senario
You have just been appointed as Chief Dental Officer for a
low-income country of seven million people called NeverLand. This
country of NeverLand has a very young population. Almost half (45%)
of the population is aged 15 years of age and under. There is a
simple but comprehensive educational system where all children can
attend a local school from the age of six up to 15 years of
age.
An international university has been supporting your country
and recently conducted a national survey of school childrens’ oral
health. You have been presented with survey data which show that
90% of children have dental caries at ICCMS score 2 and above
(caries in enamel or worse); 60% have ICCMS 3 and above and 20%
have ICCMs 5 and above. Between 10% and 15% of children across all
ages report experiencing pain from their teeth in the past three
months.
Children enter school at six years of age with an average of
three teeth affected by dental caries (range 0-12).
Disease levels increase with age and then fall during the
transition from a primary to a secondary/permanent dentition, but
rise again so that on leaving school 15-year- old children have an
average of four teeth affected by decay (DT=4) and overall a mean
caries of DMFT=5. No children have received fillings.
The water supply comes from local sources and is not
fluoridated. Toothbrushes are increasingly being used; however,
toothpaste is not always available outside of the capital
city.
Dental services are limited with only 20 dentists located in
the capital city, where about 20% of the population is based,
paying occasional visits to rural areas using one mobile dental
caravan to provide care.
The country has a medical school but there is no dental
education. All the dentists in the country have trained
abroad.
Dental nurses are trained on the job and there are no other
dental care professionals (dental auxiliaries) in the
country.
The country does have trained community health workers who are
based across the country including rural areas who promote health
and help people to access care. Finally, the country has just
established a registration council for health professionals and
want to develop guidance on professionalism for dentists.
1-Summarise the needs in Country and identify what other
information you would like to collect, justifying why, so that you
can plan for the whole population.
2-What is your plan of action to promote oral health across
the child population in a whole population approach? Please outline
your plan in line with the ‘five action areas’ of the Ottawa
Charter (WHO, 1986). (l
In doing so, very briefly please outline what other health
workers you would collaborate with in promoting oral health and
why.
3-What plans will you put in place to ensure that accessible
dental services are available for the whole population using
Penchansky & Thomas’s (1981) dimensions of access (5As).
Please also outline your plan to developing and using the oral
and dental workforce to meet the needs of the population.
4-List 10 important aspects of professionalism for the dental
profession which you will recommend to the new registration body
for dentists. Please provide one practical example for each of the
ten points.