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SOME ASPECTS OF ORAL HEALTH CARE IN LITHUANIA. Baltic meeting Sep . 21– 22, 2012 Palanga , Lithuania. Erminija Guzaitiene Member of the Council of the Lithuanian Dental Chamber. Current situation *. Total POPULATION in Lithuania Children population Dentists Dentist specialists
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SOME ASPECTS OF ORAL HEALTH CARE IN LITHUANIA Baltic meeting Sep. 21–22,2012 Palanga,Lithuania Erminija Guzaitiene Member of the Council of the Lithuanian Dental Chamber
Current situation* • Total POPULATION inLithuania • Childrenpopulation • Dentists • Dentistspecialists • Oralhealthspecialists • Expenditurefororal health • 3.2 mln • 0.689 mln • 2 974 • 629 • 3 193 • 0,21 billion Lt in a year (0,19% of Grossdomesticproduct) ________ *Statistics Lithuania Lithuanian Dental Chamber database Websana. Lietuvos Respublikos odontologų rūmai 2008-2012. 2012, 52 p. CECDO figures, EU & EEA//https://www.cecdo.org/pages/database%20intro.html
Difficultieswitheatingfoodandpain 27% of Lithuanians experienced difficulties with eating food and pain. (EU average 15%)* ________ *Eurobarometer 330. (Oral health, 2010)
Satisfaction of the teeth and dentures’ appearance* • 15% Lithuaniansfelt embarrassed of the appearance of their teeth and dentures.(EU average is 7%). • This heads some interviewers to restriction of their participation in social activities. ________ *Eurobarometer 330. (Oralhealth, 2010)
Eatinghabits* • 22% of Lithuanians who responded to the survey question “how often do they eat biscuits, cakes, cream cakes“ answered “often”. (EU average is 18%) • Citizens in Poland, Hungary, Lithuania, Slovakia, Greece appear to be the most regular eaters of confectionery. ________ *Eurobarometer 330. (Oralhealth, 2010)
Preferedtype of dental facilities* • 74% of Lithuanians prefer to go to dentist’s office orprivate dentists, others – to clinics run by the city, government or university. (EU average is 79%). ________ *Eurobarometer 330. (Oralhealth, 2010)
Prefered type of dental facilities* • Percent of Lithuanians, whoresponded to the surveyhavevisited dentists in the last 12 monthsis 46. Fromthemonly 26% visited state or municipalinstitution. It meansonly 11,96% of population visited clinics run by the city,government or university. ________ *Eurobarometer 330. (Oralhealth, 2010)
The frequency of visitingdentists* • The frequency of visitingdentistofLithuanianswho claimed to have seen a dentist within 12months is 2,1 (EU average– 2,2). • The worse situation is if to explore the reasonfor the last visit among those who claimed tohave visited a dentist within the last year.Only 21% of Lithuanians visited for check-upexamination or treatment (EU average –50%, Netherlands – 79%, UK –72%, Denmark–69%). • Another figure is regarding emergency treatment–24% (EU average –17%, Netherlands, UK –8%)and routine treatment –54%(EU average –33%, NL–13%) ________ *Eurobarometer 330. (Oralhealth, 2010)
Mainreasonwhyrespondentshaven’tconsulted a dentistin the last 2 years* • Their dental problem was not considered to be serious enough. • Having no teeth, or the fact that the respondent had false teeth, the cost of dental consultation and treatment were also frequently mentioned reasons. ________ *Eurobarometer 330. (Oralhealth, 2010)
Targetsfor oral health careshould be: • Improve oral health • Improve access to services • Develop appropriate oral health care • Develop oral health database • Prioritise investments • Involve other stakeholders and health professionals.
