On approval of the Standard of organizing dental care in the Republic of Kazakhstan

Invalidated Unofficial translation

Order of the Minister of Health and Social Development of the Republic of Kazakhstan dated December 12, 2016 No. 1053. It was registered with the Ministry of Justice of the Republic of Kazakhstan on January 11, 2017 No. 14664. Abolished by Order of the Minister of Health of the Republic of Kazakhstan dated February 24, 2023 No. 31.

      Unofficial translation

      Footnote. Abolished by the Order of the Minister of Health of the Republic of Kazakhstan dated February 24, 2023 No. 31 (effective after ten calendar days after the date of its first official publication).


      In accordance with subparagraph 6) of paragraph 1 of Article 7 of the Code of the Republic of Kazakhstan dated September 18, 2009 On Public Health and Health Care System I hereby ORDER:

      1. To approve the attached Standard of organizing dental care in the Republic of Kazakhstan.

      2. In the manner prescribed by law the Department of Standardization of Medical Services of the Ministry of Health and Social Development of the Republic of Kazakhstan shall:

      1) provide the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan;

      2) within ten calendar days from the date of the state registration of this order, direct a printed and electronic copy of it in the Kazakh and Russian languages to the Republican State Enterprise with the Right of Economic Management “Republican Center of Legal Information” for official publication and inclusion in the Reference Control Bank of Regulatory Legal Acts of the Republic of Kazakhstan;

      3) place this order on the Internet resource of the Ministry of Health and Social Development of the Republic of Kazakhstan;

      4) within ten working days after the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan, report to the Department of Legal Service of the Ministry of Health and Social Development of the Republic of Kazakhstan on execution of the actions indicated in subparagraphs 1), 2) and 3) of this paragraph.

      3. Control over the execution of this order shall be assigned to the Vice-Minister of Health and Social Development of the Republic of Kazakhstan E.A. Birtanov

      4. This order shall take effect upon expiry of ten calendar days after the date of its first official publication.

      Minister
      of Health and Social Development
      of the Republic of Kazakhstan T. Duysenova

  Approved
by order No. 1053 of the Minister
of Health and Social Development
of the Republic of Kazakhstan
dated December 12, 2016

      The Standard of organizing dental care in the Republic of Kazakhstan

      Chapter 1. General Provisions

      1. The standard of organizing dental care in the Republic of Kazakhstan (hereinafter - the Standard) has been developed in accordance with subparagraph 6) of paragraph 1 of Article 7 of the Code of the Republic of Kazakhstan dated September 18, 2009 On Public Health and Health Care System (hereinafter - the Code) and establishes requirements to the organization of medical care provision to patients with dental diseases.

      2. Definitions used in this Standard:

      1) specialized professional - a medical professional with a higher medical education with a certificate in the field of "Dentistry (adult and pediatric)";

      2) clinical protocol - a document that establishes general requirements for the provision of medical care to a patient in a particular disease or clinical situation;

      3) prevention - a set of medical and non-medical measures aimed at preventing the occurrence of diseases, progression in the early stages of diseases and controlling already developed complications, damage to organs and tissues;

      4) dental diseases - diseases of tooth tissues (carious, non-carious), periodontal disease, oral mucosa, tongue disease, red border of the lips and disease of maxillofacial region (acute, chronic nonspecific and specific inflammatory diseases; diseases of the salivary glands; diseases of the temporo-mandibular joint and facial nerves; injuries; congenital and acquired defects and deformations of the maxillofacial region; abnormalities and defects in the development of teeth, jaws and face; precancerous diseases, benign tumors and tumor-like maxillofacial lesions);

      5) dental care - a set of medical services provided to patients with dental diseases, including diagnosis, treatment, prevention and medical rehabilitation;

      6) guaranteed volume of free medical care (hereinafter -GVFMC) - a single volume of medical care provided to citizens of the Republic of Kazakhstan and oralmans as determined by the Government of the Republic of Kazakhstan on the unified list of medical services;

      7) preventive medical examinations of target population groups - screening examinations aimed at identifying diseases in early stages and preventing development of diseases, risk factors that contribute to the occurrence of diseases, formation and promotion of public health.

