Oral Health Division Ministry of Health Malaysia

ORAL HEALTH CARE FOR
SCHOOL CHILDREN IN
MALAYSIA
Dr Norliza Mohamed
Deputy Director
Oral Health Division
Ministry of Health Malaysia
COUNTRY PROFILE
2
Country Profile
Malaysia consist of 13 states and
3 Federal Territories
3
Country Profile
SYSTEM OF
GOVERNMENT
• Constitutional monarchy and parliamentary democracy
• Head of State – King
• Head of Government – Prime Minister
DEMOGRAPHY
• 30 million people (2014)
• Males:Females are 51:49
• Life expectancy is 72 years for males and 77 years for females
(2013)
• Average population growth rate is 1.3% per annum
ECONOMIC
INDICATOR
• Total Expenditure on Health as a % of GDP: 4.5% ( USD 8.7 illion)
• Total Expenditure on Health : Public 52.3% ; Private 47.7%
• Total Dental Health Expenditure only 0.2% of the total Health
Expenditure
Source: Department of Statistic Malaysia4
& Health Facts 2014
Oral Health Care Financing System
5
DENTAL HEALTH
DENTALPROFILE
HEALTH PROFILE
6
Dental Workforce
Active Dental Practitioners
YEAR
PUBLIC
PRIVATE
TOTAL
2005
1,190
1,485
2,675
2006
1,368
1,572
2,940
2007
1,540
1,625
3,165
2008
1,692
1,673
3,365
Percentage
100
80
60
55.5
53.5
51.3
49.7
44.5
46.5
48.7
50.3
PRIVATE
40
20
PUBLIC
0
2005
2006
2007
2008
7
(Source: Health Informatics Centre, MOH)
Dental Workforce
Active Dental Practitioners
YEAR
PUBLIC
PRIVATE
TOTAL
2011
2,452
1,801
4,235
2012
2,664
1,894
4,558
2013
3,256
1,979
5,235
(Source: Health Informatics Centre, MOH)
2014
3,763
2,125
5,888
8
Dentist to population ratio
(Source: Malaysian Dental Council, 2014)
2020
DENTAL AUXILIARIES IN
MINISTRY OF HEALTH
(2014)
Dental Nurses
(Therapists)
Dental
Technologists
Dental Surgery
Assistant
2,633
918
3,581
Source: Oral Health Division, MOH
9
Oral Health Division
Ministry of Health Malaysia (MOH)
Leading agency in the provision of
oral healthcare as well as the
planner of the programmes
Role of Oral Health Division
•
•
•
•
Formulation and development of policies related to the oral
health of the population
Management of oral health which includes planning, organizing,
monitoring and evaluation of oral healthcare
Promotion of oral health to ensure continual improvement of
the oral health population
Enactment and enforcement of laws and regulations pertaining
to the practice of dentistry
11
PRIMARY CARE
COMMUNITY CARE
SECONDARY CARE
• Toddler programme
• Pre-school
programme
• School Incremental
Dental Care
• Antenatal mothers
• Children with special
needs
• Elderly
• Water fluoridation
• Clinical prevention
• Prevention and early
detection of oral
cancer
• Oral Surgery
• Pediatric Dentistry
• Oral Pathology and
Oral Medicine
• Forensic Odontology
• Special Needs
Dentistry
• Orthodontics
• Periodontology
• Restorative Dentistry
• Dental Public Health
specialist
12
Oral Health Education
Clinical prevention and curative
Schools covered (2014):
Primary - 98.5%
Secondary - 84.0%
Source: Oral Health Division, MOH
Tooth Brushing Drill 13
School
based
fissure
sealant
Fluoride
varnish
Fluoride
mouth
rinse
14
 Flip charts
 Posters
 Pamphlets
 Oral hygiene kit
15
Became a national
programme in
1997
Integrates &
coordinates all the
health activities in
schools
Introduced in primary schools in
the late 1980s
Smart
partnership
between Health
Promotion
Division, Ministry
of Health and
Ministry of
Education
In 2006, recognized as one of the co-curriculum
activity in the primary school.
