585. BRAZIL: authorities shall provide for the oral health of the population

The Smiling Brazil, which is part of the Unified Health System (SUS), is the largest program of free public dental care in the world. Almost 90% of Brazilian cities have some of the 21,700 teams of dentists and technicians in oral health. According to President Dilma Rousseff, the federal government will invest in Smiling Brazil Reais 3.6 billion by 2014. In addition to the dental offices of health posts, the Smiling Brazil also has mobile units, and making joint efforts to bring the treatment of tooth or the making of dentures, dentures, regions where the poorest people live, rural areas and settlements nationwide.

Transcription:

Presenter : Hello, you in all of Brazil, Luciano Seixas I am and I'm here for another Coffee with President Dilma. Good morning, President!
President : Good morning, Luciano! And a good morning to you, the listener, who accompanies us here at the Cafe!
Presenter : President, today I wanted to talk to you about the Smiling Brazil, the program of dental care SUS. The government is expanding the actions of Smiling Brazil, President?

President : Look, Luciano , is yes . The Smiling Brazil is already the largest program of free public dental care in the world. Almost 90 % of Brazilian cities have teams of dentists and oral health technicians in the SUS, Unified Health System Now , we're expanding , you know , Luciano , the partnership with the states and municipalities . We are investing more and more so that people can treat teeth from childhood to adulthood . This means , Luciano prevent cavities , to make a filling or a more specialized service, such as the root canal treatment or gum . By 2014 , we will invest 3.6 billion reais in Brazil Smiling .
Presenter : President , tells us how the population has access to dentists Smiling Brazil . 
President : Look, Luciano , the population is served by dentists , technicians and assistants in dental offices of health posts and also in the 181 mobile clinics serving the population of the poorest and most remote areas of the country . Today , we have 21,700 teams of dentists and oral health technicians in all regions of the country , Luciano , at all . We're changing that sad people who could not go to the dentist because they had no money to pay for treatment history. Last year alone , the Smiling Brazil has more than 150 million dental care across the country . This number will grow even more , because the federal government will systematically buy offices to offer more services in municipalities.

Presenter : Chair, it is a pity that many Brazilians have lost teeth before having access to all these services Smiling Brazil, is not it?
President : It is, Luciano, is yes. But Smiling Brazil has a very important action, which is the placement of dental implants: our known denture, Luciano. These dentures help rescue the self-esteem, provide more quality of life for those Brazilians, because many people are ashamed to talk, to smile, to have trouble getting a job because he lost his teeth. To give you an idea of the importance of government action, about 4.3 million adults in Brazil need some type of dental prosthesis. Therefore, Luciano, we are also investing in the installation of new laboratories prosthesis so that they can produce these dentures in different regions of the country. Today, we have labs in 1,304 Brazilian municipalities. 

Presenter : But president sometimes these people live far from the city center and it is difficult for them to see a dentist .President : To meet these people , we are also investing in mobile clinics , which are equipped with all the equipment of a dental office . These mobile offices can do so much dental work to put these prostheses we referred to earlier . The dentist has to X- ray machine to make a more accurate diagnosis . Today , we have 181 mobile clinics throughout the country , and we will deliver to the states and county over a thousand dental units by the end of 2013 . Another good news , Luciano , is that the federal government is anticipating the transfer of resources to states and municipalities for them to organize task forces and provide care where the extremely poor live in rural areas in the settlements . We want to get people who need dental treatment. We want to save your teeth and when it is no longer possible to place implants.

Presenter : So , President , so the lady had finished speaking, these task forces will return the smile to many people!President : Ah , Luciano , the idea is that one. Next Friday, for example, I'll follow one of these task forces that are happening across the country . I go to Rio Pardo de Minas , Minas up north , to check how is the service to the population . In Rio Pardo , more than half the population lives in rural areas , as occurs in several small towns in Brazil . Then , the mobile clinic will help a lot to take care of the oral health of residents throughout the region . You know, Luciano , treating teeth is dealing with the health of the person , preventing digestive problems , preventing heart problems and even kidney . All Brazilians deserve comprehensive care to their health , so Luciano , we are making Smiling Brazil as one of the main programs of the SUS .Presenter : Chair , unfortunately , we come to the end of today's program. Thanks for this most Café.