Chapter 2. Main activities of organizations providing dental care

      3. Medical care for patients with dental diseases shall be provided in the following forms:

      1) outpatient care, including primary health care and consultative-diagnostic care;

      2) inpatient care.

      4. The tasks, functions, legal and organizational framework for the provision of dental care in the Republic of Kazakhstan are defined by the Regulation on the activities of health care organizations providing dental care in the Republic of Kazakhstan, approved by order No. 397 of the Minister of Health of the Republic of Kazakhstan dated June 8, 2012 (registered in the Register of State Registration of Regulatory Legal Acts under No. 7798).

      5. The staff of the healthcare organizations providing dental care, with the exception of organizations that are state-owned enterprises with the right of economic management, limited liability partnerships, joint-stock companies, shall be established in accordance with the standard staff and staffing standards of healthcare organizations approved by order No. 238 of the Minister of Health of the Republic of Kazakhstan dated April 7 2010 (registered in the Register of State Registration of Regulatory Legal Acts under No. 6173).

      6. Dental diseases prevention rooms shall be provided in medical centers, feldsher-obstetric centers, outpatient clinics (family health centers), polyclinics (rural, district, city), in educational institutions with at least 800 students, also in healthcare organizations that have no dental room (department).

      7. Provision of pre-medical dental care in the dental diseases prevention room shall be carried out by a dental hygienist and (or) a medical professional with a secondary medical education who has undergone a retraining course in “Dentistry” and received a certificate in the qualification of “Dentist”, “Stomatologist”, and “Dental Assistant” .

      8. The scope of clinical-diagnostic examination by dental care provision levels shall be determined in accordance with Appendix 1 to this Standard.

      9. A dentist shall provide the organization of a diagnostic and treatment process of dental diseases in accordance with clinical protocols; conduct preventive examinations and oral cavity sanation of the assigned contingent, including in educational institutions of secondary, higher and postgraduate vocational education, recruiting centers, at enterprises and organizations; carry out clinical monitoring of patients with pathology of the dentofacial system and analysis of its effect with assessment of the dental health level; provide earlier identification of persons with dentofacial anomalies, deformations and pre-conditions for their development, defects in crowns of teeth and dentitions, pathology of hard tissues of teeth and oral mucosa; in the presence of medical indications, organize referral of patients for inpatient treatment to the departments (beds) of maxillofacial surgery in multidisciplinary hospitals.

      10. If patients have symptoms indicating the presence of human immunodeficiency virus / acquired immunodeficiency syndrome, tuberculosis the dentist shall refer the patient for consultation to specialized medical organizations.

      11. A dentist shall provide the manufacture of dentures, maxillofacial prostheses and fixation of orthodontic appliances.

      12. A dentist shall conduct examination of temporary disability in accordance with the Rules for the examination of temporary disability, issuance of a slip and certificate of temporary disability, approved by order No. 183 of the Minister of Health and Social Development of the Republic of Kazakhstan dated March 31, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 10964).

      13. Together with centers for healthy lifestyle, a dentist shall carry out sanitary and hygienic education of the population on prevention, formation of a healthy lifestyle and nutrition, including with the involvement of paramedical staff (dental hygienist).

      14. Specialists of dental care medical organizations shall conduct preventive examinations of patients for early detection and prevention of dental diseases and provide specialized medical care to patients with dental diseases applying modern medical technologies and diagnostic and treatment methods based on evidence-based medicine principles.

      15. Screening examinations of the child population are aimed at the prevention and early detection of dental diseases, the development of which is associated with particular features of the anatomical and physiological development in various age periods of life, including in the juvenile period.

      16. Preventive examinations, including screening examinations followed by dynamic monitoring and rehabilitation, shall be carried out in accordance with the Rules for conducting preventive medical examinations of target population groups, approved by order No. 685 of the acting Minister of Health of the Republic of Kazakhstan dated November 10, 2009 (registered in the Register of State Registration of Regulatory Legal Acts under No. 5918).

      17. A dentist shall carry out a specialized screening examination stage of the child population with filling out the recording and reporting documentation, also a comprehensive examination of a child with assessment of the condition of the occlusion, periodontium, the degree of caries activity, clinical examination, rehabilitation and prevention plan.

