COUNTRY REPORT SRI LANKA A Fulfilment of the Report for Application for ORAL HEALTH SCIENCE EDUCATION, JFY 2008 Training Course in Japan Type: Trainers.

COUNTRY REPORT SRI LANKA

A Fulfilment of the Report for Application for ORAL HEALTH SCIENCE EDUCATION, JFY 2008 Training Course in Japan

Type: Trainers Training No. J08-00737From April 23,2008 to August 9, 2008By Dr. S.I.

BangamuarachchiSri Lanka Ministry of Health

Country Report - Sri Lanka

Date - 15th May 2008

Name of the Training Course - Oral Health Science Education

Name of the Applicant - Senadhi Indrajith Bangamuarachchi

BDS (Sri Lanka) , DHDP (Colombo)

Home Address - 339/A , New Kandy Road, Kothalawala, Kaduwela

Phone No - +94 (0)714012584

Office Address - Community Dental Clinic Central Dispensary Waga

Phone No - +94 (0)714012584

General Information1.1 Basic facts

Sri lanka is an island in the Indian Ocean with approximately 65,654 square km, which starch maximum 435km length and 225km width.

Agricultural country, rich with natural beauty , cultural heritage and sandy beaches.

The per capita GDP was 1,355 US $ with growth rate of 6% .

Official Currency Rupee (Rs.) and govern byParliamentary democratic system while Colomboremains as capital.

1.2 Population

Total population 21.1 million with an annual growth rate of 1.7 .

72.2% of the population live in rural areas while 21.5% live in urban areas.

Main Ethnic Groups (%)

Indian Tamils 5.5%

Others 0.8%

Moors 7.1%

Sinhalese 74%

SriLankanTamils 12.6%

Religions Commonly Practised (%)

Hinduism 15.5%

Christianity 7.6%

Islam 7.5%

Buddhism 69%

1.3 Vital Statistics ( According to the Annual Health Bulletin )

Crude birth rate - 17.3% (rate per 1000)

Crude death rate - 6% (rate per 1000)

Maternal mortality rate - 0.23% (rate per 1000 births)

Infant mortality rate - 16.3% (rate per 1000 births)

Life expectancy at birth - 70.7 years (male)75.4 years (Female)

Literacy rate - 90.1% (age 5yrs and above)

1.4 Health Service

Health care service provide by both public sector which covers the 60% of the population and privet sector.

95% of in-patient care given by public sector , through the network of Teaching, Provincial, Base, District, Peripheral Unit, Rural Hospital, Central Dispensaries & Maternity Home throughout the Island.

The Board aim of Health policy of Sri Lanka, Increase life expectancy and improvement in quality of life.

5.6% of the national expenditure accounted for health services and funded by Sri LankaGovernment and NGO’s (WHO, UNICEF, JICA etc..).

1.4 Health Service (cont..)

Doctor : Population ratio 1 : 2739

Medical officers and dental surgeons trained through University curriculum leading to a bachelor degree and the post graduate institute of medicine provides specialist training.

Department of health provide various in-service training and refresher courses for other health care workers.

In addition international establishments offer training courses off shore.

0 500 1000 1500 2000 2500 3000

Traumatic Injuries

Diseases of the respiratory system, excluding diseases of upper

respiratory tract, influenza and pneumonia

Viral diseases

Symptoms, signs and abnormal clinical and laboratory findings

Diseases of the gastrointestinal tract

Intestinal infectious diseases

Direct and indirect obstetric causes

Diseases of the urinary system

Diseases of the musculoskelital system and connective tissue

Diseases of the skin and subcutaneous tissue

Hypertensive diseases

Leading Causes of Hospitalization

Cases per 100,000 population

Excludes single spontaneous delivery, false labour and those admitted and discharged before delivery.

Annual Health Bulletin – Source : Medical Statistics Unit

0 5 10 15 20

Ischaemic heart disease

Diseases of the gastrointestinal tract

Cerebrovascular disease

Pulmonary heart disease and diseases of pulmonary circulation

Neoplasms *

Diseases of the respiratory system, excluding diseases of upper

respiratory tract, influenza and pneumonia

Toxic effects of pesticides

Symptons, signs and abnormal clinical and laboratory findings

Zoonotic and other bacterial diseases

Traumatic injuries

Pnemonia

Leading Causes of Hospital Deaths

Deaths per 100,000 population

* Includes details reported (not classified by type of neoplasm) from Cancer Institute, Maharagama.

