Oral Health is vital for overall well-being and quality of life. Poor oral health can have a detrimental effect on general health. Taking into account the oral health situation in the country, Government of India has initiated a National Oral Health Programme to provide integrated, comprehensive oral health care in the existing health care facilities with the following objectives:
- To improve the determinants of oral health
- To reduce morbidity from oral diseases
- To integrate oral health promotion and preventive services with general health care system
- To encourage Promotion of Public Private Partnerships (PPP) model for achieving better oral health.
In order to achieve above listed objectives, in Tamil Nadu, the National Health Mission - Tamil Nadu (NHM TN) initiated the National Oral Health Programme in 2015-16 and now it is implemented in all the Districts across the State. NHM TN assists the State Government in initiating provision of dental care along with other ongoing health programmes implemented at various levels of the health care system to provide accessible, affordable and quality oral health care services. Funding has been made available through the State PIPs for establishment of a dental unit.
The NHM Dental Units are equipped with necessary trained manpower, equipment including dental chair and support for consumables are provided through the NOHP. These units are established primarily in Sub District Hospitals and Primary Health Centres across the State.
Manpower such as a Dental Surgeon and Dental Assistants are supported by NHM TN and are appointed on contractual basis.
Equipment for the dental unit such as dental chair, x-ray machine and other supportive instruments are procured through Tamil Nadu Medical Services Corporation ad are supplied to the NHM Dental Units by the State Government.
Funds are also sanctioned for the procurement of consumables required for the unit.
Oral Cancer Screening Programme
In Tamil Nadu, the burden of oral cancer is very high, contributing greatly to morbidity and mortality. The main risk factors for oral cancer are HPV, tobacco, alcohol consumption, and the rates are higher in disadvantaged groups, who are more likely to smoke or drink and have low access to dental care. Oral cancer is often diagnosed at a late stage, which results in poor prognosis and a low survival rate, hence screening and early detection is crucial.
National Health Mission in Tamil Nadu is leading the country by launching the Oral Pre-Cancer Screening program in 2016 to promote prevention and enable earlier detection. The State Government of Tamil Nadu have taken the initiative to identify Precancerous and Cancerous lesions in oral cavity through the NHM Dental units existing in Primary Health Centers and Sub District Hospitals. This innovative program supports the Oral Health professionals under NHM to raise awareness of Oral Precancer & Cancer, identify people at risk, discuss the risk factors, encourage behavior change, detect early signs, refer appropriately and reduce the impact of the disease.
The programme consists of two components - a door to door comprehensive survey is being carried out by the Dental Assistants and opportunistic (passive) screening by Dental Surgeons for patients attending OP.
A mobile application is used for screening for Oral Precancer and Cancer lesions and real time reporting, data generation and online analysis is being carried out.
Planned activity under the Oral Cancer programme:
- To entrust the age group (0-18) years to the RBSK scheme as it is flagged. (RASHTRIYA BAL SWASTHYA KARYAKRAM)
- A three-pronged approach to be used for the general population, namely,
- The actual survey by Dental Assistant – covering the area systematically.
- An opportunistic survey at the PHC & GH. Charts to be placed in the PHC's & GH's & all patients reaching PHC for various ailments, if users of tobacco /alcohol or self-appraised individuals, to be referred & seen by the Dental surgeon posted in the PHC. A register may be maintained at the PHC & entry with the respective VHN for follow up of cases.
- The health workers both male and female in various schemes can also refer cases to the Dentist in the PHC.
- The Hospital on Wheels – the mobile clinics can also be used to screen individuals as and when approached.
The State Nodal Unit in Department of Public Health Dentistry, Tamil Nadu Government Dental College, Chennai helps in imparting training to the Oral healthcare professionals and as well as general healthcare professionals for an integrated approach to better oral health. The State Nodal Unit also monitors the implementation and progress of the programme from time to time through established mechanisms.