      18. Screening examination results of the child population target groups shall be entered into statistical form 025–07 / y “Record of preventive medical examination (screening) of a child”, approved by order No. 907 of the Acting Minister of Health of the Republic of Kazakhstan dated November 23, 2010 “On approval of the forms of primary medical documentation of healthcare organizations ”(registered in the Register of State Registration of Regulatory Legal Acts of the Republic of Kazakhstan under No. 6697) (hereinafter - Order No. 907) and communicated to the parents and (or) legal representatives.

      19. In the event of detected abnormalities in the development of the dento-maxillary system, the medical organizations’ specialists providing dental care, shall ensure subsequent organization and conduct of a diagnostic examination and subsequent sanation of the patients.

      20. Professionals of the dental care medical organizations shall provide the patient, relatives or legal representatives of minor children with information about the diagnosis, prognosis and alternative methods of treatment, rehabilitation, carry out activities to prevent dental diseases, promote a healthy lifestyle among the population of the Republic of Kazakhstan.

      21. To sustain its activities, the dental room (department) shall avail of the capabilities of all the medical diagnostic and auxiliary units of the medical organization, in which it is established.

      22. In dental clinic conditions, specialists shall provide prevention, diagnosis and treatment of dental diseases in accordance with clinical protocols; in the detected complications of dental diseases – make case discussions and analysis of the causes of the identified complications; organize and conduct follow-up care of patients with dental diseases; conduct examination of temporary disability of patients with dental diseases.

      23. Dental clinic shall be used as a clinical, training, production base for medical and pharmaceutical education organizations that implement programmes of technical and vocational, post-secondary, higher, postgraduate and further education in accordance with the legislation of the Republic of Kazakhstan in the field of education, as well as technical and vocational education organizations of the corresponding profile.

      24. Patients with dental diseases who receive medical care in the conditions of clinical, educational bases of the departments of medical higher educational institutions, extension course institutes for medical practitioners, also production practice bases for medical students in secondary education, shall take part in the educational process, conducting medical and diagnostic procedures in the presence of third parties.

Chapter 3. Organization of dental care in the Republic of Kazakhstan

      25. Medical assistance to the population with dental diseases shall be provided within the GVFMC framework.

      26. Paid medical services for patients with dental diseases shall be provided by public and private medical organizations in accordance with the Rules and conditions for the provision of paid services in healthcare organizations, approved by Order No. 304 of the Minister of Health and Social Development of the Republic of Kazakhstan dated April 30, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 11341).

      27. Dental medical care within the GVFMC framework shall be carried out in the following forms:

      1) primary health care (hereinafter - PHC);

      2) consultative and diagnostic assistance (hereinafter - CDA);

      3) emergency medical care.

      28. Primary health care for patients with dental diseases shall be provided in accordance with the Rules for the provision of primary health care and the Rules for attaching citizens to primary health care organizations, approved by Order No. 281 of the Minister of Health and Social Development of the Republic of Kazakhstan dated April 28, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 11268).

      29. A healthcare professional with a secondary medical education (nurse, paramedic) of a medical center and feldsher-obstetric center, outpatient clinic (family health center) shall ensure the organization and conduct of a range of actions for patients, including those with dental diseases, in accordance with order No. 7 of the acting Minister of Health of the Republic of Kazakhstan dated January 5, 2011 “On approval of the Regulation on the activities of health organizations providing outpatient care”(registered in the Register of State Registration of Regulatory Legal Acts under No. 6774).

      30. A healthcare professional with a secondary medical education (nurse, paramedic) of a medical center and feldsher-obstetric center, outpatient clinic (family health center) shall ensure the delivery of patients with acute and exacerbated chronic dental diseases, injuries to the nearest hospital in emergency and urgent cases to provide qualified medical care.

      31. A mobile dental clinic (hereinafter - MDC) shall be established as a structural unit of a dental clinic or dental department of a medical organization to provide medical care for dental diseases outside the stationary premises of a medical organization, including in remote and isolated settlements, by dentists or other dental specialists included in the staff of the dental clinic or dental units of the medical organization, taking into account regional characteristics and needs of medical treatment in dental diseases.

