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Oral and Dental Care Acknowledgements Estonia This Handbook has been produced by Mrs. Tiina Juhansoo, who offers grateful thanks to the following for their guidance, support, donation of appropriate materials and proof reading for accuracy of this package of information. Mr. Laine Paavo Lecturer, Tallinn University Mrs. Eve Epner Team Member, Tallinn Health College Mr. Tõnu Kauba Head of the Chair of Dental Technology, Tallinn Health College Mr. Veikko Keimann, Dentist, Novamed OÜ Mr. Andry Tulp, Assistant, Novamed OÜ Mr. Gunnar Riisenberg Project Assistant, Tallinn Health College Graphic Design Rhinoceros Ltd for layout Mr. Matti Remsu (co-ordination of the project) All materials of the project are downloadable for free from partner colleges’ websites: Oral and Dental Care www.hesote.edu.hel.fi Tallinn Tervishoiu Kõrgkool www.davinci.nl www.ttk.ee www.kbs-pfl ege.de www.kellebeek.nl www.vitaliscollege.nl This Handbook for Students has been produced within Leonardo www.linkoping.se/birgitta da Vinci - programme as a pilot project “Learning Materials for www.stevenson.ac.uk Social and Health Care Students’ Foreign Placements / ETM II” www.oszee.de (FI-06-B-P-PP-160 704) during 2006 – 2008. This publication has been funded by the European www.dundeecoll.ac.uk/?about_us/european_projects.xml Commission. The Commission accepts no responsibility for the contents of the publication. Oral and Dental Care in Estonia Content Introduction 3 1. Guidelines on Oral and 4 Dental Health Policies of WHO and EU 2. Oral health care services in Estonia 8 2.1. History and Challenges for the Future 8 2.2. Variety of Clinics 12 2.3. Organization of Oral Health Care for Special Groups 14 2.4. Insurance Arrangements 15 3. Oral Health Care Teams 17 3.1. General Dental Clinic 17 3.2. Dental Specialists 19 3.3. Dental Laboratories 19 4. Status and Position of the Dental Nurse 20 4.1. The Law and Ethics 20 4.2 Some Facts 22 5. The Dental Nurse in the Workplace 25 5.1. Hygiene and Maintenance of Equipment 27 5.2. Documentation and Administration 28 5.3. Promotion of Oral Health Care 29 5.4. Treatment, Assisting the Dentist 30 1 6. Communication 34 6.1. Communication with Patients 34 6.2. Communication with the Team 35 7. A Day in the Life of a Dental Nurse 36 8. Vocational Education in Estonia 37 8.1. Studying in Estonia 37 8.2. General Goals of the Dental Nurse Curriculum 37 8.3. Description of the Practical Nurse Profession and Core Competences 39 References 41 Glossary 42 Appendix: Dictionary 43 2 Introduction Dear Student ◆ We are happy that you chose to do you practice in Estonia. Welcome! We hope that you will have a worthwhile learning period here and that you enjoy staying in our country. The purpose of this handbook is to give you a brief overall view of health and dental nursing education system, focusing more on oral care in Estonia. In the booklet you will also find some practical recommendations which may help you to prepare your visit to Estonia. You fill also find description of a working day in dental centre and some descriptions of the roles of doctors, dental nurse/assistant in a real work situation – we hope that it will help you in your practical placement. We have added to this booklet a short glossary to be sure that we all have mutual understanding of terms used in oral care and a very short bilingual dictionary (Estonian – English, English – Estonian) for everyday use in your practical placement. You will also find some useful internet addresses in this booklet for additional information. 3 1. Guidelines on Oral and Dental Health Policies of WHO and EU ◆ Oral health is not to be seen just as infections and immune disorders to a specific of health care and promotion mention a few. of well-being – it means more than just good teeth, it is integral and essential From a broad based viewpoint such as to general health. This viewpoint has common oral health issues like caries been identified in the World Health and periodontal diseases are global Organisation’s (WHO) ‘The World problems as well as other oral diseases Oral Health Report 2003’ resulting too, they are to be considered as major in ‘Continuous Improvement of Oral public health problems. This applies Health in the 21st Century – the both to industrialised countries as approach of the WHO Global Oral well as developing ones. According Health Programme’. to WHO’s global estimation some five billion world-wide have experienced The future oriented disease-preventing dental caries. Such estimation is and health promoting policy is based convincing evidence that oral health is on the following common facts: oral an integral part of general health and health as in integral and essential factor any person’s well being. of general health implies being free from chronic oro-facial pain, oral and What makes oral care and combating throat cancer, oral tissue lesions and the most common problem, dental other diseases and disorders that