302. APSO - Portuguese association of oral health

Portuguese association of oral health

Headquarters: Faculty of Dentistry

Rua Dr. Manuel Pereira da Silva

4200 Porto,

PORTUGAL

Phone and fax: 351 225 511 139

301. School of Dental Medicine of Lisbon (FMDL)

School of Dental Medicine of Lisbon

Address: Cidade Universitária 1649-003 LISBON - PORTUGAL

Website: http://www.fmd.ul.pt/

(Enter here and see the website translated into English)

Phone: +351 217 922 600

Fax: +351 217 957 905

E-mail: correio@fmd.ul.pt

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The FMDL is responsible for:

-Provide education on the degree in dentistry or other degrees in the sciences of oral health;

-Provide education regarding the Bachelor of Oral and Dental Prosthesis;

-Provide education on the attainment of master's degrees and a doctorate in dentistry;

-Provide the postgraduate education and conduct refresher courses, further training, university extension or others deemed necessary in the fields of dentistry or oral health science;

-Encourage and carry out scientific research within their specialty;

-To contribute to the protection of public health and welfare of the population in the area of oral health;

-Collaborating with institutions, organizations and public or private agencies and other individuals within their jurisdiction.

300. Half of the Portuguese can not afford dentist

Speaking to Lusa, the president of the Dental Association estimates that 50% of the population is unable to pay a consultation dental facilities. Orlando Monteiro da Silva cited a study by the University of Liverpool, with Portugal to present 'the blackest scenario in Europe in oral health care." The order of the Dental Association also wrote a letter to the Minister of Health advocating the exemption of value-added tax of toothpaste containing fluoride, according to a recommendation from the World Health Organization.

"If the Portuguese population to have passed all access to oral health care, the dentists likely did not arrive," he told Lusa Orlando Monteiro da Silva, president of the Dental Association. And it's largely the fact that there is no offer from the National Health Service (SNS in Portuguese language) at the level of dentistry that is also creating a surplus of these professionals in the country. The Order regrets the "lack of manpower planning."

According to the accounts of the Order, half of them do not have access to oral health. "We estimate that about 50 percent of its population is unable to pay even a dental consultation in private. While there are dentists in health centers or delivery systems, people will be excluded from the oral health."

In Portugal, only the autonomous regions have oral health systems to serve users of the SNS, with 19 dentists in the public health system in the Azores and an agreement between the regional health service of Madeira and the private in the public system partially reimburse the cost of users who use private dentists. The Dental Association also wrote to the Minister of Health to apply for exemption or reduction to five per cent of value added tax in toothpaste with fluoride, which takes a critical asset for the promotion of oral health. The Order is also based on a recommendation from the World Health Organization.

A toothpaste with fluoride bought from a supermarket now costs about two euros, and being free of value added tax, could be at 1.60 euros.

For there is a risk that the multinationals that manufacture toothpaste prices rise to compensate for the loss of value added tax, Orlando Monteiro da Silva says that you must take out public engagements with major manufacturers, as well as monitoring of the competition authority.

Esquerda.Net

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Unfortunately the study does not mention is the family of current and former ministers, legislators, political leaders, judges, businessmen and the like are included in the percentage of Portuguese who are unable to have access to medical oral medicine private.

Basically, everything is political, the day they want, all the Portuguese may have equal rights. Until then, we are one country with two different societies, according to social class to which it belongs.

299. Analysis of the National Study of Prevalence of Oral Diseases in 2008 (Part 4)

The introduction of the National Study of Prevalence

of Oral Diseases 2008

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In the introduction to the National Study of Prevalence of Oral Diseases 2008 is referred to "significant reduction in dental caries in Portugal, especially in children and youth." This is directly related to the socio-economic development of Portuguese society, particularly with the changing age structures, the extension of the purchasing power of middle class, the educated population growth and the expansion of health care throughout the country.

However, the study acknowledges that currently "dental caries is highly prevalent and is also a public health problem, with a clear distribution asymmetric" stressing that "changes in behavior require integrated action for health promotion and prevention chronic diseases, among which include oral diseases." It is still curious that analysis, which points to the need for integrated actions in the country, something that unfortunately very little has been done in our country over the past thirty years.

Describes the introduction of the document since 1986 came promotion programs of oral diseases for children and youth, especially in kindergartens and schools, and unfortunately the reality of the past twenty years has shown that these programs were almost always located and covered a small part of childhood and youth, disregarding the overwhelming majority of the needy. Even today you can wait three years for the first consultation in some public health units that offer the valence of stomatology. Therefore, the contribution of these programs under the guidance of the Directorate General of Health or rare little impact resulted in the hard realities on the ground.

