Oral disease continues to be a serious public health problem in the Philippines. The prevalence of dental caries on permanent teeth has generally remained above 90% throughout the years. About 92.4% of Filipinos have tooth decay (dental caries) and 78% have gum diseases (periodontal diseases) (DOH, NMEDS 1998). Although preventable, these diseases affect almost every Filipino at one point or another in his or her lifetime.

Table 1: Prevalence of the Two Most Common Oral Diseases by Year, Philippines

The oral health status of Filipino children is alarming. The 2006 National Oral Health Survey (Monse B. et al, NOHS 2006) investigated the oral health status of Philippine public elementary school students. It revealed that 97.1% of six-year-old children suffer from tooth decay. More than four out of every five children of this subgroup manifested symptoms of dentinogenic infection. In addition, 78.4% of twelve-year-old children suffer from dental caries and 49.7% of the same age group manifested symptoms of dentinogenic infections. The severity of dental caries, expressed as the average number of decayed teeth indicated for filling/extraction or filled permanent teeth (DMFT) or temporary teeth (dmft), was 8.4 dmft for the six-year-old age group and 2.9 DMFT for the twelve-year-old age group (NOHS 2006).

Table 2 – Dental caries Experience (Mean DMFT/dmft), per age groups, Philippines

Filipinos bear the burden of gum diseases early in their childhood. According to NOHS, 74% of twelve-year-old children suffer from gingivitis. If not treated early, these children become susceptible to irreversible periodontal disease as they enter adolescence and approach adulthood.

In general, tooth decay and gum diseases do not directly cause disability or death. However, these conditions can weaken bodily defenses and serve as portals of entry to other more serious and potentially dangerous systemic diseases and infections. Serious conditions include arthritis, heart disease, endocarditis, gastro-intestinal diseases, and ocular-skin-renal diseases. Aside from physical deformity, these two oral diseases may also cause disturbance of speechsignificant enough to affect work performance, nutrition, social interactions, income, and self-esteem.            Poor oral health poses detrimental effects on school performance and mars success in later life. In fact, children who suffer from poor oral health are 12 times more likely to have restricted-activity days (USGAO 2000). In the Philippines, toothache is a common ailment among schoolchildren, and is the primary cause of absenteeism from school (Araojo 2003, 103-110). Indeed, dental and oral diseases create a silent epidemic, placing a heavy burden on Filipino schoolchildren.

          MISSION:         The state shall ensure quality, affordable, accessible and available oral health care delivery.

          GOAL:               Attainment of improved quality of life through promotion of oral health and quality oral health care.     

OBJECTIVES AND TARGETS:

1.      The prevalence of dental caries is reduce         

Annual Target : 5% reduction of the prevalence rate every year

2.      The prevalence of periodontal disease is reduced

Annual Targets : 5% reduction of the prevalence rate every year

3.      Dental caries experience is reduced

Annual Target : 5% reduction of the mean dmft/DMFT for 5/6 years old and 12 years old children every year

4.      The proportion of Orally Fit Children (OFC) 12-71 months old is increased                       

Annual Targets : Increased by 20% yearly        

The national government is primarily tasked to develop policies and guideline for local government units. In 2007, the Department of Health formulated the Guidelines in the Implementation of Oral Health Program for Public Health Services (AO 2007-0007). The program aims to reduce the prevalence rate of dental caries to 85% and periodontal disease by to 60% by the end of 2016. The program seeks to achieve these objectives by providing preventive, curative, and promotive dental health care to Filipinos through a lifecycle approach. This approach provides a continuum of quality care by establishing a package of essential basic oral health care (BOHC) for every lifecycle stage, starting from infancy to old age.

The following are the basic package of essential oral health services/care for every lifecycle group to be provided either in health facilities, schools or at home.

STRATEGIES AND ACTION POINTS:

1.  Formulate  policy and regulations to ensure the full implementation of OHP

a. Establishment of effective networking system (Deped, DSWD, LGU, PDA, Fit for School, Academe and others)

b. Development of policies, standards, guidelines and clinical protocols

– Fluoride Use

– Toothbrushing

– Other Preventive Measures

2. Ensure financial access to essential public and personal oral health services

a. Develop  an outpatient benefit package for oral health under the NHIP of the government

b. Develop financing schemes for oral health applicable to other levels of care ( Fee for service, Cooperatives, Network with HMOS)

c. Restoration of oral health budget  line item in the GAA of DOH Central Office

3. Provide relevant, timely and accurate information management system  for oral Health.

a. Improve existing  information system/data collection (reporting and recording dental services and accomplishments )

