703. Only half of the dentist's checks issued by ARS (Alentejo) were used

A recent study on oral health was presented, which indicates that 45 percent of Portuguese children with six years old have dental caries. A high number at a time when the dental check and the existence of hygienists in hospital are already acquired. The "Diário do Alentejo" wanted to know how our children's mouths went and learned that although there are still problems, the number of children with oral health problems has been decreasing.
In Alentejo, and although we are still not meeting the goals set by the World Health Organization for 2020 (80 per cent of children at 6 years old free of cavities), between 2000 and 2014, the evolution is notorious , 3 percent to 67.4 percent).

In the third National Study of Prevalence of Oral Diseases, which aimed to evaluate the prevalence and needs of dental treatment in Portuguese children and adolescents, with the purpose of outlining strategic programs promoting oral health throughout the country, it was concluded that despite the problems being smaller than in previous years, there is still a large group of children, 12 years old, in our country, with problems (47 percent have dental caries). This number increases in the age group of 18 years, with 67.6 percent of young people with cavities.Delmira Regra, an oral hygienist, oral health manager at the Beja Health Center, in an interview with the "Diário do Alentejo", reports that the oral health service of Ulsba (Local Health Unit of Baixo Alentejo), which has four hygienists for 13 municipalities, has been following some national programs to promote and educate children and young people in public schools in this area of ​​health. At this moment we continue to work with all the directives of the General Directorate of Health and the National Program for the Promotion of Oral Health (PNPSO). Since 2014 we have applied fluorine varnishes in accordance with guideline nº 013/2013 of the Directorate-General for Health (2013), which defines for the biannual application of fluoride varnish in children under the age of seven and who attend the garden -childhood.

The National Program for the Promotion of Oral Health and the Information System for Oral Health are two of these programs. In the first case, the already famous dentist's checks are included. In this regard, from 2009 to this part the government issues this type of checks, intended for school-age children. The first check is assigned at the age of seven, the second at 10, and the third at the age of 13. Each child can be counted on more than one check per school year if his or her situation so requires.
According to data provided by the hygienist, citing the General Directorate of Health, in the Regional Health Administration of Alentejo, almost 3,000 (2 977) checks were issued to children aged seven years. It turns out that only 1 552 were used. In the case of the second check, assigned to the 10 years, 4 144 checks were issued and 1,785 were used, and the third check (13 years) was delivered 3 655 checks and only used 1 648.

The same has happened with the reference for recourse to an oral hygienist. That is, in the 7-year age group, 1,036 children were referred for this type of follow-up, but only 742 presented at the consultation. In the next age group, 10 years, 267 children were selected, but only 162 benefited from the consultation and the treatments. The 13-year-old children, selected for follow-up by an oral hygienist, were 683, but only 379 benefited from the consultation.
For Delmira Regra: as we can see, the utilization rate of the documents that allow treatment and prevention is below expectations, however there is always room for improvement, and we will do our best to reach the goal of 100 percent.  

Still according to data provided by this health professional, the number of children, up to six years old, without dental caries has been increasing from year to year. In 2000, only 30.3 percent were caries-free Alentejo children. In 2002/2006 this number rose to 59.5 percent and in 2013/2014 the percentage was around 67.4 percent. In the latter case, this is higher than the national average, which is 54.4 per cent.
Another encouraging fact has to do with the number of cases of children who at age 12 already showed oral health problems. In 2000, in the Alentejo, 5.49 percent had problems, while the national average was 2.95 percent. In 2005/2006 the number decreased to 1.77 percent, and in 2013/2014 it is around 0.75 percent, below the country average of 1.18 percent and already well below the targets set by the World Organization for 2020, which is 1.5 per cent.

The Oral Health Service of ULSBA has existed since October 1994 and, for this oral hygienist, in public health, the results are not immediate. One must know how to expect and work on promotion and prevention in an innovative way. This is what we have done here, always with the agreement and support of the various health coordinations that have passed through our district.
At the beginning, the work was about stimulating and increasing the interest of our target population with playful educational spaces, such as the Tooth Fair, in 1999 and 2001, where children were invited through the school to participate with posters about this theme. During the week of activity they participated in games, watched small plays. As a reward there was exposed fruit and were invited to take what they liked.

In 2002, with the financial support of the Calouste Gulbenkian Foundation, the Lion Project was started in Aljustrel. The objective of this project was to determine if brushing, when carried out at school with fluoridated paste and supervised by teachers, twice a day would be effective in reducing the incidence of dental caries.This was followed by the project Smile in Motion, which won the Missão Sorriso prize, which aimed to implement good oral health practices among children.At this moment we are working on a play, which has as protagonists the Lidador, emblematic figure of Beja, the Legend of Beja with his monster snake and bull and oral health, which will be presented next year to the children of the 1st. Primary school cycle. On the other hand, we hope to hold next year the Oral Health Days and the importance of peers, which will target parents, teachers, nurses, doctors and oral health professionals.Text Natacha Lemos
Diário do Alentejo

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Unfortunately the public bodies linked to oral health in Alentejo work extremely poorly. In the middle of the XXI century, half of the available dental checks are not used. Some questions are put to the ARS of the Alentejo: why is only half of the checkers used? Where does the money from check - dentists go that is not used? Why are not there campaigns that allow the use of 100% of the checkers?
This situation is neither justified nor contemplated. Problems of incompetence are very easy to solve; just put the right people in the right places and this would not happen in Portugal. Someone has to be held accountable for what is happening.