Well, they say life begins at 60…Presently, Brazilians live more and at the age of sixty, they still consider themselves young enough to live with maturity, autonomy and financial stability. But, what about your buccal health? Is it good? If so, perfect! Let us see how it is and how it can be improved.
According to IBGE (the Brazilian Institute of Geography and Statistics), the demographic, social and economic transformations through which the Brazilian society has been going have an impact on the life and health standards of the population, as well as generating new demands from the country’s health care system. In addition, according to the same institute, in a report published by BBC Brazil, the number of Brazilians over 65 should practically double before 2060.
Geriatric dentist Dr. Fernando Brunetti talks about that:
1) How does Brazil take care of the buccal health of its senior citizens?
FB – There may even be government programs for treating the elderly, but it does not reach most of the population of seniors that exists today. We could mention the great service done by the Centros de Referência de Idosos (Senior Reference Centers) – the ones that count on a dentist – throughout Brazil, but one should not forget that services are limited to the residents of an area and not for all seniors of the same city. In the regular Primary Health Care Centers (Postos de Saúde), there is a clear emphasis on children, youngsters and adults, which, if added together, are in greater number than the number of seniors. However, this population group is the one that grows the most in Brazil at the current moment. Only a few cities have a specific program to treat seniors, and the ones that do, are not enough to cope with the REAL demand.
2) How do you, as a geriatric dentist, assess the situation?
FB – The course of Geriatric odontology should be available at the Colleges of Odontology. That is the only way to create more dentists that have knowledge and expertise to treat the elderly. In the 220 colleges of Odontology all over Brazil, less than 18 or 20 have this subject available and there are not any Master’s or Doctor’s degree courses in that area to form professors that are more capable. Many colleges just invite a professor from another institution to talk to students about geriatric odontology.
3) What must change? And where can we “improve”?
FB – We hope the scenario will change from now on given the fact that the National Undergraduate Performance Exam (which evaluates the performance of colleges all over Brazil) carried out by INEP/MEC (Brazilian Ministry of Education) has added “Geriatric Odontology Clinical Attending” to the topics to be asked about by examiners. The results in that Exam is responsible for the Ministry of Education official college ranking. A few colleges have manifested interest in having the course but the question is if there are enough specialized teachers available. The great volume of necessary professionals to attend those 19 million senior citizens will have to graduate from those colleges of Odontology.
4) Do senior citizens have more support from the public health system nowadays?
FB – Primary care units/AMAs/State and City schools/UBS or other local institutions supply health services to the population, not necessarily seniors, and dentists that work at those places, probably, have not received specific training in college or continuing education about how to treat the elderly. Of course, there are cities, even if just a few, that really try to give attention to the elderly but those activities always depend on the isolated actions of a certain mayor or heath secretary and available funding at a certain time and place. The continuity of good projects for the elderly suffers a lot with the changes in the priorities of the public health system.
5) What do we need to guarantee the Brazilian senior citizens’ good buccal health?
FB - Presently, what is needed is:
1) Massive prevention information URGENTLY for patients who still have their teeth and consistent preventive information for those who already wear dentures as well;
2) Information about medications and their consequences and side effects for the buccal health;
3) Basic information for attending dentists;
4) Information from the academic community to the dentists population in graduate courses;
5) Better communication of the specialty to graduated dentists and the availability of updating courses on Geriatric odontology (faster courses) and also specialization courses (usually taking 24 months) for dentists;
6) City, state and federal contractors should require their professionals to be updated on Geriatric odontology;
7) Companies that administer odontology health plans should, at least, inform its network of dentists of the basic clinical attitudes in geriatric odontology and those companies should place geriatric odontology among the specialties covered by their plans, observing its particularities;
“As you see, there is a lot more to be done to solidify this area in terms of quality in buccal health for the elderly”, says the Master and PhD from the College of Odontology of the University of São Paulo.
6) What difficulties does Geriatric odontology face in Brazil today?
FB – I believe that the greatest difficulty is the lack of general information. Firstly, to the patients (at least preventive). Secondly, to the professionals (many still believe that geriatric odontology is only about knowing how to make perfect dentures). Thirdly, to the boards and congregations of colleges of odontology that need to realize that, soon, 20 million seniors – many of whom without any teeth – will be living in Brazil and something must be done NOW. Finally, to the authorities who, in face of the huge needs that this continental country shows, will have to do really something to supply odontology services to those millions of individuals who have paid taxes their whole lives and should have rights to good odontology care.
“Presently, there are no more than 300 geriatric dentists in Brazil for a universe of almost 19 million seniors over 60. We have to agree that that is too little”, says Dr. Fernando.
Fernando Luiz Brunetti Montenegro has a Master and a PhD degrees from the College of Odontology of the University of São Paulo; is a specialist in Prosthesis and Periodontics (from CROSP); is the Coordinator of the course of Specialization in Geriatric Odontology at NAP INSTITUTO and at ABO-SP. Long duration Gerontology course at the College of Odontology at the University of São Paulo.
CFO Communication – Sources: IBGE/BBC Bras.