687. JADA

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686. LISBON: Homeless will have dental appointments

The approximately 800 people who live on the street and who receive support from the Lisbon City Council will now have oral health care. In the first stage, a screening will be done, and then the necessary dental interventions will be performed.For the realization of the program Sorrir não Custa, this Thursday was signed, in the City Hall of Lisbon, a protocol between the autarchy and the person in charge of the project. The program is expected to start later this month, said Mário Almeida, head of the Municipal Homeless Program. The aim is to consult the entire homeless population of the capital.Paulo Varela, a dentist and clinical director of Sorrir não Custa, said many people complain that they do not go to job interviews because their teeth are not in good condition. To reverse this situation, the project aims to identify people who need help, educate them on oral hygiene and treat them through dental implants whenever possible.In order to reach the entire homeless population of the capital, the project will count on the support of the Lisbon Center for Homeless Planning and Intervention (NPISA), in an articulated work with the street technical teams, explained the coordinator of the nucleus, João Marrano.The Councilor for Social Rights of the municipality, João Afonso, said that there is no date for the conclusion of the program. The Chamber will be a facilitator to implement this program, which will not have costs for the municipality, he stressed.
Correio da Manhã

685. Dentists doctors of the National Health Service "no conditions to attend" on the waiting list

Hundreds of thousands of Portuguese users are on the waiting list for consultation of Dentistry through the National Health Service (SNS), which has only 58 dentists for all the attendances. The professionals gathered this Saturday in Aveiro, at the 1st National Meeting of Dental Medicine of the SNS, to discuss priorities in care.
The debate was part of an initiative of the Ministry of Health aimed at bringing together several dentists practicing in the SNS, in order to analyze working conditions, forms of access to consultation by users and the interconnection between different levels of care. We seek to create a consensus regarding the type of users to whom priority should be given, because, with the resources that exist, there are no conditions to meet all, said the member of the organization of the event, José Farias Bulhosa.

The difficulties in accessing the consultation are felt all over the country: in Baixo Vouga, for example, there are 380 thousand users on the waiting list and in Lisbon, there are doctors with 200 thousand potential users waiting for it.
With regard to professionals, there are only 18 dentists in the continent, 11 in Madeira and 29 in the Azores, all without a clinical career, since the State considers them to be senior administrative technicians.
The size of the request for oral pathology is not a type of consultation where it is done for the first time, and the patient is discharged. Sometimes it takes scheduling of several queries to handle it, but we can not tell you to come after five years, because the list is quite large, explained Jose Bulhosa.

Many of the users who expect to be in the SNS are people who are economically fragile to access private care. Although there are equipment, these are stopped or underutilized because they do not open spaces for professionals.
Dentists acknowledge the attention given to the subject by the Government. However, they seek to avoid failures already noted in the pilot projects announced for the Alentejo and Tagus Valley. To this end, they intend to have a national and regional coordination carried out by people who have sensitivity to the Dental Medicine, preferably trained in the area, in order to reach the distinct realities of each service.

Last week, the head of the Order of Dentists, Orlando Monteiro da Silva, had already appealed to the opening of vacancies within the public service: In a country with so many deficiencies in access to oral health, it was particularly common sense to take advantage of dentists underemployment, and place them serving the most needy population, within the SNS.
Monteiro da Silva spoke about the document Numbers of the Order 2016, which showed a 4.6% increase in the number of professionals enrolled in the Order, a growth considered much above the needs of the country and the WHO recommendation of a dentist for each two thousand inhabitants.

Jornal Médico  

684. ULS Northeastern dentists in the first national meeting of the specialty

The medical dentists of the Local Health Unit of the Northeast participated, on July 8, in the 1st National Meeting of Dental Medicine at the National Health Service, which took place in Aveiro. This initiative aimed to promote a discussion and analysis of working conditions, forms of access by users, interconnection between different levels of care and sharing of organizational experiences.

