The role of innovation in dentistry II.

The second part of the interviews related to prevention in the field of oral health. As is

mentioned in the introduction of this research, WHO (2012) and WDF (2015) claim, that tooth

decay is the most extended chronic disease and becomes on o the major global health

challenge. WHO argues, that this challenge must be solved by prevention of oral disease and

promotion of oral health. Furthermore, patients are motivated to become pro-active in their

own care. Thanks to this there are expected increasing quality of healthcare services and

facilitation of healthcare at all.


Šmucler pointed out, that most of the countries plan to eradicate tooth dicey until the 2029. He does not believe that the Czech Republic would achieve it. Even though, the state of tooth

decay and missing teeth are declining. Unfortunately, the epidemiological data about the Czech Republic are missing. In the Czech Republic, surveys on tooth status and treatment have not been conducted since 2006. The last oral health analysis of the Czech population was published in 2003. Nevertheless, it is expected increase in the dental caries experience among children and young adults in areas in which prevention and education have been neglected or removed (Glass, 1982).


From the long-term perspective, according to the First International Conference on the Declining Prevalence of Dental Caries (Glass, 1982), the dental caries experience was

decreasing until the 1982. The prevalence of dental caries may increase as urbanization

increases, especially in developing countries.


According to a study carried out by the Czech Dental Research Institute (Horálková, 2012), the

state of teeth in the Czech Republic is below the European standard. Statistics provided by the OECD (2018) describe the data related to dental health status of the Czech population. The data are available only for the years between 1987 and 2006. In 2006, the DMFT index of the Czech Republic was 2.6 in 2006. Compare to Denmark and the United Kingdom which scored 0.8 DMFT. DMFT index is commonly used to measure the prevalence and severity of dental cariesin a defined population. The index refers to decay, missing or filled teeth in 12-years-old age group.


The data available in Datahub (2018) provides clear insights of the national oral health status. In the Czech Republic, between 40 – 59% of 12-years-old children in average have caries. To

compare, in Denmark and the United Kingdom it is between 20 – 40% in the 12-years-age-

group children.


The question is: What must be done in order to achieve zero of dental pain experience until

2029? Elhadad argues that it is the health care system which must become aware of the cost-

effectiveness of public health promotion. The system is controlling what is acceptable and what in unacceptable on the cost-effective treatment. Elhadad pointed out, that some countries have very low number of cavities such as Norway, Sweden or Denmark. What drives the dentist to apply new technique is how much money they can charge. It is all about that, he claims. In the Scandinavian countries for example, they are awarded by providing and developing oral health education and oral health prevention technology. But many other countries such as Italy and Spain are not very well educated in this field. The preventive approach will be dominant, Elhadad says, that only if in the future it will be promoted by public healthcare service. Once, they will understand that in long-run they can reduce the cost of that sector, they will change the way how they allocating the reimbursement of the different services.


Elhadad does not trust the system. He says that the system is completely necrosis. It is basically waiting for disease to appear and fix. The statistics according to Elhadad shows the rate of reimbursement for prevention examinations or tooth cleaning is less reimbursed that the cavity, than the crowd and the cavity canal. The same opinion has Šmucler. Ha claims, that the health care system in the Czech Republic is based on treatment of cavities rather than on

prevention.


Nevertheless, Šmucler believes that we are entering gold era of dentistry. Dentist are working

on the total eradication of tooth decay, there is huge revolution due to the use of artificial intelligence and robotics. According to Šmucler, the patients will see a completely different

world.


But, Elhadad is not so optimistic in the way how technology might help to solve the problem of

global decay epidemic. He believes that prevention is not about technology at all. It can help

the patients who are already educated about how important the toothbrush is. The problem

according to Elhadad is, that the patients do not know about it. It does not make sense to offer a smart toothbrush which is doing the job for him. Because these patients do not understand the value and do not want to pay for it.


Elhadad claims, that first of all it is important to educate patients in order to understand why he has to brush. It is very simple. All is about education. Doctors have to start with children and then family. It depends on the education level of the parents and the way the dentist has to influence them to be better.


Built upon the literature review, the last part if the interviews focused on businesses involved in prevention. Šmucler says that thanks to many commercial companies involved, the Czech

Dental Chamber was able to organize 650 dental prevention events just in one week.

Furthermore, he claims that even government and insurance companies are becoming

interested are starting to participate. Elhadad agrees. He thinks that private companies

participate in the cost of the public health dept. It is mutual relationship which is beneficial for

both the public sector and the private sector. Elhadad believes that it is not unethical to sell a

toothbrush which looks like a children's super hero, if the children is using it right. But, he says, the relationship between private companies and public health institutions should be more in tune and in control.

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