Improveoral and general health • The common risk factor approach emphasises the need to tackle the common risk factors and conditions that are shared by chronic non-communicable diseases. • These common risk factors include: • tobacco use • poor diet • stress • alcohol consumption • poorhygiene • injuries • sedentarylifestyle
Improveoral and general health • Targeting these risk factors at a population and individual level would help reduce the incidence of: • obesity • heart disease • stroke • cancers • diabetes • mentalillness • oraldiseases
Action of improvingoral and general health(1/III) • The mosteffectiveandefficientmethod of promotingoralhealthisto integrateoralhealthpromotionwithhealthpromotion. • Commissionoralhealthpromotioninterventionsthat are evidence-basedandevaluated. • Improve the effectiveness of oralhygieneinstructionprovidedbyoralandotherhealthprofessionals.
Action of improvingoral and general health(II/III) • Promote the developmentandadoption of nutritionandhealthyeatingguidelineswhichemphasizereducing the frequency of intake of sugarydrinksandfoods. • Ensureschools, collegesandothersettings are aware of andadoptguidelinesonfirstaidfor dental injuries.
Action of improvingoral and general health(III/III) • Dental teams should routinely enquire about patient’s tobacco use and to give smoking cessation advice. • Regular engagement with General practitioners and dental teams (conferences with General practitioners, courses). • Provide training for dental teams to develop their health promoting knowledge and skills.
Improve access to dental services • 46% of Lithuanian population had seen a dentist over last 12 months. This means need to achieve a 57% (EU average) increase.* • 90% of children should have an oral examination. ________ *Eurobarometer 330. (Oralhealth, 2010)
Action to improve access to dental services (I/II) • Make information about dental services available in a form that is acceptable, accessible and familiar to the public. • Encourage good oral health by making preventive adviceeasily accessible (TV, internet, messages in non-medical environments). • Establish and maintain a single point of contact or dental ‘portal’ by internet. • Review need for specialist services, (e. g. oral surgery, periodontology and endodontology ), and develop services ir regions.
Action to improve access to dental services (II/II) • To tackle the problems: • children and adults with disabilities at home • older people in residential homes • people with mental health problems • Develop appropriate oral health care • The 4th most frequently mentioned reason not visiting dentist or hygienist in the last 2 years was fear(reported 10% of respondents)* ________ *Eurobarometer 330. (Oralhealth, 2010)
Whatwas the mainreasonyoudidnot visit a dentistin the last 2 years? (EU)* ________ *Eurobarometer 330. (Oralhealth, 2010)
Action • Establish and support development of specialist services e. g. sedation, patients with special needs. • Develop anxiety management services to include conscious sedation • Develop sedation services • ???
Actionshould be taken of NationalHealthinsuranceFund: • Prioritise investments to prevention – vouchers for pregnant, kids for free treatment (in the year 2011 the number of births was 34 385). • Invest resources effectively according to needs of population. • Support IT development for dental practices
Action of developingoralhealthdatabase • Undertake regular epidemiological surveys to establish oral health/ health needs of the population and evaluate it. • Collect and monitor need of oral health profesionals. • Review data collected through patient satisfaction surveys.
Action of involvingotherstakeholdersandhealthprofesionals (I/II) • Consider training General Practitioners to undertake examination of the oral mucosaof tobacco users, heavy drinkers and older people. • Encourage and train pharmacists to recognise oral health problems that need referral to dentist or specialist care. • Promote mouth guard wear for sports where risk of toothdamage is high.
Action of involvingotherstakeholdersandhealthprofesionals (II/II) • Consider funded scheme for provision of mouth guards. • Ensure schools, colleges and other settings are aware of andadopt guidelines on first aid for dental injuries. • Use media, TV, internet, social advertisment to promote oral health.
References • CECDO figures, EU & EEA// https://www.cecdo.org/pages/database%20intro.html • Eurobarometer 330. (Oral health February 2010). • Lietuvos Respublikos odontologų rūmai 2008-2012. 2012, 52 p. • Statistical information from Lithuanian Dental Chamber database Websana. • Statistical information from Lithuanian Statistics Department http://www.stat.gov.lt