      32. An MDC shall be supplied in accordance with the list of minimum equipment for a mobile dental clinic in accordance with Appendix 2 to this Standard.

      33. An MDC specialist shall provide detection and treatment of teeth, periodontal and oral mucosa diseases; identification of patients with dentofacial anomalies and prerequisites for their development; identification and treatment (prosthetics) of patients with defects in crowns and dentitions.

      34. An MDC specialist shall refer patients with complicated forms of disease to dentists for specialized medical care on an outpatient or inpatient basis; patients with dentofacial anomalies and prerequisites for their development shall be referred to dentists with advanced training in orthodontics, and in their absence, to a dentist at the dental clinic who has undergone advanced training in orthodontics.

      35. In the need of a complex prosthetics, an MDC specialist shall refer patients with defects in the crowns of the teeth and dentitions to the dental clinic.

      36. An MDC specialist shall carry out measures to prevent dental diseases among the population, provide hygienic education and oral hygiene instruction.

      37. CDA for patients with dental diseases shall be provided in accordance with the Rules for the provision of consultative and diagnostic assistance, approved by Order No. 626 of the acting Minister of Health and Social Development of the Republic of Kazakhstan dated July 28, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 11958).

      38. CDA (according to indications) shall include:

      1) emergency dental care (acute pain) (for socially vulnerable categories of the population: anesthesia, preparation and application of fillings from composite materials of chemical curing, tooth extraction with anesthesia, periostotomy, opening of abscesses);

      2) planned dental care for children (except for orthodontic and orthopedic) and pregnant women (except for orthodontic and orthopedic) on the referral of a specialist, including tooth extraction using anesthesia, preparation and application of fillings from composite materials of chemical curing;

      3) orthodontic care for children with congenital pathology of the maxillofacial region using an apparatus to eliminate dentoalveolar anomalies (orthodontic plate).

      39. In the presence of a concomitant pathology of patients with dental diseases, doctors of related fields (on medical indications) shall be involved to provide consultation service.

      40. In cases requiring specialized medical care and high-tech medical services with round-the-clock medical supervision, patients with dental diseases shall be referred to the maxillofacial units of multifield hospitals in accordance with the Rules for the provision of inpatient care, approved by Order No. 761 of the Minister of Health and Social Development of the Republic of Kazakhstan of 29 September 7, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 12204).

      41. When providing CDA, a dentist shall direct to the GVFMC doctor, who has referred the patient for consultation, a consultative and diagnostic report on 071 / у form (“Medical Report”), approved by Order No. 907, in which examination and treatment results shall be indicated, as well as recommendations for further treatment of the patient with dental diseases.

      42. A dentist shall provide consultative medical report for completion of a dental patient’s documents for referral for sociomedical examination to establish disability and degree of disability, also to determine the needs of the examined person for social protection measures in accordance with the Rules for conducting sociomedical examination approved by order No. 44 of the Minister of Health and Social Development of the Republic of Kazakhstan dated January 30, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No.10589).

      43. In the event of detected cancer symptoms during the medical care provision to a patient with a dental disease, medical care shall be provided to the patient in accordance with the standard of the cancer care organization for the population of the Republic of Kazakhstan, approved by order No. 452 of the Minister of Health and Social Development of the Republic of Kazakhstan dated August 2, 2013 (registered in the Register of State Registration of Regulatory Legal Acts under No. 8687).

      44. After the diagnosis verification, treatment of malignant neoplasms of the maxillofacial region of children shall be carried out in specialized oncological organizations.

      Reparative surgeries after removal of neoplasms in the maxillofacial region, according to indications, shall be performed in health organizations that provide medical care to cancer patients or in children's maxillofacial units of multifield hospitals.

      45. Emergency medical care to patients with dental diseases shall be provided in accordance with the Rules for the provision of emergency medical care and medical assistance in the form of medical aviation, approved by order No. 269 of the Minister of Health and Social Development of the Republic of Kazakhstan dated April 27, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 11263) and include round-the-clock emergency medical care to adults and children in life-threatening (of patient and (or) people around them) conditions, accidents, acute serious illnesses, both at the accident scene and along the route.

