721. Castêlo da Maia Health Unit will have dental care office

A protocol was signed on December 17 between the Municipality of Maia and ARS Norte, which will allow the opening of two dental care offices in Maia, one of them in the Health Unit of Castêlo da Maia.
The integration of dentists in primary health care at the national level and the consequent widening of the scope of the provision of oral health consultations in the SNS deserved the full availability of the Municipality of Maia, which considers it “an area where the fragility of the response of the public health service is notorious ”.
The municipality of Maia assumed the responsibility of providing the stomatology equipment and material, supporting the estimated costs of 90 thousand euros, thus enabling the installation of an Oral Health valence at the Castêlo da Maia Health Center.

Notícias Maia

720. Dentists from the National Health Service (SNS) formed an association

The Portuguese Association of Dentists of Public Services - APOMED-SP is the new autonomous organization, established on December 14.
Dentists José Frias Bulhosa, Manuel Nunes and Ricardo Viveiros Cabral signed the act of constitution of the new association. Provisionally, the headquarters had been installed in the city of Castelo Branco.
APOMED-SP aims to represent all dentists working in Portuguese public services and aims to contribute to the support to the competent entities, in order to plan and implement strategies for various projects in the field of public dentistry, in the Continent and in the Autonomous regions.
The first annual meeting of the new association is scheduled for the end of May 2019, in Matosinhos.
Contact:
apomed.sp@gmail.com

dentalPRO

719. Oral health for children and young people: only 3 out of 10 children

In total, 30.6% of the students covered by the PNSE were targeted for interventions in the area of Body Hygiene / Oral Health, with the Algarve region having the highest percentage (36.6%).
In total, 61.6% of the children who attended preschool and 50.6% of the children who attended the 1st cycle of basic education were targeted in this area, highlighting the Northern region where 74.1%. of Preschool students and 58.7% of 1st cycle students were targeted for Body Hygiene / Oral Health interventions.
Only 5.1% of the students of the PNSE students who attended the Secondary School were targeted in this area, with this percentage being less than 7.0% in any region and particularly low in the Alentejo region (0.4% ).
Gerações mais saudáveis

* * *

The National Health Council, which is part of the Order of Dentists (Orlando Monteiro da Silva), concluded that in the school year 2016/17, only 3 out of 10 children and young people were covered by body hygiene actions (???) and oral health; thus, 7 out of 10 children were excluded from those actions.When tens of millions of euros of Portuguese taxes are spent annually to train dentists, stomatologists and oral hygienists, millions of Portuguese children and young people have no access to oral health.
Shameful? Ridiculous? Bunch of corrupt politicians?

718. Government ensures career creation for dentists in SNS is not forgotten

The Secretary of State for Health, Raquel Duarte, assured this Friday that the creation of a dentist career in the National Health Service (S.N.S.) is not entirely forgotten, but under review. There is a strong commitment to maintain the oral health of the population in the context of the SNS that is not entirely forgotten, but under consideration, said the official, at the official opening of the 27th Congress of the Order of Dentists, in Matosinhos, district from Porto.

Saying not to be unaware of the expectation of these health professionals, Raquel Duarte stressed that the Ministry of Health, which underwent refurbishment, maintains the firm conviction that it is essential to value them. In addition to this issue, the new Secretary of State said that the project to integrate dental medicine in the SNS, expanding the number of health centers with oral health care is to continue and increase.

The placement of dentists in primary health care began with the current government, first through pilot projects that were progressively expanded. We want to expand the number of health centers with dentists so we can have coverage across the country, he explained.
Before the Secretary of State's intervention, the president of the Order of Dentists, Orlando Monteiro da Silva, insisted on the need to move forward with the creation of a career for dentists in the SNS, noting that the process has already been approved by the Ministry of Health, but has been waiting for almost a year for finance. It is fundamental and necessary, in the interest of quality, to create a career in dentistry, as it is a specific profession, he said.

