Status of Prevention of Dental Diseases in Estonia

1. Status of Prevention of Dental Diseases in Estonia Mare Saag

2. From the Guidelines for family doctors and other cooperating health care workers Decree of the Minister oh Social affairs17.01.2010 • Family doctors must check oral health and advise parents to visit the dental clinic at the age of 12, 24 and 36 months • Children should be checked by a dentist concerning oral health as a rule at the age 6,7,9,12,14,and 15 years • School nurses also direct (motivate) children to visit the dentist annually

3. School health services - nurses Work load: 40 hours a week for 600 pupils Duties: .......... Spreading evidence based information about health Advising about diet Cooperating with other health professionals and parents of the children

4. Changes • Up to 2003 all the children belonged to the target group for prevention • 2003-2008 6-12 years old children were covered

5. Budget for oral health care in Estoniain thousands of Euros

6. Number of treatment cases

7. Target groups for prevention of dental diseases Born in- Number of children (1988) 22442) • 1999 12431 • 2002 13091 • 2004 13973 • 2005 14000 2008 No of visits for treatment 403 333 (1,5 visits per child)

8. No of visits for prevention Year No of visits No of children % 2003 151 148 190 480 79,35 2004 148 308 198 780 74,61 2005 115 296 194 980 59,13 2006 116 759 198 730 58,75 2007 115 016 202 860 56,69 2008 113796 201 120 56,58 2011 271 868

9. Budget per child • Prevention 2009 14,51 Eur 2010 actual 14,26 2011 budget 14,49 • Dental treatment (children) 1 case 2009 48,40 2010 46,11 2011 47,81

10. Project based prevention of diseases • Financed by the Estonian Sick Fund or the Ministry of Social Affairs, sometimes by city councils • Budget 6400 – 31640 Eur • 1- year- projects • No permanent general impact on the health care system

11. HistoryProjects 1996-2005 • Seminars, lectures, workshops for kindergarten- andschoolteachers in regions • 3 conferences for dentists on prevention of dental diseases • Methodological books, videos, info-pamphlets and sets oftransparencies for teaching purposes have been prepared. • A special one-month schoolprogram for 2nd classes in preliminary schools hasbeen carried out in 1996-2005(sponsored by Procter Gamble)

12. History Projects 1996-2005 2 • Programme for 4th classes sponsored by Colgate Palmolive • Stickers designed to promote dental health • TV talk shows about dental health • Board game with messages about dental health • In 2000 a preventive program for 5-6 years old children 20 000 children of this age all over Estonia were studied and preventive measures were performed

13. History“Dental passport” 3 • This document was meant for registration of dental health situation and performed treatment and preventive measures for the child.

14. Prevention 2011 • The child’s health development concentrating upon the network around the child to develope good physical and psychological/social life, good environment for playing and studies • Extensive project to promote dental health

15. Dental health in childrenHealth promotion project 2011Contract No 2-21/49 Estonian Sick Fund Estonian Dental Association Estonian Society of Oral Hygienists

16. Budget & content of the project in 2011 Program director Dr. Marek Vink Target group is 3 years old children, their parents, teachers in kindergartens, nurses Total of 31960 Eur including expenses for: • Guidelines in internet for midwifes, nurses of family doctors, health promotion specialists, teachers in kindergartens • Illustrated manual „prevention of dental diseases in children“ for the health professionals

17. 2011 • Poster „Sugar clock“for kindergartens, family doctors praxis, • A smaller interactive teaching aid material with stickers • Coloring book with 24 pages about dental health, also in Russian. Printed books are distributed to the 40 kindergartens participating in the project • Animated drawings in internet • A cartoon „Jänku-Jussi“

18. 2011 • Leaflets for nurses to distribute to the parents of 4,5 months old infant’s parents • Cooperation with the Society of Cardiologists • Establish links to the web-pages perekool.ee/lastehammastetervis; www.toitumine.ee www.ut.ee/tervis/hambad • Courses for nurses (min 30) working with family doctors • Seminars for nurses (min 100) working with family doctors

19. Aim and expected results of the project • Overall aim of the study is to start prevention of dental caries before being infected • In case of turning the project into system it is possible to raise a new caries-free generation • Due to improved oral health all the health indicators of the population will improve leading to decreased expences on health care directly and indirectly. Life quality of the population will change for better.

20. Minimal aim Minimal aim of prevention of dental diseases is to reach the level of DMFT to the recommended by WHO level In West-Europe it means that • at least 80% of children are caries-free • Average DMFT index in 12-year-olds will be less that 1,5

21. More distant aims Oral hygienists and dental nurses participating in this project will provide a network to carry on the project in future As many as possible, teachers and healthcare professionals and officials will be engaged in prevention of dental caries

22. What can you see today ? Cartoons •  http://www.lastekas.ee/index.php?go=web&t=1&id=3902 •  http://www.lastekas.ee/index.php?go=web&t=1&id=3936 •  http://www.lastekas.ee/index.php?go=web&t=1&id=3938