Annual Health Bulletin – Source : Medical Statistics Unit

1.5 Dental Services

Dental services are provide through both public and privet sector.

National level coordinated by Deputy Director General Dental Services and each district by a regional dental surgeon.

Dental health man power

Dentist population ration - 1 : 22,000

Operator population ratio - 1 : 15,725

1.5 Dental Services (Cont..)

Dental health man power

Consultant Dental & Maxillotacial surgeons - 20

Consultant orthodontics - 08

Consultant in restorative dentistry - 03

Dental public health consultants - 06

Dental surgeons in public sector -1100

Dental surgeons in private sector - 300

School Dental therapists - 400

Dental technician in the public sector - 38

Dental technician in the private sector - 40

Unqualified practitioners - 120

1.5 Dental Services (cont..)

Dental Health care providing institution in Sri Lanka

(A) Hospital dental services -Services mainly curative and free except for nominal fee

for orthodontic and prosthetic appliances.

(B) School dental services - Completely free and mainly focus on preventive care.

(C) Community dental services -Provide both curative and preventive care.

(D) Dental services in armed forces -Free dental care to service personal and their immediate families.

(E) University dental services

(F) Private dental services

1.6 Present situation and trend of the dental diseases

In year 1983/84 and 1994/95 respectively first and second national oral health surveys had been conducted with aid of WHO.

Periodontal Disease - Escalate toward major dental health problem in Sri Lanka.

Dental Caries - 2nd most common problem in Sri Lanka.

Oral Cancer - Is the commonest cancer seen among the Sri Lankan Population.

Dental Fluorosis - Mild to severe types were seen

2.5% - 6 years olds 5.6% - 12 years olds 0.7% - 35-44 years olds

Dentotacial Anomalies - Emerging problem in Sri Lanka

Traumatic Dental Injuries - Very common among children and young adults groups

1983/84 1994/95

Health Gums 12 % 13.4 %

Those who with Periodontitits

% with bleeding gums only 9 % 29.7 %

% with bleeding & calculus only 75.5 % 54.1 %

% with bleeding calculus & pocketing 3.5 % 2.9 %

Table I - 12 years old Periodontal Status

Table II

Age group/Type of teeth Prevalence 83/84

Prevalence 94/95

DMFT 83/84

DMFT 94/95

6 year old/deciduous teeth 78 % 76.42 % 4.4 4.1

6 year old/permanent teeth 14 % 9.61 % 0.2 0.17

12 year old/permanent teeth 67 % 53.17 % 1.9 1.4

15 year old - 69.71 % - 2.5

35-44 year old 92 % 91.16 % 9.2 10.1

65-74 year old 64.65 % - 22.5

Comparison of prevalence and DMFT in different age groups in two national surveys.

Fig 1 : Prevalence of Periodontal Disease % of various indicators

in Sri Lanka

0102030405060708090

100

6 12 15 35-44 65-74

Age in Years

Healthy Bleeding Calculus Shallow Pocket Deep Pocket

%

Pre

vale

nce

Fig 2 : Treatment Needs for Periodontal Disease

0

20

40

60

80

100

6 12 15 35-44 65-74

Age in Years

No Treatment D.H.E. only Prophylaxis only Complex care

% R

eq

uir

ing

Tre

atm

en

t

Fig 3 : Distribution of Treated & Active Caries Percentage of Persons

in Sri Lanka

0102030405060708090

100

6 Deci 6 12 15 35-44 65-74

Age in Years

Active Caries Treated Caries

%

Dis

trib

uti

on

Fig 4 : DMFT of Subjects in Sri Lanka

0

5

10

15

20

25

6 D 6 P 12 15 35-44 65-74

Age in Years

Decayed Missing Filled

DM

FT

0

20

40

0 6 7 8 9 10 11 12 13 14 15Age in years

% of Children with tramatized

anteriorFemale Male

Distribution curve of incidence of traumatized anterior teeth according to their ages.

Distribution of types of accidents

Road-traffic Acc. 9.18%

Impacts with persons

3.06%

Impact with Objects

24.5%Unknow 1.02%

Falls of Pushes 51.02%Sports 11.22%

This chart clearly illustrated the distribution of type of accidents in traumatic dental injuries.

Organization Chart of The Ministry of Health

Dr. Senadhi I. Bangamuarachchi BDS (Sri Lanka), DHDP (Colombo) Sri Lanka Ministry of Health