The Order has long claimed an adequate status for these professionals, enshrined in a career. The congress, which began on Thursday and ends on Saturday, has on the table, in addition to socio-professional issues, topics such as implantology, endodontics or periodontology. Simultaneously with the congress is the Expodentária, the largest oral health fair in the Iberian Peninsula, which, in this edition, counts on the presence of 139 exhibitors, distributed by 507 booths.

09.11.2018

Correio da Manhã

  

717. Objectives for the promotion of oral health in primary health care, within the framework of the review of the National Oral Health Promotion Program

1 - Considering the results achieved with the pilot experiments carried out under Order No. 8591-B / 2016, published in the Diário da República, 2nd Series, No. 125, of July 1, 2016, are defined The following objectives for the promotion of oral health in primary health care, within the framework of the revision of the National Program for the Promotion of Oral Health, orienting the strategic action of the National Health Service (S.N.S.) in the oral health area to 2020 to :
(a) Promote equity in oral health care provision by increasing and improving oral health coverage in primary care through the implementation of oral health consultations in all municipalities of the country;
(b) ensure adequate access to oral health responses in primary health care based on referral by the family doctor and the performance of clinically necessary treatments by dentists, excluding strictly aesthetic interventions;
c) Develop an integrated delivery of oral health care in primary health care, fostering the articulation of dentists, general and family doctors, public health doctors, oral hygienists, nutritionists, psychologists. , nurses and other health professionals to promote integration of care in the family health team;
d) To foster the articulation between the oral health team of primary health care with the stomatology services and other hospital specialties, in order to guarantee a simple and effective referral of patients who need hospital care;
e) To develop national, regional and local training activities, according to the needs identified, in order to improve the response to the oral health needs of the population and to make the importance of promoting oral health more visible;
f) To develop actions to promote oral health and prevention of oral cavity diseases, in various contexts, in a continuous manner over time and framed in the promotion of oral health literacy and training, namely through the National School Health Program, the Health Literacy and Care Integration, and the SNS + Proximity initiative;
g) Build partnerships with Municipalities to develop oral health promotion initiatives and projects, with a special focus on primary health care, in line with Local Health Plans;
h) Share good oral health practices implemented by dentists and health professionals working in the oral health field and disseminate experiences and results that translate into effective gains;
(i) promote the proper recording of dentist activity data on primary care in the Oral Health Information System (SISO);
j) Invest in oral health information and knowledge, promoting and encouraging research in Oral Health;
k) Monitor and evaluate the actions developed under the previous paragraphs, using quality indicators that translate into health gains.
2 - The Directorate-General for Health (DGS) shall define the indicators referred to in paragraph k) of the preceding paragraph within 30 days of the entry into force of this Order, including a user satisfaction assessment strand, after Order of Dentists.

3 - The DGS shall review the National Oral Health Promotion Program developing the strategic objectives by 2020 and present it for public discussion within 30 days of the entry into force of this Order.
4 - The Shared Services of the Ministry of Health, EPE (SPMS, EPE), adapt and develop SISO to this policy of oral health care in primary health care, as well as elaborate the Oral Health Bulletin, which should be available on the Health Data Platform (PDS) by December 31, 2018.
5 - The entities of the Ministry of Health and the NHS shall pursue the 2020 objectives defined under the terms of this Order and, in order to promote access and equity in the provision of health care, ensure as concrete objectives that:
a) By the end of the first semester of 2019, at least 30% of the municipalities have at least one dental office;
(b) By the end of 2019, at least 60% of municipalities have at least one dental practice, and at least one such response should exist in all health center groupings;
c) By the end of the first half of 2020, all municipalities have at least one dental practice.
6 - The DGS shall, in conjunction with the other entities referred to in the preceding paragraph, namely with the Regional Health Administrations, the Central Administration of the Health System, IP (ACSS, IP), the SPMS, EPE, and the Order of Dentists, a semiannual evaluation of the implementation of the objectives defined in the terms of this order, which should include recommendations, to be published on the NHS portal and on the entity's website, by September 1 and March 1, respectively.
7 - Costs related to the operationalization and monitoring of this strategy are supported by ACSS, I. P.
8 - This Order shall enter into force on the day following its publication.
September 14, 2018. - The Assistant Secretary of State and Health,

Fernando Manuel Ferreira Araújo.

