419. Which way forward for the Order of Dentists?

Portugal remains in the XXI century, without defining a strategic policy in the context of oral health. Governments continue to simply ignore the importance of oral health for the well-being of people and many hundreds of thousands of children and young people remain without any prospect of having access to oral health consultations in good time. Our country continues to discriminate against the citizens' access to oral health care, violating any principles of human dignity, not respecting international conventions it has signed, including the Charter of the Rights of the Child.

Currently, Portugal, oral health is only accessible to the privileged social classes, including the bourgeoisie, allied to political power and economic force, the overwhelming majority of the working class, pensioners, retirees and dependents are manifestly unable to gain access to oral health by SNS (National Health Service), which offers no answers to the needs of the population.

We all know that there is lack of economic resources, the problem lies solely in the bad government we have today, heavy and overly bureaucratic and administrative, stealing billions of euros annually from our taxes to support jobs that simply do not produce anything for the country, all this money should revert to the pressing needs of the population and the state should dramatically reduce many cabinets full of unproductive people who are useless to a country that wants to be modern and developed, persists while the current model of public administration.

It's completely false the idea that it is extremely costly to create a national network of oral health care in all health centers in the country, this mercantilist conception of health has no pertinence, because health can not be bought or sold. We all know that oral health prevention can save a fortune endless financial resources in the medium and long term, so that any investment made today will quickly be amortized in the future, augmented by huge gains in health improvement.

In this regard, the crucial position of the Order of Dentists; it should have to choose between the option of continuing to let everything be as it is or if you really want to contribute towards radically changing the policies followed by oral health in Portugal.

The choice is simple: to continue being a country where only the privileged have access to oral health, given that only have the private profit interests and see oral health as a business (doing nothing to prevent and combat oral diseases In order to guarantee themselves a niche market in the medium and long term, constituting an obstacle to any improvement in overall oral health of its population and behaving as in most third world countries, where economic interests overlap social interests), or changes its direction and understand oral health as well as an essentially social (not economic), elementary and fundamental to all people, fighting for full integration of oral health in the SNS (National Health Service) and the universality of access to all citizens, without discrimination on the basis of their economic possibilities and striving for a clear and manifest soon prevention of childhood.

Is the Order of Dentists to match the requirements of civil society and population, not to be swayed by the interests of the political regime installed and the economic groups, the first only interested in hunting to vote and to be perpetuated in power and only the second win in money in return for public health?

418. Involution of oral health in the National Health Service

Oral Health is arguably a decisive element in the general welfare of the people and the attitude of compartmentalization, which involves a view of the mouth in the non-holistic or integrated, is the cause of negative and sometimes permanent changes in the overall health of individuals, thus In their quality of life.

Oral diseases are the most common chronic diseases. Moreover the current Portuguese Constitution states:

Article 64. º Health

1. Everyone has the right to health protection and the duty to defend and promote.

2. The right to health protection is achieved:

a) through a national health service and general and universal, taking into account the economic and social conditions of citizens require;

b) the creation of economic, social, cultural and environmental conditions that guarantee, inter alia, the protection of children, youth and old age, and the systematic improvement of living conditions and working as well as the promotion of physical culture and sports in schools and popular, and for the development of health education for the people and practices of healthy living.

3. To ensure the right to health protection, primary duty to the State:

a) ensure access for all citizens, regardless of their economic circumstances, care of preventive medicine, curative and rehabilitative;

b) ensure a rational and efficient coverage of the whole country in human resources and health facilities;

c) to guide its work for the socialization of the costs of medical care and medicines;

d) to regulate and supervise the business and private forms of medicine, linking them to the national health service, to ensure, in the institutions of public and private health, adequate standards of efficiency and quality;

e) to regulate and control the production, distribution, sale and use of chemical, biological and pharmaceutical products and other methods of treatment and diagnosis;

f) establish policies for preventing and treating drug addiction.

4. The national health service is decentralized and participatory management.

Thus, regardless of what the Constitution calls for the country as we saw in relation to other areas of Health, the State generally better or worse, has been met, but now with regard to the area of oral health, may said that there was a regression in relation to what existed before April 25, 1974. To date, the New State contained in the ranks of the former Provident Fund offices of Dental Medicine, where they were practiced at least some basic treatments.

But after April 25, although in the new Health Centres then created, some of them want United States aid, both from Sweden and Norway, contained offices of Dental Medicine, which gradually came to be dismantled, not giving the opportunity to new dentists in abundance that started coming out of colleges, would eventually be integrated into the SNS, just like the other clinical areas of health, to provide functionality to such offices, providing access to oral health care to the general Portuguese population, which is the same as bald as the fundamental law of the country so determines.