      46. Dental medical care shall be provided to the patient after obtaining his informed consent in the form of a written voluntary consent of the patient in the invasive intervention cases, approved by order No. 364 of the Minister of Health and Social Development of the Republic of Kazakhstan dated May 20, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 11386)

      Refusal from medical care with the indication of possible consequences in accordance with paragraph 3 of Article 93 of the Code shall be recorded in medical documents and signed by the patient or his legal representative, and also by a medical professional.

      47. Need of qualified, specialized medical care and high-tech medical services with round-the-clock medical supervision, shall be the indication for planned hospitalization of a patient with dental diseases, including for:

      1) diagnosis specification in cases that are unclear and difficult for diagnosis and treatment and selection of the necessary treatment regimen;

      2) treatment of chronic diseases of the oral cavity and maxillofacial region in the acute stage;

      3) surgical treatment of benign tumors and tumor-like diseases;

      4) treatment of injuries and purulent-inflammatory diseases of the maxillofacial region;

      5) surgical treatment of defects and deformations of the maxillofacial region;

      6) surgical treatment of congenital pathology of the maxillofacial region.

      48. Hospitalization of patients with dental diseases in emergency cases shall be carried out on referral from a pediatric dentist, general practice dentist, general practitioner, pediatrician, ambulance station (department) teams, air ambulance accompanied by a medical professional or in independent seeking of medical assistance and with any other methods of patient’s delivery, regardless of place of residence and place of attachment within the GVFMC framework.

      49. Indications for emergency hospitalization shall be:

      1) acute or exacerbated chronic odontogenic and non-odontogenic inflammatory diseases of the maxillofacial region;

      2) injuries of the maxillofacial region;

      3) bleeding of the maxillofacial region.

      50. Emergency dental surgical care for adult population with minor bleeding in the maxillofacial region, acute inflammatory processes (acute periostitis of the jaw, hard palate abscesses), injuries of the maxillofacial region (dislocations and fractures of the teeth) shall be provided by a dentist of the dental room (department, dental clinic).

      51. Emergency dental surgical care for adult population with severe bleeding in the maxillofacial region, severe acute periostitis of the jaws, acute odontogenic osteomyelitis of the jaws, abscesses and phlegmons of the maxillofacial region shall be provided by dentists, maxillofacial surgeons, doctors with qualifications of “general surgery (thoracic, abdominal, transplantology, coloproctology)”, who have undergone advanced training in maxillofacial surgery (adult) in the departments of surgery, maxillofacial surgery in the surgery departments of multifield hospitals.

      52. Emergency dental surgery for children with bleeding in the maxillofacial region, acute inflammatory processes and injuries of the maxillofacial region shall be performed by dentists, doctors with qualification “maxillofacial surgery (adult, pediatric)”, doctors specializing in “general surgery ( thoracic, abdominal, transplantology, coloproctology)”, who have undergone advanced training in “maxillofacial surgery (pediatric)” in dental clinics, children's surgical wards of maxillofacial surgery, children's surgical units of multifield children’s hospitals.

      53. Dental care for adults with inflammatory, inflammatory-dystrophic, functional-distention disorders of the temporomandibular joint shall be carried out by a dentist of the dental rooms (departments) of polyclinics and dental clinics.

      54. Dental care for children with inflammatory, inflammatory-dystrophic, and functional-distention diseases of the temporomandibular joint shall be carried out by a dentist at the children's dental clinic, children's departments of dental clinics, and the children's unit of maxillofacial surgery of a multifield hospital. On indications, surgical treatment of children with arthrosis and ankylosis shall be carried out by the children's department of maxillofacial surgery in a multifield hospital.

      55. The following patients shall be admitted to the maxillofacial surgery units of multifield hospitals:

      1) with bleeding in the maxillofacial region;

      2) with acute and exacerbated chronic inflammatory diseases;

      3) with injuries in the maxillofacial region;

      4) with functional-distention disorders of the temporomandibular joint, requiring reconstructive surgery in the maxillofacial region (according to indications);

      5) with benign and tumor-like formations in the maxillofacial region.

