Dental Health Programme

DENTAL (ORAL) HEALTH PROGRAMME

Introduction:

Dental (Oral) Health Programme is run by the Dept. of Health Care, Human Services and FW, Govt. of Sikkim.

For more than three decades, the State Dental (Oral) Health Programmes is being carried out under the supervision of the Health Care, Human Services & FW Dept. The Programme is supervised by the Principal Director (Dental) – cum- State Nodal Officer,(NOHP) stationed at Gangtok.

Dental clinics in the STNM Hospital, Gangtok, the four District Hospitals and the eleven PHCs are run daily. School Dental Health Programmers’ and Dental Health Camps are organized in Schools, districts and remote villages. In the Urban areas 75% of children suffer from Dental Diseases (Dental caries) because of exposure to refined foods and excessive sweets and chocolate. In Rural areas, 70%of the children suffer from Periodontal Diseases (Gingivitis/ Periodontitis) because of poor Oral Hygiene. Precancerous lesions like Oral Sub mucous Fibrosis and Lichen Planus are quite common, although the % has decreased after the Govt. of Sikkim banned Gutka Betelnut/Betal leaf, supari, Pan Parag, Tulsi etc) in Sikkim. Oral cancer is quite high due to poor oral hygiene in the rural areas and intake of betel leaf and Khaini/Surti (tobacco with lime). Malocclusion (irregular teeth), cysts, tumors and fracture of jaws due to MVA are quite common.

The STNM Hospital, which is a Central Referral Hospital, Gangtok, has a full fledged Dental Department with several Specialists and Dental Surgeons. The Dental Clinic is well equipped with Dental Chairs + Units and equipments. The District Hospitals and the eleven PHCs are manned by Dental Surgeons and are well equipped, but out of the two CHCs & twenty four PHCs, fifteen PHCs still require Dental Surgeons and eleven Dental Chairs & Units and equipments.

Apart from the Curative aspects, preventive aspects are also carried out at the STNM Hospital, District Hospitals and PHCs and also during School Dental Health normal Programmes.The total number of Dental patients treated at the Dental Clinic, STNM Hospital Gangtok in 2011 Total No; patients- 24435 (Male=11941 & Female=12494) in 2012 total patients was 25125. In 2012-13 it was 27762 (male=13161; female=14601). In the year 2013-14 was 32857 (male=16245, female=16612), n the year 2014-15 was 35698 (male=19654, female=16044) . In the year 2015-16 was 36214 (male=22369,female=13845) . (OPD=18146,Extraction=5088,TA(SurgicalExtraction)=192,Scaling=3560,OralCAcases=44, Fracture=28,Filling=5620,Post&core(crowns)=54,RPD=104,CD=12,NightGuard=16,crown=120, FPD=8,Ortho Appliance(Hawleys appliance, Expansion appliance, Z-Spring appliance & appliance for tongue thrust)=36, Minor surgery=28). ), Major oral surgery cases ( Tumor of jaw, Dentigerous Cyst , cleft lip and palate, etc) = 63 , Minor cases = 338

The total number of Students treated at various schools during the School Dental Health in 2010-11 was 7048 (which includes Private Schools). Total number of school students treated in Govt. School in 2012-13 was 2826.In 2013-14 was 4259. In 2014-15 was 5982 and in 2015-16 was 6505; which includes 1477 students between six weeks to six years (male: 561 and female: 916) and 5024 students between seven years to eighteen years (male: 3453 and female: 1571). Four cases of Cleft lip and Palate were also reported.

Apart from the STNM Hospital, there are four Dental Units in the four District Hospitals ( viz-Namchi, Gyalsing,Singtam & Mangan) and fifteen Dental Units in the fifteen PHCs( Ravang, Jorethang, Chungthang, Soreng, Dentam, Rongli, Pakyong, and Rongpo,Rinchepong, Renok, Sombaray, Phodong , Melli, Yang Yang & Namthang).The Dental facilities in the four District hospitals and the thirteen PHCs are similar. In the year 2007, five new Dental Chairs & Units were provided in District Hospital Singtam and Jorethang, Rongpo, Soreng and Chungthang PHCs. One Dental X-Ray Machine was provided at Singtam Hospital in 2007. In 2012, Renok & Rinchenpong PHCs received new Dental Chair & Unit; along with other instruments.