Knowing the state Oral Health of individuals produces significant effects on their quality of life and that some aspects of oral pathology has implications:

Not only Physics,

- How Psychic,

- And turn Social.

Consider:

a) Some studies have shown that a child affected by caries at 3 years of age have on average less than one kilogram of a child without caries;

b) The occurrence of infection and pain can change their eating habits and sleep disturbances (irritability);

c) The estimated number of hours lost from school for reasons related to oral health is 117 000 per 100,000 children;

d) These impacts daily activities are not limited to the individual, also end up affecting your family;

e) Thus also the society in general.

We also know that the whole cascade of problems associated with oral diseases are not limited to younger age groups may be even more significant in the elderly, who experience rates of edentulism (missing teeth), which ranges from 30 to 70% as communities, treatment practices and the availability of rehabilitation (technical and budget). It will be noted that the dietary choices of elderly individuals are often compromised and thus may cause significant nutritional deficits.

One of the aims of the Primary Health Care is the reduction of social inequalities among individuals, especially in relation to health, will therefore be necessary to increase the attention on Oral Health Care, for accessibility to such care can translate into valid results and staff for the General Health of individuals. However, the lack of Oral Health Professionals (Doctors and dentists Dentist) in the overwhelming majority of the Portuguese Health Centres and the limitations of Oral Hygienists in the treatment of some diseases of the oral cavity have led to one of the lowest rates of dental treatment Europe, a fact perfectly compatible with policies for the budgeting of the Portuguese Ministry of Health Oral Health of 0.0035% of the total budget.

In contrast to the previously mentioned:

- Some studies have classified as oral treatments rooms most expensive of all treatments;

- Many developed countries spend between 50-10% of its budget for Public Health Oral Health. As examples, in some Spanish provinces, the rate of oral treatment in children and adolescents over 80%.

In our country, by order No. 153/2005, 5 January, which set the objectives of the National Oral Health Promotion (PNPSO) reducing the incidence and prevalence of oral diseases in children and young people, improving the skills and behavior about oral health and promoting equity in the provision of oral health care to children and youth with special health needs, was underway by 2007, a School Oral Health Program, in which dentists or dentists, received per patient € 75, they had many or few treatments to do, ie, the state appealed, and appeals to the excess supply / demand and a competitive way, to make oral health, on top of the current agreement with OMD (the Medical dentists), which I think is not the correct path, as many times as it takes into disrepute by encouraging the neglect and poor professionalism on the part of many professionals who get caught in the flurry of others that go every year for a multitude of Colleges (7), given the present needs of the country, without regulatory frameworks in fact, whether existing medical associations, unions, or more recently the Regulators, are forced to participate in these campaigns opportunistic Ministry of Health, the Conventions and even the insurance companies, each with its own rules and tables obsolete and limiting, in a true chaos of service offerings and economicíssimo maladjusted to reality.

More recently, from 2008, with the order No. .4324/2008, 19 February, was given the extension of the PNPSO two other groups deemed particularly vulnerable (pregnant women and elderly people in need) and developing an intervention strategy oriented to the provision of oral health care to a much larger number of children and youth. So PNPSO, now covers:

1 - Pregnant women followed in the SNS - Sum of assigned dental checks (maximum 3) can not exceed 120 € (the execution of the treatments can be completed within 60 days after delivery);

2 - Beneficiaries of the solidarity supplement for older users of the SNS - Sum of assigned dental checks (maximum 2) may not exceed 80 € per year;

3 - Children and Youth under the age of 16 years - Sum of assigned dental checks (maximum 2) may not exceed 80 € per year.

For the purposes of Removable Prosthodontics, there is a financial contribution to 75% of expenditure for the purchase and repair of removable dentures for up to € 250 per period of 3 years.

Conclusion:

From everything stated above and given the disclosure of data to check the current OMD, the Sun newspaper on 13/11/2009, the number of users of the SNS has benefited from 305,382 to date, so here is concludes that although the Portuguese population is of a few million (Portugal, including Azores and Madeira an estimated population of 10,529,255 people - INE estimate of the December 31, 2004, representing a population density of 114 persons per square kilometer ) the number of users above treated under the SNS National Programme for the Promotion of Oral Health (PNPSO) is negligible if not ridiculous, and this program does not comply with what is recommended in the fundamental law of the country, since the point of view of oral health, citizens are being treated in a preventive, curative and rehabilitative, equally universal and tend to free.