Despacho n.º 8861-A/2018

716. Immigrant dentists do not want to return to Portugal

About 70% of dentists who work abroad do not intend to return to Portugal, according to data from the Dental Medical Association, which warns that the country forms excess professionals and throws them into precariousness and emigration. According to the Order, one in ten Portuguese dentists is working abroad, a total of 1,500 in 11,000 active professionals.
We are not providing security, remuneration and career conditions. What we are offering in Portugal is a great precariousness for these young dentists. And many of them will go abroad, particularly to countries in Europe, said the staff member, Orlando Monteiro da Silva, in an interview with the Lusa agency.

The vast majority of emigrants who do not even want to return to Portugal indicate that they have better working and living conditions abroad. According to the Employability Study, carried out last year and now published, 60% of dentists working in Portugal work in two or more offices and more than half of those who have been trained for less than a decade work in more than four offices.
The Dental Physicians staff member stresses that working conditions are difficult, especially for younger doctors who work long hours, in several offices at the same time and with large journeys, sometimes within an hour or two of the place of residence. Our younger colleagues, especially those with less than 10 years' experience, have a high level of precariousness, low salaries and no career prospects, and this leads them, in particular, to emigration. It is essential that the society and the candidates of the course of Dental Medicine inform themselves about the conditions of employment that they will find and that they undo this idea that the dental medicine is a profession where it is obtained very well. This is not the case for a long time, says Orlando Monteiro da Silva.

To the Government, the president of the Order of Dentists recommends and calls for the reduction of vacancies in the seven courses of Dental Medicine existing in Portugal. It seems obvious to me that faculties have to rethink their offer so that we will not continue to train people to invite them to practice outside of Portugal, says the staff member, noting that every year between 600 and 700 new graduates in dentistry leave the courses.
He argues that this figure should be progressively reduced, at least 10 to 15 percent per year, rather than postgraduate training. Colleges themselves know that they are training dentists or for unemployment or, perhaps even more serious, for underemployment, precariousness. A dental practitioner, as a still liberal profession, can rarely be considered unemployed. He is in a serious situation of underemployment, comments the canon of the Dentists.
Portugal has one dentist doctor per thousand inhabitants, when international recommendations point to a professional for 1500 to 2000 inhabitants.

PÚBLICO  

715. There are already dental clinics in 55 health centers

At the same time as the dentist check distribution program is being extended, another of the Government's promises, which goes on to integrate dentists into primary health care, is slowly advancing - at the end of last year, 55 health centers of the country, they already had dental clinics available. But the Government's goal is more ambitious: by the end of 2019, it is intended that all groups of health centers (ACES) have at least one dentist, according to announced in March the Assistant Secretary of State and Health, Fernando Araújo. This year, he specified, more than half of the [dentists] who are missing will be placed and the rest will start working at the National Health Service (NHS) in the first half of 2019.

By the end of 2017, there were 24 ACES that had dental consultations, less than half of the country's total clusters, in a project that started in the third quarter of 2016, with pilot experiments in 13 Alentejo and Lisbon health centers and Tagus Valley. Last year, this project was extended and, throughout the country, in December, there were dental consultations in 60 oral health offices of 55 health centers. The regions of Lisbon and Vale do Tejo (26) and North (22) were the ones with the most oral health offices, followed by Centro (six), Alentejo and Algarve (with three offices each).

Project at an embryonic stage - This project, synthesized by Paulo Melo, president of the general council of the Order of Dentists (OMD), is in an embryonic phase. The health centers have a dentist and a dental assistant, who perform basic treatments, such as tooth extractions, derangements and devitalizations, exemplifies. According to the latest Report on Access to Health Care in SNS Establishments, last year 68,910 thousand consultations were made and 51,386 users referred in primary health care. This innovative project, which is read in the document, will continue to be extended, with the opening of more oral health offices, after the renovation of spaces, purchase of equipment and hiring of new teams (dentists and medical assistants dental surgery).