But the good wills of the campaigns developed over the past twenty years by the central government services have been primarily guided by the guidelines merely theoretical practices that often never reach the target audience.

When reading the introduction of the study, many questions arise. What percentage of children and young people who were at the national level and between 1987 and 2005, together with the notes of fluoride and the achievement of a rinsing solution of sodium fluoride, carried out fortnightly in school? 5%? 25%? 90%?

What was the number of children at 7 to 13 years, had the application of fissure sealants in permanent molar teeth in the period between 1987 and 2005? What is the evolution of the number of oral hygienists that have been integrated into the National Health Service and the number of children assigned to application of fissure sealants in permanent teeth?

It is easy for the Ministries of Education and Health to publish the numbers, then just divide the universe of the population of those ages and gets to know the true impact of the programs that were developed under the supervision of the Directorate General of Health.

Since 1999 was followed a strategy of contracting dentists and dentists from the private sector for "the treatment of dental caries prevention could not avoid the application of fissure sealants in those same groups, when the Health Center does not had oral hygienists", children 6 to 16 years. What the professionals who adhere to such programs, which provide that service and how a child or young person can be served? It's been 9 years since the beginning of this strategy and is becoming more important to bring this information to all schools in the country and pass the information to those who really need.

Just putting the programs available to the needy is that we can actually win the battle of promoting oral health in our country, hang or hide information shoots to the ground every good intention that you wish. Use it to public television to all this information that often never reach our students, the good will is in the hands of the Directorate-General for Health and the Ministry of Education. Or will we continue as more stone for twenty years?

Link: Estudo Nacional de Prevalência das Doenças Orais

298. IS TOOTH

I hereby suggest the initiative IS TOOTH, thought withdrawal from the development of programs and opportunities-developed in education and training.

Thus, IS TOOTH could self-finance itself through the conduit of the various contributions made to the state by oral health professionals and by channeling funds provided by the current state budget for the prevalence of oral health, to ensure a specialized consultation monthly symbolic value (20 euros) to each child or youth enrolled in public school.

It is proposed that necessarily needs to be crafted and stitched, I find it very positive and to be the way forward in Portugal to overcome the serious problem of current public health that affect a large majority of children and youth of the country.

Leave your comment to this suggestion: it could be a starting point for everyone to sit round the same table and finally understand what is at stake in the health and lives of very large margin of the population, is now in the hands of politicians and professionals oral health unwilling or unable to resolve this problem and give the right to a natural smile to all children and young people.

For me and with the launch of this initiative, within 10 years there would be no children or teenagers with problems of oral health in Portugal.

297. Reports of self-evaluation

Faculty of Dental Medicine, University of Porto

296. They know, is not resolved anything. Why?

The Parliamentary Group of the Left Bloc took the initiative to present to Parliament a draft law No. 154/IX on the 'Integration of the dental Service National Health (SNS)'. This presentation was made under Article 167 of the Portuguese Constitution and Article 131 of the Rules, bringing even the formal requirements of Article 138 of the Rules. The initiative fell to eighth Commission for issuance of their report and opinion that follows. The present bill is scheduled for discussion in general to the plenary on 6 February 2003.

The bill No 154/IX providing for the 'Integration of Dentistry in National Health Service' focusing its scope in the definition of dental technicians and senior health. In considering urgent:

-Extend qualitatively and quantitatively the Oral Health Program for Children and Adolescents;

-Ensure oral health care to poor people, especially elderly people, drug addicts, the disabled, prisoners, migrants and nomads;

-Give special attention to oral health of patients with diseases such as infectious patients, heart disease, hemophiliacs, hemodialysis, rugged area maxillofacial or others with increased risk;

-Establish a strategic program of oral health promotion activities that integrate prevention, early diagnosis, treatment including emergencies and rehabilitation of all the teeth;

-Provide for the continuity of the program through collaborative partnerships in particular with local authorities and the contracting of dentists.

Concludes that it is the duty of the State:

-Ensure, free of charge and under the National Health Service, basic care for oral health;

-Give priority to the monitoring groups particularly vulnerable and at increased risk derived from untreated dental disease;

-Ensure the human and technical resources in the health centers, hospitals and prisons.

For the classification of dental and higher health technicians, establishing criteria for placement and professional services and establishments under the Ministry of Health, Santa Casa da Misericordia of Lisbon and the Ministry of Justice, in proposing the amendment of Decree Law 414/91 of 22 October, in Articles 2 and 9. Proposed in its transitional provisions in its phased implementation, and from the third year of validity applies to all health facilities.

