ABSTRACT
ABSTRACT OBJECTIVE To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. METHODS A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. RESULTS A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. CONCLUSIONS A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent permanent education activities.
Subject(s)
Humans , Primary Health Care/statistics & numerical data , Oral Health , Delivery of Health Care/statistics & numerical data , Dental Health Services/supply & distribution , Dental Instruments/supply & distribution , Brazil , Serial Cross-Sectional Studies , Dental Health Services/classification , Dental Health Services/statistics & numerical data , WorkforceABSTRACT
O objetivo deste estudo foi avaliar o uso regular de serviços odontológicos entre adultos, identificando grupos nos quais esse comportamento é mais freqüente. O estudo foi realizado em Pelotas, Rio Grande do Sul, Brasil, com desenho transversal de base populacional, envolvendo 2.961 indivíduos, que responderam um questionário estruturado. A prevalência de uso regular encontrada foi de 32,8 por cento. Estiveram positivamente associadas ao uso de forma regular as seguintes características: ser do sexo feminino, ter idade < 60 anos, não ter companheiro, ter alta escolaridade, ter maior nível econômico, usar serviços privados, ter autopercepção de saúde bucal boa/ótima, não ter autopercepção de necessidade de tratamento, ter recebido orientação sobre prevenção e ter manifestado opinião favorável ao profissional. O uso regular foi pouco freqüente, especialmente entre os menos favorecidos (15 por cento). Restringindo a análise apenas para usuários do serviço público, observou-se maior utilização regular entre os mais escolarizados. Os serviços de saúde, em especial o público, devem trabalhar a fim de incrementar o uso regular e preventivo.
The aim of this study was to estimate the prevalence of regular use of dental services by adults and identify groups where this behavior is more frequent. A cross-sectional population-based study was carried out in Pelotas, southern Brazil, including 2,961 individuals who answered a standardized questionnaire. Overall prevalence of regular use of dental services was 32.8 percent. The following variables were positively associated with regular use: female gender, age > 60 years, no partner, high educational level, high economic status, private service user, good/excellent self-rated oral health, and no perceived need for dental treatment. Those who had received orientation on prevention and expressed a favorable view towards the dentist had higher odds of being regular users. Especially among lower-income individuals, regular use was infrequent (15 percent). When restricting the analysis to users of public dental services, schooling was still positively associated with the outcome. Dental services, especially in the public sector, should develop strategies to increase regular and preventive use.