ORAL HEALTH PROGRAM

In the Philippines, the main oral health problems are DENTAL CARRIES (tooth decay) and PERIODONTAL DISEASE (gum disease). These are observed to be significantly more prevalent in rural than in urban areas. With this, the delivery of the oral health care became the responsibility of the local government under the Local Government Code of 1991. VISION: Empowered and responsible Filipino citizens taking care of their own personal oral health for an enhanced quality of life. 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. 2. 3. The prevalence of dental caries is reduce. Annual Target : 5% reduction of the prevalence rate every year. The prevalence of periodontal disease is reduced. Annual Targets : 5% reduction of the prevalence rate every year. 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. The proportion of Orally Fit Children (OFC) 12-71 months old is increased Annual Targets : Increased by 20% yearly

4.

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.. Stages of Life Mother (pregnant women)

Types of Services (Basic Oral Health Care Package) Oral examination Oral prophylaxis Permanent fillings Gum treatment Health education Dental check up as soon as the first tooth erupts Health instruction on infant oral health care and advice on exclusive breastfeeding.

Neonatal and infants under 1year old

Children 12-71 months old

Dental check up s soon as the first tooth appears and every months thereafter. Supervised tooth brushing drills. Oral urgent treatment (OUT) -removal of unsavable teeth -treatment of post extraction complications Application of Atraumatic Restorative Treatment (ART)

School children (6-12 years)

Adolescent and youth (10-12 years) Other adults (2559 years)

Oral examination Supervised tooth brushing drills Topical fluoride therapy Pits andfissure sealant application Oral prophylaxis Permanent fillings Oral examination Health promotion and education, adverse effects of consumption of sweets and sugary beverages, tobacco and alcohol Oral examination Emergency dental treatment Health instruction and advice Referrals oral examination extraction os unsavable tooth gum treatment relief f pain health instruction and advice

Older persons

The 2006 National Oral Health Survey (NOHS) 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. 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).

PERIODONTAL DISEASE Cause: Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly
form a sticky, colorless "plaque" on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form "tartar" that brushing doesn't clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.

TYPES:

Gingivitis Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place. Periodontitis In periodontitis, gums pull away from the teeth and form spaces (called "pockets") that become infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed. Risk Factors

Smoking. Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment. Hormonal changes in girls/women. These changes can make gums more sensitive and make it easier for gingivitis to develop. Diabetes. People with diabetes are at higher risk for developing infections, including gum disease. Other illnesses. Diseases like cancer or AIDS and their treatments can also negatively affect the health of gums. Medications. There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medications can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep gums clean. Genetic susceptibility. Some people are more prone to severe gum disease than others. Who gets gum disease? People usually don't show signs of gum disease until they are in their 30s or 40s. Men are more likely to have gum disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line. Symptoms of gum disease include:

Bad breath that won't go away Red or swollen gums Tender or bleeding gums Painful chewing Loose teeth Sensitive teeth Receding gums or longer appearing teeth

DENTAL CARIES Tooth Decay or Cavities or Dental Caries is one of the most common human diseases. Main cause of dental caries is the loss of minerals

from the tooth enamel due to the action of acids produced by dental plaque. Cavities are most likely to develop in pits on the chewing surfaces of the back teeth, in between teeth, and near the gumline or at the unprotected root if it is exposed by gum recession. If left untreated the tooth decay can destroy the tooth through the enamel, to the dentin and down to the pulp of the tooth. Factors as nutrition habits, quality of oral hygiene, dry mouth problems, presence of fluoride in water or toothpaste and heredity play a significant role in how susceptible your teeth may be to tooth decay. Symptoms - How to check for Dental Caries: Early caries may have no symptoms. Tooth decay begins with a small patch of demineralised enamel at the tooth surface, often hidden from sight in the fissures or in between the teeth. At this phase tooth decay can be identified visually only by your dentist. When the decay has progressed deeper in the enamel, the teeth may be sensitive to sweet foods or to hot and cold temperatures. Later, when the cavity has reached the pulp, the acute pain or swelling will be a clear sign of dental caries. CLASSIFICATION OF ORAL INTERVENTIONS:
1. Preventive services consist of measures that which will promote oral health and

provide specific protection from the occurrence of dental caries and other oral diseases. Types: -oral examination is the careful checking of oral cavity by duly trained dentist to detect and diagnose oral diseases and conditions, oral examinations, and detect signs and symptoms of sexually Transmitted Disease-AIDS and other non communicable diseases such as diabetes. -oral hygiene is a basic personal measure to prevent and control tooth decay and gum disease. It includes among others oral prophylaxis, regular and proper way of toothbrushing, gum massage, eating detersive foods and the use of mouthwashes. -pit and fissure sealant program a non invasive preventive and control measure against tooth decay for children. Fluoride therapy is best for smooth surfaces but limited where grinding surfaces are concerned owing to the pressure of pit and fissures on the surfaces. -fluoride Utilization Program a non invasive and control measure through multiple use of fluorides in areas where fluoride content is low. Fluoridation can be done in systemic and local route.

2. 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. INCLUDES: -permanent filling which is the restoration of saveable teeth with amalgam, composite or glass filling materials -Gum treatment is the deep scaling and root planning of affected tooth or teeth for pregnant mothers and older person with periodontal disease. -atraumatic restorative treatment is manually cleaning dental cavities using hand instruments and filling cavities with fluoride. -temporary filling is the treatment of deep seated tooth decay with zinc oxide and eugenol. -extraction is the removal of unsavable teeth to control foci of infection. -treatment of post extraction complication such as dry sockets and bleeding -drainage of localized oral abcesses-incision and drainage
3. Promotive service promotive services includes health education activities directed to

the priority groups thru individual or group approach using accepted tools and media. How to Brush What Is the Right Way to Brush? Proper brushing takes at least two minutes that's right, 120 seconds. To properly brush your teeth, use short, gentle strokes, paying extra attention to the gumline, hard-toreach back teeth and areas around fillings, crowns or other restoration. Concentrate on thoroughly cleaning each section as follows: Clean the outer surfaces of your upper teeth, then your lower teeth Clean the inner surfaces of your upper teeth, then your lower teeth Clean the chewing surfaces For fresher breath, be sure to brush your tongue, too

1. Tilt the brush at a 45

2. Gently brush the outside,

3. Gently brush your

angle against the gum line and sweep or roll the brush away from the gum line.

inside and chewing surface of each tooth using short back-and-forth strokes.

tongue to remove bacteria and freshen breath.

What Type of Toothbrush Should I Use? Most dental professionals agree that a soft-bristled brush is best for removing plaque and debris from your teeth. Small-headed brushes are also preferable since they can better reach all areas of the mouth, including hard-to-

reach back teeth. For many, a powered toothbrush is a good alternative. It can do a better job of cleaning teeth. How Often Should I Replace My Toothbrush? You should replace your toothbrush when it begins to show wear, or every three months, whichever comes first. It is also very important to change toothbrushes after you've had a cold, since the bristles can collect germs that can lead to reinfection.