Tuesday, 24 January 2017

670. Dentistry and the National Health Service (SNS)

The degree in Dental Medicine has existed in Portugal since 1976. Its duration was six years, such as the degree in Medicine. The first three years (basic cycle) were superposable to the first three years of the medical course, with the last three (clinical cycle) referring to the study of oral cavity pathology and annexed structures. However, in these last three years the patient was not seen as a whole, being a part of the curricular plan referring to systemic manifestations of oral pathology and vice versa. With this curricular profile, the doctor-dentist would then be a physician who underwent an early differentiation process within medicine.
The statutes of the
Order of Dentists refer that the doctor-dentist is responsible for the study, diagnosis, prevention and treatment of diseases of the teeth, mouth, jaws and attached structures. In this way, dental medicine as an independent profession, as in any other medical specialty, can apply medical-surgical therapy, with autonomy of prescription, the right to issue medical certificates and death certificates and others.
The contribution of dental medicine to the health of the population is not exhausted in the strict field of oral health, nor in practice as a liberal profession. The doctor-dentist should always act as an important agent for the integral promotion of health. The importance of a well-treated mouth that is not the focus of infection and / or inflammation would save millions of euros annually in the treatment of diseases such as cancer, diabetes, kidney disease and cardiovascular disease.
In this way, it is crucial to actively involve dental practitioners and other professionals working in the field of oral health in multidisciplinary teams and in activities to prevent and treat all diseases. It would be an invaluable contribution in promoting the health of populations and in the well-being of patients.
With the evolution of medical-dental science and art, a great challenge arises, at the beginning of the 21st century: to be fit and qualified to intervene in a hospital environment and in any NHS institution (health centers, family health units and others) . In addition, dentists can act in the private clinic, with sometimes high-risk interventions in medically compromised patients, it is not understood that in these 40 years dentistry is practically excluded from the National Health Service. As an example of the hospital area, these professionals could benefit from the support of other specialties in multidisciplinary teams, with undeniable benefits for the National Health Service and patients.
It seems that the political power finally looked closely at the importance of oral health, and there are signs of a political will to take clear and unambiguous steps in this direction. If this is the case, it will be a historical political decision, perhaps one of the most important ones, right after the creation of the National Health Service in 1979.
Well to the Portuguese Association of Hospital Dental Medicine (APMDH), which, with the commitment of its leaders, friends and associates, have been clamoring for this for more than a decade. In fact, the birth of the APMDH came to institutionalize a struggle of its founders initiated in the previous decade. Welcome to the North Regional Nucleus of the Portuguese League Against Cancer NRN-LPCC and its leaders, which, together with the APMDH and its clinical body of volunteers, have already carried out more than 6500 free consultations for the early diagnosis of oral cancer. The current Government wishes to express its willingness to put oral health and dentists in the place of general health and medical science, respectively.
To end a word of hope: that the implementation is properly carried out after listening to the institutions that have evidence in this field ...

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