283. Oral health is a right of all citizens

Press release number 011/08

(CGTP-IN)

* * *

The Government, instead of implementing a policy seriously prevention and treatment of oral health at the Health Center to cover the whole population, expands an existing program, admittedly insufficient to pregnant women and elderly beneficiaries of the Solidarity Supplement for the elderly, representing the latter only about 60 thousand people.

It was published the order number 4324/2008, the Office of the former Health Minister Correia de Campos, to extend the National Oral Health Promotion, to pregnant women followed in the National Health Service and the elderly, recipients of the supplement for the elderly that are users of the SNS (National Health Service in portuguese). The National Program, approved in 2005 set the goal of reducing the incidence and prevalence of oral diseases in children and adolescents, as stated in the order, while providing about 60 thousand children and young curative care is recognized as is inadequate and must be reviewed by the end of 2008.

This finding of the mismatch of the program is not surprising, because it is demonstrative of the failure of policies that do not have this strategic objectives, such as oral health. CGTP-IN complained, over time, that the SNS was equipped dental consultation, as the general population has no access to these consultations, and, although we know that oral health, as recognized in that order, is an important public health problem, since it affects a large population and influence their levels of health, welfare and quality of life.

In Portugal, the situation is a shame in this area and, therefore, are the countries of the European Union where there is more oral health problems, since only those with substantial means or gets into debt, you can go private, given the costs high, both in prevention and treatment. Data from the Directorate General of Health, 2006, and characterize the chaotic situation prevailing in the Health Centers.

In any Continental country, to about 10 million inhabitants, there are only 32 medical specialists: 12 and 20 dentists in dentistry.

As can be seen throughout the Alentejo region there is no single expert and there are sub-health regions, as Braga, Viana do Castelo, Vila Real, Viseu, Leiria, Guarda, Castelo Branco and Santarem, where there is also no expert . In the sub-region of Lisbon, home to hundreds and hundreds of thousands of people, there are only 15 specialists in Health Centers.

The government, faced with this grave situation in the country, rather than implement a serious policy of prevention and treatment of oral health at the Health Center to cover the whole population, expands an existing program, admittedly insufficient to pregnant women and elderly beneficiaries the Solidarity Supplement for the elderly, the latter representing only about 60 thousand people.

And the big question that arises is that the vast majority of the population remains without access to such care in the SNS and has no economic conditions for use of the private sector, which until now accept payments for some benefits to the people he had access. This kind of political charity can not be rejected, oral health is a basic right of all people.

There is a dental check of 120 euros in total for pregnant women and 80 per year for the elderly are covered by minimum social network, to go to private clinics affiliated to the program, which solves the shortcomings. These populist measures at only serve to spend public money when the country needs is that the SNS (National Health Service in portuguese) provides such care to the entire population.

DIF/CGTP-IN Lisboa, 20.02.2008

282. AFID - National Association of Families for the Integration of Disabled Persons

Oral Health in AFID

* * *

Currently, there is a growing public interest in maintaining your oral health in good condition, although there remain limitations with regard to economic conditions, availability of time and few medical resources.

Something has been done, but still much to be done, especially for this type of population. It is essential to continue this work. The training of coaches and parents is for us to be proud of, because all together we can help users with physical disabilities, physical or sensory impairment to have fewer health problems. The users acknowledge that they are removed, or at least minimized the problems of oral health for their quality of living is increasing.

Contacts: Centro Social e de Reabilitação do Zambujal, Quinta do Paraíso, Bairro do Zambujal, 2720-502 Amadora, Portugal, Phone: (00 351) 214 724 040 Fax: (00 351) 214 724 041 E-mail: afid@afid.org.pt

281. Oral Hygiene / Oral Hygienist (Characterization)

Decree Law 261/93 of 24 July and Decree Law 564/99 of 21 December - Activities to promote oral health of individuals and communities for epidemiological methods and actions of health education, provision of individual care aimed at preventing and treating oral diseases.

