ORAL HEALTH PROGRAM

Older Persons

Introduction:

In the Philippines, the main oral health problems

are dental caries (tooth decay) and periodontal
disease (gum disease). The two diseases are
widespread that 92% of our people are suffering
from tooth decay and 78.0% have gum disease.
In terms of decayed, missing, filled teeth (DMFT)
Index, Philippines ranked second worst among
21 WHO Western Pacific countries. Dental
caries and periodontal disease are observed to
be significantly more prevalent in rural than in
urban areas.

Goal:

Reduce the prevalence rate of dental caries and

periodontal diseases from 92% in 1998 to 85%
and from 78% in 1998 to 60% by end of 2010
among general population.

Objectives:
1. To increase the proportion of Orally Fit Children
under 6 years old to 80% by 2010.
2. To control oral health risks among the young
people.
3. To improve the oral health conditions of
pregnant women by 20% and older persons by
10% every year until 2010.
Basic Package of Oral Health Care:
The following are the basic package of essential oral
services/care for every lifecycle to be provided in all
health facilities including schools or at home.
Stages of Life
Mother (pregnant)

Neonatal and infants under 1 year old

Children 12-71 months old

Adolescent and Youth (10-12 years

old)

School Children (6-12 years)

Others adults (25-59 years old)

Oral examination
Extraction of unsavable t
Gum treatment
Relief of pain
Health instruction and ad

Classification of Oral Interventions:

There are classifications of oral interventions

that need to be carried out to address oral
problems. These are: 1) preventive, 2) curative,
3) promotive services.

*Preventive services consist of the following measures

which will promote oral health and provide specific
protection from the occurrence of dental caries and other
oral diseases. These are types of preventive
interventions:

Oral examination
Oral hygiene
Pit and fissure sealant program
Fluoride Utilization Program

*Curative/Treatment services these are remedial

measures applied to halt the progress of oral disease
and restore the sound condition of the teeth and
supporting tissues. It includes:

Permanent filling
Gum Treatment
Atraumatic restorative treatment
Temporary filling
Extraction
Treatment of post extraction complication such
as dry sockets and bleeding
Drainage of localized oral abscesses-incision
and drainage

Types of Oral Services

Oral examination

Oral prophylaxis
Permanent Fillings
*Promotive services includes health education activities
Gum treatment
directed to the priority groups thru individual or group
Health Education
approach using accepted tools and media.
Dental check-up as soon as the first tooth erupts
Health instruction on infant oral health care and
advice on exclusive breastfeeding
Dental check-up as soon as the first tooth
appears and every 6 months thereafter
Supervised tooth brushing drills
Oral urgent treatment (OUT)
o removal of unsavable teeth
o referral of complicated cases
o treatment of post extraction complications
Application of Atraumatic Restorative Treatment
(ART)
Oral examination
Supervised tooth brushing drills
Topical Fluoride Therapy
Pits and Fissure Sealant application
Oral prophylaxis
Permanent Fillings
Oral examination
Health promotion and education, adverse effect of
consumption of sweets and sugary beverages,
tobacco and alcohol
Oral examination
Emergency dental treatment
Health instruction and advice
Referrals

NUTRITION PROGRAM

Introduction:

Malnutrition continues to be the public health

concerns in the country. The common nutritional
deficiencies are; 1.) Vitamin A 2.) Iron and, 3.)
Iodine. These deficiencies lead to a serious
physical, mental, social and economic condition
among children and women.

NUTRIENTS IN FOOD

Goal:

To improve the nutritional status, productivity

and quality of life of the population thru adoption
of desirable dietary practices and healthy
lifestyle.

Objectives:

Increase food and dietary energy intake of the

average Filipino
Prevent nutritional deficiency diseases and
nutrition-related chronic degenerative diseases
Promote a healthy well-balanced diet
Promote food safety

Vitamin(s)/Minerals
Vitamin A (retinol)

Functions
Maintain normal vision,
skin health, bone and
tooth
growth
reproduction
and
immune
function;
prevents
xerophthalmia.
Food sources:
Breastmilk; poultry;
eggs; liver; meat;
carrots;
squash;
papaya; mango; tiesa;
malunggay;
kangkong;
camote
tops; ampalaya tops

