Strategies in place, or the lack of it

(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)

WITH THESE measures (among many others), the implementation of a policy, strategy or action plan for oral health is in place, according to the World Health Organization (WHO) country report.

The Department of Health’s (DOH) 2003 National Policy on Oral Health, for example, mandates local governments to implement oral health programs.

Also in place are health manpower dedicated to oral health and who are working as part of the DOH program on non-communicable diseases.

However, according to statistics cited by a University of the Philippines (UP) Manila study, the Philippines has a 1:53,000 dentist to population ratio, showing a shortage in dental care providers.

The study, published December 2020 in Acta Medica Philippina journal, was written by Dr. Michael Antonio F. Mendoza, College of Dentistry, University of the Philippines (UP) Manila; Ma-Ann M. Zarsuelo of the Institute of Health Policy and Development Studies, National Institutes of Health, UP Manila; Leonardo R. Estacio Jr., PhD, College of Arts and Sciences, UP Manila; and Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD, College of Public Health, UP Manila.

Still, unequal distribution of oral health professionals and a lack of appropriate health facilities restricts access to primary oral health services.

Dentists diagnose, treat and prevent diseases, injuries and abnormalities of the teeth, mouth, jaws and associated tissues by applying the principles and procedures of modern dentistry. They use a broad range of specialized diagnostic, surgical and other techniques to promote and restore oral health.

As of Oct. 31, 2021, there were approximately 4,280 dentists in the Philippines, reflecting a slight decrease from the previous year, according to statista.com. The total number of health care professionals was 188,200.

According to WHO’s National Health Workforce Accounts data platform, there were 28,154 dentists in the Philippines in 2020. That’s a ratio of about 2.6 per 100,000 population, on average for 2014-2019.

There are only 246 dental assistants and therapists and 682 dental prosthetic technicians, according to WHO’s National Health Workforce Accounts data platform.

Dental assistants and therapists provide basic dental care services for the prevention and treatment of diseases and disorders of the teeth and mouth. They perform these tasks according to care plans and procedures established by a dentist or other oral health professionals. The category of dental assistants and therapists also includes dental hygienist and dental nurses.

Dental prosthetic technicians design, fit, service and repair dental devices and appliances following prescriptions or instructions established by a health professional. They may serve a wide range of support instruments to correct dental problems, such as dentures, and dental crowns and bridges.

Oral health auxiliaries such as dental aides and dental hygienists are not well established.

The maldistribution of dentists is evident in their concentration in urban areas; many dentists emigrate abroad. In South Cotabato province, municipalities with budgetary constraints combine their resources to be able to afford to share a dentist.

There are efforts to remedy the situation. The Return Service Agreement in the Universal Health Care Law requires recipients of government-funded scholarship programs in allied and health-related courses, including dentistry, to serve in priority areas for at least three years.

The Professional Regulation Commission allocates 10 percent of units earned from continuing education programs to be community service. Continuing education is required to renew a professional license.

According to the study, the UP Manila College of Dentistry requires graduates to practice dentistry in the Philippines for two years upon graduation and obtaining a license to practice. It is a good idea to expand this practice to other schools as well.

According to the Philippine Dental Association, there are 21 dental colleges in Luzon, 10 of them in Metro Manila; four are in the Visayas and four in Mindanao.

Dental education, currently focused on clinical over public health discipline, may give more emphasis on prevention rather than cure. Dental Public Health is now recognized by the Professional Regulations Commission as a dental specialization and has accredited the Philippine Academy of Dental Public Health as a professional organization.

In 2021, according to the WHO country report, procedures for detecting, managing and treating oral diseases in the primary care facilities in public facilities were available. That is, 50 percent or more of patients in need received oral health screening for the early detection of oral diseases and urgent treatment for providing emergency oral care and pain relief.

However, basic restorative dental procedures to treat existing dental decay reached less than 50 percent of patients in need, according to the WHO country report on the Philippines.

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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists;  Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.

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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN

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