National Classification of Occupations / 2006 - It may act in promoting oral health of individuals and communities, using epidemiological methods and actions of health education:

-plans, executes and evaluates public health programs, oral;

-participates in education for health in the field of public awareness, provide knowledge on the implementation of oral care, personal hygiene in the prevention of oral diseases;

-running clinical techniques appropriate to the prevention and control of gingivitis, periodontitis and tooth decay, collecting clinical information through the evaluation of the registration of medical history, dental and food of the individual, measurement, evaluation and registration of vital signs, examinations of the head, neck and intra-oral health assessment of periodontal and oral hygiene examination of the dentition and occlusion, results of radiographic intraoral, recognition of emergencies and the implementation of dental impressions to develop models to study;

-executes and evaluates the effectiveness of treatments performed, including removal of the above computation and sub gingival root planing, polishing crowns and amalgams, application of topical fluoride, sealants for fissures and desensitization of hypersensitive teeth;

-perform other clinical tasks, including application and removal of surgical dressings, fillings debortantes detection, manipulation of media, application of the dike and cleaning of dentures, provides information on the implementation of individual oral hygiene.

Sindicato das Ciências e Tecnologias da Saúde

280. Analysis of the National Study of Prevalence of Oral Diseases in 2008 (Part 1)

PREFACE

This is a foreword to the National Study of Prevalence of Oral Diseases 2008 published by the Directorate General of Health Follow up with further comments in due course where there will be a detailed and careful analysis of each of the chapters that make up the study.

A publication by the Directorate General of Health, the National Study of Prevalence of Oral Diseases 2008, by the way, referring to the 2005/06 school year, come be a further document to the appropriate diagnosis and analysis of the health of the Portuguese, in which case regard to oral health.

Praising all the work done by the team that took him out, now it is suggested not to lose momentum, teamwork, persuading it to continue its invaluable work and to deepen the theme, extending it to a larger universe. Being one of the few research as part of oral health carried out at national level, may be suggested to the Directorate General of Health to strengthen the team that put it together and that they may continue their activities, now more favored with the expansion of new technologies for collecting, processing and analysis. It is suggested that the establishment of working partnerships between the team that conducted the study and the various national authorities that may somehow contribute to research in this area, either because they are directly related to oral health, for example the various professional and training entities associated with oral health or other entities independent of the Ministry of Education and that may contribute to the collection and processing of information, either by opening initiatives that allow the input of others, individually or collectively, to solve the problems detected.

Therefore, the National Study of Prevalence of Oral Diseases 2008 is not an end but the beginning of a comprehensive national program to combat oral health problems affecting the population.

Another suggestion is made to the Directorate General of Health is allowing the release of National Study of Prevalence of Oral Diseases 2008 at an address directly on the Internet without the need to necessarily download it from the site of the Directorate General of Health, allowing easier access to its content.

279. DIRECTORATE GENERAL OF HEALTH: Dental caries increased 21% in the last 20 years

Cavities in Portugal increased in young people between six and 15 years. The data are from a national study of the Directorate General of Health that reports of an increase of 21 percentage points over the last 20 years.

Young people between six and 15 years are more careless in the care they should have with their teeth and, therefore, increased tooth decay in our country over the past 20 years to 21 percentage points. The data come from a national study of the Directorate General of Health, which shows the evolution over 20 years of oral health of children and young Portuguese, a document that examines the period between 1986 and 2006.

The study also indicates that with increasing age there are more problems in the gums, as well as greater habit of brushing teeth at least twice a day, but also shows a positive trend in population with healthy teeth. Looking further study and a focus on regions shows that Lisbon and Tagus Valley comes up with the best results, as Madeira and the Azores registered the lowest values. The letter also says that with the contracting of private services also increased the number of people with teeth treated between 2000 and 2006.

In one of the most important part of dental hygiene, like brushing your teeth at least twice a day, the percentage tends to increase with age, rising from 50 percent to six years to 69 percent at age 15.

After revealing all the data the study recommends the implementation of the strategies of the National Oral Health Promotion, "as soon as possible, the lives of children" and prevention to be integrated into health promotion in general. The study of the Directorate General of Health also recommends the establishment of oral health care services accessible to children and young people, and a system for collecting epidemiological information for evaluating the cost-effectiveness of interventions.