Café com a Presidenta

584. SINAS@Saúde.Oral

This area is provided with information regarding the quality assessment on providers of oral health care. The designation Oral Health relates to the intention to include the various types of care available - dentistry, dentistry, dentistry ... - a global and comprehensive area.

Until the emergence of SINAS (national system for health assessment), Oral Health in Portugal, was not subject to any assessment in terms of quality of services: nonexistent to date in our country, systematic and structured work in assessing the quality for Oral health; addition, there was a lack of an aggregator document the indications and clinical guidelines for use in daily practice, despite the existence of technical manuals. Aiming to fill this gap in terms of documentary systematization, a working group dedicated to the production of a system of quality assessment for the area of ​​oral health, which could be integrated in SINAS Project was created.
The group with the collaboration of external elements to the Regulatory Authority for Health (ERS), invited by his experience and recognized merit, trying to cover various areas of clinical and technical expertise from the field of oral health care to the quality, hygiene and safety. It is not intended here to evaluate clinical practice in technical or ethical dimension, but rather to assess the existence and adherence to procedures and requirements leading to better quality of services.

Are subject to review all establishments where providing oral health care, whether private practitioners with dentistry, dental or dental, which are recorded in the ERS and, where applicable, duly Licensed. The data underpinning the assessment are submitted by providers and their sole responsibility. However, are performed by ERS systematic audits, establishments randomly selected, with the aim of verifying on the spot, the consistency of the information submitted.

It is common knowledge that all stakeholders, in accordance with Article 51., No. 1, al. c) of Decree-Law n. º 127/2009 of 27 May, the non-provision of information, and the provision of inaccurate or incomplete by providers of health care information when required by the ERS in the use of its powers, is practice of administrative offense, punishable by the imposition of a fine of € 750 to € 3,740.98 (Single Person) or € 1000 to € 44,891.81 (Individual Collective), pursuant to the first part of al. c) n., article 1. # 51. of the same law.

The Monitoring Committee SINAS@Saúde.Oral, consisting of diverse personalities reference and recognized competence, has been following the development of the project since its inception. The ERS is thus seeking to ensure that all stakeholders are represented, actors and stakeholders in the process.

The Commission shall meet at intervals understood as necessary and appropriate, evaluating the system itself, giving advice and opinions regarding the same. Despite being a non-binding advice, the Commission's work has been an invaluable asset, particularly as guide to the guideline of the project in its global.

Composition of the Monitoring Commission SINAS@Saúde.Oral:

Professor Américo Afonso ( Dentist / Professor Medical Faculty of Dental Medicine, University of Porto / Teacher CESPU - Cooperative Higher Education , Polytechnic and University ) , António Faria ( Dentist ) , Dr. Carlos Falcão ( Dentist ) , Professor Dr. Filomena Salazar ( a dentist / CESPU - Cooperative Higher Education , Polytechnic and University ) , professor Germano Rocha ( Dentist / Faculty of Dental Medicine, Medical University of Porto ) , professor Jaime Portugal ( Dentist / Associate Professor , Faculty of Medical Dental Medicine, University of Lisbon ) , professor José Pedro Figueiredo ( Stomathologist / professor Medical School of Medicine , University of Coimbra ) , Luís Tovim ( Dentist ) , Engineer Manuel Batista ( Civil Engineer ) , Nuno Afonso ( Dentist ) , Professor Patricia Manarte Monteiro ( a dentist / Fernando Pessoa University ) , Professor Paulo Maurício ( Dentist / Higher Institute of Health Sciences Egas Moniz Doctor ) , Professor Pedro Nicolau ( Stomathologist / Faculty of Dental Medicine, Medical University of Coimbra ) , professor Rui Amaral Mendes ( Dentist / Portuguese Catholic University - Borders Regional Centre ) , professor Rui Pinto ( Dentist ) and Dr. Vanda Urzal ( a dentist ).