– setting of essential indicators

– development of IT system on recording and reporting oral health service accomplishments and indices

– Integrate oral health  in every family health information tools, recording books/manuals

b. Conduct Regular Epidemiological Dental  Surveys – every 5 years

4. Ensure access and delivery of quality oral health care servicesa.

a. Upgrading of facilities, equipment, instruments, supplies

b. Develop packages of essential care/services for different groups (children, mothers and marginalized groups)

-revival of the sealant program for school children

– toothbrushing program for pre-school children

– outreach programs for marginalized groups

c. Design and implement grant assistance mechanism for high performing LGUs

– Awards and incentives

– Sub-allotment of funds for priority programs/activities

d. Regular conduct of consultation meetings, technical updates and  program implementation reviews with stakeholders

5. Build up highly motivated health professionals and trained auxilliaries to manage and provide quality oral health care

a. Provision of adequate dental personnel

b. Capacity enhancement programs for dental personnel and non-dental personnel

Current FHSIS Indicators/parameters:

a)      Orally Fit Child (OFC)– Proportion of children 12-71 months old and are orally fit during a given point of time. Is defined as a child who meets the following conditions upon oral examination and/or completion of treatment a) caries- free or carious tooth/teeth filled either with temporary or permanent filling materials, b) have healthy gums, c) has no oral debris, and d) No handicapping dento-facial anomaly or no dento-facial anomaly that limits normal function of the oral cavity

b)      Children 12-71 months old provided with Basic Oral Health Care (BOHC)

c)      Adolescent and Youth (10-24 years old) provided with Basic Oral Health care (BOHC)

d)      Pregnant Women provided with Basic oral Health Care (BOHC)

e)      Older Persons 60 years old and above provided with Basic Oral Health Care (BOHC)

Policy/Standards/Guidelines formulated/developed:

a.      AO. 101 s. 2003 dated Oct. 14, 2003 – National Policy on Oral Health

b.      AO 2007-0007 – Dated January 3, 2007 Guidelines In The Implementation Of Oral Health Program For Public Health Services In The Philippines

c.       AO 4-s.1998 – Revised Rules and Regulations and Standard Requirements for Private School Dental services in the Philippines

d.      AO 11-D s. 1998 – Revised Standard Requirements for Hospital Dental services in the Philippines

e.      AO 3 s. 1998 – Revised Rules and Regulations and Standard Requirements for Occupational Dental services in the Philippines

f.        AO 4-A s. 1998 – Infection Control Measures for Dental Health Services

Trainings/Capacity Enhancement Program:

a.      Basic Orientation Course on Management of Public Health Dentist

The training program was designed with the Public Health Dentists (PHDs) as the main recipients of the Basic Course on the Management of Oral Health Program.  The training is expected to provide an in-depth understanding of the different roles and functions of the PHDs in the management and delivery of Public Health Services. A training module was developed for the basic course.

Researches:

a.      National Monitoring Evaluation Dental Survey (NMEDS).

The Department of Health (DOH) has been conducting nationwide surveys every five years (1977, 1982, 1987, 1992, and 1998) to determine the prevalence of oral diseases in the Philippines. Data gathered provide continuous information that enables planners to update data used in planning, implementation and evaluation of existing oral health programs. The latest NMEDS was conducted in 2011. Results will be available on the 1^st quarter of 2012.

Existing Working Group for Oral Health:

National Technical Working Group (TWG) on Oral Health (DPO 2005-1197)

Member Agencies:     Department of Health (NCDPC, HHRDB, NCHP)

DOH- Center for Health Development for NCR, Central Luzon and Calabarzon

Philippine Dental Association

Department of Education

Up- College of Public Health

Department of Interior and Local Government

Department of Social Welfare and Development

Local Government Units ( Makati, Quezon City)

Print materials:

1.      Leaflets (Malakas ang dating Buo ang Ngipin) for Children, Adolescent, Pregnant Women and Older Person

2.       Training Module on Basic Course on Management of Oral Health Program

Non-Government Organization Major Partners:

Philippine Dental Association

Fit for School, Inc.

Program Managers/Coordinators:

                Dr. Anthony P. Calibo

OIC-Division Chief, cHILD hEALTH  Development dIVISION

Ms. . Lita Orbillo

National Oral Health Program Coordinator

Disease Prevention and Control Bureau

Department of Health

Manila, Philippines

(632) 651-7800  loc. 1726-1728

E-Mail : [email protected]

REGIONAL DENTAL COORDINATORS