Clínica Dento-Médica - Dr. Sílvio Ribeiro, Ldª.

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SNS - National Health Service in Portugal

417. Audit says dental checks discriminate patients in defiance of the law

Were announced in 2007 as the first step in providing the population oral health care - so far lacking in National Health Service but the Court of Auditors (CT) believes that dental checks issued by the previous Socialist government for children, youth , pregnant and elderly low-income violate the principles of universal and equitable access to health care.

The audit now published on the National Oral Health states that were not covered all children and young people of school children from three to 16 years, nor those attending public schools, with no explicit legal basis. And he makes the recommendation to Health Minister Ana Jorge, to ensure the legality, extending this service to all users.

Between 2006 and 2008 - the year the program was done under contracts with dental practices - the TC indicates that 95% of the school population has not benefited from the program, which shows a lack of efficiency and universality. Until they were provided 15 million and were used only 11.7 million euros.

This is just one of several repairs left by CT. The audit says the funding is not clear nor transparent (because it is divided by three institutions) and stresses that only two Regional Health Administrations have programs for quality assessment. The audit concludes that even in the face of not conducting periodic inspection or verification of establishments and clinical audits of care provided, there are risks associated with passenger safety and confirmation of care paid by check.

The TC raises doubts about the price paid for each treatment - which was negotiated with the Order of Dentists, but not based on any study - and makes a broad set of recommendations. From the choice of healthy foods in schools with measures that discourage the free sale and products harmful to oral health in the vicinity.

On the issue of universality, the Ministry responded to the progressive nature of the program, taking into account the existing budget, and the choice of a population more vulnerable to kick-start initiative. As the proposed measures for schools, states, several contradictory points outside the competences of that Ministry.

Rute Araújo
iOnline

* * *

Truly disturbing the findings of the Court of Auditors, in addition to any irregularities and disregard for the equal treatment of all citizens (even worse when done by the state), is deeply regrettable that the program annually reaches only one in every twenty children.

Translating in other words, this oral health program implemented by the governments of the Socialist Party will not reach all children within 20 years, that if anyone born in Portugal in two decades, and assuming that some of the existing children have access to the program since then having completed 30 years of age.

416. Institutional advertising: 'Always Smiling' costs 385 000 €

The Directorate General of Health (DGS) spent 384,933 euros on the campaign 'Always Smiling'. The 11 contracts, which include production of a video and pay television advertising time to, were all made on the basis of direct negotiations, ie without recourse to contest. The acquisition of the design services of an advertising spot, alluding to good oral hygiene practices within the National Programme for the Promotion of Oral Health, was hired for Utopia Filmes and cost the coffers of DGS 35 892 euros.

By issuance of this branding campaign in May, the DGS has paid 29,098 euros to RTP, 37,326 euros to SIC, 53,604 euros to TVI and 9144 euros to ZON - SIC Notícias. In September, the video where kids talk about their dental checks, again appeared on several television channels. By this time, the DGS has paid over 49,524 euros to RTP, 54 539 euros to SIC and 58 581 euros to TVI. The lead time on all contracts was 21 days.

Beyond the advertisement was still contracted to the company Look Concepts creative design services for brochures, on three occasions. In total 57 260 euros was paid for about one million of tryptic informative.

On day 12 the Portuguese Court of Auditors criticized the funding model of the Oral Health Programme, which in his opinion has not been structured in a transparent manner.

Correio da Manhã

* * *

This action disclosure of a program already fallen into disrepute and contrary to the principle of equity in the provision of oral health care is absolutely disgraceful and unacceptable in any civilized country. How can the Directorate General of Health sizes promote waste resources by allocating funds to RTP is a public company, already supported by public funds or private media?

This is purely criminal acts by withdrawing funds that were to be fully spent on medical care, severely hindering so unspeakable, the scarce resources allocated for oral health in the National Health Service (SNS) to the overwhelming majority of its population.

Instead of investing for example by granting funds to schools and giving an oral health card to each child and teenager in the country, the Directorate General of Health, with the connivance of the Ministry of Health and the passive role of the Order of Dentists, proclaims a discredited program of oral health in jeopardy by the Court Portuguese, filling the pockets of money to some media colluded with the current political regime and robbing the expectation of access to oral health of many hundreds of thousands of children and adolescents country.

