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"Child`s Health" 3 (63) 2015

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Positive aspects of dental unit restoration at the outpatient department of City Children''s Hospital

Authors: I.A. Mochalov, O.V. Klitynska — State Higher Educational Institution "Uzhhorod National University", Uzhgorod

Categories: Pediatrics/Neonatology

Sections: Clinical researches

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Improving the system of dental care in Ukraine is urgent and acute issue and maintenance of dental care for children - in particular. At present, the prevalence of dental caries and periodontal diseases among the population of Ukraine have negative trends and moves to 100%. Performing of health care reform has withdrawn dental care for children from primary care chain of health care system, which limited its availability and prevention became impossible.
In Ukraine the prevalence of dental caries in 6-year-olds children is about 87,9%, 12-year-olds — 72,3%. Level of dental caries depends on region, for example, in the east of the country - 73-93%. Experts of dental care believe that while maintaining the current level of communal and individual prevention of caries prevalence will continue rates of dental caries in the population of Ukraine will rise and be able very quickly reach a 90,3% rate [2,5,6,7,11,13].
Today in Ukraine dental care for children is provided at dental institutions of private, state and municipal ownership. Budgetary institutions have different level of organization - district, regional and national level. Dental health care for children belongs to highly specialized type of medical care and according to the logic and concept of Ukrainian health care system reforming appears on the third level of medical care only. This situation does not response  to requirements of nowadays and contradicts the logic of structured and integrated approach of most preventive programs for dental disease in Ukraine. Implementation of health reform in that vein violates the rights of the child population in the availability and timeliness of dental care [4,10,14,15].
At present, the legal status of schools' dental offices in Ukraine is uncertain at all. Lot of legislative and regulatory legal acts can not be interpreted in favor of the organization and functioning school dental ofices which are necessary component of primary prevention of dental diseases among children Ukraine. Dental office at school may be considered as a center providing dental care to children in school-preschool stage: during a semesters dental office provides therapeutic and preventive care for children, students of the institution where office is located. During a vacation time dental care may be  carried out  for children visiting pre-school institutions from a designated territory or group of preschool institutions. 
Unfortunately, the deficiency of the state and local budget does not allow adequate financing for existing system of governal, municipal and regional dental clinics. In this way, we can forget about state funds for the organization of some dental offices in schools [3,8,9].
Medical and economic feasibility of the planned dental health and preschool center dental care system has been fully proved by Professor T. Vinogradova and several researchers in Soviet times. Today, modern dental treatment and diagnostic technologies, and especially preventive measures and hygiene education are often inaccessible to children. The reasons of this are quite simple - the level of prosperity of the family, places of employment of parents, availability of transport and logistics problems, especial feathures of socio-economic and demographic development of the region [1]. 
Unfortunately from the early 90s of the XX century and the beginning of the new century, most of school dental offices were left without funding. According to existing system of dental care for children in Transcarpathian region there are only 30 full-time positions in pediatric dentistry for more than 300 000 perrsons of children population. Unfortunately, the social importance of pediatric dentistry is not underestimated today. The transfer of the serving the children population to general dental practioners did not justify itself - the practitioners have no motivation to provide dental care for children, this kind of work is more complex and hard. That's why pediatric dental care is adequately perceived by enthusiasts of dentistry only. 
Organization of dental care for children of Uzhgorod has its specific features. Full range of dental care is provided only at pediatric department of Regional Dental Clinic and pediatric cabinet in District dental polyclinic of railway station “Uzhgorod”. Specialized dental in-patient care may be provided at selected 5 beds ENT department of A. Novak's Transcarpathian Regional Hospital,  general surgical departments at Uzhgorod City Clinical Hospital and Regional Children's Hospital (located in Mukachevo.). Dental office was not organized at the staffing structure of Uzhgorod City Clinical Hospital (and later after reforming — at Municipal  Institution "Uzhgorod city center of primary medical and sanitary care"). This situation in the presence of largest children's population on the territory of Ukraine and adverse environmental conditions - pronounced biogeochemical deficiency of iodine and fluoride ions in the soil and water — causes a lot of problems. Private dentistry can not adequately fulfill responsibilities for implementation of state and municipal programs in the health sector. Medical care child population of the area is not complete and comprehensive. There was even a gap in the consultative medical care for children, not to mention about prevention.
In that situation a new agreement between Uzhgorod City Clinical Hospital and Uzhgorod National University was signed. According that agreement on the territory of out-patient department of  Uzhgorod City Clinical Hospital a new dental office was organized by Department of Dentistry of Childhood of  Uzhgorod National University. A new dental office began to provide a consultive and preventive dental care for patients of Clinic. Annually amount of consutation is about 2000. The staff of office if fulled by staff of University and by Internship and Mastership students.Abovementioned decisions were the first step of solution the problems of dental care for children in Uzhgorod.
Thus, the problem of modernization and development of pediatric dentistry in Ukraine is relevant because of its high social value and economic viability. The work of the system at all levels will solve the complex issue of prevention of dental diseases, early detection and treatment of oral pathology tissue, providing clinical supervision for children and teenagers and a long and active surveillance of their health. 


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