In the presentation made at the event, the head of the Dental Medicine at the ULS Nordeste, Dr. Susana Silva (right in the photo), highlighted the work developed in this area in the district of Bragança, at the level of prevention and promotion of Oral Health. The geographic dispersion (the district of Bragança being the 5th largest in the country), associated with the problems of accessibility and the specific conditions of interiority are the main characteristics of the territory served by ULS Nordeste.

In this context, the team, composed of five Dentistry doctors, ensures this valence in all Health Centers in the district of Bragança. The work developed in this specialty is directed to users between the ages of 3 and 16 enrolled in the School Park of the locality associated to each Health Center. The work developed by ULS Nordeste in this area has proved an asset for the Target population and the district, namely the increase in the number of children free of dental caries, reduction in the severity of dental caries, greater personalization in contact with the user, easier access to consultation and improvement of Public Health.

Following the communication, the ULS Nordeste team was praised by Dr. Manuel Oliveira, member of the Commission for the Reform of Primary Health Care, at the level of his method of work. ULS Nordeste professionals were also invited to participate in the next Congress of Dental Physicians of the SNS of the Archipelago of the Azores, by its responsible Dr. Ricardo Viveiros Cabral.

Unidade Local de Saúde doNordeste, EPE   

683. Dentists seek career in SNS within one year

By day 250 users are having consultations in health centers. There are those who have never been to a dentist for lack of money. The head of the Dental Physicians' Order hopes that within a year the Ministry of Health will have created the career that integrates these professionals into the National Health Service (SNS), giving rules and an equal salary scale for all. The pilot project, created by the Ministry of Health, started at the beginning of the month in 13 health centers in the areas of Lisbon and Vale do Tejo and Alentejo. By day, there are 250 users with consultation, paying seven euros of moderating fee.

If the ministry intends to have dentists to practice in the SNS, whether in health centers or hospitals, given the specificity of the profession, it must create a career as a dentist. The commitment to the sustainability of the SNS begins the process. Evaluation of the pilot experience will allow steps to be taken in this direction. I hope it will be there in a year, said Dr. Orlando Monteiro da Silva, a member of the Dentistry Department.
The issue has already been discussed with the ministry and the Order, it is fundamental that the future career guarantee the independence of the dentist, continuing education, teamwork, suitability of services, equal pay grids for all that reference the gross salary of a doctor Senior assistant. The reference of the 13 new dentists of the SNS is the career of technician of superior health, with a gross salary to be around the 1500 euros. But the few who were already in the SNS receive less.
The president of the dental doctors' order believes that this is a historic step and that the trend will be to extend the project. The Ministry of Health explains that the expansion to other health centers is planned, but that the number and approach of the process is dependent on the evaluations that are carried out. The project will be evaluated in several phases, the first in early 2017.

Ana Filipa Neto is the dentist of the Monte da Caparica Family Health Unit, one of the health centers with a pilot project. There is no doubt about the success of the measure. When they arrive at the reception they tell how it went well, that it did not give anything. Some say that it was the first time they went to the dentist because they had no economic conditions, others because they had several complications, and the private clinics did not take care of them for fear, he says.
The users who attend, every day of the week between 8.00 and 18.00, are referenced by family doctors. When the assistant calls them they are very happy and say they have been waiting for this for a long time. The project comes to give oral health care to the chronically ill: people with diabetes, cancer, kidney, respiratory or cardiac diseases.

Ana's work begins with the question if she has complaints or toothaches, an x-ray is made, the diagnosis and the action plan are drawn. A work in partnership with other doctors as cardiologists, when in case of surgery it is necessary to review the medication that the patient already does. Many are excited when I ask if we can start treatment at the first appointment. We feel every day that we are helping people, she recalls, recalling one of the stories that has affected her the most: A woman in her 50s, who had several health problems, had radiation therapy, can never go to the dentist for lack Conditions. I had an infection, we treated the teeth on the left side. I wanted to prescribe acetaminophen and told me it was not worth it because I could not afford it.For the medical dentist, it makes sense to extend this offer to the entire population in the future. You need to integrate more dentists. If that happens, I'm very happy. It is not just patients at risk who need care. It's the whole population, he says.

