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8Received by the Editor 11.02.2021
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PROBLEMS OF FORMING A HEALTHY LIFESTYLE AND SANITARY KNOWLEDGE IN DENTISTRY IN THE POPULATION
U. Kalmaganbetov
"International Kazakh-Turkish University named after Khoja Ahmed Yasavi ", Kazakhstan, 161200, Turkestan region, Turkestan city, B. Sattarkhanov Avenue, building 29B
Purpose: to give a literary review of the problems of forming a healthy lifestyle and sanitary knowledge in dentistry in the population.
Task: to analyze the literature sources.
Materials and methods of research: this review is aimed at describing and analyzing data from the literature on the organization of preventive measures related to dental diseases.
Results: education and literacy in the field of hygiene of the oral cavity should be focused primarily on minimizing social inequalities in health through measures taken at the local level. Prevention of dental diseases requires a general and targeted intervention.
Keywords: dental care, healthy lifestyle, prevention.
ПРОБЛЕМЫ ФОРМИРОВАНИЯ ЗДОРОВОГО ОБРАЗА ЖИЗНИ И САНИТАРНЫХ ЗНАНИЙ НАСЕЛЕНИЯ В СТОМАТОЛОГИИ
Калмаганбетов У.
"Международный казахско-турецкий университет имени Ходжи Ахмеда Ясави", Казахстан, 161200, Туркестанская область, город Туркестан, Проспект Б. Саттарханов, строение 29В
Цель: провести литературный обзор проблем формирования у населения здорового образа жизни и санитарных знаний в стоматологии.
Задача: провести анализ литературных источников.
Материалы и методы исследования: данный обзор направлен на описание и анализ данных из литературы об организации профилактических мероприятий, связанных с стоматологическими заболеваниями.
Результаты: образование населения и грамотность в области гигиены полости рта должны быть сосредоточены, прежде всего, на минимизации социального неравенства в отношении здоровья посредством мероприятий, принятых на местном уровне. Профилактика стоматологических заболеваний требует общего и целенаправленного вмешательства.
Ключевые слова: стоматологическая помощь, здоровый образ жизни, профилактика.
СТОМАТОЛОГИЯДА ХАЛЬЩТЬЩ САЛАУАТТЫ 0М1Р СYРУ САЛТЫ МЕН САНИТАР ЛЫЩ Б1Л1МД1 ЦАЛЫПТАСТЫРУ МЭСЕЛЕЛЕР1
^алмаFанбетов У.
«Кожа Ахмет Ясауи атындагы Хальщаралык; казак^р^ университет!», Казахстан, 161200, ТYркiстан облысы, ТYркiстан каласы, Б. Саттарханов дацгылы, 29Б гимарат
Максаты: Стоматологияда халыктын салауатты eмiр суру салты мен санитарлы; бiлiмдi калыптастыру мэселелерше эдеби шолу жасау.
Мшдетк эдеби дереккездерге талдау журпзу.
Зерттеу материалдары мен эдктерк Бул шолу стоматологиялы; ауруларга байланысты алдын-алу шараларын уйымдастыру туралы эдебиеттеп деректердi сипаттауга жэне талдауга багытталган.
Нэтижелерк Тургындардын бiлiмi жэне ауыз куысынын гигиенасы саласындагы сауаттылык, ен алдымен, жергiлiктi денгейде кабылданган iс-шаралар аркылы денсаулыкка катысты элеуметтiк тенсiздiктi азайту тургысынан назар аудару керек. Стоматологиялы; аурулардын алдын-алу жалпы жэне максатты араласуды кажет етедi.
ТYЙiндi сездер: стоматологиялык кемек, салауатты eмiр салты, профилактика.
Active medicine is divided into various aspects and elements: health (medical) literacy, hygiene and anti-hygiene habits, consultations with medical institutions, including preventive ones, performing medical consultations, including in a clinical clinic, participation in public health, etc. Academician Yu. P. Lisitsyn [1] refers to active medicine not only positive, but also the preservation and promotion of health, a healthy lifestyle. The cultural level, Consciousness, and knowledge of the population are important in disease prevention and counseling.