Iodine

As part of the two thyroid

hormones,
iodine
regulates
growth,
physical and mental
development
and
metabolic rate.
Aids in the development
of the brain and body
especially in unborn
babies
Food sources:
Seaweeds;
squids;
shrimps;
crabs;
fermented
shrimp;
mussels; snails; dried
dilis; fish

Iron

Essential in the formation

of blood. It is involved
in the transport and
storage of oxygen in
the blood and is a cofactor bound to several
non-hemo
enzymes
required for the proper
functioning of cells.
Food sources:
Pork; beef; chicken;
liver
and
other
internal organs; dried
dilis; shrimp; eggs;

Proper nutrition is important because:

It helps in the development of the brain,

especially during the first years of the childs life.
It speeds up the growth and development of the
body including the formation of teeth and bones
It helps fight infection and diseases
It speeds up the recovery of a sick person
It makes people happy and productive
Proper nutrition is eating a balanced diet in
every meal

Balanced diet is made up of a combination of the 3

basic groups eaten in correct amounts. The grouping
serves as a guide in selecting and planning everyday
meals for the family.
THE THREE (3) BASIC FOOD GROUPS ARE:
1. Body-building food which are rich in protein and
needed by the body for:
normal growth and repair of worn-out body
tissues
supplying additional energy
fighting infections
Examples of protein-rich food are:
fish;
pork; chicken; beef; cheese; butter; kidney
beans; mongo; peanuts; bean curd; shrimp;
clams
2. Energy-giving food which are rich in carbohydrates
and fats and needed by the body for:
providing enough energy to make the body
strong
Examples of energy-giving food are: rice; corn;
bread; cassava; sweet potato; banana; sugar
cane; honey; lard; cooking oil; coconut milk;
margarine; butter
3. Body-regulating food which are rich in Vitamins
and minerals and needed by the body for:

Nutrients are chemical substances present in

the foods that keep the body healthy, supply
materials for growth and repair of tissues, and
provide energy for work and physical activities.
The major nutrients include the macronutrients,
namely; proteins, carbohydrates and fats; the
micronutrients, namely vitamins such as A, D,
E and K, the B complex vitamins and C and
minerals such as calcium, iron, iodine, zinc,
fluoride and water.
IMPORTANT VITAMINS AND MINERALS

Nutrition is a state of well-being achieved by eating the

right food in every meal and the proper utilization of the
nutrients by the body.

normal development of the eyes, skin, hair,

bones, and teeth
increased protection against diseases
Examples of body-regulating food are: tisa; ripe
papaya; mango; guava; yellow corn; banana;
orange; squash; carrot

pechay;
alugbati

saluyot;

Setting

Hyperalimentation process
IV infusion with CHON,
regulated by a
machine

CHO

MALNUTRITION

An abnormal condition of the body resulting from

the lack or excess of one or more nutrients like
protein, carbohydrates, fats, vitamins and
minerals.

PRIMARY CAUSE: POVERTY

1. Lack of money to buy food
Majority of the victims of malnutrition comes
from families of farmers, fisherfolk, and laborers
who cannot afford to buy nutritious foods.
2. Lack of food supply
3. Lack of information on proper nutrition and food
values
SECONDARY CAUSES
1. Early weaning of child and improper introduction
of supplementary food
2. Incomplete immunization of babies and children
3. Bad eating habits
4. Poor hygiene and environmental sanitation:
a. lack of potable water
b. lack of sanitary toilet
c. poor waste disposal
FORMS OF MALNUTRTION
1. Protein-Energy Malnutrition (PEM) is a nutritional
problem resulting from a prolonged inadequate
intake of body-building and/or energy-giving food in
the diet.

a) Kwashiorkor protein deficiency

b) Marasmus carbohydrate deficiency (energygiving food)

Deficiency
Age
Major Signs &
Symptoms
Hair Changes

Skin

Behavior
Management
Hospital

Causes:

Kwashiorkor
Marasmus
Disease
Muscle wasting
experienced by
an elder
child upon the
birth of a new
baby
CHON
CHO
Toddlers
(1-3 All ages
years old)
Facial edema, Muscle wasting,
moon facie
old mans facie
(+)
color (-) hair changes
changes from
black to
brown or from
brown to golden
yellow
(+) sparse flag
sign
Dermatosis:
(-)
dryness, peeling
off of the skin,
desquamation
Irritable
Apathetic
High CHON diet High CHO diet
Total Parenteral Nutrition (TPN)

not eating enough foods rich in vitamin A e.g.