The Order of Dentists is also involved and there are municipalities that pay for the works and purchase of equipment for some health centers, says Paulo Melo, who assumes that it will be necessary to progress gradually until coverage of the entire country is achieved. As a result of the work that has been developed, the epidemiological situation is improving, highlights the OMD leader, Orlando Monteiro da Silva. If a few years ago the percentage of children with caries at six years was more than 70%, now it is around 50%, exemplifies the canon, satisfied that Portugal is close to achieving some of the goals set in the international recommendations.
But the path is far from complete, he says, noting that a measure that is central to accessing dentistry in public hospitals, where some stomatologists currently exist - the creation of a career as a dentist in the SNS recommended by the group study of the situation. There is still a lack of ministerial endorsement, explains Paulo Melo.

PÚBLICO 

 

714. Oral Health Support Center opened in Lisbon

On 23 April, the non-governmental organization Mundo A Sorrir inaugurated the 3rd Oral Health Support Center (CASO) of the country at the Laura Alves Social Center in Lisbon. The project, in partnership with the Lisbon City Council and the Santo António Parish Council, aims to provide medical-dental treatments and psychosocial support to populations in situations of socio-economic vulnerability, with a view to their social reintegration.
The inauguration session was attended by Miguel Pavão, President of the Direction of the Mundo a Sorrir, Vasco Morgado, President of the Parish Council of Santo António, Cláudia Prazeres, Head of Division for Participation and Citizenship and Nuno Veludo, representing the Councilor Ricardo Robles, of the Municipality of Lisbon. The session was also attended by numerous social partners, supporters and voluntary organizations.

The C.A.S.O. project Lisbon will remain the same as the procedures already implemented in other areas, that is, referrals of users will be carried out through the Parish Council of Santo António and the nearest social institutions that wish to become partners in the project. A service will be available for users and also for employees, and the amount payable per consultation will be defined based on the daily capitation amount. By December, the project aims to reach more than 75 people.
The Oral Health Support Center was created in 2009, in partnership with Santa Casa Misericórdia do Porto, and since then it has performed around 25,000 medical-dental treatments and donated 458 prostheses. In 2015, in partnership with the Municipality of Braga, Mundo A Sorrir opened the second Oral Health Support Center in the country, having already performed more than 14,800 treatments. Now, in 2018 Mundo A Sorrir opens from the third Oral Health Support Center this time in Lisbon.

Address | Centro Social Laura Alves - Calçada Moinho de Vento 2, 1150-225 Lisboa 

Mundo A Sorrir 

713. smile... always smile

I would like to explain everything that has happened in the European Court of Human Rights, because a lot of people continue to walk around and enjoy life, at the expense of the taxes I pay today, without being responsible for what directly and indirectly caused me and condemned me to unhappiness forever, with no chance of reversibility; I just wish they were going through exactly what I'm going through today.
I hope that there is justice and that those responsible pay in justice exactly the same suffering that they knew and should have avoided and for which they threw me forever; I do not want and I will refuse any monetary compensation - only and I only want them to be punished in the same proportion of suffering that they have offered me for the rest of my life.
Many professional people should have thought at the right time that I also wanted to be properly accepted in interpersonal terms, to marry and to constitute a family ...

Read and open the following texts

Document 1

Because children and young people do not yet have the psychological capacity for discernment to realize when adults are acting negligently. One day I hope that the authorities will do justice where so many have helped many but have always closed me every door. ALL POSSIBLE HELP WILL ALWAYS BE WELCOME

Document 2

Waiting time has expired for replies that never arrived (1 February 2008). I do not give up, this is something I would never do.I move on to a second phase: translate and organize all the consolidated material (for English / French), in particular all the correspondence I had with the official bodies, both local and central. Subsequently I fill in the necessary forms and I will get them to the right of the European Court.For me and for all the children and young people of Portugal. 