Medical activity, like other aspects of a healthy lifestyle, is the prevention of diseases for the formation of a healthy lifestyle. Today, medical activity occupies a special place in life, both in other countries and in our country. In his research, N. V. Elshtein called on men aged 35-59 years to identify heart diseases previously observed or hidden in Tallinn. According to the results of the indicator, the incidence of patients who did not seek medical help in time is more complicated than in patients who were examined in a timely manner. This means that some groups of the population are indifferent to their health. The development of entrepreneurship in state and municipal dental institutions and the growth of dentistry in private ownership against the background of negative indicators in the dental health of the population became a prerequisite for the need to develop a new model of the organizational structure of the dental service and the management of service resources [2].
Currently, increasing attention is paid to new approaches to the management of health care institutions allowing significantly and comprehensively evaluate the activities of medical institutions. The need to find internal resources to improve the effectiveness of the activities of medical and preventive institutions and their structural divisions is increasing [3].
As the main concept of improving dental activities is the link to corporate strategy focused on the patient, with the financial indicators, supplemented by the following fundamental qualitative characteristics are: an efficient strategy management offices of the organization to link its operational and price factors; determination of the volume of consumption of dental care to different age and sex groups; financial support that allows us to develop adequate measures for the reform and rationalization of dental activities [4].
The multivariate analysis of the dental organization in the scorecard, equivalent to a 5-year dynamics: analysis of the main indicators of the provision of dental care; evaluation of the level of professional training and the motivation to work health workers; evaluation of patients ' satisfaction with dental care provided. The strategy of medical and economic development and the financial environment of dental organizations operating in the system of compulsory medical insurance are evaluated, and recommendations for improving the activities of dental organizations are given. The rationale is given for the possible directions of the system of rational financing of the MSS system, which can ensure the implementation of the goals of dental care for the population [5].
The competitiveness of dental structures of various systems in healthcare has a positive impact on the availability and quality of dental services for the population, especially in its highly specialized types. The human resources of the dental service are concentrated in urban dental organizations (up to 87%). The provision of dentists is 3.0 per 10 thousand population, respectively, and the supply of dentists and technicians and 3.0 and 1.2 per 10 thousand population, which is considered below the average rate in Russia. Particularly relevant is the question of the fullness of dentists and hygienists in state and municipal health systems. In the positive changes in the development of fixed assets of dental institutions, the indicators of economic analysis and comprehensive assessment indicate insufficient resource supply, which is associated with the wear and tear of equipment and insufficient staffing of medical personnel (34%). Insufficient resource provision does not meet the needs of the population in dental services [6].
The conducted sociological studies show that the population pays great attention to dental health. Among the main reasons for complaints-treatment and removal of a tooth (65%), cleaning of the oral cavity, only 17,1% of respondents. At the same time, the respondents noted the need to visit the dentist in order to carry out preventive measures in a timely manner. The applied methods of multivariate analysis identified three leading factors that affect the condition of the oral cavity and the frequency of visits to dentists: nutrition, dental literacy, and the cost of services. The data
obtained indicate the insufficiency of preventive measures in dental activities in the region. The issue of accessibility of dental care to the population is acute. The specific weight of dental morbidity in the total morbidity of referrals reaches 30-35%, which are faced only with therapeutic issues. The share of primary morbidity from the total morbidity was 40%. There is a direct positive correlation between primary morbidity and referrals, which confirms the "hidden" needs of the population for dental care. Morbidity data can serve as an indicator for determining the resource coverage and evaluating the effective economic activity of a dental organization. System analysis dental activities edges and dental health of the population served as the basis for strategy development and problems of dentistry, gave the rationale for the scientific approach to management of dental care [7].
In the context of a budget deficit, one of the most difficult problems is the search for ways to improve dental activities. Important to the development of rational management options, dental activities with the features of socio-economic development of the region, dental morbidity of the population and its main trends, security resources, financial sustainability, environment and other socio-hygienic factors affecting dental care.