      56. Inspection of newborn children in order to identify dentofacial anomalies and deformities shall be carried out by a doctor specializing in neonatology of obstetric organizations; inspection of children of preschool and school age shall be carried out by a medical professional in the dental disease prevention room, dentist in the dental room (unit) of the clinic, dental room(unit) of a children's clinic, dental room of educational organizations, departments of maxillofacial surgery, a dentist of medical universities’ dental clinics.

      57. When a congenital dental pathology is detected in a newborn, doctors specializing in neonatology and pediatrics shall refer the child to the dentist in the dental room of the children's clinic, children's dental clinic to decide on specialized dental care.

      58. In the presence of medical indications, the dentist shall refer the child with congenital dental pathology for a consultation to doctors specializing in pediatrics (general medicine, otorhinolaryngology (audiology) (adult, pediatric), traumatology-orthopedics (cambustology) (adult, children's) ”,“ endocrinology (adult, children's)”, “neuropathology (adult, children's)”, also to a specialist with higher pedagogical education in “defectology”,“speech therapy”.

      If there are indications for surgical treatment, the dentist shall refer the child with maxillofacial anomalies and deformities to the maxillofacial surgery department of the children's hospital, medical university clinic for surgical intermediate rehabilitation with previous and subsequent orthodontic treatment.

      59. For patients with defects in the development of hard tissue of teeth, the dentist shall provide dental care in a dental clinic or specialized rehabilitation centers.

      According to the indications, the dentist shall refer a child for a consultation to doctors qualifying in "pediatrics ("general medicine", "endocrinology (adult, pediatric)","medical genetics".

      60. Dental care for children with congenital and acquired face and jaw malformations shall be carried out by a dentist and a doctor specializing in maxillofacial surgery (adult, pediatric) of a pediatric dental clinic, a pediatric unit of a dental clinic, a pediatric maxillofacial surgery unit of a multifield hospital.

      61. Medical assistance to children with dental caries shall be provided by a pediatric dentist in children's dental clinics, children's dental rooms (units), dental rooms of educational institutions, and mobile dental clinics.

      62. When a child is diagnosed with multiple dental caries (damage rate of more than three teeth), the dentist shall refer him for consultation to pediatric doctors of other fields ("pediatrics", "endocrinology", "otorhinolaryngology", "neuropathology", "rheumatology", " allergology", "nephrology").

      Children with multiple caries shall be subject to regular medical check-up with the dentists of children's dental rooms, where comprehensive preventive measures are provided in accordance with clinical protocols.

      63. Dental care for children with acute pain shall be provided by a dentist in priority order in a children's dental clinic, dental office (unit) of a children's clinic, children's departments of dental clinics, a dental office of educational organizations, and dental clinics of medical universities providing dental care for children.

      64. For children with disabilities (children with established disabilities), a dentist shall provide dental care according to indications under general anesthesia (if there are medical indications and no counterindications) in the conditions of a children's dental clinic, children's units of dental clinics, dental clinics of medical universities providing dental care to children.

      65. Medical assistance to children with periodontal diseases shall be carried out by a dentist in the conditions of a children's dental clinic, a children's dental office (unit) of a children's clinic, a dental office of clinics (rural, district, city) in accordance with clinical protocols with subsequent follow-up care on an outpatient basis.

      In the event of a severe degree of periodontal disease, the dentist, if necessary, shall refer the children for consultation to other relevant specialists.

      66A dentist shall conduct medical care to children with diseases of the oral mucosa (acute herpetic stomatitis, exudative multiform erythema, candidiasis and other lesions of the oral mucosa) in a children's dental clinic, a children's dental office (unit) of a children's clinic, a dental room of a clinic ( rural, district, city), in accordance with clinical protocols.

      Proceeding from indications, the dentist shall refer the patient for consultation to doctors qualifying in "pediatrics", "otorhinolaryngology", "infectious diseases", "allergology", "dermatovenerology", "neuropathology", "medical genetics" in medical healthcare organizations.

      In case of a severe course of diseases of the oral mucosa in children, treatment shall be carried out in specialized departments of hospitals (clinics).

