"Even if all deliveries stop tomorrow, we have something to treat people": Interview with Oleg Yanushevich, chief freelance dentist of the Ministry of Health of the Russian Federation
Oleg Olegovich, so will there be problems with the lack of materials or tools?
Oleg Yanushevich:As the chief dentist, I officially declare that 88 percent of our positions are completely covered by Russian materials. Even if all deliveries stop tomorrow, we have something to treat people with. In addition, only one foreign company refused to supply its products to the Russian market. Therefore, we cannot say that we will be left without imported goods. At the end of September, the largest dental exhibition was held in Moscow, and we see that there was no serious decrease in the representation of foreign companies. Companies from Europe and the USA have been replaced by manufacturers from China, India, South Korea, who produce high-quality analogues; dentists are simply reorienting themselves to other segments of the world market. There are, however, two problems, but they concern imports in general. The first is the complexity of logistics. The second is the exchange rate who plans from minus to plus. The purchase price of a number of dental consumables may change. But their share on average does not exceed 7 percent of the cost of the service. And in this regard, I would like to warn colleagues, especially from a private network: do not shift your costs to the patient in such a difficult time. To date, there is every opportunity not to increase prices even with rising prices for materials.In dentistry, 88 percent of positions are completely covered by Russian materials: even if all deliveries stop, there is something to treat people
I hope you are heard. And as for the equipment and tools - are there domestic analogues for them?
Oleg Yanushevich: In principle, we have analogues of almost all instruments. Those that are produced by our enterprises in Kazan and Serpukhov have long been in demand among Russian dentists because of their low cost and good ergonomics. Maybe there are problems with burs, but this is a problem that can be solved. There are issues with composite materials of domestic production, which so far fall short of the quality of imported ones. But to say that we do not have composites would be a lie. We have composites that work fine. But a dentist often chooses an imported one because he is used to it. And the second point: our manufacturers do not always maintain a stable level of quality. But the quality control system is not only a problem for dentistry, and it must be addressed.
As for dental units, we have three companies producing them. One of them, where the leader is a thoughtful engineer, produces an analogue that is in no way inferior to Western ones. Now we at the university, together with a Kazan enterprise, are also launching a project for a Russian installation. Because back in 2020, the Minister of Health set us the task of achieving import substitution in dentistry. And we have already achieved something in a number of areas, in particular, in composites. For example, they developed a nanomaterial with graphene, which has no analogues in the world, and published an article about it. And already after February 24, I received 12 invitations from Japan, Italy, France, Germany and other countries to come with a message about this material. Naturally, I'm not going anywhere...
This year, your university turned 100 years old, and you opened a research institute of dentistry in its structure. What will he do?
Oleg Yanushevich: In this research institute we will unite all the laboratories involved in import substitution. And I hope that in a year or two we will solve the tasks for all the positions that we have not yet closed.
And how are things going with the equipment and materials for dental prosthetics?
Oleg Yanushevich: For turning crowns, inlays, bridges from zircon, our enterprises have produced a 3D milling machine, which, in my opinion, is not inferior to any other machine in the world. Taking into account the fact that we also have domestic zircon blanks, there will be no problems with the manufacture of prostheses based on zircon. And this is the most relevant material for prosthetics, because modern dentistry is gradually abandoning cobalt-nickel alloys. But with metals, including gold alloys, we had and have everything in order.
And the technologies of prosthetics themselves - are they also changing?
Oleg Yanushevich: I have a book published in 1906, which is absolutely relevant today. Because in dentistry, it was not technologies that were improved, but technological links. For example, there are two articles about gutta-percha used to fill root canals. Yes, then they did not use a microscope or titanium nitrite burs, which do not break in the canals, but gutta-percha was used, and this is still the main method of filling the root canal.
Yes, there were other implants, but archaeologists have found jaws in Egypt with metal pins screwed into them. That is, by and large, for five thousand years, this idea has not changed. And at the beginning of the last century there were jacket crowns - porcelain, which was fired on gold foil, that is, the same metal-free ceramics. In 1891, Alexander III held his last state council, at which Sklifosovsky stated that attention should be paid to the quality of dentistry in Russia. And after that, several dental schools were formed, and before that there was no training of dentists as such, and the main method of treatment was tooth extraction, and with virtually no anesthesia. Today, everything has changed here too: dentists widely use anesthesia, so young people do not have the fear of dental treatment that their parents had.
Will there be problems with these drugs and special carpool syringes, which make even an injection practically painless?
Oleg Yanushevich: I want to reassure you: one of our companies has organized such a production, and we will have no problems with anesthetics and syringes.Today, dentists widely use anesthesia, so young people do not have the fear of dental treatment that their parents had.
Dentistry has changed dramatically in recent years. In your opinion, did this affect the state of the teeth of the population?
Oleg Yanushevich:Of course, the volume of dental care that is provided today contributes to improving the culture of the population in terms of hygiene, dental care and visits to the doctor. But Russia is not only Moscow and St. Petersburg. Unfortunately, graduates of dental faculties, even taking into account the target recruitment, are not always willing to return to the regions. And in some regions, especially with large territories, they are sorely lacking. This is the first dissonance. The second dissonance is the number of honest and correct doctors and the number of doctors who are trying to make money on the patient. This is not only our problem, it is global. I always cite two countries as an example - Kazakhstan and Belarus. In Kazakhstan, dentistry has been completely transferred to the private sector. And Belarus has retained the state system, and the level of dental health is an order of magnitude higher in it. But Kazakhstanis still came to the conclusion that it is necessary to return state aid. When it is proposed to transfer all dentistry to paid services, I say: this cannot be done, we must leave it in the system of state guarantees and give a package that will maintain the dental health of the population at a certain level. Chewing function - the position of the lower jaw as a result of the health of the mandibular joint, diseases of the mucous membrane, periodontal disease, primary caries, etc. It's all medical care. Everything else is beauty, expensive crowns, etc. - it's already at the expense of your pocket. which will maintain the dental health of the population at a certain level. Chewing function - the position of the lower jaw as a result of the health of the mandibular joint, diseases of the mucous membrane, periodontal disease, primary caries, etc. It's all medical care. Everything else is beauty, expensive crowns, etc. - it's already at the expense of your pocket. which will maintain the dental health of the population at a certain level. Chewing function - the position of the lower jaw as a result of the health of the mandibular joint, diseases of the mucous membrane, periodontal disease, primary caries, etc. It's all medical care. Everything else is beauty, expensive crowns, etc. - it's already at the expense of your pocket.
It is well known that hygiene and prevention are extremely important for dental health. How are things going with this?
Oleg Yanushevich:Prevention of dental diseases made its main breakthrough from the late 40s to the early 70s of the last century. There is no doubt that the state program for the prevention of dental diseases would save both money and the health of citizens. So far, we do not have such a program. And she was. Finland, which in the 1970s was one of the most unfavorable in Europe in terms of the incidence of caries, adopted our state prevention program: milk and water were fluoridated, and the level of initial caries was controlled in schools. And already in the early 80s they defeated caries and even closed one of the dental schools, which then did not work for several years - there were no need for so many dentists. I perfectly understand that now it is more important to fight oncology, cardiovascular pathology, and engage in primary care. But that, that it is impossible to improve the health of teeth only by brushing them - this is unambiguous. I am very encouraged that young people are developing a culture of responsible attitude to their health. It becomes an important value for them, and there is no health in general without healthy teeth.Rossiyskaya Gazeta - Special Issue: Healthcare No. 236(8884)
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