Contact via email to provide any kind of help

alves.saudeoral@gmail.com  

712. The future of oral health in the National Health Service?

The World Health Organization considers that oral health is an essential component of health in general and a high oral health index is a fundamental human right, but the Portuguese National Health Service, when it was created in 1979, left out health oral.
Access to dental care has been provided by dental practitioners in private practices, but obviously for those with economic resources for such, which are less than half the population. Not surprisingly, Portugal has one of the worst situations in terms of oral health compared to other European countries. Last year, the Portuguese Observatory of Health Systems (OPSS) warned that the poorest countries continue to have less use of specialist consultations, particularly in access to oral and mental health and medicines, whose costs are classified as catastrophic expenses for these Portuguese.

Only in 2008 a first step was taken so that users of the National Health Service (SNS in portuguese) could access oral health consultations. The National Program for the Promotion of Oral Health, known as the Dentist's Check, in which the SNS hires adherent professionals, today more than 4000, some treatments for special groups of the population, children and adolescents, pregnant women, people with HIV / AIDS and combat to oral cancer. That is, only a small part of the population benefits from the Dentist's Check.

To extend oral health care to the entire population, several ways are possible: equip health centers and hire dentists to serve the population; extend the Check-Dentist program; to participate in the convention regime (type ADSE) the consultations of the users of the SNS by the State or to combine the previous hypotheses. The current government decided two years ago on the first hypothesis. It was a political option that deserved the applause of the Order of Dentists (OMD). How it would have deserved the same applause if the option had been another. From the perspective of the Order of Dentists and people, what is needed is to promote access for all to quality oral health care. If this is done in the public sector or in partnership with the private sector, it is indifferent. There are good international examples for both options.

In 2016, work was done in some health centers in the south of the country and dentists were hired for a pilot project aimed at providing care to the most vulnerable population. Since 2017, the pilot project has been extended and currently more than 50 health centers in the continent have dentists to serve the population, in appropriate facilities and equipment at the level of what happens in the private sector. The Government wants that by the end of the next year all the Groupings of Health Centers (ACE) have consultations of dental medicine.
In the pilot project, dentists are hired as providers of services, without employment or exclusivity, and for a period of 12 months without entitlement, for example, holiday allowances, Christmas or medical leave. Extending the supply of oral health consultations to all ACEs requires, however, that dentists to practice in the SNS have an appropriate framework, a career in dentistry. To this end, a working group was appointed by the Government which produced a proposal which was approved by the Ministry of Health. A career of its own because dental medicine is a unique profession. It combines the intellectual conception of a work, with the medical, surgical and surgical execution of the same with adequate procedures performed in the patient.

Dental medicine is an autonomous profession throughout the world, with a minimum of five years' training and 5,000 hours of university work directed at the specificity of dental medicine. It is not a specialty of medicine and has its own organization, through the Order of Dentists. In direct contact with the patient, the dentist, within the functional content of the profession, integrates medical and scientific knowledge acquired in the elaboration of the diagnosis and treatment plan with an operative and surgical approach in the patient in order to obtain the final result, prevention, maintenance and obtaining of function and aesthetics.
To this end, the dentist is assisted by a set of diagnostic, radiographic and imaging aids, among others, and a set of essential equipment and devices, dental materials and medicines, as well as the support of the health team oral, in particular dental assistant. The dentist also prescribes medicines and drugs through prescriptions and attests health and illness through medical certificates.

The current model of service delivery of the pilot project is precarious for dentists and dentists, who, without exclusivity, work in other offices and are constantly looking for a job, in search of a situation less precarious than in the SNS. Continuity of patient follow-up will always be at stake. The fact that dentists are not fully integrated makes it very difficult to articulate interdisciplinary teams as they recommend the best health practices, especially for example in the care of patients with cardiovascular diseases and diabetes, the most common in Portugal. There is no professional stability in the model, which undermines the recruitment and motivation of professionals who are subject to constant calls for tender.
To create a career in dentistry is for all these reasons to ensure that oral health consultations will be an integral and indivisible part of the SNS once and for all. The only certainty that there will be no retreat. As far as oral health is concerned, Portugal has wasted almost 40 years to guarantee a constitutional right. The fundamental rights and duties of the Constitution of the Republic of Portugal include that everyone has the right to health protection and the duty to defend and promote it and that, in order to guarantee the right to health protection, it is primarily the responsibility of the State to guarantee access for all citizens , regardless of their economic condition, to the care of preventive, curative and rehabilitative medicine. In oral health this right has been forgotten. 