Management decisions should be made in relation to a specific region on the basis of monitoring the dental morbidity of the population using methodological approaches and computer-oriented information technologies that take into account the compliance of budget funding. It is necessary to develop measures for timely correction of the volume of necessary medical and preventive measures, resource provision, structural changes in the activities of dental service institutions [8].
In the National Social Project" Densaulyk", priority is given to primary health care provided to the population. In Russian conditions, dental medical care provided to the population is the most popular area in health care and in many areas (preventive, therapeutic, surgical) it should be considered among the first.
The high level of public access to health care facilities in order to obtain various types of dental services can be explained, first of all, by a whole complex of medical and social factors. First of all, it is necessary to take into account the main dental diseases in the population, among which, first of all, it is necessary to take into account dental caries, periodontal disease (periodontitis) and diseases of the oral mucosa [9].
For instance, V. N. Kalashnikov (2008) on the basis of a systematic approach and methodology of strategic planning has received new data on the epidemiology of oral diseases among the adult population, age and gender factors; the substantiation of the conceptual approaches to assessing the quality of dental care to the population and the method of assessing the quality; conducted a deep research of the quality of basic dental services (medical, surgical, orthopedic) provided by dental institutions of various territorial ownership (urban and rural settlements); studied public satisfaction with medical assistance dental institutions; to identify the needs of the adult population of the region in the obtained types and amounts of dental services [10].
At various stages of the treatment and diagnostic process, the following results of therapeutic dental care were achieved (in relation to the maximum possible indicator obtained as 100%): the quality of the patient's examination - 80,3%; the validity of the diagnosis - 92,3%; compliance and completeness of procedures - 96,0%; the quality of medical documentation - 78,8%. At the same time, taking into account all types of pathologies, the following clinical results were obtained: recovery - 65.1%; remission - 6,4%; improvement - 27,1%; no changes - 1,3%. When providing surgical care at the same stages, the following results were obtained: 88,3; 95,7; 99,3 and 83,0%. The results of treatment were as follows: recovery - 95,0%; improvement - 4,5%; development of complications - 0,5% [11].
According to V. K. Leontiev [2], it is most effective in order to optimize the management of activities:
- carrying out reforms of the organizational structure of the state dental service with the creation of official management bodies of the dental service in the structure of the health
management bodies. Management of dental service in the region dental service as authority on the minimum applicable dental care should count the one that really provides dental services with a significant role in managing and improving the dental service in the region;
- creating conditions for further improvement and increasing the role of public management structures( StAR, regional associations), improving the relationship between the activities of state and public administration bodies (contract system), increasing the level of professionalism in the management of dental activities;
- creating conditions for the activities of state institutions (executive authorities, departments, organizations, mandatory social insurance funds, antimonopoly authorities, tax authorities, educational institutions, etc.) that create conditions for the implementation of the legislative and legal foundations of their activities, not limited to obstacles in the management of dental activities. This condition is largely determined by the fact that the management of these institutions puts departmental interests above the interests of public health protection determined by law;
- organization of the system of initial training of senior personnel of dental services and improvement of the next stages of work with senior personnel of the dental service [12].
The reforms carried out in recent years in the government structures of Russia, the principles of separation of powers at various levels of executive and legislative power, refer the implementation of policies in priority social areas, including in the field of healthcare, to the competence of regional and municipal bodies [13].
It is proved that the prevention of dental diseases is one of the most effective methods to reduce the prevalence of major dental diseases (. In all developed countries of the world, preventive measures are carried out by special personnel with secondary medical education-a dental hygienist. In countries where preventive programs are implemented, dental morbidity is reduced by 2-4 times, children aged 12 years have a CPI index of no more than 1,0-2,0. However, with the transition to market relations, the implementation of preventive programs in Russia at the expense of full state funding has become impossible [14].
In 2001, a new specialty" preventive dentistry "with the qualification" dental hygienist"was introduced into the nomenclature of medical specialties in Russia. Jobs dental hygienist: dental outpatient clinics for children and adults; dental offices and clinics of medical institutions; institutions of social protection and education; sanatorium-and-Spa institutions (Ministry of health order No. 33, 2001) [15].