      67. Dental care for children with limited acute and chronic odontogenic and non-odontogenic inflammatory diseases, with acute trauma to teeth, soft tissues of the face and oral mucosa, congenital and acquired defects and deformations of the maxillofacial region shall be carried out sequentially: by a dentist, a doctor qualifying in “maxillofacial surgery (pediatric)” in children's dental clinics, dental offices (departments) of children's clinics, dental rooms of clinics (rural, district, city), dental clinics with medical universities.

      68. Dental care for children with diffuse and severe forms of odontogenic and non-odontogenic inflammatory diseases (abscesses, phlegmons, jaw osteomyelitis, furunculus, carbuncle, adenoflegmon, sialadenitis of the salivary glands, thrombophlebitis of the facial veins), shall be provided in children’s maxillofacial surgery units.

      69. Dental care for children with odontogenic acute and exacerbated chronic inflammatory diseases of the maxillofacial region (pulpitis, periodontitis, periostitis, subgingival abscess) shall be provided in dental clinics, according to indications in children's departments of maxillofacial surgery in multifield hospitals, in medical university clinics.

      70. Dental care to children with limited benign and tumor-like formations, maxillofacial malformations shall be provided by a dentist, a doctor specializing in maxillofacial surgery (pediatric) and shall be performed in dental clinics, and with extensive lesions of more than one anatomical area of the face - in children's maxillofacial departments of multifield hospitals.

      71. The quality of medical services at medical organizations rendering dental care, regardless of ownership and departmental affiliation, shall be provided in accordance with the Rules for organizing and conducting internal and external examinations of the quality of medical services, approved by Order No. 173 of the Minister of Health and Social Development of the Republic of Kazakhstan of March 27, 2015 (registered in the Register of State Registration of Regulatory Legal Acts under No. 10880).

  Appendix 1
to the Standard of organizing
  dental care
in the Republic of Kazakhstan

Scope of clinical-diagnostic examinations by dental care provision levels

Levels of providing medical assistance in accordance with the structure of dental care organization

List
of diagnostic measures

List
of remedial measures

Note

1. Primary medico-sanitary care (pre-medical care):
organizations:
feldsher-obstetric station,
outpatient clinic,
dental disease prevention rooms
personnel:
mid-level medical staff,
that underwent a training course

1. Clarification and detailing of complaints,
2. Medical history taking.
3. Physical examination (basic methods).
4. X-ray inspection.

1. Oral hygiene instruction.
2. Professional oral hygiene.
3. On indications – referral to dental room.
4. In emergency cases – referral for hospitalization (for specialized care in hospital conditions).


2. Outpatient care (primary medico-sanitary care, consultative-diagnostic assistance)
Organizations:
dental room as part of dental polyclinics (oblast, city), including children’s units of multifield hospitals, clinics;
mobile dental clinic;
dental room in schools
dental disease prevention room
Personnel:
Doctor qualifying in "dentistry (adult and pediatric)";
dentist;
X-ray laboratory assistant

1. Clarification and detailing of complaints.
2. Medical history taking.
3. Physical examination (basic methods).
4. Examination with the use of supplementary examination methods (thermotest, electroodontometry, X-ray examination, apex location, carrying out diagnostic tests, determination of dental indices).

1. Oral cavity sanation.
2. In the presence of indications – referral for consultation to related professionals. 3.Provision of emergency care in urgent conditions.
4. In the presence of indications – referral for hospitalization.


Specialized dental care.
Organization:
dental clinic, including dental clinic of medical universities
Personnel:
Doctor qualifying in “Dentistry (adult and pediatric)”;
X-ray laboratory assistant

1. Clarification and detailing of complaints,
2. Medical history taking.
3. Physical examination (basic methods).
4. On indications – referral for laboratory examination, X-ray radiography, tomography, ultrasound examination, densitometry, electrodontometry, echoosteometry, rheoparadontography, cytological examination, index assessment of teeth condition, of paradontium, functional tests, gnatodynamometry, myography.

