National Prevention Program as a base of the Dental Care Strategy. A.Paeglītis

CDO

Head of Centre of Dentistry and Facial surgery

of Pauls Stradins clinical hospital of University.

The Strategy of Dentistry included in the Strategy of Latvian Health Treatment is adopted and confirmed with the Government resolution on the 24th September 1996.

Dental Care Strategy

National Program consists of 5 blocks:

Information-motivation block

Educational block

Scientific block

Preventative block

Data bank block

Information-motivation block

Competent institution Oral Health Centre

A comprehensive system to educate children and their parents on oral health;

Media involvement – TV, radio, newspapers, magazines, publishing of books, booklets;

Collaboration with various specialists to popularize a healthy life style;

Evaluation of Oral Health and Accessibility of Dental Services for Children Project of Oral Health Centres (OHC)

Current Location of OHCs in Latvia:

Regional - 4– novadu Local - 26

Classes and events in Kinder gardens

The presentation of Scientific research Works for School grade 6 and 7

Different Events

Presentation of Results

Team of Dentalbus Team of Dentalbus North–East Latvia Oral Health CentreNorth–East Latvia Oral Health Centre

Team of Dentalbus Team of Dentalbus North–East Latvia Oral Health CentreNorth–East Latvia Oral Health Centre

Lelles

Drawing competition for school children “Color your

teeth bus !”

Educational Block Competent institution Oral Health

Centre - development of dental hygienist curriculum and

practical training; - development of specialized preventative educational

programs (for children according to their age groups, pregnant women, new mothers);

- organizing courses, lectures in preventative strategy; - collaboration with the AML – Health School, Youth

Health Centre, specialists of the Base Education System (school-board).

Scientific Block Competent institution Oral Health

Centre Usage of the epidemiologic data analysis of the ICS-II project to implement and assess the National Prevention Program;

Regular usage of epidemiologic data to assess efficiency of preventative measures;

Performance of regular epidemiologic research.

1993 2000 2001 2002 2004 2010

5.8

3.93.6 3.5 3.4 3.4

0

1

2

3

4

5

6

KPE pastāvīgiem zobiem 12 gadus veciem bērniem

KPE for 12-year old children in KPE for 12-year old children in north-east Latvia (1999 -2001)north-east Latvia (1999 -2001)

5,75,4

4,7 4,7

3 2,9

2,2 2,3

3,2

0

1

2

3

4

5

6

Valmiera 793

Valka 336

Cēsis 600

Limbaži 448

Gulbene 437

Madona 563

Balvi 335

Alūksne 391

average3903

KPE with KPE with 1212 year old year old childrenchildren

(school year 2004/2005)(school year 2004/2005)

2,24

3,47

1,89

2,632,83

2,27

3,31

2,58

0

0,5

1

1,5

2

2,5

3

3,5

Valmiera

Cēsis

Limbaži

GulbeneMadonaBalvi

Alūksneaverage

Number of children 1546

KPE structure for 12KPE structure for 12 year old, year old, 2007/20082007/2008

0

0,5

1

1,5

2

2,5

3

3,5

4

Kz 1,6 1,71 1,10 1,42 1,08 1,67 1,37 0,96

Ez 0,08 0,05 0,02 0,02 0,03 0,03 0,07 0,09

Pz 1,57 0,86 1,51 1,39 0,74 1,05 0,76 1,37

Latvija* (3,25)

Limbaži (2,61)

Cēsis (2.63)

Madona

(2.83)

Balvi (1.85)

Gulbene

(2.75)

Alūksne

(2.21)

Valka (2.42)

*total number of children 1811; KPE 2.48

KPE + Ki structure for 12KPE + Ki structure for 12 year year old, old, 2007/20082007/2008

0,00

0,50

1,00

1,50

2,00

2,50

3,00

3,50

Kiz 0,11 0,23 0,29 0,10 0,20 0,13 0,70

Kz 1,71 1,10 1,42 1,08 1,67 1,37 0,96

Ez 0,05 0,02 0,02 0,03 0,03 0,07 0,09

Pz 0,86 1,51 1,39 0,74 1,05 0,76 1,37

Limbaži (2,72)

Cēsis (2.87)

Madona (3.13)

Balvi (1.95)

Gulbene (2.96)

Alūksne (2.34)

Valka (3.12)

Number of children 1811; KPE 2.73

CCaaries free forries free for 12 year old 12 year old children (1999 – 2001)children (1999 – 2001)

91,10%

8,90%

CariesCaries free

3133 children examined

CCaries freearies free ((1212 year old children) 2004/2005 year old children) 2004/2005

%number

% 23.51 14.72 32.06 20.96 23.16 26.54 19.23

number 75 24 84 35 63 43 35

Valmiera Cēsis Limbaži Gulbene Madona Balvi Alūksne

Number of children 1546; average % 23.67

Number of caries free children Number of caries free children in 2007/2008 in 2007/2008 ((1212 year old) year old)

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0%

% 25.1 22.0 19.1 34.7 16.7 29.5 25.8

Limbaži Cēsis Madona Balvi Gulbene Alūksne Valka

Number of children 1811; average 24.7 %

Preventative Block Competent institution Centre of

Dentistry Implementation of base and individual programs to ensure preventative and medical service for children and youth from 0-18.