RTP

278. Oral health plan leaves 1.7 million to spend

The plan that provides dental care for children from three to 16 years spent only 3.3 of the five million available in 2007. And not even cover the 65 thousand subjects provided. "Regrettable," says the Dental Association.

The National Oral Health Promotion Directorate General of Health (DGS) included 52,771 children and young people last year. Five thousand more than in 2006, but below the 65 thousand down, despite the budget increase. This amounts to an implementation rate of 81%, well below the 92% in 2006.

Despite the "remarkable" gains in the face of health conditions available, the president of Dental Association regrets that the implementation to "inexplicably not be complete. This in a country that has about 1.3 million children and young people in those age groups.

Assuming that you can not reach everyone - not least because many families opt for private - Orlando Monteiro da Silva considers that, at least, the children at health centers should be gradually covered, starting with the youngest. If so how many the children of pregnant women assisted in the National Health Service (65 000/year), will be between three to 16 years, 795 000. "The coverage does not reach 7%. There are children on the waiting list to enter the program and the country gives itself the luxury of not spending the money available."

Orlando Silva attributes the low performance of the shortage of dentists contractually agreed to the program (which involves schools and health centers). They are 1191 dentists in a recruitment process which bureaucracy "hangs" new accessions and the price - 75 euros / year / child - are unworkable.

Says the DGS (Directorate - General Health) that the 52 771 children involved 112 850 queries, ie, an average of 2.3 each. Arguing on the number of cavities treated (there were 150 147 before the intervention medical and dental, going to 34 321 after), to which we must add seals and fillings, we can see that "the number of treatments is much higher than the number of queries" . And, he adds, "the biggest complaint from colleagues is that the most frequent cases are children under ten or more cavities.

For OMD (Dental Association), the solution to improve a program that the former Minister Correia de Campos considered "inadequate" (in order of January in which determined the enlargement to 80 000 children this year) would impose the schedule dental check up for pregnant women and elderly people in need. Dentists are part voluntarily and receive 40 per consultation.

The few children from three to five years covered (4711, when there is in Portugal about a hundred thousand) is another critical Orlando Silva. Why is following them early on that it prevents and prevents tooth decay and meets the program.

Jornal de Notícias

* * *

It is unfortunate that a socialist government almost completely devastates the access of children and adolescents to oral health programs, this is a very serious crime of negligence by the Public Health Ministry, so I would ask all readers of this blog they denounce this attack perpetuated by the government and they deliver their complaints to all the institutions of civil and human rights, both in Portugal and abroad.

The government can not continue to act criminally negligent by placing the health of children and young people at risk for permanent and the rest of their lives, with all the serious physical and psychological problems that result from irreversible, it is time to say enough is enough. Someone can put an end to this barbarity committed by a government of a country that is part of the European Union.

277. São José Hospital: A call from a mother

Helena said ... Reading the comments I regret to inform you that the health care system remains the same or worse than 34 years ago, because I have 2 children one with 6 and another 5 years I have asked family doctors to consult a dentist exactly to prevent cavities and other problems that may exist, the application was made for an appointment to the Hospital of São José in April and I am still waiting for a response - we are in August right?

August 10, 2008 21:44

* * *

Please thank this mother who let their contacts in my e-mail address (tempogero@gmail.com) to myself determine the reasons and answer promptly to your request.

However left the balance of the Oral Health Program for children and adolescents for the year past, is here made its analysis within a few days. At the outset it seems that sin is of the same mistakes that have happened in previous years' programs, ie, the current pace only within 40 / 50 years is that all existing children and youth in Portugal are entitled to a consultation for the above program , that if within that period the birth rate were to be zero in the country.

276. State vs Oral Health: A mess

In the beginning was the PICS: Integrated Care for Oral Health. It was a program of oral health in the community. Implemented in 7 of the 11 municipalities in the district of Castelo Branco, the PICS lasted 6 years and ended in 1997.

Given the good results achieved, the Dental Association (Professional Association of Dentists, the relevant date), just as the Medical Association, concluded with the General Directorate of Health a partnership agreement providing for the contracting professional of his associates that, in their offices, make the necessary treatments to the permanent teeth of children attending public school, discriminated against those of private education. It began so PAMDIA - Program of Dentistry for Children and Adolescents. The treatment of permanent teeth of each child was worth 75 euros.

