Proposed 10 Year Regional Plan On Oral Health

Proposed 10 -Year Regional Plan On Oral Health • Lessons learned 1993 -2006 • Forty national oral health surveys indicate a marked decline between 35% to 85% in the prevalence of dental caries, attributed mostly to cost-effective salt and water fluoridation programs • Burden of oral disease is severe and remains high in certain geographic areas and high risk populations • Strong scientific evidence suggests the associations between oral infections, chronic diseases and adverse pregnancy outcomes • Best Practice Models on prevention and delivery of oral care Pan American Health Organization

Typology Table in Oral Health 1990 2004 EMERGENT DMFT > 5 GROWTH DMFT 3 -5 CONSOLIDATION DMFT < 3 Belize Argentina Bahamas Bolivia Canada Bermuda Guatemala St. Lucia Brazil Colombia Cuba Chile Ecuador Guyana Costa Rica C. Island Dominican Republic El Salvador Guatemala Haiti Honduras Jamaica Nicaragua Paraguay Mexico Panama Peru Trinidad Venezuela USA Argentina Bolivia Chile Dominican Republic Honduras Panama Paraguay Anguilla Jamaica Aruba Nicaragua Bahamas Peru Barbados Suriname Belize Trinidad Bermuda Turks and Brazil Caicos Canada Uruguay Cayman USA Colombia Venezuela Costa Rica Mexico Cuba Curacao Dominica Ecuador El Salvador Grenada Guyana Haiti Uruguay

PAHO/IADB Clinical Trials in Ecuador, Panama and Uruguay PRAT PROBABILITY OF SUCCESS AND FAILURE • Dentist doing amalgam • Dentist doing ART • Auxiliary doing ART Success 0. 943 0. 960 0. 942 Failure 0. 057 0. 040 0. 058

Pan American Health Organization

Oral Infections and Pregnancy Outcomes Scientific evidence suggest that pregnant women with periodontal disease are seven times more likely to deliver PTLBW baby. This risk is much higher than tobacco and alcohol. Clinical trials suggest that treating oral infection in pregnant women before 26 weeks of gestation reduces the incidence of PTLBW by 28% to 82%.

Framework for the strategy • • Best Practice Model Partnerships Downstream Investment Measurement of Progress Pan American Health Organization Primary priority countries: Bolivia, Haiti, Honduras, Guyana, Nicaragua Secondary priority countries: Ecuador, Guatemala, and Paraguay Priority groups: MCH, Children, Women in reproductive age groups, HIV/AIDS, Indigenous groups, Elderly

GOAL # 1: A Minimum Level of Oral Health Care For All By Addressing Gaps in Care For the Most Vulnerable Groups Reduction of Oral Infections Increasing Access to Oral Health Care

GOAL #2 The Integration of Oral Health Into PHC Services P P P Develop mechanism to integrate oral health within current PHC services Incorporate oral health component into prenatal programs Scale up best practice models

GOAL # 3 Scaling-Up of Proven Cost Effective Interventions Salt fluoridation P Support Bolivia, Ecuador, Haiti, Honduras, Nicaragua, Paraguay and Saint Lucia to reach full implementation of fluoridation programs P Consolidate fluoridation programs with appropriate surveillance Sealants FL Supplements Water Fluoridation Salt Fluoridation $21. 17 $2. 53 $0. 54 $0. 06

Scale Up Oral Health Coverage Using Cost-Effective and Simple Technologies, PRAT $ 1. 50 to treat/seal a tooth Peru 200, 000 children treated with PRAT Uruguay priority PRAT program 100, 000 disadvantage children Mexico over 10 million restorations under PRAT

In Summary • Best practice model provides a framework to implement at large scale oral health programs • We have the evidence and the knowledge that it works • Evidence demonstrates feasibility with extreme costbenefit • Implementation requires leadership, commitment to guide downstream investment to improve equity and efficiency and quality of life in the Americas • Action by the Executive Committee for government support for dental public health programs and technical Cooperation Plan and Proposed Budget Pan American Health Organization

Trends of DMFT-12 for the Region of the Americas EVIDENCE 1987 -2003 PROJECTIONS 2007 -2010