SINAS@Saúde.Oral 

583. BRAZIL: Public debate on dental plans

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http://www.youtube.com/watch?v=l3jKAJQxMi0

582. The state of dentistry in Portugal (Portuguese language video)

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CopyRight @ MédicosDentistas

581. suggestion: 1 year compulsory internship in the health centers of the National Health Service (SNS)

The president of the College of Dentists, Orlando Monteiro da Silva defended today in Penafiel, the upper forming those health professionals to take back six years, reversing the Bologna recommendations. With Bologna, lost a sixth year, important in terms of clinical experience and integration of dentists in the labor market, he said, told Lusa. For the president, for that matter, there is a growing consensus within the profession and dental faculties.

Orlando Monteiro da Silva criticized the other hand, the fact that Portugal was too nimble to adopt the Bologna declaration, particularly in the area of health and dentistry. Revealing that, soon, in Coimbra, that the professional will discuss the issue with the Secretary of State for Higher Education, the president admitted that this meeting may leave an official document requesting the sixth year. Several European countries are below this line and we can not lag behind in this regard, he recalled.

The president of the College of Dentists in Penafiel spoke on the sidelines of a congress of the scientific society GIRSO, sponsored by the Cooperative Higher Education, Polytechnic and University (CESPU), which brings together dozens of oral health experts from several European countries. In this congress, the president of the organizer, Almeida Dias seized the opening session to defend the extension from five to six years in academic training of dentists. At Lusa, the president admitted that the extension to be replaced by a stage, if well structured and coordinated among all stakeholders, including colleges, hospitals, health centers and private practice of any profession.

The internship or a period of clinical internship can be very helpful, noted Lusa, defending, however, the introduction of clear rules. Orlando Monteiro da Silva noted that the new law of professional bodies, which is under review in Parliament, already provides a stage. I think this is an opportunity to take into account, he said.
The extension of training goes, insisted, build consensus for an activity of health, where the output too early to contact with the profession should be rethought and quality of dentistry and training.

RTP Notícias 

 

580. Health threat in 50 dental clinics false

In Portugal, more than fifty dental laboratories providing services illegally. The Jornal de Notícias (JN) visited some and found a dangerous scenario threat to public health and the right to the image.

Medical devices and prostheses molds with rust, syringes stored in bottles of Coca-Cola, technical whipping the oral cavity without gloves and non sterile objects, cleaners to assist dentists offices operating in private villas, old facilities and decrepit toilets, garbage separation, camcorders (not authorized by the National Commission for Data Protection, confirmed JN) at the door and in the waiting room of the doctor's offices, dental technicians doing odd jobs in offices of dentists and dentists to extract teeth in private homes, prosthetic that anesthetize, pull teeth and remove implants. In two weeks we have traveled the country, making us spend per customer, witnessed unusual situations such as unthinkable for the XXI century.

Even more incredible is that almost all laboratories visited continue to work normally, without fearing inspections, despite the complaint made and published by the Dental Association (OMD) in May, the Inspector - General of Health Activities, Central Administration health System, and Infarmed Ministry of health, entities who sent a long list of laboratories that provide healthcare directly to users, which is not allowed by law.

In Espinho, there is a dental laboratory that without fears, post, in the street, a placard with the hours of service to the public and announces the emergency room, knowing that the intervention in the oral cavity is the sole responsibility of the dentist or dentist and in some cases the dentist.

The reporter JN entered the said premises, waiting in the waiting room by the output of another patient. When his turn came, he told the doctor your medical history: I want an implant removed and replaced with a prosthesis. Make this service? The offering and how much they charge?

To remove the implant, suggest a dentist of our confidence. Everything else we do. We charge 250 euros per tooth, replied, quite naturally, the doctor.

Before that, since the JN had visited another laboratory, the adjoining building. In the waiting room, common to other services on the same floor, we asked if there was that drew teeth and dentures placed. An elderly hastened to answer bluntly: It is here, yes, but this is crush. It's cheaper, but not as good as others in the building next door. This takes more money but has more quality and fame.

Still in Espinho, visited another prosthetist, who tell the same story clinic. The coach, who served us in the waiting room without gloves or a minute needed to make the diagnosis: Go to a dentist to remove the implant and come here to do and put the prosthesis.

