The Dental health care Service was started in the year 1968-69, since then the dental health care services has not improved and remain poor both in preventive and curative aspects.The state has high incidence of dental caries , periodontal diseases (gum diseases)ulcer , cyst , malocclusion , RTA etc. and it is well established that dental/oral diseases are public health problem and have a great impact on general health. Poor dental/oral health causes poor aesthetic affects mastication adversely , causes agonising paina and can lead to loss of production due to loss of man-hour.
There is need of strengthening the dental health care services with general healthcare right from villages. Having people suffering from oral diseases and their impact on general health needs to be paid attention in terms of prevention and curative aspects. There is acute shortage of machinery , equipment and materials to run the clinic is seen making inability to provide even the primary level treatment to the needy and poor and also there is lack of oral health awareness in the rural population and their impact on general health
In the year 2005 a multi centric oral health survey was conducted through out the country as a pilot project and seven states were chosen and Arunachal Pradesh was one of them and papumpare district was taken as a representative district because of its cosmopolitan in nature by Directorate General of Health Services,Ministry of Health and Family Welfare , Govt.of India and WHO collaborative programme and a book was published namely Oral Health in India December-2007.
Present status-Health facility Centres
There is one state referral hospital ( Trimhs) , 6 general hospital,11 district hospital, 63 CHC, 143 PHC and 584 health sub-centres under Directorate Health Service DDHS-Deputy Director Health Service, P.O- Programme office , N.O-Nodal officer. There are 69 dental surgeons as regular , 7gdmo , 25rbsk , 16nohpcontractual under NHM.
Summary
The dental caries prevalence was found to be 60-80% in adult and about 45-48% in children , the average DMF was about 1-1.5 in children and 2.6 in adult. The geriatric population had higher score in the range of 6-7 because of more edentulousness in this group. There were less than 1% filled teeth in the entire population indicating poor oral health care service in the state and lack awareness. No cases of dental flourosis were reported.Gingival bleeding was found to be low perhaps due to use of betel nut and quid among the whole spectrum of population.
The tobacco smoking habit was seen 6% in adult and 17.5% in geriatric population. The chewing tobacco habit was reported in 6-7% of the children and 17% of geriatric population. Poor and very poor self perception of oral health was reported in 30% of geriatric population indicating complete negligence about oral health care elderly population. The proportions of population who have never visited a dental operatory were 50-70% high almost in all age group.
Overall it seems that the prevalence of gingival problem is low in the population but it requires steps in the direction of dental caries prevention and oral hygiene maintenance. Therefore oral health care service requires augmentation especially in the restorative and Prosthodontic aspect.
As per data analysis and result brings out two major points:-
1.There is lack of Oral health awareness which effects oral health perception,behavior and practices in all age group.
2.There is wide gap between oral health needs and provision of oral health care.
Therefore to improve the overall oral health care delivery in the state two pronged approach is required.
a.Promotion of oral health awareness and diseases prevention.
b.Improving the oral health care delivery facilities.
Tentative Preventive and curative strategies-
1. Promotion of oral health awareness and disease prevention by-
a. Training of school teacher, ASHA, ANGANWADI and paramedical personnel’s for imparting oral health education to the school children and in community level.
b. Distribution of IEC material like poster, pamphlets, radio talks etc.
c. To organise Dental health camps,exhibition,workshop by holding cartoon/ smile competition etc.
d. Provision of denture at subsidized rate to economically poor section of elders to reduce the oral morbidity and improved the nutrition.
e. Creation of post for Dental Health services for all categories like Jt.DHS&DDHS(Dental) under Directorate of Health Services, Jt.DME,&DDME(Dental)Under Directorate of Medical Education. M.O Dental, Dental Technician, Dental Hygienist & Dental assistant.
2. To improve the oral health care delivery services-
a. Strengthening of infrastructure by provision of adequate machinery, equipment, materials and deployment of dental surgeon upto PHC level.
b. Emphasis on provision of oral health care to the disadvantaged population such as elderly, physically and mentally challenged individuals.
c. Establishment of Multi specialty Dental unit/Clinic in TRIHMS State Hospital-Naharlagun.
d. To start intensive Dental Health care service on Mobile Dental clinic.
e. Establishment of Dental college.