Status of Prevention of Dental Diseases in Estonia Mare Saag

From the Guidelines for family doctors and other cooperating health care workers Decree of the Minister oh Social affairs Family doctors must check oral health and advise parents to visit the dental clinic at the age of 12, 24 and 36 months Children should be checked by a dentist concerning oral health as a rule at the age 6,7,9,12,14,and 15 years School nurses also direct (motivate) children to visit the dentist annually

School health services - nurses Work load: 40 hours a week for 600 pupils Duties: Spreading evidence based information about health Advising about diet Cooperating with other health professionals and parents of the children

Changes Up to 2003 all the children belonged to the target group for prevention years old children were covered

Budget for oral health care in Estonia in thousands of Euros prognosis 2011Changes compared to 2010 Dental treatment for children % Prevention In children % Orthodontics % Emergency Treatment for adults % TOTAL %

Number of treatment cases 2009 factual2010 budget2010 prognosis 2011 budgetChanges compared to 2010 Dental treatment cases in children % Prevention in children % Orthodontics % Ewmergency treatment in adults % TOTAL %

Target groups for prevention of dental diseases Born in-Number of children (1988) 22442) No of visits for treatment (1,5 visits per child)

No of visits for prevention YearNo of visits No of children % , , , , , ,

Budget per child Prevention ,51 Eur 2010 actual 14, budget14,49 Dental treatment (children) 1 case , , ,81

Project based prevention of diseases Financed by the Estonian Sick Fund or the Ministry of Social Affairs, sometimes by city councils Budget 6400 – Eur 1- year- projects No permanent general impact on the health care system

History Projects Seminars, lectures, workshops for kindergarten- and schoolteachers in regions 3 conferences for dentists on prevention of dental diseases Methodological books, videos, info-pamphlets and sets of transparencies for teaching purposes have been prepared. A special one-month school program for 2nd classes in preliminary schools has been carried out in (sponsored by Procter Gamble)

History Projects Programme for 4th classes sponsored by Colgate Palmolive Stickers designed to promote dental health TV talk shows about dental health Board game with messages about dental health In 2000 a preventive program for 5-6 years old children children of this age all over Estonia were studied and preventive measures were performed

History “Dental passport” 3 This document was meant for registration of dental health situation and performed treatment and preventive measures for the child.

Prevention 2011 The child’s health development concentrating upon the network around the child to develope good physical and psychological/social life, good environment for playing and studies Extensive project to promote dental health

Dental health in children Health promotion project 2011 Contract No 2-21/49 Estonian Sick Fund Estonian Dental Association Estonian Society of Oral Hygienists

Budget & content of the project in 2011 Program director Dr. Marek Vink Target group is 3 years old children, their parents, teachers in kindergartens, nurses Total of Eur including expenses for: 1.Guidelines in internet for midwifes, nurses of family doctors, health promotion specialists, teachers in kindergartens 2.Illustrated manual „prevention of dental diseases in children“ for the health professionals

2011 Poster „Sugar clock“for kindergartens, family doctors praxis, A smaller interactive teaching aid material with stickers Coloring book with 24 pages about dental health, also in Russian. Printed books are distributed to the 40 kindergartens participating in the project Animated drawings in internet A cartoon „Jänku-Jussi“

2011 Leaflets for nurses to distribute to the parents of 4,5 months old infant’s parents Cooperation with the Society of Cardiologists Establish links to the web-pages perekool.ee/lastehammastetervis; Courses for nurses (min 30) working with family doctors Seminars for nurses (min 100) working with family doctors

Aim and expected results of the project Overall aim of the study is to start prevention of dental caries before being infected In case of turning the project into system it is possible to raise a new caries-free generation Due to improved oral health all the health indicators of the population will improve leading to decreased expences on health care directly and indirectly. Life quality of the population will change for better.

Minimal aim Minimal aim of prevention of dental diseases is to reach the level of DMFT to the recommended by WHO level In West-Europe it means that o at least 80% of children are caries-free o Average DMFT index in 12-year-olds will be less that 1,5

More distant aims Oral hygienists and dental nurses participating in this project will provide a network to carry on the project in future As many as possible, teachers and healthcare professionals and officials will be engaged in prevention of dental caries

What can you see today ? Cartoons