Ana Maia

Diário de Notícias

 

 

682. Oral Health Group PT (FaceBook)

https://www.facebook.com/groups/376006582519771/

681. FaceBook Oral Health

https://www.facebook.com/saude.oral.7

680. ESPOSENDE: Partnership guarantees oral health care for children and young people in need of the municipality

The Local Social Action Council (CLAS) of Esposende has established a partnership with the Clínica Senhora da Saúde, Esposende, in order to guarantee oral health support for children and young people from poor families in the municipality.

The protocol for the operationalization of the + Oral Health project was formalized last 12, by the President of CLAS and Mayor of Esposende, Benjamim Pereira, and Technical Director of the Clinic, Thierry Zão da Silva.

This project is part of the intervention of the Esposende Social Shop and aims to respond to the fragile economic situation of some families, especially in access to oral health services, such as screenings and medical-dental treatments.Clínica Senhora da Saúde undertakes to receive and attend monthly, free of charge, up to three children or young people under the age of 18, referenced and sent through the Social Store and who are in a situation of proven socioeconomic deficiency.This partnership reflects, on the one hand, the unique dynamics of the Social Store in the search for and diversification of responses to the most vulnerable population of the county and, on the other hand, reflects the social responsibility of Clínica Senhora da Saúde and its concern to ensure health services To children and young people whose households do not have the financial capacity to provide care. An example that may be followed by other entities / companies that want to join the Social Store in improving the living conditions of the population.
Correio do Minho

679. State would spend € 280 million a year on dentistry for all

The state would need 280 million euros annually to give all users access to dental care under a convention with private practices, according to a study by the Universidade Nova de Lisboa.
The study, which the Lusa agency had access to, offered several scenarios to increase Portuguese access to oral health care, and recommends that public coverage be increased through private provision, a scheme agreed on as in other areas (analysis Clinics, for example). The application of this scheme points to a charge of the National Health Service (SNS) of 280 million euros per year, which would give an expense of 28 euros for each Portuguese.

The head of the Order of Dentists, which ordered the study, said that the most reasonable option in terms of costs and equipment already installed would be to take advantage of the approximately 10,000 dentists who are distributed by nearly 7,000 clinics and offices. In an interview with the Lusa agency, Orlando Monteiro da Silva, explained that the annual cost of 280 million euros would allow to include about 90% of health care for all users of the SNS. That is, those costs include the most frequent care and treatment, such as extractions, devitalization or cleaning.

The president recognizes the economic weight of the measure, assuming that it is not carried out suddenly, but rather in a gradual perspective, opening up oral health care to the population successively, starting with, for example, the most disadvantaged or users with chronic pathologies. There is a gradual path that can be traversed. And it must be done, already wasted too much time, with other costs: the cost of doing nothing is much higher than this, the cost of having a population to avoid food, the cost of absenteeism to work, children missing school , The social cost of toothless walking, he said.The study by Alexandre Lourenço and Pedro Pita Barros, from Nova School of Busines & Economics, also outlined the scenario of an entirely public oral health care setting, equipping health centers and hiring dentists. To meet the needs of the country, it would be necessary to hire 6,500 dentists, which would represent an annual cost of 182 million euros, only for the payment of salaries of these professionals.

The study did not carry out other accounts for this scenario, but the OMD estimates that the value would triple if expenses were recorded for dental assistants, adaptation works, equipment and maintenance costs, as well as consumables used in Queries. Forty years later, the NHS landscape changed radically, with almost 7,000 dental offices and clinics. The study recommends not duplicating and looking for a possibility to take advantage of the private investment that is wasted, he summed up.For the president of dentists, the future path does not have to go through a fully public or fully agreed solution, and there may be a combination of both. One of these possibilities of mixed solution could be to have a scheme agreed with a small network of health centers with dentists for some groups of patients, such as oncological or renal insufficiencies or other type of chronic patients.