Came, then the PPSOCA: Program for Promotion of Oral Health in Children and Adolescents, for still and only students in public schools. Dental care of permanent teeth of each child started to cost 75 Euros.

Finally, there is the current PNPSO: National Program for the Promotion of Oral Health. Its first part requires the treatment of temporary teeth (deciduous, milk or deciduous) and permanent teeth of each child or adolescent. Despite the increased workload, increased taxes and the increase of dental materials, all the treatments still worth 75 euros per person treated.

Another component of this PNPSO is the Oral Health of Pregnant. Pregnant women are entitled to the issuance of checks issued in dental health care facilities for the treatments that need be made. However, only pregnant women who are followed in the health centers are entitled to such checks. The other, even if they are followed in the National Health Service, are not entitled to dental check. Discrimination is evident. According to several legal opinions, endorsed also by forensic experts, this is an outrage to the Constitution of the Portuguese Republic. It is therefore an unconstitutional situation wound.

All the dental care of pregnant worth 120 Euros - an amazing recovery for the value of treatment provided to children and adolescents. But there's more: no dental check can be issued if there is no dental care to be undertaken. A scaling (cleaning) does not warrant the issuance of a check, as set out in the circular normative Directorate General of Health. And the first check issued to a pregnant then the Health Center of Olivais and sponsored by the Health Minister has served, according to recipient to make a clean, since there was no need for other treatments. Television showed and gave voice to that user of the Center for Health. The conclusion seems obvious: the rules conveyed by circular normative not be honored.

Finally, watch out about the third part of PNPSO: the issue of dental checks by family physicians in health centers, pensioners who benefit from the Solidarity Supplement for the elderly. Although morally acceptable - are vulnerable members of society - the present situation involves, once again, a trampling on the Constitution, given the explicit discrimination in the rules of the Oral Health Program for the elderly.

With regard to payment of medical and dental instruments, we are witnessing yet another surprise: the processing undertaken in the oral cavity of elderly worth 80 euros per senior per year, without specifying the amount of work is pursued. Thus, the oral health of the elderly, which is worth 80 Euros, worth more than the oral health of the child or adolescent (75 Euros) and unless the oral health of pregnant (120 Euros). No one explained the criteria that led to the allocation of those values. Nor is it explained why the Health Centers Oleiros, Castelo Branco, Covilhã and Belmonte were not allowed to deliver dental checks, if the Minister of Health stated that all health centers in the country could do.

Other situations exist that make up something wrong in the Ministry of Health, as part of Oral Health. The circular establishing the normative PNPSO clearly says that will be handled by professional contractors in the program that users can not treat the institutions of the National Health Service. The Health Minister certainly does not agree with this position that determines PNPSO since it excludes the hypothesis of a citizen to enjoy a medical and dental consultation in the Health Center asks: who should do the Doctors in office at the Health Center? There is also advise that the verification of existing resources, as the Doctors concerned. There is only "about 20" of those professionals working in the National Health Service should be clarified: in 16 health centers of the Azores work 17 Doctors, in Castelo Branco, there are 2 more, the IPO of Porto, 2; in Viseu, 2, plus more of those oral health professionals in Aveiro, Bragança, Hospital S. João, ...

The attachment of the Dentists National Health Service is a real surprise in terms of legal violations, there's the Dental Board Staff, Technicians and Career General in conducting clinics. Within the same career, there are Dental Clinic prohibited from exercising within the National Health Service, with purely administrative functions. There Dentists Resolves contract with a fixed term that are based on the Medical Career Hospital and others that are based on the Career of General Technicians. Both of clinical functions and do the same work schedule. However, they have ordered different. To all these receipts, there was also green.

The conclusions, of course, belong to the reader. Likewise, the anger that can lead to action.

Manuel Nunes

Dentist

Jornal Reconquista

275. Project Area of the 12th year of the School of Tondela

Link: Enter here

* * *

We are a group of project area in the 12th year of the Secondary School of Tondela. We are conducting a project entitled "Oral Health: How to increase pride in our teeth?"