1.4 / DISEASE CONTROL PROGRAMME
1.4.1.e / Non-Communicable Diseases control: Oral Health services management improvement project(as of March 2008)
A / Focal Point / D.D.G./MS
B / Implementing Agencies / D.D.G. (D.S)
Respective Regional Dental Surgeons
C / Target Areas & Beneficiaries / Pre school children and school children
Ante natal mothers
Hospital Dental Service and population in general.
Young adults in high Fluoride area
Adults at age of 35 years or more
Project Summary:
The Oral Health Services Management Improvement Project aims to improve efficiency of the oral health care delivery system through the provision of promotive, preventive, curative and rehabilitative services of high quality, so that the entire population will achieve high level of oral health.
The following activities are implemented by Central Ministry of Health and Provincial Ministries of Health with the assistance of local and international agencies:-
- Oral health promotion of pre natal and post natal mothers, parents of pre-school children targeting the child population
- Screening of children at 1 ½ years and 3 years to identify those with high risk of dental caries and start early interventions
- Promotive and Preventive programmes directed towards improvement of Oral Health of the school-going population.
- Provision of latest developments in Dentistry in the field of Restorative Dentistry to people who cannot afford its high cost in the private sector.
- Improvement of curative dental services in the country by updating equipment and technologies in hospitals and expanding Dental Specialist Services up to Base Hospitals.
- Dental Services made accessible to remote areas in the country.
- Alleviate sufferings of youth affected by dental fluorosis in high fluoride areas.
- Reduce the disease burden caused by oral cancer.
1. Justification:
The demand for health care is high, while budgets are limited. Therefore emerging strategies and programmes of health care provision need to be pro-poor, efficient and equitable. At present oral health care provision should be viewed in such a scenario. The state sector oral health care system has the responsibility in ensuring good oral health care of the population.
Promotion of oral health, reducing the disease burden by preventing oral diseases and provision of comprehensive oral health care to people is primary goal of oral health care system. However its failure needs sophisticated dental treatment such as composite fillings, root canal treatment, crowns ad bridges and dental implants which could be catastrophically costly. Hence, the attempts should be made to reduce the disease load to a level which can be managed by the treatment programme.
Interventions for dental caries and periodontal disease have to start from the formative years of teeth and childhood as early as 1 ½ years. Local literature reveals that maximum movement of early childhood caries to be seen in the first 3 years of age. School children up to the age of 13 years are being taken care of mainly by the School Dental Therapists. There are only a few Adolescent School Dental Clinics in the country manned by Dental Surgeons to care for the Adolescent children. Hence the urgent need is to establish more Adolescent clinics. The National Oral Health Survey 2002/2003 revealed that the DMFT (Decayed, Missing or Filled Teeth) for 12 year olds is 0.9 which we must try to bring down further or least maintain at tat level.
The equipment in most Government Dental Clinics is mostly outdated and we cannot expect a satisfactory service unless they are replaced with modern ones gradually.
The problem of Fluorosis is affecting a considerable number of young adults in the North-Western, North-Central and Southern Provinces who cannot afford treatment for their ailment. The establishment of Fluoride treatment centres in these areas and separate interventional machinery possibly integrated for other sectoral approaches to a timely need.
The working condition of the existing school dental Clinics managed by School Dental Therapists need much improvement
2. Important Assumptions/Risks/Conditions:
The government shows total commitment in developing oral health care in an equitable manner.
3. Project Objective:
Objective / Indicators / Means of VerificationTo reduce the oral diseases burden to a level which would be manageable with service programme /
- Prevalence and severity indices of common oral diseases
- Surveillance programme and national survey
4. Project Output/Product:
Outputs / Indicators / Means of VerificationChildren at the age of 1 ½ years, 3 years screened for early childhood caries and necessary interventions done /
- % of registered children screened and treated
- Community dental services returns
Children at grade 1,4,7,10 and 12 screened for oral diseases and interventions done /
- % of registered children screened and treated
- dental services returns
Per natal mothers orally healthy and convinced on oral health promotion of their offsprings /
- % of registered mothers treated
- Community dental services returns
Morbidity and mortality due to oral cancer reduced /
- % of reduction of pre-cancer and severe forms of oral morbidity
- Oral cancer surveillance
Quality, accessibility and affordability of dental treatment improved /
- Proportion of extraction to restorations in oral health care delivery system
- Returns
5. Related Projects:
Project No. / Project Title- Cancer control programme
- Mother and child care programme
- School health programme
6. Relevant Agencies to be Coordinated:
Ministry of Health, Provincial Ministries of Health, Faculty of Dental Sciences, University of Peradaniya, Ministry of Education
7. Monitoring & Evaluation:
1. Who? DDG (Dental Services), Regional Dental Surgeons
2. When? Regularly in specified intervals.
3. What actions to be taken based on results of monitoring & evaluation?
Planning for continuous improvement
8. Activities:
Activities / Expected Results / Process Indicators1 / Establishment of a community dental service in a phased out manner / Oral health services for antenatal mothers, pre school children improved / No of MOH areas with community Dental Surgeons
2 / Provide dental equipment and necessary materials to hospitals, school dental clinics and community dental clinics / Quality,acessability and affordability of dental treatment improved / No. Of dental clinic with updated technology
3 / Establishment of advance restorative laboratory and the National Institute for Cosmetic Dentistry, Dental Public Health and Oral Epidemiology at Maharagama / Advance dental treatment made available and national dental public health programme coordinated / Training programmes conducted and no. Of advanced treatments given
4 / Improve the referral system in the school and community dental services / Referral system improved / No. of dental clinics in tertiary care hospitals with facilities to receive referrals
5 / Establish a dental flurosis intervention campaign / Dental flurosis intervention campaign launched / Develop the proposal
Develop material
6 / Establish a programme for prevention and early detection and treatment of oral cancers / Disease burden of oral cancers reduced / No. Of districts in which the surveillance in operation
7 / Promote private-public partnership for advance dental treatment procedures / Improved accessibility for advanced dental treatment to public / Endorse relevant policy changes
Develop operational mechanisms for private and public partnerships