Foreign Dental Health Research and the Philippine Dental

Foreign Dental Health Research and the Philippine Dental Act Dr. Len Ramos

Philippine Epidemiology (1998) • . [i]In the Philippines, the limited financial public resources are mostly spent on urgent medical and social problems. As caries and periodontal diseases are not regarded as life threatening, prevention and treatment of dental diseases have a low priority. [ii]94% of 5 -year-old Filipino children had caries and in 12 -year-old children the mean DMFT was 4. 6. Ninety percent of the decay was untreated. [i] Community Dentistry and Oral Epidemiology 2003; 31: 129 -35, Blackwell Munksgaard, 2003 [ii] 1998 National Dental Survey

Methodology MRT by 2 German dentist and 2 so called health care workers • ERC( Xavier University) • DECS • 19 Elementary public schools in • rural areas of • Misamis Oriental, mindanao Grade 1 students on their first molar and mouth exodotias as compensation

Methodology • ART =excavation on vital teeth using only excavator palcing a flouride releasing GIC restoration. Bacteriostatic. • MRT = same rpocedure but placing amalgam directly wthout the liner and base.

Method diagram

Bioethical Principle • Autonomy Why the Grade 1 students of 19 elementary school of Misamis Oriental? • Beneficence – Is mouth exodontia a real benefit as compensation as well as the research restoration? • Justice • Can a research be an excuse to waive the existing law in the area?

Informed Consent • • • Why these subjects? Research procedures Their purpose Risk and anticipated benefits Alternative procedures (Where therapy is involved) • Statement of offering the subject to ask question and withdraw at any time from the research • How the subjects are selected

Assessment of the Risk and Benefits

Physical Harm • Possibility of future mercurialism due to absence of liners and base • Bacterial entrapment • Non manipulation may result to tarnishing • Conductor of heat may result to future devitalization • Non-bio-compatible with the pulp

Legal Harm • • 1. 2. 3. 4. 5. Code of Ethics RA 4419 Article IV Examination and regulation, Section 13. Pre requisite to the practice of dentistry Section 14. Definition of Dentistry Section 15. Exemption to registration RA 4419 Article VII Penal provision Sction 38. Foreign Reciprocity

Nuremberg Code • • Free power of choice Fruitful results for the good of the ociety Result of animal experimentation Avoid unneccesary physical harm. Proper preparation should be made and adequate facilities • Conducted only by scientifically qualified persons

Recommendations • Springboard to strenghen the Philippine Health Care system especially access of dental health • Bioethics be a means to mediate on social injustices especially in the health of the people(Solus populi suprema Lex) • Strengthening of competence of the ethics review board and propagate its establishment.

Sawat dee kah!!!