The study also evaluates the scenario of increasing the private coverage of oral health care through insurance with private provision, and the State has to negotiate with the insurance sector. According to the authors, this hypothesis could allow a reduction of the financial risk of the families and make the existing private provision profitable, but the political and social framework is adverse to the use of the insurance sector to assure functions of the State.
The dentists' leader points out that the country has already waited too long for universal access to oral health care, considering that political decisions should be weighed against the scientific and technical bases and without ideological prejudices as a backdrop.

Porto Canal    

678. Oral health consultations in health centers start as of Saturday

As of Saturday, oral health consultations are beginning to be phased in at the health centers, initially aimed at more vulnerable users and, starting in 2017, all registered users. According to an order published this Friday in the Diário da República, from July 2 pilot experiments are being started in some health centers in Greater Lisbon and Alentejo to expand the National Program for the Promotion of Oral Health ( PNPSO).In the first phase, which runs until 31 December of this year, patients with diabetes, neoplasias, chronic cardiac or respiratory disease, renal failure on hemodialysis or peritoneal dialysis, and transplant patients, enrolled in Centers Groupings (ACES) where the pilot experiences are taking place. In the second phase, as from 1 January 2017, depending on the assessment of unmet needs and waiting times, the project can be extended to all users enrolled in these ACES, in a phased and progressive manner, depending on the referral By the family doctor.

In the area of the Regional Health Administration of Lisbon and Vale do Tejo, the pilot experiences will be held in the ACES of Almada-Seixal (Monte da Caparica Health Center), Arco Ribeirinho (Moita Health Center), Médio Tejo (Health of Fátima), Lezíria (Salvaterra de Magos, Cartaxo and Rio Maior Health Centers), Tejo Estuary (Azambuja, Alenquer and Arruda dos Vinhos Health Centers) and Oeste Oeste (Health Centers of Lourinhã and Mafra -Ericeira).
Within the scope of the Alentejo Regional Health Administration, pilot experiments are carried out at ACES Alentejo Central, namely at the Montemor-o-Novo and Portel Health Centers.
Users enrolled in these health centers may be referred for oral health consultations following a decision of the family doctor, and the doctor who provides the oral health consultation should maintain close articulation with the other professionals of the family health team. The order specifies that the oral health care included in the pilot experiments only includes those treatments considered necessary in clinical terms, leaving interventions of a strictly aesthetic nature.
Currently, under PNPSO, children and young people under the age of 18 are pregnant, undergoing prenatal surveillance at the National Health Service, elderly beneficiaries of the solidarity supplement and users infected with the HIV / AIDS virus. The PNPSO is reviewed by the Directorate-General for Health until July 29, 2016.