Oral health in general and dental caries in particular has always been understood in Portugal as an important factor for the development of global intervention to the health of the population.

Knowledge of high levels of oral disease but also its high vulnerability to simple preventative measures, affordable and proven effectiveness have led to intervention programs developed under the Community School Health, Child and Adolescent and monitoring of pregnant women . Teachers, coaches for municipalities and charitable organizations have long collaborated with health professionals including primary health care to achieve targets for control of the health problem most common in all age groups of the portuguese population .

The causal risk factors for this health problem are multiple and it is therefore necessary that your fight has always been a multi-profile and multi hopefully. Despite all the preventive strategy, there is still remaining condition for which need to be addressed in particular through dental care.

Although there are human resources in sufficient numbers (doctor or dentist to dentist about 2000 inhabitants, whereas the WHO recommends 1 / 1800 or 1 / 2000), accessibility to medical treatment and rehabilitation has been limited. It is estimated that only 40% of its population have easy access to curative care in private oral health.

In particular we say that 'the socially excluded groups and children with disabilities, not only the decay has a higher prevalence, such as accessibility to preventive services and treatment is low' (Health Gains in Portugal, DGS, March 2002). The problem of accessibility joins as well, another equity when you consider that probably the greatest need are those with greatest impediment economic, cultural or geographic area to use those services that are developed almost entirely in the private sector providing care. The treatments are virtually restricted to those who can pay directly or have health insurance in the oral health.

Additionally, we know that the seven schools of dentistry in the country, formed around 350 young professionals whose job is to target the private sector of care. During 1999, following a national study of prevalence of dental caries, drew up a comprehensive prevention strategy based on three sub-programs:

-The Basic Program of Oral Health, within the activities of School Health;

-Program-Specific Application of sealants, integrating the boards of health centers more Oral Hygienists (62 professionals in March 2002);

-The Intervention Program Medical, Dental, called Program for Promotion of Oral Health in Children and Adolescents, with the contracting of curative care with oral health professionals and for which payment is made according to a capitation system.

This program involved 40 000 children from 6-7 years, 177 health centers and 400 private practitioners on a contract system. Under review published in 2002, the health gains from implementation of the Oral Health Program allow us to be among the countries with moderate prevalence of disease indicators, to 12 years of age (CPO index equal to 2.95) consistent with the recommended by the WHO European Region (DMFT index equal to 3.00).

Observed that the number of professionals is woefully inadequate and that there will be a lot of equipment is certainly not profitable. Not know its state of repair.

In the hospitals of the Service National Health (SNS), it seems that only 30% of them have service dentistry, according to a survey conducted by the informative Dental Association in June 2001. Care is provided in outpatient or emergency department physicians with the specialty of dentistry and enrolled in the Order of Physicians.

We conclude that, despite the good performance of indicators and the gains in oral health, it seems that you will need:

-Strengthening the basic program and collaboration with schools and local authorities;

-Increase the number of oral hygienists in health centers;

-Progressively extend the contract system of oral health care, covering populations other than just the school;

-To promote the systematic epidemiological assessment;

-Making decisions before the existing equipment while minimizing the wastage of use.

Party of Prime Minister José Socrates

295. Dentists want to create the 'dental family'

Dentists have proposed to the Portuguese Minister of Health to establish an ''dental family" to be given to children like the doctor, a proposal that so far has not been accepted, reports as saying.

The proposal was made by two representatives of the Dental Association to join the group analysis of the oral health program, said Paulo Rompante, one of the physicians. The idea is to place a child, when born, a dentist who works as a kind of family doctor for oral health, but without integrating professionals in the health centers. "We are not proposing dentists to health centers. The proposal is for a system of convention", explained Paulo Rompante.

The program of oral health promotion in schools, the doctor points out some flaws and calls for a reorganization of this project, criticisms are accompanied by other clinicians and by the president of the Dental Association. The basic and essential step of this program is to promote the daily brushing at school, which is not being done in most institutions.

"As the program was designed only entitled to access to the other stages of the program, schools that promoted daily brushing. No program works if the brushing is not promoted", commented the expert. The argument advanced by some schools that are unable to promote oral health can not be accepted among dentists.

Portugal Diário

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For the Portuguese know how will the oral health program in Portuguese schools. Simply does not exist in most schools. Ask why the Prime Minister and the Minister of Education.