In Castro Daire, who visited the lab is a mess. The technician took it, was not lacking in there tool, and even extraction implants would. To this end, he suggested, as almost all prosthetic, a trip to a doctor friend - immediately pulled out a pack of cards, which was right there at hand, with the name (interestingly, both with the same last name) and contact the dentist - and clarified: will there that it extracts and then implant the prosthesis covered here. He is young guy, but he begins to have experience. I also own there will sometimes help. Three hundred euros for a skeletal prosthesis and 1200 euros for five teeth in a fixed prosthesis was as we asked.

In Viseu, in an old building, something scary, the prosthetist assistant, in his absence, ensures that the service provided to patients there is of excellent quality, is skeletal prosthesis, acrylic, or fixed orthodontics. You know, Mr. MC has a lot of experience dealing with the mouth of the patient, explains.

In Valongo, visited the office works in a modest dwelling, with video surveillance at the door. A dental assistant is the cleaner that very diligent, explains JN ever attended any patient there - and have been many guarantees - had reason to complain. If you need to extract a tooth, here comes home every Wednesday afternoon, a dentist, you can do this job. If you prefer to be treated at the Porto, by Mr. FS, he also has an office there, clarified the auxiliary medical action, providing a card with addresses medical.

In Marinha Grande, center integrated oral health - just announced at the door of a dwelling - has a well-known coach in the land, which also has office in Leiria. We have entered in your office, we sat down in the dentist chair and prosthetic saw the mouth of the reporter JN, made ​​the diagnosis, pointed at a pricing of prostheses and gave good news: If you want to remove the implant that has the mouth, to impose a prosthesis made ​​by me, I do it without problems and without costs. As for the prosthesis, if three teeth, stop 160 euros (acrylic) or 340 euros (skeletal).

In Leiria, the clinic visited by JN, whose waiting room has video surveillance - an illegal situation, ensures the CNDP - assumes applying all types of prostheses and fixed and removable appliances. Just do not do tooth extractions and surgeries. Here, we recommend a dentist down the street here, said a technique, a quick conversation, since there someone waiting for you. And when the reporter left the premises JN four seniors entered the building and questioned us about the location of the dentist, who puts prostheses.

The most luxurious of the laboratories visited by JN, operating a modern and imposing building services, is located in Leiria, next to a dentist. In the waiting room, a patient confides to the reporter who was sent there by a doctor in a hospital. Had an operation and left me a plate. Assumed that paid me a new and told to come here, that after they made accounts with this lab, said. When the journalist asks: But it comes only to the mold or is here that you also apply the plate and settle down '. Answer: No, the technicians here do everything. Then, the hospital pays them. In fact, the reporter, minutes later, just to confirm that's right, inside, sitting in a dentist chair. In the presence of a prosthesis, and promised that the observed skeletal apply a prosthesis with three teeth, for 380 euros, and already has the necessary prior removal of an implant. Then you can still make a attention in the price promised.

Here, as in many other laboratories visited by JN, the cards have a space to mark the day and time of the consultation. It is further proof that serve patients, which is illegal, says the president of the OMD which finds no explanation for the fact that some laboratories - in Espinho, for example - announced agreements with health subsystems.

In Matosinhos, the only place visited by JN employees whose speech had a more defensive - a flashy video surveillance system at the door, moreover, leaves soon transpire a certain fear with uninvited guests - the service also illegal, but that the whole neighborhood know there exists, relates to the application of corrective dental appliances to children. When questioned about apply prosthetics, sent, ready for a trusted dentist in Porto, and, as in almost all other laboratories visited were right there to hand a card to offer.

If we find that there is some relationship between illegal or objectionable dentists and prosthetists, we will take all legal steps to denounce and punish offenders, assured, JN, Orlando Monteiro da Silva, who, in the last instance, the case threatens to deliver the prosecutor.

JN - It's cool to a technician directly contact customers dentures ? 
Orlando Monteiro da Silva - The prosthetists are solely responsible for the manufacture of medical devices that are prescribed by dentists . Direct contact with the patient or the placement of the device in the oral cavity may not occur. 
JN - What are the crimes in question ?
Orlando Monteiro da Silva - offenses against physical integrity , usurpation of functions , fraud , among others .
JN - From what we saw in illegal clinics visited , the prices are lower than in legal clinics , with dentists . This apparent increase in illegal provision of health care is a result of the economic crisis ?
Orlando Monteiro da Silva - There is a logic that can be established. But to think that it is cheaper is a mistake . If someone can not practice health acts , because they do not know how it is supposed to do a safe practice , it is not cheap . It is much more expensive . People who suffer with less happy results realize how much more expensive to repair injury and damage resulting possible.