Público

677. MIGUEL STANLEY: There are offices with 16 daily consultations; the managers defuse the concept of dental medicine.

Celebrating 20 years of profession and associate of several foreign organizations, Miguel Stanley leaves several alerts and speaks of the benefits of the public service. The government announced that it intends to strengthen health centers with dentists. Is this an important step? 
There are several types of dental medicine: emergency, basic care and total reconstruction. The introduction of dental medicine in the SNS (National Public Health Service in Portugal) is very good for the Portuguese. The simplest treatments should be in the SNS. I demand that my taxes be applied to help the Portuguese who are suffering from basic problems.
What are basic care?
Restoration, simple devitalization, tooth whitening, removable dentures. This I believe the SNS can guarantee without great costs. Above this scale, in the case of complex devitalizations, reconstruction of gums, implies equipment and more expensive material stocks. 
How much does it cost to set up the dental practice?
To set up a licensed office with all the rules, the cost per cabinet is tremendous. It requires several certifications and equipment for the most basic care and for the most complex treatments. If you take the value of income, decoration and costs with human resources, setting up an office can reach one hundred thousand euros. It can be cheaper without panoramic X-ray or CT, which I consider to be essential for dental implants. The dental practitioner is almost obliged to work the most expensive side in order to have an open clinic. There are more than 5,000 clinics, which have to face the competition and an increasingly aggressive market.
What are the effects of competition? 
The business in Portugal is 100% private, which leads to that often the only focus is profit. There may be oversolding of the aesthetic versus basic care. If there are so many dentists and no State support, this can happen. If there is basic care in the SNS, and with this state regulation, it may be good for the business because people no longer come hostage to the basic problems.
But there are regulations that doctors need to follow.
In the business of dentistry can only invest or save on three things: materials, dentist and consultation time. For many the only way to survive is to save on the dentist, on the price of materials - as long as they are recognized by the Infarmed and within validity is acceptable - and at the time of the consultations. There are offices with 16 consultations per day. Managers defile the concept of dental medicine. Quality and excellence come through time. I think the existence of dental medicine in the SNS is fundamental and that the average consultation time is one hour so that the SNS, which is paid with our taxes, can teach the quality of the doctor's act to the people.
What are the risks of less time consuming appointments? Is it a lack of hygiene problem? 
This is my new battle. When people ask clinics and clinics what the price of a particular treatment is, they should also ask how much time they will spend on it. The national average time per visit in Portugal is 30 minutes. People get more consultations and then end up losing their teeth. The insurers pay by act and the same value to all. There is no incentive to quality. It is not a problem of lack of hygiene. 
How can the NHS change this?
I understand that the NHS will raise the bar of quality over time per consultation. The guidelines say that the average disinfection time between queries should be between eight and ten minutes. I can not say that they do or not, but I hope they do. I have no indication of faults, but it is an alert. 
Ana Maia

DN PORTUGAL

676. Conceptsmile

Operative Dentistry: is the area of ​​Dental Medicine that is related to restorations of decayed teeth. These restorations nowadays are highly aesthetic in that the color of the restoration is equal to that of the tooth, thus improving its appearance
Endodontics: Endodontics is the medical procedure to be performed when the carious lesion reaches the dental pulp, (commonly known as Nerve). Or for another reason and the necrotic pulp, we have to carry out their total removal thus eliminating the bacteria present in the channel and subsequently fill / fill them. 
Oral Surgery: This area includes a wide range of treatments, from simple and complex teeth extraction, apicetomy, removal of cysts, pre-prosthetic surgery when necessary and bone regeneration, when there is insufficient bone that makes implant placement impossible.
Tooth Whitening: it is an aesthetic treatment, which can be done when there are few restorations. It is a whitening of the tooth surface through the contact of active substances. External bleaching can be done at home through a tray or in the office. Each of them has its indications and contraindications and as such should be advised with your dentist.A devitalized and darkened tooth can also be bleached through internal bleaching. 
Peridontology: is the area responsible for the prevention, diagnosis and treatment of diseases of the gums and structures supporting the teeth. Gingivitis is a clinical situation often related to gingival inflammation and bleeding. It is reversible upon removal of the aggressive agent (bacteria). Periodontitis is a result of the accumulation of calcified plaque (tartar) resulting in loss of bone support enveloped in the tooth, which causes tooth mobility and sometimes premature tooth loss. 
Removable prosthesis: The removable prosthesis is a solution that we can use when it is not possible for fixed rehabilitations (implants or fixed prosthesis). These prostheses can be of two types: Acrylic (Directly supported on the gingiva) or Skeletal (supported on teeth and has a metallic base).
Pediatric Dentistry: This area is reserved for children. The main objective is to prevent cavities and for this we can put Fissure Sealants on the occlusal surface of the tooth without caries so that it becomes smoother. In this consultation it is also important to explain to the child the techniques of brushing, topical application of fluoride and dental floss.
Implantology: a specialty of dental medicine that is constantly evolving and also has a high success rate. The implant is a titanium device that is no more than an artificial root, allowing the replacement of one or more teeth, contributing to better mastication, phonetics and aesthetics. After the placement of the implant that is completely painless through the anesthetic technique, we proceed to the prosthetic phase, that is, the placement of the tooth.
Orthodontics: This area aims to diagnose, prevent and treat dento-facial irregularities (bent teeth) that prevent correct occlusion. In this area, fixed appliances (metallic or aesthetic brackets) or removable brackets are used, which will correct these problems, thus establishing an aesthetic harmony of the smile and promoting the health of the masticatory system by the tooth movement and orientation of the bone growth. 
Fixed prosthesis: Fixed prostheses are ceramic structures fixed to the tooth. This solution stands out above all for high aesthetics, strength and comfort. There are crowns and bridges. The blades are placed when a tooth is very destroyed and thus give it greater strength. The bridges are indicated for cases of one or more teeth missing, one or more artificial teeth being attached to the adjacent ones, reproducing the natural tooth aesthetic.