yellow vegetables and yellow fruits
lack of fat or oil in the diet which help the body
absorb Vitamin A.
poor absorption or rapid utilization of Vitamin A
during illness

Eye Signs

night blindness (early stage); total blindness

(later stage)
bitots spot (foamy soapsuds-like spots on white
part of the eye)
dry, hazy and rough appearing cornea
crater-like defect on cornea
softened cornea; sometimes bulging

Other Manifestations

Kinds:

Etiology

2. Vitamin A Deficiency (VAD)

a condition in which the level of Vitamin A in the
body is low.
VAD is most common in children suffering from
PEM and other infectious diseases. Bottle-fed
infants are also at risk of VAD especially if the
milk formula used is not fortified with Vitamin A.
Common among preschoolers and infants
(FNRI)

increased cases of childhood sickness, and

death and decreased resistance to infection
susceptibility to childhood malnutrition and
infection (measles, diarrhea and pneumonia)

Prevention

eating foods rich in Vitamin A, such as liver,

eggs, milk, crab meat, cheese, dilis, malunggay,
gabi leaves, kamote tops, kangkong, alugbati,
saluyot, carrots, squash, ripe mango, including
fats and oils
breastfeeding the child
immunizing the child
taking correct dose of Vitamin A capsules as
prescribed

SCHEDULE FOR RECEIVING VITAMIN A

SUPPLEMENT TO INFANTS PRESCHOOLERS AND
MOTHERS
Schedule

Infants
(6-11
mos.)

Preschooler
s (12-83
mos.)

PostPartum
Mother

Give 1
Dose

100,000
IU

200,000 IU

100,000
IU

200,000 IU

200,000
IU Within
one month
After
delivery of
each child
only

Give after
6 months
High risk
Condition
Present

SCHEDULE FOR TREATMENT OF VITAMIN A

DEFICIENCY
Schedule
Give Today
Give Tomorrow
Give After 2
Weeks

Infants (6-11
mos.)
100,000 IU
100,000 IU
100,000 IU

Preschoolers
(12-83 mos.)
200,000 IU
200,000 IU
200,000 IU

PREVENTION OF IRON DEFICIENCY

Dosage
0.7 mg daily
1 mg daily

TREATMENT OF IRON DEFICIENCY

Children 0-59 month
4. Goiter

enlargement of thyroid gland due to lack of

iodine in the body.
common in areas where the iodine content in the
soil, water and food are deficient.

Effect of Iodine deficiency to fetus:

may be born mentally and physically retarded.

Goiter can be prevented by:

3. Anemia - a condition characterized by the lack of

iron in the body resulting in paleness.
S/S: paleness of the eyelids, inner cheeks,
palms and nailbeds; frequent dizziness and easy
fatigability
Common cause: inadequate intake of food rich
in iron; can also be caused by blood loss during
menstruation, pregnancy and parasitic
infections.
Prevention:
Eating iron-rich food such as liver and other
internal organs; green leafy vegetables; and
foods rich in Vitamin C

Recommended Iron
Requirements
Infants ( 6-12 months)
Children ( 12-59 months)

Dosage
3-6 mg./kg. Body wt./day

daily intake of food rich in iodine

use of iodized salt
IODINE SUPPLEMENTATION

Children 0-59 months

( in endemic areas)

Dosage
Iodine capsules (200 mg)
potassium iodate in oil
orally once a year.

NUTRITIONAL GUIDELINES
1. Eat a variety of food everyday.
2. Breastfeed infants exclusively from birth to 4-6
months, and then, give appropriate foods while
continuing breastfeeding.
3. Maintain childrens normal growth through
proper diet and monitor their growth regularly.
4. Consume fish, lean meat, poultry or dried beans.
5. Eat more vegetables, fruits, and root crops.
6. Eat foods cooked in edible/cooking oil daily.
7. Consume milk, milk products or other calciumrich foods such as small fish and dark green
leafy vegetables everyday. Use iodized salt, but
avoid excessive intake of salty foods.
8. Use iodized salt, avoid excessive intake of salty
foods
9. Eat clean and safe food.
10. For a healthy lifestyle and good nutrition,
exercise regularly, do not smoke, avoid drinking
alcoholic beverages.