Department of Health (DOH) Secretary Teodoro Herbosa along with the Philippine Health Insurance Corporation (PhilHealth) Board of Directors (Board) en banc approved on Friday the country’s first preventive oral healthcare benefit package.

The benefit package is designed to pay for annual routine preventive oral care services for every Filipino, such as mouth examination/oral screening, dental prophylaxis or cleaning, and fluoride varnish application.

There will also be coverage for pit and fissure sealant and Class V procedures as needed for a maximum of two teeth.

Emergency tooth extractions and dental consultations will also be part of the benefit package.

The PhilHealth Board approved the landmark expansion of primary care benefits to cover the mouth in line with the overall vision of “Ngiting 70-20” to ensure that more Filipinos will reach the age of 70 with 20 permanent teeth still in place.

The approval coincided with the country’s participation in the first ever World Health Organization (WHO) Global Oral Health Meeting (GOHM) in Bangkok, Thailand, from 26 to 29 November.

“The Philippine journey for oral health care has been like a roller coaster with ups and downs in implementation,” DOH Assistant Secretary Albert Domingo said during GOHM.

“Under the administration of President Ferdinand R. Marcos, Jr. and Health Secretary Teodoro J. Herbosa, we are now rising again to fulfill the mandate of Universal Health Care that includes oral health,” Domingo added.

The PhilHealth Board approved a maximum payment of P1,000 per patient per year for preventive oral health services, to be paid as follows: P300 for the first visit, covering mouth examination/oral screening, oral prophylaxis (cleaning), and fluoride varnish application; another P300 for a second visit at least four months apart from the first visit, for the same services; and P200 per tooth (maximum of two teeth per year) for pit and fissure sealant or a Class V procedure.

There will be no co-payment allowed for public dentists, while private dentists will be allowed maximum co-payment charges per visit of P1,500 for mouth examination and oral prophylaxis; P600 for pit and fissure sealant or Class V procedure; and P600 for emergency tooth extraction.

Applying fluoride varnish strengthens enamel or the outermost layer of teeth, to prevent new cavities from forming or to slow down or stop tooth decay from worsening.

Pit and fissure sealants are procedures that protect from tooth decay by filling in grooves and pits of teeth where bacteria combined with leftover food or sugars can cause damage.

Meanwhile, Class V procedures remove decayed or damaged tooth tissue, and then replace the area with composite resin material.

Herbosa stressed that the universal health care must have otal health care “and the best way to make it sustainable and felt by all Filipinos is through primary care.”

“The Board agreed on a preventive oral health benefit to be delivered by dentists working in PhilHealth Konsulta package providers, and also by stand-alone dentists based on referrals from the Konsulta providers,” Herbosa said.

“We want dentists to come together and join us for UHC. This new PhilHealth oral health benefit will help make that happen,” he added.

The next step will be for PhilHealth Management under its President and Chief Executive Officer to write and publish the details in a PhilHealth Circular, which will then lead to the development or enhancement of IT systems that will be used to capture data and facilitate payments.

PhilHealth staff will also be training and orienting stakeholders prior to roll-out and implementation anticipated to be in the first to second quarter of the new year.