ConceptSmile

675. Reform Plan: Doctors warn of health constraints

The National Reform Plan, presented on Thursday by the Government, provides, among other measures, ophthalmological screening in 28 health center clusters (ACES) and free dental consultations in the framework of pilot projects under development.Speaking to Lusa, rod José Manuel Silva considered these two measures positive, highlighting the inclusion of dental medicine and stomatology in the primary care of the SNS (Portuguese public health service).We welcome dental medicine in primary health care. We salute the ophthalmological scrubs that are going to be implemented, but they must be done with doctors and dentists of the SNS, said José Manuel Silva, still defending a career in dental medicine / stomatology in primary health care within the SNS.He also acknowledged that the state itself contributes to the withdrawal of doctors to the private sector by paying more to private sector doctors working for the SNS.We see with great concern, to keep for the public sector the philosophy of enter one, leave two or leave two, enter one. Recently there has been much talk about hospital infections, and we all realize that there is a dramatic lack of human resources in hospitals. Strengthening the hiring of nurses and technical and operational assistants is apparently not foreseen and this will continue to put constraints on functioning, he said.José Manuel Silva also called attention to the need for the measures that are foreseen in the National Reform Plan not to be made through outsourcing.We will see how the pilot experience will be implemented and then how it will be analyzed, but it is positive, there has been a gap [absence] of dentistry in the SNS, he stressed.

Notícias ao Minuto

674. My Dentist: claim your credit until March 9

DECO is aware that the My Dentist dental clinic (DIZIN - Saúde, S.A), operating throughout the country, is undergoing a Special Revitalization Process (PER). An analysis of consumer complaints led to the conclusion that most of the budgeted and contracted treatments were concluded through the financing of Popular Servicios Financieros. In many cases, there are treatments that have not been met, which is why consumers have an active credit agreement.

We are dealing with a consumer credit related to the service agreement. In these situations of breach of contract, consumers must complain to the financial institution - that is, Popular Servicios Financieros -, since they may oppose payment of the benefits. Consumers who hold these related credits must send a copy of their complaints to our contacts, in order to mediate the conflict with Popular Financial Services.

For consumers who have contracted and paid directly to the dental clinic for treatments that were not provided to them and for which they have not been repaid, they must be brought to the attention of the provisional judicial administrator. The standard letter that we have provided is prepared for this purpose. It must be sent registered and with acknowledgment of receipt, accompanied with a copy of all the relevant documentation.

This letter must be addressed to Dr. Carlos Cintra Coimbra Torres, Av. 25 de Abril de 1974, 23 - 1º A, 2795-197 Linda-a-Velha, in the framework of process no. 2918 / 16.0T8SNT, which runs its terms in the Commercial Section - J5 of Sintra - of the District of Lisbon Oeste.

DECO

   

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 

* * *

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.

Diário de Notícias 

670. Dentistry and the National Health Service (SNS)

The degree in Dental Medicine has existed in Portugal since 1976. Its duration was six years, such as the degree in Medicine. The first three years (basic cycle) were superposable to the first three years of the medical course, with the last three (clinical cycle) referring to the study of oral cavity pathology and annexed structures. However, in these last three years the patient was not seen as a whole, being a part of the curricular plan referring to systemic manifestations of oral pathology and vice versa. With this curricular profile, the doctor-dentist would then be a physician who underwent an early differentiation process within medicine.
The statutes of the Order of Dentists refer that the doctor-dentist is responsible for the study, diagnosis, prevention and treatment of diseases of the teeth, mouth, jaws and attached structures. In this way, dental medicine as an independent profession, as in any other medical specialty, can apply medical-surgical therapy, with autonomy of prescription, the right to issue medical certificates and death certificates and others.

