The World Health Organization considers that oral health is an essential component of health in general and a high oral health index is a fundamental human right, but the Portuguese National Health Service, when it was created in 1979, left out health oral.
Access to dental care has been provided by dental practitioners in private practices, but obviously for those with economic resources for such, which are less than half the population. Not surprisingly, Portugal has one of the worst situations in terms of oral health compared to other European countries. Last year, the Portuguese Observatory of Health Systems (OPSS) warned that the poorest countries continue to have less use of specialist consultations, particularly in access to oral and mental health and medicines, whose costs are classified as catastrophic expenses for these Portuguese.
Access to dental care has been provided by dental practitioners in private practices, but obviously for those with economic resources for such, which are less than half the population. Not surprisingly, Portugal has one of the worst situations in terms of oral health compared to other European countries. Last year, the Portuguese Observatory of Health Systems (OPSS) warned that the poorest countries continue to have less use of specialist consultations, particularly in access to oral and mental health and medicines, whose costs are classified as catastrophic expenses for these Portuguese.
Only in 2008 a first step was taken so that users of the National Health Service (SNS in portuguese) could access oral health consultations. The National Program for the Promotion of Oral Health, known as the Dentist's Check, in which the SNS hires adherent professionals, today more than 4000, some treatments for special groups of the population, children and adolescents, pregnant women, people with HIV / AIDS and combat to oral cancer. That is, only a small part of the population benefits from the Dentist's Check.
To extend oral health care to the entire population, several ways are possible: equip health centers and hire dentists to serve the population; extend the Check-Dentist program; to participate in the convention regime (type ADSE) the consultations of the users of the SNS by the State or to combine the previous hypotheses. The current government decided two years ago on the first hypothesis. It was a political option that deserved the applause of the Order of Dentists (OMD). How it would have deserved the same applause if the option had been another. From the perspective of the Order of Dentists and people, what is needed is to promote access for all to quality oral health care. If this is done in the public sector or in partnership with the private sector, it is indifferent. There are good international examples for both options.
In 2016, work was done in some health centers in the south of the country and dentists were hired for a pilot project aimed at providing care to the most vulnerable population. Since 2017, the pilot project has been extended and currently more than 50 health centers in the continent have dentists to serve the population, in appropriate facilities and equipment at the level of what happens in the private sector. The Government wants that by the end of the next year all the Groupings of Health Centers (ACE) have consultations of dental medicine.
In the pilot project, dentists are hired as providers of services, without employment or exclusivity, and for a period of 12 months without entitlement, for example, holiday allowances, Christmas or medical leave. Extending the supply of oral health consultations to all ACEs requires, however, that dentists to practice in the SNS have an appropriate framework, a career in dentistry. To this end, a working group was appointed by the Government which produced a proposal which was approved by the Ministry of Health. A career of its own because dental medicine is a unique profession. It combines the intellectual conception of a work, with the medical, surgical and surgical execution of the same with adequate procedures performed in the patient.
In the pilot project, dentists are hired as providers of services, without employment or exclusivity, and for a period of 12 months without entitlement, for example, holiday allowances, Christmas or medical leave. Extending the supply of oral health consultations to all ACEs requires, however, that dentists to practice in the SNS have an appropriate framework, a career in dentistry. To this end, a working group was appointed by the Government which produced a proposal which was approved by the Ministry of Health. A career of its own because dental medicine is a unique profession. It combines the intellectual conception of a work, with the medical, surgical and surgical execution of the same with adequate procedures performed in the patient.
Dental medicine is an autonomous profession throughout the world, with a minimum of five years' training and 5,000 hours of university work directed at the specificity of dental medicine. It is not a specialty of medicine and has its own organization, through the Order of Dentists. In direct contact with the patient, the dentist, within the functional content of the profession, integrates medical and scientific knowledge acquired in the elaboration of the diagnosis and treatment plan with an operative and surgical approach in the patient in order to obtain the final result, prevention, maintenance and obtaining of function and aesthetics.
To this end, the dentist is assisted by a set of diagnostic, radiographic and imaging aids, among others, and a set of essential equipment and devices, dental materials and medicines, as well as the support of the health team oral, in particular dental assistant. The dentist also prescribes medicines and drugs through prescriptions and attests health and illness through medical certificates.
To this end, the dentist is assisted by a set of diagnostic, radiographic and imaging aids, among others, and a set of essential equipment and devices, dental materials and medicines, as well as the support of the health team oral, in particular dental assistant. The dentist also prescribes medicines and drugs through prescriptions and attests health and illness through medical certificates.
To create a career in dentistry is for all these reasons to ensure that oral health consultations will be an integral and indivisible part of the SNS once and for all. The only certainty that there will be no retreat. As far as oral health is concerned, Portugal has wasted almost 40 years to guarantee a constitutional right. The fundamental rights and duties of the Constitution of the Republic of Portugal include that everyone has the right to health protection and the duty to defend and promote it and that, in order to guarantee the right to health protection, it is primarily the responsibility of the State to guarantee access for all citizens , regardless of their economic condition, to the care of preventive, curative and rehabilitative medicine. In oral health this right has been forgotten.
Today, the investment is done and properly budgeted, dentists are contracted, missing only one last step, the essential co-approval of the career of dental medicine by the Ministry of Finance. We all hope that it will come quickly so that everything is not lost. The Portuguese deserve it.
Bastonary of the Order of Dentists
Bastonary of the Order of Dentists
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