415. Statistic 2009

414. SPAIN: Examples of investment in oral health

The Dentibús reached Albacete, offering free dental checkups for the entire population - Closer to the population, educate and raise awareness about the oral care and prevention of oral diseases. This is the objective pursued by another year the coach of oral health in the Plaza del Altozano of Albacete, a project organized by the Official Board of Dentistry and Stomatology in collaboration with College of Dentists of Albacete.

This bus will serve as the roving dental office. Since last Monday, the team of dentists that is Dentibús makes revisions to all free people who come to the square of Altozano. The dental bus will remain parked until next Wednesday and will move through the municipalities of the province to reach as many people as possible will Hellín Thursday and Friday at La Roda. The bus is equipped with the materials needed for screening and diagnosis of various oral health problems facing the population.

Dental experts offer information to the general public about preventing common oral diseases. This project is part of a national campaign for oral health disease prevention, this time the bus has traveled throughout the Levant and this stage ends with a visit to Albacete.

Dentibús coordinator in our province, María Rosa López, says that in just one day can get to meet about 75 people, exceeding a hundred in the weekend periods. The revisions are designed to perform all the general population, while according to the dental team working on this project pays particular attention to correcting the habits acquired by children as well as to educate on the need for good hygiene daily. Gonzalo Hidalgo, Albacete Dentibús dentist explains that primarily serve prosthetic problems, periodontal and common conditions such as cavities.

Laverdade.es

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Spanish dentists and dentists give the Mayor of Murcia Award - Mayor, Miguel Ángel Cámara, you will receive prize tonight Oral Health Promotion, which has been granted by the General Council of Colleges of Dentistry and Stomatology of Spain. The event, held in Madrid, will be attended by some 200 people and is chaired by the prime minister, Manuel Alfonso Villa Vigil, and will also be attended by the President of the College of Dentistry and Stomatology of Murcia, Oscar Castro.

The oral health program for children and the agreement for preferential treatment for older people with limited resources launched by the city of Murcia are two programs that have received the recognition of Spanish dentists. For over 15 years and through the School Health Program, children 6 to 12 years the town go to the municipal offices of Beautiful Plaza to make their revisions and fluoride application, and are referred to appropriate services when they require other care. More recently, in 2005, launched another program to offer a preferred oral care to the elderly, through the municipal social services. Through this initiative, pensioners who need prostheses, can use this service if their cost exceeds the benefit provided free health care system.

Teleprensa.es

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Problems are always resolved when there is a will. Shall apply in Spain are good examples in the prevention of oral health and local political leaders are aware.

In Portugal still had much to do in the area of prevention, both for oral health professionals but also by the mayors and central government.

It is urgent that we can all give our best so that we can radically change the face and dramatic and tragic current landscape of the oral health of its population.

413. President of the Dental Association wants to negotiate with SNS table contributions to road users in private

The re-elected today president of the College of Dental Association (OMD), Orlando Monteiro da Silva, has promised to negotiate with government reimbursement for a table that users of the National Health Service (SNS) may resort to private dental clinics.

In comments to Lusa news agency, Orlando Monteiro da Silva found that the National Health Service (SNS) has not been able to meet the needs of oral health among the Portuguese and he defended the need to create a system of reimbursement of medical acts by the state along the private.

We are interested in negotiating a schedule of repayments of some acts of dentistry on the SNS in private clinics, he said.

EPA
* * *

Oral Health gives congratulations to the reelection of Orlando Monteiro and wishes him a highly skilful work during his mandate at the helm of the Order of Dentists.

The coming years will be of immense work in the area of oral health in our country; oral health can not continue to be marginalized by the SNS and is only available to the privileged and ruling classes, accomplices of the state apparatus and party installed in power in Portugal.

Is an urgent need to extend access to oral health care to all portuguese, without any discrimination on grounds of social class or income, because, after all, we are all Portuguese, who pay the taxes for the training of dentists.

412. Saturday dentists choose new president

About 6500 dentists choose a new president Saturday after a campaign marked by the difference in positions in relation to dentist-check, but with common features such as integration of these professionals in public services.

Orlando Monteiro da Silva, now president of the College of Dental Association (OMD) and a candidate for a fourth term, it is proposed to continue the important issues that are under negotiation with the Government. In comments to Lusa news agency, Orlando Monteiro da Silva stated that it is negotiating the extension of the dentist-check program, the negotiation of the reimbursement mechanism for consultations and the inclusion of dentistry in occupational medicine and dentists in hospitals and health centers.