The contribution of dental medicine to the health of the population is not exhausted in the strict field of oral health, nor in practice as a liberal profession. The doctor-dentist should always act as an important agent for the integral promotion of health. The importance of a well-treated mouth that is not the focus of infection and / or inflammation would save millions of euros annually in the treatment of diseases such as cancer, diabetes, kidney disease and cardiovascular disease.

In this way, it is crucial to actively involve dental practitioners and other professionals working in the field of oral health in multidisciplinary teams and in activities to prevent and treat all diseases. It would be an invaluable contribution in promoting the health of populations and in the well-being of patients.

With the evolution of medical-dental science and art, a great challenge arises, at the beginning of the 21st century: to be fit and qualified to intervene in a hospital environment and in any NHS institution (health centers, family health units and others) . In addition, dentists can act in the private clinic, with sometimes high-risk interventions in medically compromised patients, it is not understood that in these 40 years dentistry is practically excluded from the National Health Service. As an example of the hospital area, these professionals could benefit from the support of other specialties in multidisciplinary teams, with undeniable benefits for the National Health Service and patients.

It seems that the political power finally looked closely at the importance of oral health, and there are signs of a political will to take clear and unambiguous steps in this direction. If this is the case, it will be a historical political decision, perhaps one of the most important ones, right after the creation of the National Health Service in 1979.

Well to the Portuguese Association of Hospital Dental Medicine (APMDH), which, with the commitment of its leaders, friends and associates, have been clamoring for this for more than a decade. In fact, the birth of the APMDH came to institutionalize a struggle of its founders initiated in the previous decade. Welcome to the North Regional Nucleus of the Portuguese League Against Cancer NRN-LPCC and its leaders, which, together with the APMDH and its clinical body of volunteers, have already carried out more than 6500 free consultations for the early diagnosis of oral cancer. The current Government wishes to express its willingness to put oral health and dentists in the place of general health and medical science, respectively.

To end a word of hope: that the implementation is properly carried out after listening to the institutions that have evidence in this field ...

João Leite Moreira - Dentist, Coordinator of the Unit of Stomatology and Dental Medicine of the Portuguese League Against Cancer - Regional Nucleus of the North and Portuguese Association of Hospital Dental Medicine
Jornal de Notícias

      

669. Portuguese health service drops to 20th place in international ranking

Inequality in access to health services, delays in surgeries, difficulty in getting treatment abroad, high numbers of cesareans, difficulty accessing family doctors and oral health care outside the National Health Service are some of the areas that are contribute to a more negative evaluation of the Portuguese health system. According to the international ranking made by the Swedish organization Health Consumer Powerhouse, Portugal appears in the 2015 edition in the 20th place of the European Medical Assistance Index, when in 2014 it was in 13th place.
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As for Portugal, the country appears in red on topics such as direct access to consultations with medical specialists, waiting times for non-urgent surgeries, Staphylococcus aureus infections resistant to the main antibiotics, dialysis out of hospital, access Dental physicians and the consumption of alcohol. In yellow, issues such as the publication of data on the quality of services provided, access to innovative drugs, consultations with the family doctor on the day, waiting time for oncological treatments or some complementary diagnostic tests. The cases of depression, years of life lost and cancer survival are also cause for concern. On the contrary, the country achieves green results in subjects such as electronic prescription, access to a health line 24 hours a day (Health Line 24, 808 24 24 24), reduction of deaths from stroke and stroke, cataract surgery, Kidney transplants and vaccination.

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On the other hand, the Health Consumer Powerhouse highlights that the best results are found in countries with health systems based on social insurance - Portugal has a public service financed essentially by taxes.

Romana Borja-Santos

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