700. Check-dentist: what it is, how it works and who has the right

Created in 2009, the National Oral Health Promotion Program began by covering children and young people up to the age of 16 who attend public schools or private social solidarity institutions (IPSS). Subsequently, it was extended to pregnant women, the elderly, people infected with HIV, children and young people of 7, 10 and 13 years of age with special health needs.
In 2018 an electronic oral health report will be made available, a measure included in the Simplex + program. This document will be made available on the SNS portal. From then on, dental checks will also be issued digitally, arriving to the users by sms or e-mail. The number of checks that each group of beneficiaries is entitled to is defined by the Ministry of Health. The purpose of this measure is to avoid the loss of checks and to increase the use of checks.

Who can benefit from dental checks?
- Children up to 6 years of age in a situation considered to be serious, taking into account criteria such as pain and degree of infection in temporary teeth, a dentist's check may be assigned per year;

- Children attending public schools or IPSS (private institutions of social solidarity): at 7 and 10 years of age they are entitled to 2 dental checks, for an equal number of consultations. At the age of 13, 3 consultations are planned. The first check is provided through the school and the following by the dentist. To young people with 15 years of age who have been beneficiaries of the PNPSO and following their treatment plan at the age of 13, a dental check may be awarded per school year;
- Children and young people of 7, 10 and 13 years of age with special health needs, such as those with mental illness, cerebral palsy, trisomy 21, among others, who have not yet been covered by PNPSO;

- Young people of 18 years, provided they have been beneficiaries of PNPSO and concluded the treatment plan at the age of 16;- From the age of 65, those who receive the solidarity supplement for the elderly benefit from 2 annual checks to treat the teeth;- Pregnant women in the National Health Service receive 3 consultations, which can occur up to 60 days after delivery. They will be assigned by the family doctor;-In the case of HIV patients, the program provides for 6 checks. The first is assigned by the family doctor and the rest by the dentist. Checks also cover HIV patients who have already been covered by PNPSO and have not been receiving treatment for more than 24 months;- High-risk patients (eg those who have had tumors, smokers and heavy drinkers) or suspected mouth injuries are entitled to two annual diagnostic checks of € 15 each and, if necessary, another two for the biopsy (each check for 50 euros). The process of assigning the check is triggered by the family doctor;

Where can you use it?
Check-dentist can be used in any dentist doctor, in private dental clinics or clinics. They do not have any restrictions regarding the area of residence of the user, and can be used anywhere in mainland Portugal. Consult the list of participating dentists on the General Health Directorate page.
The scope of use of check-dentist provides for the promotion of oral health, prevention and treatment of oral diseases. In the use of the dental check, for each beneficiary group and in the scope of treatment, there is a set of specific acts of their own. In particular, in the case of children, the program only covers the treatment of definitive teeth, except in the dental check for children under seven years.

Jornal Económico   

699. The importance of dental medicine in the National Health Service (SNS)

Since the 1980s, when I finished my degree in Dentistry, I hear about the importance of having dentists to provide oral health care at the National Health Service (SNS in portuguese). By that time, all those who had just finished their dental school were immediately working. All! Those who were very good students, the average and even the less skilled. We could all get to work. And all, or almost all, in the private exercise of the profession.But this abundance of work and the ease with which we settled in the professional world did not prevent the first leaders of the Professional Association of Dental Practitioners (APMD) from striking to see the political power of the time how important it was to entry of dentists into the public health service so that they could, broadly speaking, have access to oral health care. From the first moment that the maximum leaders of the APMD, in that time led by Professor Doctor João Carvalho, did everything to obtain this objective. It should be noted from the above that it was not because we had difficulty working, but because we could not be indifferent to the fact that a large percentage of the population, much more than today, does not have the economic capacity to access the offices and to private clinics.

A question of justice, enshrined in the Constitution of the Portuguese Republic: The right to health protection is carried out through a universal and general national health service and, taking into account the economic and social conditions of the citizens, is free. Guarantee the access of all citizens, regardless of their economic condition, to the care of preventive medicine, curative and rehabilitation.Unfortunately, since its inception, dental medicine has been excluded from the National Health Service. It was therefore quite natural that since 1991, when the APMD was created, this issue was part of the concerns, struggles and negotiations with the guardianship It's been over 25 years. It was not because of lack of commitment or lack of will of dental practitioners and their leaders that, with the exception of a few cases scattered throughout the Continent and the reality of Madeira and the Azores, oral health remained outside the public service.

It was because the politicians, the decision makers at this level, never wanted to take the step forward and always preferred to postpone the decision, making use of a wide variety of excuses to do so. I want to emphasize, as it is true and for justice, that all the staff members, secretaries-general and leaders of the APMD and the OMD have always defended and always beat each other to change this state of affairs. Only the political class, first, did not listen to us and then, when it began to hear us, was postponing the resolution of the problem.
And so it was in January 2016 when the Secretary of State Assistant and Health, Professor Fernando Araújo, announced the intention of his Government to create the conditions for dental medicine to enter the SNS. To this end, he proposed to dialogue with the OMD, in order to reach the much desired presence of dentists in the SNS.

The solution proposed by the Government in April last year did not meet our demands, as is well known. For this reason, it unanimously decided that the Governing Board of the OMD did not sign with the Government the protocol that defined the conditions of the 2016 pilot project and that led to the entry of 13 colleagues in other health centers to provide primary oral health. However, by not having signed the protocol, the Board of Directors of the OMD also wanted to keep the doors open for dialogue so as to be heard and to contribute to improving the conditions of care provided, should the Government decide, as it happened, to extend the pilot project, after the first year.Would another position be responsible? Could we seriously sulk and closed this door that had just opened? Even if it did not open as we all wanted? Indeed, some improvements have been achieved from the first to this second model of oral health care delivery in health centers: the contracts to be established are preferably from one to two years, from 13 health centers to more than 50, the geographical area it is no longer just Lisbon, Tagus Valley and Alentejo to cover the North, Center and South of the country, the salaries of the dentist and dental assistant are improved, etc. ...

We are all aware that the present conditions are not yet desirable and that there is much more to do. Nobody could expect that, after more than 25 years without anything very relevant having happened, immediately, in a year or two, if all the conditions we desired for the professional practice of dental medicine within the NHS were reached.
The recent decision of the Government to form a working group, which aims to create the conditions to reach the dental medicine career in the SNS, should concentrate our efforts in a serious and responsible way, continue to beat us for such important desiderato . I would remind you that the electoral program with which the current OMD board has presented itself to elections, this point, referring to the public service in the SNS, is one of the priorities.

It is really important to ensure that, even for the most disadvantaged and the poorest, there may be, within the NHS, dental clinics where primary oral health care is provided. We know that this process will take time to bear fruit. Let us not create false expectations. We want to hear all the social bodies of the OMD. We count on the collaboration of all the dentists; we will want to hear the whole class in a public consultation on this matter.

Portuguese dentists are needed, with a dignified career, in the National Health Service. The Portuguese population deserves, and needs, that this happens.
Dr. Pedro Pires, Vice-Chairman of the Board of Directors of OMD
O JornalDentistry