering a quiz about oral hygiene.Despite the promotion of this type of awareness campaigns, the studies indicate that there is still a great margin to improve the Portuguese oral health care. An example of this is that oral health professionals recommend changing toothbrushes at least every three months, but Portuguese only buy toothbrushes on average twice a year. Another indicator is the fact that only 36% of Portuguese households have purchased elixirs at least once in a year. As for the child population, recent studies have found that almost half of children between the ages of 2 and 7 do not brush their teeth properly (they do not brush their teeth long enough, they only brush their front teeth), and consequently there is a decrease in their health oral health of Portuguese children, which causes a high incidence of dental caries at these ages.

Calendar Wagon-traveling itinerary Oral Health Mission

LISBON:

     7 / March | C.C. Colombo (main entrance) with the presence of the Ambassador of this edition of the "Oral Health Mission", Carolina Patrocínio.
     8 / March | Luís de Camões Square
     9 / March | Terreiro do Paço
     10 / March | Jumbo Cascais
     11 / March | Gare de Oriente
     12 / March | Small field
     13 / March | Large field

PORTO:

     14 / March | Campaign
     15 / March | São Bento
     16 / March | Rua de Santa Catarina
     17 / March | Av. França (Casa da Música)

COIMBRA:

     18 / March | Republic square
     19 / March | Tollgate
     20 / March | CC Solira Tour (Rua João Deus Ramos)

 shoppingspirit