Misson Report on Oral Health in the Philippines
2 - 30 April 1998
by Dr Wong Hee Deong

EXECUTIVE SUMMARY OF A MISSION REPORT

Objectives of mission:
In collaboration with the Government of the Philippines:

• To provide technical support in the planning and organization of a national dental epidemiological survey;
• To develop a survey protocol;
• To conduct training in survey methodology including calibrating the survey examiners:
• To advise on preparation for the survey, day-to-day survey procedures and handling of the survey forms and data for processing and tabulation;
• To advise on the analysis and interpretation of the processed data.

Summary of activities, findings, conclusions and recommendations:
Activities comprised a series of meetings with Dr Venus Gamboa, Director, Dental Health Services, and her staff to review past surveys and their methodologies and to discuss areas where improvements could be made to increase cost-effectiveness. During these meetings, a plan was drawn up for the entire survey to be undertaken. An appropriate national sample and the mechanics of random sampling were discussed and designed. Initial steps in the random selection of examination sites were also taken.

A training course of WHO basic methods in oral health surveys was also conducted from 20 to 22 April 1998 for 21 participants from the Dental Health Services. During the course, a hands-on session on clinical examination of subjects, with special attention given to the leader, examiners and recorders selected for the coming survey, was also organized. Their findings for each of ten subjects examined were compared with each other and variations were analysed and discussed. Ways to overcome examiner variations were also demonstrated.

Past surveys, although comprehensive, were cumbersome to conduct. As much of the data collected found little use, the decision to switch to WHO basic methods is technically sound and should lead to cost savings.

Recommendations include:

• Before launching the survey, more sessions should be arranged for all the intended examiners to practise systematic dental examination and their findings for each subject examined should be compared and discussed between themselves so as to attain a much higher level of agreement.
• Examiners should get into the habit of following the recommended sequence of examination and examining all tooth surfaces for dental caries.
• Examiners performing the periodontal examination should ensure that the line of insertion of the probe is correct and that the probe's tip remains in contact at all times with the surface of the tooth being examined when determining the periodontal status.
• All examinations should be carried out with adequate lighting directed into the oral cavity of the subject being examined.