STNM Hospital received four Chamundi-Confident Dental Chair & Unit and one Confident-Intra Dental X-Ray Machine in 2008; along with two Portable Micromotor sets and one Hanging Motor set. The Chamundi-Confident Dental Chair and Unit are semi-functioning and the supplier has been informed for repair of the same through the CHSC. One is being kept at STNM Hospital and three are being shifted to the District Hospital/PHCs through CHSO.

One Kodac Dental X-ray Machine and one Kodac RVG-5100 system has been installed at STNM Hospital in June 2010.

Twenty two (22) new Dental Chair & Units (Chamundi & Mokambika) have been received from the NE fund for the STNM Hospital, four District Hospitals & CHC & PHCs. (Table III)

Out of the 2 CHCs & 24 PHCs, only 15 PHCs(+CHCs) have Dental Chair & Unit and Instruments (old + New) only in 11 PHCs (CHCs) Dental Surgeons have been posted. Still 15PHCs require Dental Surgeons .Three (03) Dental Surgeons are to be appointed under NOHP, NHM shortly. Most of the PHCs (CHCs) do not have Dental Hygienist/Assistants. Additional posts for the same are required to be created for posting of the same.

On 12.03.2016 under NOHP, NHM training of (Dental Surgeons, Medical Officers, Dental Hygienists, Dental Assistants and Nurses was held at the Conference Hall, Police HQ, Gangtok. They were trained on Book Keeping, Auditing, Budget Prep and Condemnation, etc.

Table III

LIST OF DENTAL CHAIR, UNITS AND EQUIPMENTS AT STNM HOSPITAL .4 DISTRICT HOSPITALS, 2 CHCs AND 24 PHCs

Sl
No
HOSPITAL /Dist Hosp/CHCs/PHcsNew Dental Chair and UnitOld Dental Chair and UnitNew Equipment /Instrument
1STNM HOSPITAL07 *101*
2Namchi District Hospital01 *101*
3Gyalshing District Hospital01 *101*
4SingtamDistrict Hospital01 *101*
5Mangan District Hospital01 *101*
6Chungthang PHC01 *101*
7Phodong PHC
01 *101*
8Rangpo PHC
01 *101*
9Pakyong PHC
01 *101*
10Dentam PHC
01 *101*
11Soreng PHC
01 *101*
12Sombaray PHC
01 *101*
13Rinchenpong PHC
001 **01**
14Ravangla PHC01 *
101*
15Jorethang PHC01 *101*
16Renok PHC001 **01**
17Rongli PHC00 ***101***
18 Namthang PHC01 *001*
19Yamgang PHC
01 *001*
20Melli0101****

*NE fund – 2015

**NRHM Fund – 2008

***To receive from Border Roads Fund

**** Old Instruments /Equipments

For the New 1000 Bedded STNM Hospital at Sichey, Eight (8) new Dental Chairs & Units are required. And also one each for the four Districts and thirteen PHCs are required.

Apart from the curative, treatment component includes School Dental Health and Community Dental Health Education through IEC activities.

Four Dental Surgeons under the NRHM have been appointed at Rinchenpong, Melli, Phodong Sombarey and Renock PHCs and one each at District Hospital Namchi and Gaylsing for School Health have been appointed in 2010&2012 :Total- six new dental surgeons.