1. Endodontic dentistry.
2. Restoration of teeth.
3. Paradontological dental care.
4. Treatment of oral mucosa pathology.
5. Outpatient surgical interventions.
6. Orthodontic care.
7. Orthopedic care.
8. Dental implantation of teeth.
9. Orthodontic rehabilitation of children with congenital pathology of maxillofacial region.
 


High-tech medical services
Organizations: department (beds) (adult, pediatric) of maxillofacial surgery in a multifield hospital (city, regional);
maxillofacial hospital
dental clinics of medical universities
Personnel: doctor qualifying in maxillofacial surgery (adult, pediatric); Doctor specializing in “Dentistry (adult and pediatric)”;
X-ray laboratory assistant

1. Clarification and detailing of complaints,
2. Medical history taking.
3. Physical examination (basic methods).
4. On indications – referral for laboratory examination, X-ray radiography, tomography, ultrasound examination.

1. Treatment of pathology of maxillofacial region.
2. Dental and maxillary prosthetics.
3. Dental implantation of teeth.



  Appendix 1
to the Standard of organizing
  dental care
in the Republic of Kazakhstan

List of minimum equipment for mobile dental clinic

Name

Number, units

Dental equipment and tools

1

Dental set, comprised of a dentist unit, dental couch, dental hydraulic unit, assistant unit with a vacuum cleaner and saliva ejector, an dental surgery lamp

1

2

Oil-free compressor

1

3

A set of dental handpieces (turbine, angular, straight, pneumatic micromotor)

3

4

Dental scaler (device for removing tartar deposits)

1

5

Dentist’s chair

1

6

Assistant’s chair

1

7

Photopol lamp

1

8

Apex locator

1

9

Surgical knife (coagulator)

1

10

Bactericidal irradiator

1

11

UV bactericidal recirculator for indoor air disinfection

1

12

Therapeutic tool kit (basic):
tool tray
mirror with handle
dental probe,
dental forceps,
excavator,
double-end sickle-shaped burnisher,
root canal plugger,
cement spatula

20

13

Disinfection and pre-sterilization containers for medical items (set - 1 liter, 3 liters, 5 liters and 10 liters)

1

14

A set of disposable dental instruments for dental examination and treatment:
tool tray;
dental mirror;
angular probe;
metal forceps ;
sterile gloves;
saliva ejector;
cotton rolls;
apron for the patient;
mask;
a cap on the headrest;
microbrushes;
latex head for polishing teeth and fillings;
synthetic bristle head;
napkin for patient
 

1 000 pieces a year

15

A set of forceps for removing permanent teeth and upper and lower tooth roots

2

16

A set of forceps for removing temporary teeth and upper and lower tooth roots

2

17

A set of dental elevators for removing tooth roots

2

Sterilization equipment

1

Sterilizer (autoclave)

1

2

Water distiller

1

3

Chamber for storage of sterile instruments

1

4

Installation for ultrasonic cleaning and disinfection of medical instruments and products (ultrasonic washing)

1

5

Disinfection and pre-sterilization containers for medical devices (set - 1 liter, 3 liters, 5 liters and 10 liters)

1

6

Means for disinfection and pre-sterilization treatment of medical devices

As they are consumed

7

Dressing boxes (sterilizing boxes for storing sterile instruments and materials)

As they are consumed

8

Indicators for quality control of medical devices sterilization

As they are consumed

9

Reagents for the quality control of disinfection and pre-sterilization cleaning of medical devices

As they are consumed

X-ray diagnostic equipment

1

X-ray dental apparatus

1

2

Notebook

1

3

Dental X-ray protective apron with collar

2

Furniture for a dental office

1

Doctor's desk

1

2

Office chair

2

3

Medical cabinet for storing consumable supplies

1

4

Medical cabinet for medicines

1

5

Cabinet for medical clothes

1

6

Table with sink combined

1

Other equipment and tools

1

Power supply unit

1

2

Submersible electric pump

1

3

Air conditioner

1

4

Fan heater

1

5

Fan

1

6

Electric water heater

1

7

Thermometer

1

8

Fire extinguisher

1

9

Alarm system

1

10

Water supply of at least 60 liters

1

11

Cables

1

12

Household cleaning stock

1


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