Transcript Article Over 50clínicas provide illegal services, written by journalist Miguel Gonçalves, published in the Journal of Writing Daily News June 24, 2012 (Google automatic translator)

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The statements of the president of OMD are clarificadoras little to solve the problem. After all who is forming the prosthetic? Who were the instructors and national institutions that formed technicians causing bodily harm, usurp functions, scams, etc..? Then yes, President of OMD, should have identified each of these instructors and institutions ...

579. Study to students of Casa Pia were subjects complied with all laws and national and international conventions

The School of Dental Medicine, University of Lisbon (FMDUL) who carried out a study of dental treatment to children from Casa Pia, between 1997 and 2006, argues that it complied with all laws, regulations and conventions, national and international, related with the ethical and protection of human participants.
The statements made ​​by press release, come a day after Secretary of State for Solidarity and Social Security have requested the Attorney General's Office (PGR) to ascertain whether there was any criminal offense in the execution of a protocol that took dental treatment of 507 children from Casa Pia de Lisboa.

Participation, the minister stated that the study in question was the subject of a report by RTP, last May 28th, called As Cobaias and it is said that the substances used in the treatments were very toxic. However, House Study sink as it was called, it was reported by the public on November 14, 2003. Relates to a U.S. study on the use of mercury amalgam, the vulgar leads in dental treatments with 500 children from Casa Pia. From the first day, there was controversy - who rekindled now, thanks to a report issued by RTP1 in late May.

As reported PUBLICO nine years ago, a job that gave right and the headline that stretched four pages inside the issue November 14, 2003, there was the time trial national who could boast of having a budget as large - nine million euros. The Casa Pia Study was, at the time of its release, the most expensive project of the National Institute of Dental Research (NIDCR), one of 27 research centers of the National Institutes of Health U.S..

The study The Casa Pia Study of the Health Effects of Dental Amalgam in Children was done in partnership between FMDUL and the University of Washington, Seattle. Simultaneously, the U.S. ran a parallel study under the responsibility of the New England Research Institute. All materials, including dental amalgam, consisted of commercial materials certified and techniques used in tooth restorations complied with standardized protocols.

The use of dental amalgam was and continues to be advocated by various international bodies. Namely: the World Health Organization, the World Dental Federation, the Food and Drug Administration (a U.S. organization equivalent to Infarmed Portuguese), the Council of European Dentists and the European Commission.

Besides being requested consent to students who participated, The FMDUL also requested authorization to parents and legal guardians and providers both Casa Pia, Luís Rebelo and Catalina Pestana, also gave authorization.

Contrary to what is stated in the report, there were 16 teeth restored per student, but 16 surfaces. The average number of filled teeth per student was between five and six, the statement said. The safety of students and interim results were subject to ongoing monitoring by an independent commission formed by a group of experts in the various areas of interest to the study. This committee had the responsibility and power to stop the experiment.

Between 2005 and 2007 he was made ​​an audit of the ethical and protective of the participants by Office for Human Research Protections, an agency of the U.S. federal government, because of a complaint that included issues addressed in the report. This audit concluded that the complaints were unfounded and the case was closed permanently.

PÚBLICO

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Regardless of violations that may have occurred with the experience mentioned in the news, is extremely unfortunate and shows a complete lack of ethics and immorality see a Secretary of State for Solidarity and Social Security to be worried about a situation that occurred in the past and do an exhaustive audit of existing oral health programs that address less than 10% of the needs of dental and oral health of children and young Portuguese, discriminating the overwhelming majority whom the program should be directed.
The demagoguery and shame should have limits for certain politicians.     

578. ORAL HEALTH IN PORTUGAL: Medical experiments on children from Casa Pia

Medical experiments on
children from Casa Pia

 Rita Marrafa de Carvalho /

Carlos Oliveira / Sara Cravina 

28 Mai, 2012, 23:00