As the State Govt. has limited resources, if Seventeen Dental Surgeons and twenty one Oral Hygienists / Dental Mechanics are appointed under the National Rural Health Mission (NOHP), and North East Council (NEC) Fund, GOI; along with a provision of(15 for PHC + 04 for DIS HOSP +09 for STNM= 28 ) twenty eight Dental Chairs & Units and twenty eight sets of Extraction, Filling & Scaling instruments, it would go a long way in benefiting the poor villagers in the remote areas. Orientation and motivation programmes are being carried out for maintaining good oral hygiene.

With the assistance of the NHM(NOHP) and the North East Council (NEC), we would be able to take the National Oral Health Programme and Dental treatment to the doorstep of the poor villagers, like the medical treatment carried out by the Medical Officers under NHM.

To facilitate proper implementation of the National Programme (NOHP) and to carry out the State level Dental Programmes, additional funds, additional Dental Equipments/ Instruments and additional Manpower are required as follows

Strategies and Priorities for the year 2015-2016

A) Restrengthing of Infrastructure

Additional rooms/space in the Dental Clinic of the STNM Hospital

Additional rooms/space in the District hospital and PHCs

Prosthetic, Orthodontic & Endodontic Laboratory at S.T.N.M. Hospital, additional Chair & Unit & equipments at STNM Hospital, District Hospitals and one at CHCs,PHCs; along with dental x-ray machines, autoclave(instaclave), Dental Extraction instruments, filling and diagnostics, scaling instruments.

Table II

LIST OF DENTAL SUGEONS, SISTERS & DENTAL HYGENISTS /ASSISTANTS POSTED AT PHCs AND CHCs-2015

DENTAL SURGEONS

1. Regular Dental Surgeon = 29

2. Adhoc Dental Surgeon = 07

3. NRHM Dental Surgeon = 07

1. Regular Sister = 01

2. Regular Dental Hygienists =04

3. Dental Assistants = 09

4. NHM Dental Assistants =06

DENTAL SURGEONS POSTED AT THE PHC

1. Jorethang 2. Rangpo 3. Soreng 4. Melli

5. Dentam 6. Chungthang

7. Ravangla 8. Pakyong 9. Sombaray 10. Phodong 11. Rhenok

Total Dental Surgeons posted =11

Required =26-11=15

DENTAL HYGENISTS/ASSISATNS POSTED AT PHC

1. Jorethang 2. Rangpo 3. Soreng 4. Rongli

5. Dentam 6. Chungthang 7. Rinchenpong 8. Pakyong 9. Rhenok

Total PHC (24) + CHC (2) =26

Total Dental Hygienists /Assistants posted =9

Required =26-9=17

Dental Surgeons required at District Hospital Gyalshing = 2 Nos

Dental Hygienists /Assistants required at (a) Gyalshing ,(b) Namchi ,(c) Singtam and (d )Mangan = 4 Nos ( one each )

Dental Hygienist/ Assistant required at STNM Hospital = 4 nos

Sister/ Nurse required at STNM Hospital = 02 nos

Dental Hygienists /Assistants required for Urban School Health ( RBSK ) = 01

ADDITIONAL REQUIREMENT

NEW DENTAL CHAIR & EQUIPMENT REQUIRED FOR:-

1. Four District Hospitals (4X1)= 4 No’s

2. CHCs and PHCs (26-13) = 11 No’s

3. For the new 1000 Bedded STNM hospital at Sichey = 09 No’s

Grand Total = 24 No’s

Equipments, Instruments and Consumable Items are also required for Oral & Maxillofacial Surgery, Orthodontia, Prosthodontia, Endodontics & Conservative Dentistry, Oral Diagnosis & Radiology, Periodontics, Oral Cancer Cell and twenty beds for Indoor Dental patients.

Dental Checkups and treatments were also carried out through National Oral health programme (NOHP) viz;on 7-3-2015 at European Commission hall, STNM Complex, 14-3-2015 at Panchseel Bhawan, Jorethang PHC, South Sikkim, 24-7-2015 Bihari Dharamsala , Singtam, on 13-6-2015 Geyzing, West Sikkim and 14-7-2015 Enchey gumba Complex.

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