Almost a year after its historic launch, the Health Reform Plan is now poised to target one of the most challenging sectors of healthcare in Iran. Oral hygiene is one area where the country has long struggled due to negligence and lack of insurance coverage - a set of conditions that have relegated Iran to the lowest common denominator in oral care. The near extortionate costs of dental care have only made it affordable to a selected few.
Data from Tooth Decay Prevention Center at Iran University of Medical Sciences indicates that on average, 12 year-olds have 2 cavities, 15 year-olds 3, 18 year-olds 4, 35 year-olds 9 and people in their 40’s have 12 cavities. Figures that demand the latest phase of the health overhaul plan start delivering. The health ministry says the plan which officially took off on Sunday has ‘’prevention’’ at the forefront.
‘’The programs include unilateral initiatives by the ministry itself as well as coordinated measures in collaboration with the ministry of education to familiarize schoolchildren with oral care’’, said Saeed Asgari, secretary of the Oral Health Council at the ministry of health. Asgari says cooperation from primary insurances would be key to the success of the plan. “Besides these programs we also are focused on the quality of dental care services.”
What remains uncertain, however, is the extent to which the plan reaches out to rural communities - which are woefully deficient in dental care. According to the Persian-language daily Sharq, 25% of the rural population lack access to dental care, with many villages empty of dentists altogether.
Mission Impossible
Dr. Hussein Hesari, research deputy at the tooth decay prevention center says the current level of dental care is simply inadequate to fully address the existing challenges. He maintains that in the prevailing economic landscape and given the scale of the problems, a full resolution of the problem is not difficult, it is simply impossible - no matter how advanced the medical system.
‘’All things considered, there is no better option than prevention. We cannot handle the current load and therefore should concentrate all our efforts on prevention’’.
Referring to some countries that have been successful in their preventive programs in oral health, Hesari says, ‘’ Scandinavian countries along with Australia, New Zealand, Canada and Britain have been able to keep the rate of tooth problems low merely by stepping up prevention’’.
He drew parallels between the prevalence of tooth extraction in Iran and France saying that on average, Iranians by the time they are in their 40’s have had seven teeth pulled which leaves them with 21 or 22 healthy teeth. ‘’ This is while in France people in their 40’s have on average 28 healthy teeth which means they try to preserve their teeth with all possible methods while in Iran pulling out the teeth has become the norm’’, Hesari said, hoping that that tooth extraction will reduce in the coming years.
Insurance in Limbo
Another hurdle to efficient oral care is the hazy status of dental insurance. Hesari says although a law was passed recently to provide insurance coverage for dental care, surprisingly no dentist has so far shown interest in signing a contract with the Social Security Organization. He attributes the reason for the aversion of dentists to unrealistic SSO tariffs on dental services which discourage dentists from any insurance schemes on offer by the state bodies or otherwise.
‘’Unrealistic tariffs are also depriving people from quality dental care which has created a host of problems for them – including living with tooth decay which makes their lives rather miserable.”
