The oral health remains one of the unfinished business of the Spanish health. The 44 million euros assigned to this section in the General State Budgets (PGE) for 2022, are an insufficient amount to satisfy the demand: it touches less than one euro per citizen, they denounce from the General Council of Dentists to El Periódico de Spain. In addition, they draw attention to a fact: of the 40,000 dentists who work in our country, only around 3,000 do so in public health, which leaves those with lower incomes without coverage.
Spanish healthcare is one of the best in Europe but in dental care “we failed miserably, ” says Dr. Óscar Castro Reino, president of the General Council of Dentists , in conversation with this newspaper. He argues this, among other issues, alluding to a recent report by the World Health Organization (WHO) according to which, despite the bonanzas of our system, the “important deficiencies” of public coverage in this section are criticized in our country.
A recent WHO report recommends expanding the coverage of dental care in Spain, starting with the most vulnerable
In the document, the WHO recommends continuing to increase public spending on health and expanding the coverage of dental care starting with the most vulnerable . “You have to make an adequate health planning policy and not a political policy . They remember oral health when elections arrive, or when they have to make promises, no matter the color of the party,” complains Castro Reino, a dentist at a health center of the Region of Murcia .
An income gap
And it is precisely there, he denounces, where the great gap occurs between those who have or do not have enough income to go to a dental clinic for treatments that, in many cases, are priority and urgent. According to his estimates, of the 40,000 dentists who practice in Spain, only about 3,000 , “at most”, he says, do so in public health. With important differences, in terms of coverage, by autonomous communities. “It depends on where you were born, on your zip code, you will have one or another oral care,” he says.
In communities such as the Basque Country, one of the most advanced in this field, the Department of Health and Osakidetza, with the collaboration of an extensive cadre of registered dentists , have been ensuring free dental care for all children for years since 7 to 15 years. In others, such as Madrid, they have joined later, but they work in the same direction: these visits are free for children between 7 and 16 years old.
In Catalonia, there are initiatives such as the one launched by the Barcelona City Council : a free dentist service for people in vulnerable situations, referred by the city’s social services, under a certain economic threshold and with a diagnosed dental need .
An insufficient budget
For the highest representative of Spanish dentists, the 44 million euros allocated to oral health services in the General State Budgets for 2022 is a clearly “insufficient” amount to satisfy the demand of a country that, in addition, is one of the that less goes to the dentist in our environment. According to the White Paper on Oral Health in Spain 2020, the European average of annual check-ups is 65%, compared to 51% in Spain. Only Latvia, Hungary, Romania and Turkey are behind our country.
Oral health generates a similar concern to health in general: 65% of Spaniards are “quite or very concerned”
That same document, by way of a survey, provides other striking data: oral health generates similar concern to general health in the adult population: 65% of Spaniards are “quite or very concerned” and it is women who they show a higher degree of concern. And, although 87% of those surveyed think that a visit to the dentist should be made at least once a year, at the moment of truth, 51% of those surveyed admit to having visited the dentist in the last year, 39 % remember going 1-2 years ago and 10% more (or have not been).
Attention to the most vulnerable
Returning to the PGE for 2022, in health matters they include a specific item for the development of the Mental Health Strategy that amounts to 30 million and the aforementioned 44 million euros to expand the portfolio of oral health services . The Ministry of Health seeks the progressive expansion of this section, so that coverage reaches more and more people, especially those who have less income.
Dr. Castro Reino appreciates that this chapter of funds focuses on the most vulnerable population: children and adolescents, pregnant women, those over 75 years of age or people with disabilities. “We affect the weakest part. Children, the elderly, people with special needs. If a pensioner charges 400 euros, how can he afford to pay a dentist?”
According to the estimates of this collegiate body, Spaniards invest an average of 500 euros a year in their mouths
Special mention, for the President of the General Council, deserve the people who are undergoing radiotherapy or chemotherapy treatments due to cancer. Oral cancer, remember, is another of the most common oral problems in adults. The consumption of tobacco and alcohol, a poor diet or a poorly fitted prosthesis are risk factors that can cause the appearance of this type of ailment. “The breakdown in people with this type of treatment is tremendous. It is hard enough to suffer from cancer to be suffering from the mouth,” he remarks.
Spending versus prevention
Oral health is a right, insists the doctor but, in Spain, the accounts still do not balance and the bet in this section continues to be very weak. According to the estimates of this collegiate body, Spaniards spend an average of 500 euros a year in their mouths. Prevention fails, they say. For every 12 euros that a person spends on treatment, if the State used it for prevention, it would be one euro.
Incorporating oral services into the National Health System was one of the points of the coalition agreement between PSOE and United We Can. From the purple formation they point out to this newspaper that they agree with the gratuitousness of this type of attention because they aspire to “a comprehensive health coverage “. However, today, it remains a distant horizon, says the president of dentists.