Today, the investment is done and properly budgeted, dentists are contracted, missing only one last step, the essential co-approval of the career of dental medicine by the Ministry of Finance. We all hope that it will come quickly so that everything is not lost. The Portuguese deserve it.
Bastonary of the Order of Dentists

Orlando Monteiro da Silva

PÚBLICO

 

711. Oral Health Consultations at the National Health Service

Look on the map for the Health Center with the symbol closest to your area of residence. If you are your Health Center, or if you are a Health Center of your Health Centers Group (ACES) or Local Health Unit (ULS), you have access to oral health consultations.
You can make an appointment with your family doctor or, if you do not have a family doctor or the same is not available, another doctor at your health facility and he will give you the orientation for the first oral health consultation.

710. Interview with Miguel Stanley: Oral health is inseparable from general health

Renowned medical dentist is the scientific consultant in the field of dental medicine at Dr. Well's clinics. A conversation about the current moment of dental health in Portugal and the importance of its democratization.
These days, how would you explain the importance of oral health in anyone's life?

I've always had some difficulty understanding why it is that for so many people, the mouth is not part of the body ... I say this in jest because it obviously is. Oral health is indissociable from general health and, moreover, it is inseparable from our happiness and the smile is the maximum expression of it. I believe that the awareness of the Portuguese population about this problem is getting better and, of course, anything that puts people to brush their teeth is good for the population. Obviously in terms of health it is deeply important, but we can not forget the aesthetics, a pleasant smile can change the perception of others about us and can increase self-esteem exponentially, so I am a passionate in this matter.

One of the pillars of his partnership with Dr. Well's, as a scientific consultant in the field of dentistry, is the democratization of access to oral health care. Explain to me a little better what lies behind this concept?

Dr. Well's was born with the goal of democratizing access to quality health services. And knowing that only 5 in 100 Portuguese have the opportunity to put a dental implant, it shows that there are more than we, dentists, could do in the dental medicine industry.

How is the health of the mouth and teeth of the Portuguese?

The health of the mouth of the Portuguese should be seen by segments. I would say the children's is great, because fortunately parents have already learned and are more concerned about washing children's teeth, which is great because future generations will have more oral health. Obviously, the same can not be said of people between the ages of 60 and 100 because they unfortunately lived in an age where there were not many skilled dentists in the country and consequently there are a large percentage of them toothless and unable to afford to even think about rehabilitate your smile. Between these two segments of the population, there is a bit of everything, depending on economic ability and level of education. Obviously you can not generalize because I have experience of well-trained and economically capable people who have had the misfortune of not being well followed by your dentist and have to end up doing very costly and time consuming treatments to regain your smile.

If you were Minister of Health, what are the first steps you would take in the area of oral health in the country?

If I were health minister I would first go around the country to listen to health professionals and technicians, from north to south, to try to understand the difficulties they have. Nonetheless, I think that in terms of dentistry it would put a compulsory school program, a little like what is done in the Nordic countries, and make sure that the population, especially the most deprived, does regular oral hygiene and screening caries and early treatment. I have always found it strange that our taxes are not applied in this aspect of simpler dental medicine and I understand that it is something that should be a right of citizens.

And aesthetic medicine: is it a branch that has definitely entered the day to day of people or is it something reserved only to those who have the means to do so?

Dental medicine is one of the few medical areas that has an absolute 'crossover' between aesthetics and health. I usually say that a beautiful smile is the reflection or mirror of a healthy smile. So the first step to having a beautiful and aesthetic smile is to have it healthy. As such, people can not expect incredible aesthetic results if they do not have the functional and biologically sound part.

Destak