COUNTRY REPORT SRI LANKA A Fulfilment of the Report for Application for ORAL HEALTH SCIENCE EDUCATION, JFY 2008 Training Course in Japan Type: Trainers Training No. J08-00737 From April 23,2008 to August 9, 2008 By Dr. S.I. Bangamuarachchi Sri Lanka Ministry of Health

Country Report - Sri Lanka Date - 15th May 2008 Name of the Training Course - Oral Health Science Education Name of the Applicant - Senadhi Indrajith Bangamuarachchi BDS (Sri Lanka) , DHDP (Colombo) Home Address - 339/A , New Kandy Road, Kothalawala, Kaduwela Phone No - +94 (0)714012584 Office Address - Community Dental Clinic Central Dispensary Waga

General Information 1.1 Basic facts Sri lanka is an island in the Indian Ocean with approximately 65,654 square km, which starch maximum 435km length and 225km width. Agricultural country, rich with natural beauty , cultural heritage and sandy beaches. The per capita GDP was 1,355 US $ with growth rate of 6% . Official Currency Rupee (Rs.) and govern by Parliamentary democratic system while Colombo remains as capital.

1.2 Population Total population 21.1 million with an annual growth rate of 1.7 . 72.2% of the population live in rural areas while 21.5% live in urban areas.

1.3 Vital Statistics ( According to the Annual Health Bulletin ) Crude birth rate - 17.3% (rate per 1000) Crude death rate - 6% (rate per 1000) Maternal mortality rate - 0.23% (rate per 1000 births) Infant mortality rate - 16.3% (rate per 1000 births) Life expectancy at birth - 70.7 years (male) 75.4 years (Female) Literacy rate - 90.1% (age 5yrs and above)

1.4 Health Service Health care service provide by both public sector which covers the 60% of the population and privet sector. 95% of in-patient care given by public sector , through the network of Teaching, Provincial, Base, District, Peripheral Unit, Rural Hospital, Central Dispensaries & Maternity Home throughout the Island. The Board aim of Health policy of Sri Lanka, Increase life expectancy and improvement in quality of life. 5.6% of the national expenditure accounted for health services and funded by Sri Lanka Government and NGO’s (WHO, UNICEF, JICA etc..).

1.4 Health Service (cont..) Doctor : Population ratio 1 : 2739 Medical officers and dental surgeons trained through University curriculum leading to a bachelor degree and the post graduate institute of medicine provides specialist training. Department of health provide various in-service training and refresher courses for other health care workers. In addition international establishments offer training courses off shore.

Leading Causes of Hospitalization Cases per 100,000 population Excludes single spontaneous delivery, false labour and those admitted and discharged before delivery. Annual Health Bulletin – Source : Medical Statistics Unit

Leading Causes of Hospital Deaths Deaths per 100,000 population * Includes details reported (not classified by type of neoplasm) from Cancer Institute, Maharagama. Annual Health Bulletin – Source : Medical Statistics Unit

1.5 Dental Services Dental health man power Dental services are provide through both public and privet sector. National level coordinated by Deputy Director General Dental Services and each district by a regional dental surgeon. Dental health man power Dentist population ration - 1 : 22,000 Operator population ratio - 1 : 15,725

1.5 Dental Services (Cont..) Dental health man power Consultant Dental & Maxillotacial surgeons - 20 Consultant orthodontics - 08 Consultant in restorative dentistry - 03 Dental public health consultants - 06 Dental surgeons in public sector - 1100 Dental surgeons in private sector - 300 School Dental therapists - 400 Dental technician in the public sector - 38 Dental technician in the private sector - 40 Unqualified practitioners - 120

1.5 Dental Services (cont..) Dental Health care providing institution in Sri Lanka (A) Hospital dental services - Services mainly curative and free except for nominal fee for orthodontic and prosthetic appliances. (B) School dental services - Completely free and mainly focus on preventive care. (C) Community dental services - Provide both curative and preventive care. (D) Dental services in armed forces - Free dental care to service personal and their immediate families. (E) University dental services (F) Private dental services

1.6 Present situation and trend of the dental diseases In year 1983/84 and 1994/95 respectively first and second national oral health surveys had been conducted with aid of WHO. Periodontal Disease - Escalate toward major dental health problem in Sri Lanka. Dental Caries - 2nd most common problem in Sri Lanka. Oral Cancer - Is the commonest cancer seen among the Sri Lankan Population. Dental Fluorosis - Mild to severe types were seen 2.5% - 6 years olds 5.6% - 12 years olds 0.7% - 35-44 years olds Dentotacial Anomalies - Emerging problem in Sri Lanka Traumatic Dental Injuries - Very common among children and young adults groups

Age group/Type of teeth Table I - 12 years old Periodontal Status 1983/84 1994/95 Health Gums 12 % 13.4 % Those who with Periodontitits % with bleeding gums only 9 % 29.7 % % with bleeding & calculus only 75.5 % 54.1 % % with bleeding calculus & pocketing 3.5 % 2.9 % Table II Comparison of prevalence and DMFT in different age groups in two national surveys. Age group/Type of teeth Prevalence 83/84 Prevalence 94/95 DMFT 83/84 DMFT 94/95 6 year old/deciduous teeth 78 % 76.42 % 4.4 4.1 6 year old/permanent teeth 14 % 9.61 % 0.2 0.17 12 year old/permanent teeth 67 % 53.17 % 1.9 1.4 15 year old - 69.71 % 2.5 35-44 year old 92 % 91.16 % 9.2 10.1 65-74 year old 64.65 % 22.5

Fig 1 : Prevalence of Periodontal Disease % of various indicators in Sri Lanka % Prevalence

Fig 2 : Treatment Needs for Periodontal Disease % Requiring Treatment

Fig 3 : Distribution of Treated & Active Caries Percentage of Persons in Sri Lanka % Distribution

Fig 4 : DMFT of Subjects in Sri Lanka

Distribution curve of incidence of traumatized anterior teeth according to their ages.

Distribution of types of accidents This chart clearly illustrated the distribution of type of accidents in traumatic dental injuries.

Organization Chart of The Ministry of Health

THANK YOU. Dr. Senadhi I. Bangamuarachchi BDS (Sri Lanka), DHDP (Colombo) Sri Lanka Ministry of Health