As part of World Oral Health Day, the Portuguese Dental Association will discuss the need for a “new post-pandemic agenda”. Tomorrow’s debate will be broadcast live on DN and JN. In an interview, Miguel Bavao, president of the Portuguese Dental Association, pointed out some of the necessary reforms in terms of oral health. This is the case for the reformulation of dental examination and the need for effective integration of professionals into the National Health Service (SNS).
What is your picture of oral health in Portugal?
Oral health is something that is permanently put off due to the historical vicissitudes of not being incorporated into the creation of SNS. It was a birth error, which was hardly corrected and reversed. And it was postponed forever, because only in 2008 there was an attempt to implement a project, the examination of the dentist, in which some steps were taken. But there was an ambition for the project to develop and that ended up not happening. At the same time, there have been unstructured and unstrategic attempts to integrate dentists into the SNS. The absurdity of having an ARS happened [administrações regionais de saúde] Those who set up dental clinics and did not have a dental appointment. And then there was a little leap in 2017, with the creation of the Oral Health for All Project, by Minister Adalberto Campos Fernandez and Foreign Minister Fernando Araujo, who was, I say, the one who really embraced the issue and founded but ended up not being able to On completion of the process due to the existence of government reform. With the entry of Minister Marta Temedo, the process froze, and then the epidemic entered, which was always an excuse. If there is a development in the oral health of the Portuguese, it is up to the professionals in the private sector.
Is underinvestment in oral health in social care services creating inequality in access to care?
As of today, according to our barometer data, a significant part of the population still does not visit the dentist and does not make it to dental offices. About 41% of the Portuguese did not visit a dentist in 2021. This means that there is a level of the population largely in line with socio-economic indicators of poverty, which still does not have access to dental clinics. What happens is bipolar access to care. Whoever has the economic capacity invests. On the other hand, we have a segment of the population that does not have this potential due to lack of economic capabilities, cultural level and literacy.
Nearly 2.4 million dental checks are wasted. Should the project be reconsidered?
fully. An important leap has been made [com a criação do cheque], but the fact is that the project did not develop. In fact, he’s back. We cannot forget that after the introduction of the troika there was a decrease in value that was never updated. Dental checkups were lost across the board. There were no audits, there was no ambition in the project, and the Portuguese Dental Association feels, for the time being, completely incapable because it does not have interlocutors, either in the Ministry of Health or in the General Directorate of Health, who say “Let’s work on this file” “. This is one of the weaknesses we mentioned. I submitted a proposal to the Minister of Health, before the fall of the government, to form a working group to think strategically on the different dimensions of oral health. But so far we have not received a response.
The next legislature will be characterized by political stability and PRR money. What should be the priorities in oral health?
One priority is the integration of dentists into the SNS and the reform of primary oral health care, where the establishment of oral health units must also be coordinated. We also have a dental check-up and an oral health program. We have a third dimension that cannot be ignored and that is related to the preparation and planning of professionals related to oral health. We train too many dentists, and we have too few hygienists.
In 10 years, there was a 70% increase in the number of dentists. Do you advocate the reduction of vacancies in universities?
absolutely yes. It is not because we increase the number of dentists that the population gets more oral health care. What is missing are policies that are really programmed to achieve equity in access to medical and dental care. The World Health Organization, in 2021, launched a resolution that will affect until 2030 in an effort where member states can already adapt health professionals for a more preventative intervention. From our point of view there must be a strategic planning and vision of the measures, as we have to reduce the number of vacancies for dentists in the faculties of medicine and dentistry and prepare, so that there is training and qualification for other aspects, such as more community and preventive intervention.
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