affect caries, challenging is that dental caries oral, dental and craniofacial tissues. has been perceived in developed Oral health problems and general countries, e.g. Member States of the health problems are primarily the result EU, as a problem that has already been of the same common risk factors that overcome. The true situation however is are interrelated. Although these points that it affects 60-90% of school children capture the wider meanings and target and the vast majority of adults. In a it does not take away from the relevance similar manner dental caries is also the major global oral problems such as most prevalent disease in several Asian caries and periodontal diseases. and Latin American countries as well. Preventative work and early detection While it appears to be less severe in of oral diseases with proper treatment most African countries, the report states is crucial and positive is crucial and that with changing living conditions, has positive as in the reduction of dental caries is expected to increase in premature mortality, microbiological many developing countries in Africa, 4 particularly as a result of the growing Scholl Health Initiative, which seeks consumption of sugars and inadequate to mobilise health promotion and exposure to fluorides. education levels at local, regional, national and global levels, has recently According to WHO’s Global Oral been strengthened by an oral health Health Programme the prevalence of technical document. Increasing oral cancer is the eighth most common emphasis has also been placed on cancer of men worldwide. In south targeting the elderly; by 2050, there central Asia, cancer of the oral cavity will be 2 billion people over the age ranks amongst the three most common of 60, 80% of them living in the types of cancer. The sharp increases developing world. The Oral Health Care of oral/pharyngeal cancers have also Programme will make an important been reported in several countries and contribution to early diagnosis, regions such as Denmark, Germany, prevention and treatment of HIV/AIDS, Scotland, central and Eastern Europe, which often shows up first in oral and to a lesser extent, Australia, New fungal, bacterial or viral infections and Zealand, Japan and the USA. Smoking, lesions. smokeless tobacco, chewing betel and alcohol use are all risk factors. Poor oral health can have a profound effect on general health and the The major priorities and components of quality of life. The experience of pain, WHO’s Global Health Programme focus endurance of dental abcesses, problems on not only to addressing modifiable with eating, chewing and missing, risks such as oral hygiene practices, discoloured or damaged teeth, has a sugar consumption, lack of calcium major impact on people’s daily lives and and micronutrients and tobacco use, wellbeing. but also to major socio-cultural factors. These include: poor living conditions, European Strategy low education level as well as lack for Oral Health of traditions supporting oral health. In 2007 the European Council Globally countries should ensure the of European Dentists outlines appropriate use of fluorides for the recommendations at a conference in prevention of caries, while unsafe water Lisbon; ‘Health Strategies in Europe’. and poor hygiene are environmental The recommendations are parallel to risk factors for oral as well as general the WHO’s Oral Health Programme health. are based on the same socio- epidemiological surveys. Oral health systems need to be focused towards primary health Oral health is an integral part of general care and prevention. WHO’s Global health and well-being. Good oral health 5 enables individuals to communicate according to their differing lifestyles, effectively, to eat a variety of foods, and life stages and life conditions, is important to the overall quality of including children and elderly people. life, self-esteem and social confidence. ◆ Oral health promotion, based on A range of diseases can be classified as a common-risk approach, must be oral diseases, including dental caries, an integral part of chronic disease periodontal disease, oral pathology prevention. and cancers, dentofacial trauma and ◆ The public, patients and oral health dental erosion. These diseases, although care professionals must be educated largely preventable, affect a significant to promote a healthy lifestyle. proportion of the European Union ◆ Member States need to recognise population and exact a heavy burden on their role in actively and financially the individuals quality of life and costs supporting measures relating to oral to the health care system. health promotion. The major risk factors for oral diseases Action on health inequalities are the same as for major chronic ◆ Evidence-based population non-communicable diseases such strategies need to be developed as obesity, heart disease, stroke, and implemented to address cancers, diabetes and mental illness.
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