Treatment availability, mobile dentistry.

Preventative Block Competent institution Centre of

Dentistry Regulations No. 1036 ”On Organization and Funding of Health Care”

Classification of manipulation in dentistry

Accesibility for children and disabled persons

Project of mobile dentistry

Mobile dental practice

Kurzeme - Zemgale

Mobile dental practice for physically disabled persons

Mobile dental practice

Data Bank Block Competent institution Centre of

Dentistry Assess efficiency of preventative and medical measures in Latvia, create regular registration of dentistry for particular age groups;

Data collection is carried out by local regional Oral Health Centres (OHC) in collaboration with the State Centre of Dentistry (SCD);

Map development and data analysis is carried out by the OHC, and recommendations are given to the SDC regarding possible program adjustments.

Data Bank of the State centre of Dentistry and Facial surgery

Register of Enterprises

* Minimum Services in Dentistry* Training of Dental Care Staff

Certification of Dentists

Certification of Dental Nurses

Certification of Dental Assistants

Epidemiological Data

Medical Statistics

Health Compulsory Insurance State Agency (HCISA)

Regional Oral Health Centres

Register of Physicians Private Practices

Register of Dentists

Register of Dental Nurses

Register of Dental Assistants

Advantages

Structural changes Successful collaboration with the

Oral Health Centre Stabile State information network

Disadvantages

It is not patient-oriented. It is not service quality, validity and

protection oriented in broader definition.

It is not oriented to dentist protection.

Conclusions

Agree on unified strategic guidelines among the specialists of the Baltic States

Create a new national strategy for dental care, based on unified guidelines, as well as on experience:

Conclusions

Apply positive experience of our neighbours; in Estonia E-medicine, in Lithuania – patient protection, etc.

Propose solutions of availability in Latvia: network of Oral Health Centres, mobile dentistry

Suggestions

Build closer collaboration among the Baltic specialists

Agree on common guidelines Involve Scandinavian specialists-

experts

Suggestions

Enjoy the life!!!

vzc@latnet.lvpaeglitis.vzc@latnet.lv

www.vzc.lv

Basic principles for good dental health care in the future

Dr. Zane BendikaCentre of Dentistry and Facial Surgery Sigulda, 18.08.2011

National prevention programm (elaborated in 1995) as a basis of the Dental Care Strategy 2011-2020

Good care-about the management system for quality and patient safety in health care

Guide issued by the Swedish National Board of Health and Welfare in 2006.

Health care must be

Patient centred Accessible and timely Safe Evidence based Equitable Efficient

Patient centred care

A number of different facts indicates that health care is not always as patient-centred as it should be

The possible reasons for this include the following:

There is a lack of awareness that a patient-centred approach provides a better outcome

Patients interest in treatment process is not always sufficient

What needs to be improwed?

Legislation (Law on the Rights of Patients 1.03.2009)

Freedom of choice The formats for patient participation in health

care need to be developed

What needs to be improved?

Need for indicators and methods that measure individuals’needs and prerequisites

Information provided for the public and communication with patients and the public about the processes and results of health care must be improved

Timely care

Care is offered to patients, without waiting time having an adverse physical, mental or social effect on the patient

Timely care in dentistry

Acute cases

Follow-up assistance

Timely=accessible care

Regional accessibility/mobile dentistry

Financial accessibility

Regional accessibility

Work of the Oral Health Centres Mobile dentistry

Current Location of OHCs in Latvia:

Regional - 4

Local - 26

Mobile dental practice

Financial accessibility

Risk groups:

disabled elderly unemloyed

Safe care

Safe care is fundamental to high-quality health care, in wich the treatments used lead to the expected results, without causing risks or injuries to patients

What needs to be improwed?

Infection control

Radiology

Personal data protection

Evidence based care

Health care is based on systematically gathered, scrutinised, evaluated and compiled scientific knowledge

What needs to be improved?

Recomendations need to be developed within the areas where research is not yet particularly extensive

The production of knowledge should be coordinated in order to avoid duplication of work and contradictions

Monitoring and improvement of medical technologies

Equitable care

Health is not distributed equally and thus a health care system should strive towards equity in health care for the entire population and it should prioritise those with the greatest need. It should also be oriented towards prevention and health promotion

What neds to be improved?

The role of health care in decreasing the disparities in health should be emphasised more

Understanding and knowledge of their connections between social vulnerability and ill health care are very imortant

Equity of care must be monitored and analysed locally, regionally and nationally

Efficient health care

Efficient health care means optimal utilisation of the recources available in order to achieve desired goals. Efficient health care can therefore be said to have a high level of target attainment in relation to the recources utilised

What needs to be improved?

Health services must be oriented to health improvement and prevention

Health care providers need to develop clear incentives to stimulate cooperation and teamwork

Follow-up at individual level, unit level, health care provider level and national level is a prerequisite for analysis of effectiveness and efficiency as a whole

Thank you for your attention!bendika.vzc@latnet.lv

www.vzc.lv