WHO experts came to the conclusion that the promotion of a healthier mouth is by implementing a healthy lifestyle, giving priority to preventive measures by health care; integration of the cleanliness of the oral cavity in the case of the overall protection of human health (report of the Committee of experts).
As practice shows, in many countries, to reduce the level of dental morbidity simple enough for the rising number of dental services, funding and material support [16].
In conditions of shortage of personnel, one of the ways of practical implementation of preventive measures in dentistry is to conduct with the participation of a mid-level specialist-a dental hygienist (Kuzmina E. M., 2005). But its capabilities are not fully used in our country [6].
The World Health Organization (WHO) evaluates the prevalence of dental and periodontal diseases according to the following criteria: low-0-30; medium-31-80; high-81-100; criteria for the criterion assessment of the prevalence of periodontal diseases as gingivitis or bleeding gums occur (WHO, 1980): low-0-20; medium-21-50; high-51-100;
An important role in reducing the prevalence and intensity of dental diseases among the population belongs to the dental hygienist. It helps the patient to eliminate or reduce the influence of the main malignant factors of the most common dental diseases by conducting preventive measures with small losses, promoting careful oral care, recommendations on nutrition and the use of fluorides independently and as a mutual aid.
The introduction of preventive programs will lead to a sharp decrease in the intensity of caries and periodontal diseases, a significant reduction in the cases of tooth loss at a young age
and curb the growth in the number of children and adolescents with intact teeth. The cost of prevention methods will be 20 times cheaper than the cost of treatment of existing dental diseases [16]. Dental morbidity in our country is big enough and in the future can be expected to increase if not immediately changed favorable conditions to the development of these diseases: the decline and prevalence of caries; the increase in the number of those without plaque, a decrease in the percentage of individuals who have found signs of damage to the periodontal tissues; reducing the number of bleeding, dental calculus and pathological pockets in a radical age group in accordance with the index in need of treatment of periodontal disease [17].
There are three main forms of organizing dental care abroad: in the United States, the United Arab Emirates, and Turkey, where private medicine operates. There, the government assumed responsibility for providing free dental care to military personnel, war veterans, Indians, and representatives of the Coast Guard Service. Health care for the mentally ill, the elderly, and the poor will be provided together with government agencies at much lower levels. The municipal authorities (districts and cities under independent administration) have their own health departments, which have introduced the position of dentist. The program of oral health improvement and prevention of oral diseases primarily covers children, adolescents and young men under 21 years of age [18].
This program will provide all types of dental care, including surgical interventions. The program is funded by federal funds, district grants, and patient care fees, which depend on the size of the family, the number of family members, and the patient's financial capacity. The bulk of dental care is provided by private practice dentists. The practice of prepayment to dentists through insurance organizations and public associations is widespread [19]. The People's Health Act, adopted in Finland, gave rise to the development of dental diseases. Regular cleaning of the oral cavity (sanitation) is indicated for all children before graduation. The desire to eat a tooth is stuck in a past life: it is widespread in children, as a result of which the vast majority of the adult population loses their teeth. Currently, the deontological service is massively extended to all residents. All citizens born since 1964 are covered by medical examination measures. Dental treatment is free until the age of 17. There are 150 residents per 1 dentist, of which 68% are women.In Sweden, since 1974, national dental insurance has been provided for adults over the age of 19. Children and teenagers are treated for free.
In Great Britain, since 1948, the National Health Service has been organized, providing all residents with free and affordable care through taxation, mandatory contributions to the national insurance system and a small fee that they receive from the population [20]. In 1994, there were 19400 dentists in the country. General practitioners and dentists work on a contractual basis with local and territorial health organizations. A practice has been introduced in which the patient freely chooses the doctor and the doctor himself chooses the patient [21].
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Corresponding author: Kalmaganbetov U., - Assistant of the Department of Preventive Medicine and Dental Disciplines, Shymkent Medical Institute, International Kazakh-Turkish University named after H.A. Yasavi; Pediatria-1@mail.ru; +77718720579
