The Effectiveness of Reform in the Dental Health Systems of Transitional Countries: The Case of Montenegro Health Reform (pilot study)

Objective: The main objective of this research is to evaluate the influence of reform in the dental health care system in Montenegro on the oral hygiene awareness and health practices among children aged 11 to 14. Materials and Method: The research was performed among public schoolchildren in Montenegro. Data was obtained by evaluating a structured questionnaire fulfilled by 300 children, aged between 11 and 14 years, at the beginning of reform in the dental health care system in 2009 (n = 150) and in 2018 (n = 150). Participants were selected from three different geographical regions (North, Central and Southern). Result: Most participants reported brushing their teeth twice daily (2009: 46% in Rozaje, 48% in Podgorica and 36% in Budva; 2018: 50% in Rozaje, 48% in Podgorica and 40% in Budva). There was no difference by region in either 2009 or 2018 in the rate of self-reported gum bleeding when brushing teeth (p values 0.387 and 0.825, respectively). Most respondents went to the dentist only when they needed treatment. Conclusion: There is no significant change in the awareness and practices of oral hygiene maintenance among children aged 11 to 14 years in Montenegro at the beginning of the reform of dental health care compared to nine years later. It is necessary to introduce more continuous education programs to promote oral health.