Major oral diseases and conditions affect around 3.5 billion people worldwide. Most can be prevented and treated in their early stages, but treatment is often not affordable for the whole population.
The World Health Assembly has therefore agreed on a Global Action Plan on Oral Health (2023-2030) as part of the 2030 Agenda, which proposes 100 actions for member states to ensure that 80% of the world's population receives safe, effective and affordable essential oral health care services as part of universal health coverage by 2030.
The Government of Spain has already approved, among other actions, the Plan for the extension of the common portfolio of oral health services in the National Health System to meet this goal and guarantee benefits to citizens in all communities, especially the most vulnerable, thereby reducing inequalities in access to treatment.
What is oral health?
Oral health is the health of the mouth, teeth and oral-facial structures. It enables people to perform basic functions such as eating, breathing and speaking, and affects psychosocial dimensions such as self-confidence, well-being and the ability to socialise and work without pain, discomfort or embarrassment. It is an integral part of overall health and helps people to take their place in society and reach their potential.
What are the main oral conditions and diseases?
Those that most affect public health are dental caries, periodontopathies (gum disease), edentulism (the loss of complete teeth), oral cancer, oral trauma, noma (a type of gangrene that destroys the mucous membranes of the mouth and other tissues), and congenital malformations such as cleft lip (cleft or split in the upper lip) and cleft palate. Most are preventable.
What is oral health care?
Oral health care comprises the set of diagnostic, therapeutic and disease prevention activities, as well as health promotion and education, aimed at improving the oral and dental health of the population.
The oral health teams or units are made up of dentists, senior oral hygiene technicians and/or auxiliary nursing care technicians who carry out their activities in accordance with the professional competences covered in the current regulations.
Oral health care is included in the common portfolio of primary care services of the National Health System. In the basic portfolio, care services are fully covered by public funding. In other words, they are free of charge for the beneficiaries.
The autonomous communities have the option of extending this coverage by means of the complementary portfolio.
What is the Government of Spain's oral health plan?
The development of an oral health plan is an objective included in the Government's programme for the 14th legislature and in component 18 of the Recovery, Transformation and Resilience Plan, designed to renew and expand the capacities of the National Health System.
To strengthen the quality of the system, in April 2019 the Government approved the Strategic Framework for Primary Care, which among other priorities, envisaged oral health actions in health centres, with special attention to children, people with disabilities and pregnant women.
On 15 June 2022, the Executive fulfilled the objective of expanding this portfolio and approved the oral health plan with an initial budget of €44 million euros, to which it added another transfer to the autonomous communities of €68 million agreed by the Council of Ministers on 30 October 2023, and on 18 June 2024 thereby allocating a total of €180 million. This amount is aimed at improving prevention and increasing the number of beneficiary groups, the staff who attend them and the amount of equipment and material.
What are the objectives of the oral health plan and who are the main beneficiaries?
- To standardise oral health care services throughout the country, guaranteeing equal access for citizens, regardless of their place of residence.
- To increase common services that were previously not provided by the public health system, with a preventive focus and prioritising the following groups: children and young people, pregnant women, adults with intellectual disabilities, patients with head and neck cancer and people with neuromuscular diseases.
Will I have free dental attention?
Yes, from both the dentist and other professionals in the oral health units of the Public Health System, and from certain services included in the common portfolio of services, depending on the group to which you belong.
What services and treatments are included in the oral health plan in primary care?
Services for the whole population
- Information and dissemination on the basic hygiene and dietary measures necessary to achieve and maintain oral health, together with individualised health instructions and recommendations.
- Dental advice.
- Treatment of acute odontological processes, understood as infectious and/or inflammatory processes affecting the oral and dental area, osseodental trauma, wounds and lesions in the oral mucosa, and acute pathology of the temporomandibular joint, which connects the jaw with the lateral part of the head.
- Pharmacological treatment of oral pathology that requires it.
- Exodontia (extraction of teeth), surgical exodontia and minor surgery of the oral cavity.
- Early detection of premalignant lesions and, if necessary, biopsy of mucosal lesions.
Additional services for children and young people
In the case of children and young people and people over 14 years of age with intellectual disabilities or with a disability limiting the mobility of the upper limbs, the following actions will be facilitated, when indicated:
- Periodic check-ups.
- Preventive treatments such as scaling, application of remineralizing, antiseptic and desensitizing substances, sealing of pits and fissures.
- Restorative actions such as fillings in lesions that do not cause irreversible pulp damage, pulp treatments and the relocation, stabilization and splinting of permanent incisor and canine teeth in the case of trauma.
Additional services for pregnant women and cancer patients
Pregnant women and people diagnosed with cancer in the cervicofacial area (head and neck) will have these benefits:
- Clinical examination.
- When indicated, scaling (cleaning) and application of remineralizing, antiseptic and/or desensitizing substances to the teeth.
Additional services for the behaviourally disturbed population
Persons with objectively severe behavioural disturbances who are not able to maintain the necessary self-control to allow adequate oral health care will be guaranteed benefits through the corresponding sedative or general anaesthesia treatment, in accordance with the protocols established with the hospital care teams.
Which oral treatments are excluded in primary care?
- Permanent fillings and pulp treatment in the primary dentition.
- Pulp treatment in the permanent dentition, except in the case of traumatic injuries to the incisor and canine group.
- Orthodontic treatments
- Exodontia of healthy teeth exclusively for orthodontic indications.
- Treatments for aesthetic purposes only.
- Dental implants and dental prostheses, except those included in the common portfolio of orthopaedic services.
- Performance of complementary tests for purposes other than the benefits contemplated as eligible for financing by the National Health System.
Non official translation