Current:
Primary Sch. – 2,474 ; Secondary Sch. - 72
Empowered to give health
education and conduct health
related activities at school
Child-to-child
peer-led
HP programme
Oral Health Promotion Activities
Dental Health Education
Tooth Brush Drill
Clinical Preventive
Activities
Puppet Show
Role Play
19
Children with Special Needs Receiving
Primary Oral Healthcare, 2008- 2012
20
School Dental Clinic
21
Mobile Dental Clinic
22
Mobile Dental Team
23
ORAL HEALTH STATUS
&
QUALITY IMPROVEMENT
INITIATIVES
24
Percentage
Caries Prevalence comparison
between 1997 and 2007 surveys
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
80.9
75.5
74.5
60.9
59.6
41.5
1997
2007
1997
6-year- olds*
2007
1997
12-year- olds
2007
16-year- olds
* : caries prevalence of deciduous dentition
A decreasing trend in caries prevalence in 6, 12 and 16 year-old
schoolchildren over a decade
Source:
NOHSS 1997 – National Oral Health Survey of School Children 1997
NOHSS 2007 – National Oral Health Survey of School Children 2007
Caries Severity comparison between
1997 and 2007 surveys
3.50
3.30
3.00
Mean DMFT
2.50
2.12
1.90
2.00
1.50
1.12
1.00
0.50
0.00
NA *
1997
0.10
2007
6-year- olds
1997
2007
12-year- olds
1997
2007
16-year- olds
* NA : Not Available
A declining trend of mean DMFT over the 10 years period in 12 and 16
Source:
year-old schoolchildren
NOHSS 1997 – National Oral Health Survey of School Children 1997
NOHSS 2007 – National Oral Health Survey of School Children 2007
KEY PERFORMANCE INDICATORS (MINISTERIAL)
Domain 1: Comprehensive Oral
Healthcare For Schoolchildren
INDICATORS
Domain 2: Oral Health Status of
Schoolchildren
STANDARD
ACHIEVEMENT
(2014)
INDICATORS
•
% primary schools
treated under IDC
95%
99.4%
•
% primary
schoolchildren
treated
95%
98.5%
% of primary
school children
maintaining
orally-fit status
•
% secondary schools
treated under IDC
93%
94.9%
% of secondary
school children
maintaining
orally-fit status
•
% secondary
schoolchildren
treated
85%
85.7%
STANDARD
ACHIEVEMENT
(2014)
≥ 95%
97.9%
≥ 90%
93.0%
Source: Oral Health Division, MOH
NATIONAL ORAL HEALTH PLAN GOALS 2020
INDICATORS
GOALS
ACHIEVEMENT
(2014)
•
Percentage of 6-years-old school children
with caries free mouth
50%
34.0%
•
Percentage of 12-years-old school children
with caries free status
70%
66.5%
•
Percentage of 16-years-old school children
with caries free status
50%
55.9%
Source: Oral Health Division, MOH
DENTAL HEALTH
PROFILE
CHALLENGES
29
Percentage
Caries Prevalence comparison
between 1997 and 2007 surveys
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
80.9
75.5
74.5
60.9
59.6
41.5
1997
2007
6-year- olds*
1997
2007
12-year- olds
1997
2007
16-year- olds
* : caries prevalence of deciduous dentition
A decreasing trend in caries prevalence in 6, 12 and 16 year-old
schoolchildren over a decade
Source:
NOHSS 1997 – National Oral Health Survey of School Children 1997
NOHSS 2007 – National Oral Health Survey of School Children 2007
Detection and
management of
early caries lesion –
incorporating
ICDAS
Continuity of IDC –
focusing on Young
Adults Group
ICDAS – International Caries Detection Assessment System
IDC – Incremental Dental Care
31
• The incremental oral healthcare for school children
has brought about a tremendous increase in the
number of school children receiving primary oral
healthcare
• With an increasing school-going population,
constraints in resources, the emergence of new
materials and technologies as well as increasing
customer expectations, we have to adopt and adapt
promptly so as to continuously provide the best care
possible
32
Dr Noor Aliyah Ismail
Principal Director of Oral Health
Ministry of Health Malaysia
Dr Nurul Syakirin Abd. Shukor
Senior Principal Assistant Director
Oral Health Division
Ministry of Health Malaysia
Dr Noor Syahidah Hisamuddin
Senior Assistant Director
Oral Health Division
Ministry of Health Malaysia
Ms Fatimah Rahman
Principal Head of Dental Nurse
Oral Health Division
Ministry of Health Malaysia