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
North–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.
KPE pastāvīgiem zobiem 12 gadus
veciem bērniem
6
5.8
5
4
3.9
3.6
3
3.5
3.4
3.4
2002
2004
2010
2
1
0
1993
2000
2001
KPE for 12-year old children in
north-east Latvia (1999 -2001)
6
5,7
5,4
5
4,7
4,7
4
3
3
3,2
2,9
2,3
2,2
2
1
0
Va
lm
ier
a
Va
lk
79
3
a3
Cē
36
sis
60
Lim
0
ba
ž
i4
48
Gu
lbe
n
Ma
e4
37
do
na
5
Ba
63
lvi
33
5
Alū
ks
ne
av
39
1
era
ge
3
90
3
KPE with 12 year old children
(school year 2004/2005)
3,47
3,5
3,31
3
2,5
2,63
2,24
2
2,83
2,27
2,58
1,89
1,5
1
0,5
0
e
rag
ave
e
ksn
Alū
lvi
Ba
a
don
Ma
ne
lbe
Gu
i
baž
Lim
is
Cēs
era
mi
Val
Number of children 1546
KPE structure for 12 year old,
2007/2008
4
3,5
3
2,5
2
1,5
1
0,5
0
Latvija* Limbaž Cēsis
(3,25) i (2,61) (2.63)
Madon
a
(2.83)
Balvi
(1.85)
Gulben Alūksn
e
e
(2.75) (2.21)
Valka
(2.42)
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
*total number of children 1811; KPE 2.48
KPE + Ki structure for 12 year
old, 2007/2008
3,50
3,00
2,50
2,00
1,50
1,00
0,50
0,00
Limbaži
(2,72)
Cēsis
(2.87)
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
Madona Balvi
(3.13) (1.95)
Number of children 1811; KPE 2.73
Gulbene Alūksne
(2.96)
(2.34)
Valka
(3.12)
Caries free for 12 year old
children (1999 – 2001)
8,90%
Caries
Caries free
91,10%
3133 children examined
Caries free
(12 year old children) 2004/2005
%
number
%
number
Valmiera
Cēsis
Limbaži
Gulbene
Madona
Balvi
Alūksne
23.51
14.72
32.06
20.96
23.16
26.54
19.23
75
24
84
35
63
43
35
Number of children 1546; average % 23.67
Number of caries free children in
2007/2008 (12 year old)
%
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
%
Limbaži
Cēsis
Madona
Balvi
Gulbene
Alūksne
Valka
25.1
22.0
19.1
34.7
16.7
29.5
25.8
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.
Epidemiological
Data
Medical
Statistics
* Minimum Services
in Dentistry
* Training of Dental
Care Staff
Register of
Enterprises
Data Bank of the State
centre of Dentistry and
Facial surgery
Register of
Dentists
Certification of
Dentists
Register of
Dental Nurses
Certification of
Dental Nurses
Health Compulsory
Insurance State Agency
(HCISA)
Regional Oral Health
Centres
Register of
Physicians
Private
Practices
Register of
Dental
Assistants
Certification 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 specialistsexperts
Suggestions

Enjoy the life!!!
vzc@latnet.lv
paeglitis.vzc@latnet.lv
www.vzc.lv
Basic principles for good
dental health care in the future
Dr. Zane Bendika
Centre 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 patientcentred 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