NATIONAL ORAL HEALTH PROGRAMME (NOHP)

1.INTRODUCTION & BACKGROUND

‘Oral Health’ is an integral part of general health. With increasing life expectancy Oral Health is bound to play a major role in improving the quality of life. The prevalence of oral diseases, such as Dental caries, Periodontitis (diseases of the gum), Mal-occlusion and Oral cancer, are very high in Mizoram. Mal-occlusion of teeth is common among 50% of school children. Oral Cancer accounts for almost 40% of the total diagnosed cancer cases and the wide usage of tobacco in various forms attributes to 90% of all oral cancers. Dental caries and Periodontitis are very common in all groups of ages.

‘Oral Health’ means being free of Chronic mouth and facial pain, oral and throat cancer, oral sores, birth defects such as cleft lip and cleft palate, periodontal (gum) diseases, tooth decay and tooth loss and other diseases and disorders that effect the mouth and oral cavity.

Incidence of oral cancer ranges from 1 to 10 cases per 1, 00,000 population in most countries; 40 to 50% of people who are HIV Positive have oral fungal, oral bacterial or oral viral infections which often occur early in the course of HIV infection; 5 – 10 % of public health expenditure relates to oral health in developed countries and by using preventive strategies, the high cost of dental treatment can be avoided.

The activities of the World Health Organization (WHO) span advocacy, prevention and treatment of oral diseases and WHO gives technical support for countries that are integrating ‘Oral Health’ into their public health system.

Oral Health Programme has never been implemented in the state before but started from 2014-2015. It used to be the most neglected part of all Health & Family Welfare Department activities. It is estimated that nearly 90% of the state’s population is suffering from one or the other dental disease. And it is noticed that this alarming rise in dental diseases is mainly due to the lack of awareness among the people and the almost non – existence infrastructure of the Oral Health Care Services in the State.

Civil Hospital, Aizawl is the oldest Hospital in the State of Mizoram. It was established at the time of the British rule in India. At present, Civil Hospital Aizawl is a 300 bedded Hospital. The Hospital delivers various clinical and para-clinical services to the people not only of Aizawl, but to the whole population of the State as Civil Hospital, Aizawl is functioning as a referral centre from other Districts.

The Dental Outdoor Patient Department (OPD) started functioning since 1975 with the then two working doctors – Dr. Sharma & Dr.Sinha. In 1979 the first Bachelor of Dental surgery (BDS) among the Mizos, Dr.Lalzarliana Ralte (L) had replaced them.

Civil Hospital, Aizawl has been certified as ISO 9001: 2008 on December, 2010 vide Certified NO. IRQS/1011025 from Indian Register Quality system.

2.OBJECTIVES

At present, the average daily dental patients’ attendance is 100 at the Dental – OPD in the Civil Hospital, Aizawl which is the largest and most advanced hospital in the State. Referred dental patients are coming from all corners of the State and the serious ones need prompt and utmost care that can be done only under general Anaesthesia (GA) in Operation theatre (OT). Along with the usual routine of the OPD the patients who need treatments in the OT are looked after simultaneously by sharing the Operation Theatre (OT) of ENT dept. & Ortho – dept. OT which causes untold miseries to the poor patients. The working Dental Surgeons here comprise of 2 (two) Oral – Maxillo – Facial Surgeons, 2 (two) orthodontist, 1 (one) Periodontist and 1 (one) Endodontist 1 (one) Prosthodontist and 3 (three) general Dental Surgeons, for all these working as a team, a separate & distinct operation theatre (OT) is a must and badly needed. The proposed Dental operation theatre (OT) must be having an attached Dental ward having at least 6 (six) beds.

Among the Dental Surgeons, some were posted at CHC or PHC where any Dental Surgeon had never been posted before. In some of the Dental Surgeon posting places, like in District Hospitals etc., the Dental Chair and its unit or any other Dental Equipment had never been supplied before and even if supplied they were in-completely given and are by now non-functioning and getting rusted and all of them need replenishment or replacement.

3.PRESENT STATUS :

At present there are 52 (fifty two) (27 – Regular and 25 – Contract NRHM) Government Dental Surgeons in Mizoram, among which 9 (nine) have been promoted to Special Grade as Consultant (NF).

a)The District Hospitals where Dental Surgeons have been posted are :-

i)Aizawl Civil Hospital – Aizawl being the State Capital, it has 2 (two) hospitals attached to it, namely Kulikawn Hospital and Referral Hospital, Falkawn where dental Surgeons are also posted.

ii)Lunglei Civil Hospital – It is the second biggest District Hospital.

iii)Saiha Civil Hospital

iv)Lawngtlai Hospital

v)Champhai Hospital

vi)Serchhip Hospital

vii)Kolasib Hospital

viii)Mamit Hospital

[NB : There are 10 (ten) hospitals in the State & medically, there are 9 (nine) districts in the state, because Aizawl district is divided into Aizawl ‘E’ and Aizawl ‘W’ districts]

b)The Community Health Centres (CHCs) : Now only 5 (five) CHCs have the postings of Dental Surgeon -

i)Khawzawl iii) Biate v) Saitual Sub-District Hospital

ii)Lengpui iv) Vairengte

[NB : Total number of CHCs in the State is 12.]

c)Sub – Divisional Hospital where Dental Surgeon had been posted before but now devoid of posing:

i)Tlabung Sub-District Hospital.

d)The Primary Health Centres (PHCs) : Only 2 (two) PHCs have the postings of Dental Surgeon during 2014 – 2015 which will be extended as per MOHFW, G.O.I rules

i)Darlawn ii) Lungdai

[NB : Total number of PHCs in the State is 57.]

In order to propagate and implement Oral Health in the State, one Consultant has been posted as State Programme Officer (Oral Health) in the Directorate of Hospital & Medical Education, Health & Family Welfare Department, Government of Mizoram; who will monitor all Oral Health activities and Programmes in the State. In order to provide quality Oral Health Care, it is essential that the Central Government provide recurring grant as the State Government’s resources are limited.