BPOC

BASIC PACKAGE OF ORAL CARE

WHO Collaborating Centre for Oral Health Care Planning and Future Scenarios

College of Dental Science Radboud University of Nijmegen, The Netherlands

Authors: - Jo.E. Frencken

- Christoper J. Holmgren

- Wim H. van Palenstein Helderman

CONTENTS

Acknowledgments, preamble and foreword

Oral health priorities for the disadvantaged.

Oral Urgent Treatment (OUT) for the emergency management of oral pain, infection and trauma.

Affordable Fluoride Toothpaste (AFT) for the prevention of dental caries.

Atraumatic Restaurative Treatment (ART) for the management of dental caries.

Personnel and equipment for OUT and ART

Recommendations for establishing and evaluating BPOC demonstration programs.

References

Oral health is recognized as a fundamental contributor to general health. Oral health problems continue to affect people throughout the world. Although seldom life threatening, these problems adversely affect people's well being, quality of life and economic activities.

Governments allocate budgets for oral services, but in many non-established market economies (non-EME) the budgets are very limited and the services are not always directed to those most in need. This leads to situations in which large segments of the population have limited or no access to oral health care, and hence continue to suffer.

This situation calls for the establishment of oral health as a priority and for the implementation of the essential components of oral health care that are affordable within the prevailing health infrastructures of deprived communities.

The Oral Health Unit of the World Health Organization charged the WHO Collaborating Centre for Oral Health Care Planning and Future Scenarios in Nijmegen, the Netherlands, with the task of compiling a report on the establishment of priorities in oral health care for deprived communities based on proven and effective oral health measures.

The philosophy of Primary Health Care (PHC), with its leading principle of basic oral care for all and emphasis on prevention and affordable and sustainable services, was a guideline in writing this report. The basic assumption was that the services offered should primarily meet people's perceived needs and treatment demands. The second assumption was that periodontal diseases are not a major cause of tooth lass. Therefore, removing calculus by scaling tooth surfaces is not considered a priority. As the report focuses on oral health care within the context of PHC, the treatment of serious disorders, e.g., oral cancer, cleft lip and palate disorders, are also not addressed.

The report outlines the basic premise behind the three key components that constitute the Basic Package of Oral Care (BPOC).

Oral Urgent Treatment (OUT)

Affordable Fluoride Toothpaste (AFT)

Atraumatic Restorative Treatment (ART).

It argues for community-oriented promotion of oral health and affordable and effective interventions. It suggests that the package should be financed predominantly by public funding and implemented by competently trained primary ( oral) health care workers.

This report is a policy document. It presents the rationale that eventually leads to priorities in basic oral care. It is intended as a call to action for policy makers (Chief Dental Officers and advocates of oral health care at the Ministry of Health) and for partners in the development of oral health care (Non-Government Organizations dental academia, and industry

The report does not provide an overview of the specific content of each proposed component. Neither does it outline the tasks of various cadres of dental personnel, nor does it present a strategy for implementation. Although of great importance, these elements cannot be covered in one report. Each local situation demands tailor-made solutions with respect to the personnel involved, its content and extent of the services offered.

This report strongly recommends the implementation of small-scale (demonstration) projects to assess the effectiveness and sustainability of the basic package of oral care under local conditions before introducing the BPOC on a wider scale. In this endeavor, NGO's and industry have an important role to play, particularly in the planning and evaluation stages. They should consider themselves partners to governments in working toward improved oral health for deprived communities.

Ass. Prof. Dr. Frans H. Mikx, Director WHO Collaborating Centre for Oral Health Care Planning and Future Scenarios

For more information on WHO collaborating centre Nijmegen, visit their site