Contributors / Country - Institutions
Prof. M. Carevic (moderator) / School of Dentistry - University
of Belgrade Serbia
Dr. K. Louloudiadis / Greece
Dr.M.
Durickovic / Montenegro
Dr. N. Markovic / Faculty of Dentistry University of Sarajevo Bosnia and Herzegovina
Dr. B. Getova / Dom Zdravlja ,Zdravlje / FYROM
Title
Primary Dental Health Care in Balkan Countires
Summary
Prof.
M. Carevic / School
of Dentistry - University of Belgrade Serbia
PRIMERY DENTAL HEALTH CARE
IN SERBIA
Recent
transformation of health care systems in most Balkan countries (especially in
those undergoing transition) has almost completely excluded dentistry from
primary health care system and left it within very expensive private practice
oriented dentistry. As we have experienced so far in Serbia, dental private
practitioners have very little interest in dealing with prevention of oral
diseases. Their interest is mainly focused on treatment of the diseases which
is more profitable. To avoid total absence of primary oral health care from the
National health care system, at the beginning of 2009, the National program for
prevention of oral diseases in population of Serbia was introduced. The program
was supported by the National health insurance as a part of finances directed
for primary health care, targeting risk populations groups - pregnant women,
handicaps and children up to 18 years old. Looking at the present data it is
evident that oral health in Serbia
is generally better then ten years ago. There is significant caries reduction
primarily in schoolchildren (especially in 12 years old) but on the other hand
slight increase of caries prevalence was recorded in pre-schoolchildren
(especially children with baby bottle caries). The obtained data suggests that
National program as essential part of primary oral health care has to be more
convincing and encouraging, easy to approach all parts of society, individuals
and population groups in order to give its full contribution to oral health
improvement. In those terms, dental
professionals as well, has to shift their orientation based simply on diseases treatment
to the idea of oral health prevention and to take active part in oral health
promotion and so contribute to oral health
improvement in population of Serbia.
Dr.
K. Louloudiadis / Greece
Primary oral health
in Greece
In Greece the
primary oral health is delivered by the National Health System
(NHS) in persons age 0 to 18 and by the private practitioners in all
ages.Data from the latest national epidemiological study (2004) shows a
significant reduction of caries prevalence in schoolchildren 5-12 years
old. The data indicate a trend for continuous reduction of caries.
Unfortunately we don't have the same results of caries reduction in adult
population. As far as periodontal disease concern, the prevalence is high in
adult population but the demand fro treatment is low. Low demand for dental
services on served in all age groups, especially in groups of people that
belong to lower socioeconomic classes. Finally, the data shows a low level of
regular visits to dentist for prophylaxis and treatment, ;ow to medium level of
oral hygiene and that the annual fluoride toothpaste consumption is the lowest
among the E.U. countries.
Dr.M.
Durickovic / Montenegro
ORGANIZATION OF THE PRIMARY DENTAL HEALTH
CARE IN MONTENEGRO
The aim of this work is the representing of
the Primary Dental Health Care in Montenegro.
The Primary Health Care has been accomplished over the Institution of the
Health Centers.On that level the bearers on the health is the chosen doctor and
the chosen dentist. The chosen dentist works independently and he isn't in the
System of the Health
Center's Organization.
Therefore, Primary Dental Health Care has
been realized over system of The Privat Dental Clinic which have the concluded
contract with the "Fondation for the
Health Insurance" of Montenegro.These offices give the free of coast dental
services to the insureds at the age from 0-18 and the ones over 65.The
population group of 18-65 years of life pays all the dental services at the
market price, except the urgent interventions.
The
free of cost dental services have been regulated by the "Fondation for the
Health Insurance".
The dental health care politics is mainly
directed to the therapeutic procedure. National and population's preventive
programmes do not exist as well as the promotion of the oral health.The
health-educational work is brought down to minimum. The strategies for the
high-risky patients do not exist, as well as the application of the preventive
activites on the adults.
In the past years, Montenegro has
been aming to the promotion of the preventive measures and raising the
consciousness level of the population considering the importance of
health.Unfortunately, the aspect of oral health is unjustified neglected.
That is why it is necessary to reorganizate
the system of the Primary Dental Health Care with special accent on the
preventive and profilactic measures, by the promotion of oral health and
raising the health consciousness on the individual and social level.
Dr.
N. Markovic / Faculty of Dentistry University of Sarajevo Bosnia and Herzegovina
Primary dental health care in Federation of Bosnia and Herzegovina
Primary oral
health care in Federation of Bosnia and Herzegovina is organized through
public health services and private practice. Accessibility to insurance-funded
oral health care differs between cantons as administrative units. Private
practices as well as public in some regions are not obligated by the law to
provide regular dental care at least for children. Data that illustrate
existing differences in dental workforce (dental professionals/ population
ratio) in regions of BH are available and will be presented and discussed as
well as indicators of oral health status of the population. There are probably numerous reasons for poor
oral health condition in the population, but most importantly, the difference
is due to absence of oral disease prevention and oral health promotion programs
in BH which are standard in most developed European countries. Limiting factors
include fragmented health care system in Bosnia and Herzegovina, and
curative rather than preventive approach to health care. In most cantons, the
responsibility for dental care of children had been given to general dentists.
Some studies indicate that our dentists know the basic principles of preventive
dental care, but are not giving it sufficient attention in general treatment of
their patients. Bosnian national oral health goal should be development and
implementation of a disease prevention programs, based on education of population
and dental practitioners as well. It is necessary to improve access to dental
care and shift focus from curative to preventive procedures. Realistic goals
for improvement of oral health should be set, that can be implemented within
desired time frame, as well as to precisely define measures to be taken.
Dr.
B. Getova / Dom Zdravlja ,Zdravlje / FYROM
NATIONAL STRATEGY FOR PREVENTION OF ORAL DISEASES IN CHILDREN FROM 0 TO 14 YEARS OF AGE IN THE FYROM
Introduction - In year 2005 in FYROM appeared crucial
changes in health system. Primary, and later the secondary dental activity
became private, but pediatric and preventive dentistry remained in the frames
of the state. Current situation and bad oral health of the population, intrude
the necessity of preparing national strategy for prevention of oral diseases.
Methods
- General analysis of:
professional stuff, supply in the state dental offices and figure of children
aged 0-14 placed in 8 regions, have been done. Paedodontics, calibrated in
advance according to the criterions of WHO, did epidemic researches on random
group of kids aged 6, 8 and 12, to estimate the situation of oral health, with
special emphasis on DMFT, CPITN and prevalence of orthodontic anomalies.
Results - Gained results ( 6 years old children
without caries - 20.3%, DMFT of 12 years old 6.88, orthodontic anomalies among
kids at 6 - 28.17%, among kids at 12 - 48% and CPITN - gingival haemorrhage in
5 sextants ) and analysis of factors which contribute to this condition,
intrude the necessity certain actions to be accomplished for building a
National strategy for prevention of oral diseases among children aged 0-14. All
of these, as a unique opportunity for improving the current condition and
approaching the standards for oral health recommended by WHO. In November 2007,
with act number 6448/1, the Government of FYROM approved the National strategy,
which comprised 5 preventive measures
(sealing fissures and cavities, systemathic and topical
fluorine prophylaxis, education and motivation, reduction of sugar intake,
mechanical and chemical control of dental plaque) and it was implemented on
01-01-2008 year, across the whole country.
Conclusion - Consistent implementation of the
national strategy will create educated, high-motivated population with
preserved oral health and better quality
of life.
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