A System Dynamics Model of Caries Preventive Interventions in Thailand's School-Aged Population.

PURPOSE: To compare the long-term effects of the Ministry of Public Health's (MOPH) caries preventive interventions for 6- to 12-year-olds (supervised toothbrushing [STB], dental sealant, and combined STB+sealant) to the base case (no intervention) using the System Dynamics Model. MATERIALS AND METHODS: The System Dynamics Model was used to evaluate the intervention scenarios of supervised toothbrushing (STB), sealant, and combined STB+sealant with the base-case scenario. The effectiveness data for the model's interventions were obtained from systematic reviews and meta-analyses. RESULTS: The model determined that the caries-free population increased by 36.2%, 25.5%, and 14.5%, while the caries-affected population decreased by 8.1%, 5.5%, and 3.1% in the combined STB+sealant, sealant, and supervised toothbrushing scenarios compared to the base case at 15 years of age. CONCLUSION: Combined STB+sealant is the most efficacious intervention among those administered to children between the ages of 6 and 12 with permanent teeth. In addition, the System Dynamics Model could be helpful in comparing interventions or policies to determine the optimal intervention for a given population.

Oral Health System in Myanmar: A Review.

OBJECTIVES: The study aims at reviewing Myanmar's current situation to consider an improved oral health system and at promoting the oral health status of the Myanmar population. MATERIALS AND METHODS: This review was conducted using the World Health Organization's (WHO's) six building blocks of the health system: oral health-care service delivery, dental workforce, oral health information system, essential medicine, health financing, and leadership and governance. The review was established on scientific articles and documents and information from reliable government and nongovernment organizations' websites. RESULTS: According to the National Oral Health Survey (2016-2017), the prevalence rate of untreated caries in six-year-old Myanmar children (84.1%), and in the 35-44 and 65-74 age group (above 40%) is high, which reflects a low utilization of oral health-care services. The dentist to population ratio is approximately 1:16,000: There are around 5,000 dentists and 400 trained dental nurses in Myanmar, and only about 1,000 dentists serve in government sectors. The inequalities in dental health care are compounded by a limited dental workforce and inequality of dentists between the public and private sectors in Myanmar. In the last National Health Plan (NHP, 2006-2011), the Myanmar government's funding for required dental equipment and materials in each dental unit (around 5726 USD) has been considered inadequate. The current expenditure is not transparent. The other challenges are an insufficient supply of dental materials and instruments to all public dental sectors and a lack of oral health-care infrastructure. CONCLUSIONS: Such findings suggest a pressing need to address the effective oral health-care system and decree the specific goals for the Myanmar population's oral health.