The rival candidate, Fernando Guerra, told Lusa that the B List advocates measures that make a difference: We are key points to check the re-integration of dentistry and dentists, the amount of any national program of oral health. We also present a set of proposals that tend to balance dentistry and this involves the integration of dental practitioners in school health teams, the creation of a national emergency in the delivery of oral health and a health bulletin to newborns and all children in kindergartens, kindergarten and elementary education, explained Fernando Guerra.

Orlando Monteiro da Silva has already said he has two major concerns for this mandate: the integration of young people and dentists in order to enter the dental societies. The candidate noted that the last three years have passed from 5300 to about 7200 dentists, whereas it is necessary to sensitize public opinion and colleges to tailor the number of graduates every year out of college to real needs. Many young doctors are forced to emigrate because they have no place in Portugal, he stressed.

This is also a concern of Fernando Guerra, whereas there is a high number of entries in the courses of dentistry. There is a surplus of professionals and it is essential that OMD has replied to this by creating measures such as the creation of new specialties, defended Lusa. Fernando Guerra to be held a joint work with institutions of higher learning to be possible to reduce the number of entries and increase the places graduate of giving access to expertise that can and must create order.

Another proposal involves the List A registration in the register, without charge, the dental societies. We think this is an additional formula to have an increased control over what goes on in these societies, many of which require mainly young dentists the less dignified conditions in terms of professional practice, justified.

For the candidate list B is a set of measures necessary for the maintenance and viability of clinics and medical offices. We present concrete proposals to ease the problems of dentists and this has been the motto of our campaign, marking where the difference in the positions that the Dental Association has taken and with which we do not identify stressed Fernando Guerra.

Sol

411. Non-Governmental Organization - World Smiling

Mundo a Sorrir(http://www.mundoasorrir.org/)* * *

The NGO - Mundo a Sorrir (the World Smiling) comes in July 2005 to work in the health field, particularly in the area of Oral Health, with the main objective of causing the welfare of poor communities, excluded and marginalized. Taking the information and basic care for Oral Health to become a universal right and accessible to all individuals regardless of their economic position, cultural and social.

The World's Smiling, aims to be an organization that provides effective support and practical action and that their help is really felt close to the communities who most feel the wants and needs. Through specific projects and supported the NGO - the World Smiling, intends to set an example that can help improve the outlook for Oral Health in Portugal and the World.

Disclose, collate and exemplify what can be done differently to do better.

410. Check-dentist dominates campaign to Order

The dental checks threaten to dominate the struggle for leadership of the Order of Dentists. The current president calls the measure tooth and nail, but the opposition accused it of undermining the professional dignity.

Elections are scheduled for next December 12, but the debate has already begun to heat up a few weeks ago. Apart from proposals for each of the lists - which match up some points - he settled the controversy surrounding the National Program of Oral Health and especially the dental checks.

Instituted by the Ministry of Health for eight months, dental checks offer basic dental care for children, elderly and pregnant women in private clinics that adhere to the initiative and receive, for each query, the fixed value of 40 euros. Driven by the current president and candidate for reelection Orlando Monteiro da Silva, the program violates the dignity of the profession guarantees the opponent Fernando Guerra.

The candidate list B denounces a way, a model and an inconceivable period of operation, which does not contribute to the defense of the oral health of the population covered. With the amounts involved, there are treatments that are needed from outside, ensures Fernando Guerra, who argues that the check-dentist should not have a predefined value. There should be a different table for each treatment, he says, advocating for change of name of the measure for reimbursement of medical and dental instrument.
Fernando Guerra also accuses the current management of the OMD to go along with political power, to have been a major driver for the dissemination of dental checks. A measure that guarantees against the dignity of professionals, playing with surplus manpower in the market and reveals late payments at around five months. For the candidate, the Dental Association (OMD) has to be upstream of these programs, draw them and not limited to collude with them.

Orlando Monteiro da Silva, the list ahead of the elections, rejects the accusations of the opposition. The proposed overhaul of the program presented by the list B would equal the end of dental checks, ensures the current president. Why go back to the logic of a public health program: we must distinguish between the liberal practice of the profession and adherence to a voluntary program with agreed rules and they have to meet.

List A denies five months late in payments to dentists who have joined. There are delays, up to three months in some cases, but many of them stem from errors in billing for the professionals themselves. As for the treatments, Orlando Monteiro da Silva recalled that it was a social program, which involves the provision of basic treatments, as elected by a scientific priorities. It is not collude with power, guarantees, since it also criticizes what's wrong. And the facts belie the claims: there are over 3200 medical associates, nearly 350 000 people and covered 43 million euros allocated to the program.

Jornal de Notícias