Proposed 10-Year Regional Plan On Oral Health

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Proposed 10-Year Regional Plan On Oral Health

• Lessons learned 1993-2006
• Forty national oral health surveys indicate a
  marked decline between 35 to 85 in the
  prevalence of dental caries, attributed mostly to
  cost-effective salt and water fluoridation
  programs
• Burden of oral disease is severe and remains high
  in certain geographic areas and high risk
  populations
• Strong scientific evidence suggests the
  associations between oral infections, chronic
  diseases and adverse pregnancy outcomes
• Best Practice Models on prevention and delivery
  of oral care

Pan American Health Organization
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Typology Table in Oral Health 1990 2004
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PAHO/IADB Clinical Trials in Ecuador, Panama and
Uruguay PRAT PROBABILITY OF SUCCESS AND
FAILURE

• Success Failure
• Dentist doing amalgam 0.943 0.057
• Dentist doing ART 0.960 0.040
• Auxiliary doing ART 0.942 0.058

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Pan American Health Organization
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Scientific evidence suggest that pregnant women
with periodontal disease are seven times more
likely to deliver PTLBW baby. This risk is much
higher than tobacco and alcohol.
Oral Infections and Pregnancy Outcomes
Clinical trials suggest that treating oral
infection in pregnant women before 26 weeks of
gestation reduces the incidence of PTLBW by 28
to 82.
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Framework for the strategy

• Best Practice Model
• Partnerships
• Downstream Investment
• Measurement of Progress

• Primary priority countries
• Bolivia, Haiti, Honduras, Guyana, Nicaragua
• Secondary priority countries
• Ecuador, Guatemala, and Paraguay
• Priority groups
• MCH, Children, Women in reproductive age groups,
  HIV/AIDS, Indigenous groups, Elderly

Pan American Health Organization
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GOAL 1A Minimum Level of Oral Health
Care For All By Addressing Gaps in Care For the
Most Vulnerable Groups

Reduction of Oral Infections
Increasing Access to Oral Health Care
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GOAL 2The Integration of Oral Health Into PHC
Services

• Develop mechanism to integrate oral health within
  current PHC services
• Incorporate oral health component into prenatal
  programs
• Scale up best practice models

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• GOAL 3
• Scaling-Up of Proven Cost Effective Interventions
• Salt fluoridation
• Support Bolivia, Ecuador, Haiti, Honduras,
  Nicaragua, Paraguay and Saint Lucia to reach full
  implementation of fluoridation programs
• Consolidate fluoridation programs with
  appropriate surveillance

Sealants 21.17 FL Supplements
2.53 Water Fluoridation 0.54 Salt
Fluoridation 0.06
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Scale Up Oral Health Coverage Using
Cost-Effective and Simple Technologies, PRAT
1.50 to treat/seal a tooth
Mexico over 10 million restorations under PRAT
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In Summary

• Best practice model provides a framework to
  implement at large scale oral health programs
• We have the evidence and the knowledge that it
  works
• Evidence demonstrates feasibility with extreme
  cost-benefit
• Implementation requires leadership, commitment to
  guide downstream investment to improve equity and
  efficiency and quality of life in the Americas
• Action by the Executive Committee for government
  support for dental public health programs and
  technical Cooperation Plan and Proposed Budget

Pan American Health Organization
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Trends of DMFT-12 for the Region of the Americas
EVIDENCE 1987-2003
PROJECTIONS 2007-2010