Every year, between 500 and 600 dentists are trained on average in Portugal. But for those who leave college, the options are basically two: private medicine or emigration. Oral health is still a very limited public service reality. About 20 dentists work in health centers. That is, one for every half million users. For
the first time a government has assumed that this is a priority and by
the end of the year they have started pilot experiments with dentists in
primary health care. The proposal of the Order of Dentists was delivered yesterday to the Ministry of Health.
Of the 20
dentists working for the National Health Service (SNS in portuguese), the majority are
in the Lisbon and Tagus Valley region, six in the cluster of health
centers in the north, two in the center and one in the Algarve. The pilot project is designed to meet the needs of an economically disadvantaged and chronically ill population. But
in the future, what is wanted is that these basic care, such as
derangement, devitalization, extraction of teeth or prostheses, can
reach all by the public service.
This is what a large part of the population needs and which are the most sought after care. We welcome the initiative of the Government, which to be realized is a huge advance in the access to basic oral health care. It
will meet the requirements of the SNS in the equity of access, says to
the Orlando Orlando Monteiro da Silva, canon of the dentists. So
far, a portion of the population - pregnant women, children and young
people, elderly people with solidarity and HIV patients - have had
access to these care through the dental check, which is important to
maintain, as it has had considerable health gains, Says the baston. Last year, 545,000 dental checks were issued and 413,000 were used. In March, the project will be extended to 18-year-olds. In
an interview with DN Henrique Botelho, coordinator of the Reform for
Primary Health Care, explained that this is a project that will
continue.
The World Health Organization recommends one doctor dentists for every 2500 inhabitants. Portugal
more than meets the eye, but only in the private sector, where there
are more than five thousand clinics: one dentist for every 1236
inhabitants. The country has 8500 dentists
registered in the Order and another 1200 are working out of the country,
mainly in England (59%) and France (12%). But does the offer translate into care? More than 50% of the population does not have access to basic care. An
important part can not afford them and health insurance that guarantees
this specialty is expensive, he says, considering there must be a
dentist doctor by health center and in the larger ones more than a
professional.
Since its inception the SNS has never had oral health care. First there were not many professionals, then it was a political option, possibly it was thought that it was not fundamental. There is the realization that it is a specialty that is not cheap, that you need financial resources to equip the spaces. It is regrettable that there is equipment in primary health care that has never been used, he regrets.
For
Rui Nogueira, president of the association of family physicians, having
dentists in health centers should be a top priority, suggesting two
ways of doing this: one is dentists in the health centers, the other is
conventions with the offices And ensure direct access. We have to ask ourselves if this is an easy service to install and maintain? A convention system can guarantee a faster response and with less costs. In the more peripheral and isolated health centers we could have the service. The two solutions can work together. The doctor also says that it would be essential to have oral hygienists in all health centers.
Another priority, says
Orlando Monteiro da Silva, are dentists in public hospitals to team with
the stomatologists, a specialty that has 167 professionals working in
the SNS. More than 80% are over 50 years old. It is necessary to think in the long term in mixed teams if we want to give a multidisciplinary coverage. We
need to have teams in hospitals to treat trauma, operated patients,
hemophiliacs, deep patients who need anesthesia for dental treatments,
oral cancer, he says.
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