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Kakudate N, Yokoyama Y, Tagliaferro EPDS, Sumida F, Matsumoto Y, Gordan VV, Gilbert GH. Comparison of factors associated with the evidence-practice gap as perceived by Japanese and Brazilian dentists. J Dent 2024; 149:105255. [PMID: 39079315 PMCID: PMC11381139 DOI: 10.1016/j.jdent.2024.105255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVES To identify 1) factors of the evidence-practice gap (EPG) in Japan and Brazil as perceived by dentists and compare these factors between two countries, and 2) mechanisms to close this EPG. METHODS The study employed a cross-sectional design by administering a web-based questionnaire to 136 Japanese and 110 Brazilian dentists. The survey queried dentists' reports of which factors possibly cause an EPG, using a newly developed 20-item questionnaire. RESULTS An international comparison of 20 items related to factors of the EPG between Japan and Brazil revealed that "Dentists' own experiences are sometimes given priority over evidence" and "Dentists' own thoughts are sometimes given priority over evidence" were common factors to both countries, with over 80 % agreement. In logistic regression, "Insufficient opportunity to learn about evidence in dental education at universities", "Evidence-based treatments are sometimes not covered by the dental insurance system", and "Insufficient evidence which helps dentists choose an appropriate treatment for a patient after careful consideration of his/her own background" were significantly associated with the EPG in Japan (p < 0.05). In Brazil, "Insufficient case reports in which evidence-based dentistry (EBD) is applied to clinical practice" and "Image-based information and devices used for diagnosis vary depending on individual dentists" were significantly associated with the EPG (p < 0.05). CONCLUSIONS This study suggests that EPG could be improved in Japan: by promoting EBD education at universities, improving the dental insurance system, and accumulating evidence according to patient background; and in Brazil: by promoting EBD case reports and standardizing diagnostic information and devices. CLINICAL SIGNIFICANCE Two factors of EPG common to Japan and Brazil, namely the prioritization of dentists' own "experiences" and "thoughts" over evidence, are urgent issues for improving EPG. In addition, it will be necessary to address the country-specific factors of EPG that were identified in this study.
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Affiliation(s)
- Naoki Kakudate
- Division of Clinical Epidemiology, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka 803-8580, Japan.
| | - Yoko Yokoyama
- Graduate School of Media and Governance, Keio University, 5322 Endo Fujisawa, Kanagawa 252-0882, Japan
| | - Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Futoshi Sumida
- Daiich Dental Clinic, 5-5-7, Hanazono, Chitose, Hokkaido 066-0028, Japan
| | - Yuki Matsumoto
- Matsumoto Dental Clinic, 24-3, Komanomai, Doimachi, Okazaki, Aichi 444-0204, Japan
| | - Valeria V Gordan
- Department of Restorative Dental Sciences at the University of Florida College of Dentistry, Room D3-39 P.O. Box 100415, Gainesville, FL 32610-0415, USA
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Room SDB 109, 1720 Second Avenue South, Birmingham, AL 35294-0007, USA
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Beckman CKDC, Luppieri V, Pereira LM, Silva CR, Castelo PM, Cadenaro M, Rontani RMP, Castilho ARFD. Impact of COVID-19 on pediatric dental care in two epicenters: Italy and Brazil. Braz Oral Res 2024; 38:e068. [PMID: 39109765 PMCID: PMC11376669 DOI: 10.1590/1807-3107bor-2024.vol38.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/06/2024] [Indexed: 09/20/2024] Open
Abstract
The study aimed to compare the adherence of Brazilian and Italian pediatric dentists to the biosafety measures and operative protocols recommended by the health authorities during COVID-19 pandemic and to classify the participants according to their risk of infection. An online questionnaire with 34 questions about sociodemographic and occupational data, dental practice organization, biological risk management, and clinical operative protocols was sent to Brazilian and Italian pediatric dentists using a convenience sampling strategy. Chi-square test and multivariate analysis (two-step cluster) were performed (α = 5%). Of 641 respondents (377 Brazilians and 264 Italians), most were female (94% and 70%, respectively), aged 20-39 years (63%), with over 10 years of professional experience (58% and 49%, respectively). Based on adherence to recommended biosafety measures, participants were classified as "safer" (n = 219) or "less safe" (n = 422). Adherence to recommended protocols by the majority of participants resulted in low contagion rates (Brazilians = 5%; Italians = 12.5%). Participants with extensive professional experience in the dental setting exhibited a greater tendency to implement multiple adaptations (three or more) in their practice. Most participants (Brazilians = 92%; Italians = 80.7%) adopted the recommended minimal intervention dentistry approaches, with the use of fissure sealants and the use of non-rotary instruments for caries removal the most frequently techniques used among Brazilians (36%) and Italians (66%), respectively. Two different profiles of pediatric dentists were identified based on the biosafety protocols adopted during the pandemic. In addition, changes were implemented in the dental care provided to children, with focus on the minimal intervention dentistry.
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Affiliation(s)
- Camilla Karoline de Carvalho Beckman
- Universidade Estadual de Campinas - Unicamp, Faculdade de Odontologia de Piracicaba, Departamento de Ciências da Saúde e Odontologia Infantil, Piracicaba, SP, Brazil
| | - Valentina Luppieri
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Letícia Martins Pereira
- Universidade Estadual de Campinas - Unicamp, Faculdade de Odontologia de Piracicaba, Departamento de Ciências da Saúde e Odontologia Infantil, Piracicaba, SP, Brazil
| | - Camila Ribeiro Silva
- Universidade Estadual de Campinas - Unicamp, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora, Piracicaba, SP, Brazil
| | - Paula Midori Castelo
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Farmacêuticas, Diadema, SP, Brazil
| | - Milena Cadenaro
- University of Trieste, Department of Medicine, Surgery and Health Sciences, Trieste, Italy
| | - Regina Maria Puppin Rontani
- Universidade Estadual de Campinas - Unicamp, Faculdade de Odontologia de Piracicaba, Departamento de Ciências da Saúde e Odontologia Infantil, Piracicaba, SP, Brazil
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Zajkowski LA, Scarparo RK, Silva HGE, Celeste RK, Kopper PMP. Impact of COVID-19 pandemic on completed treatments and referrals during urgent dental visits. Braz Oral Res 2023; 37:e087. [PMID: 37672420 DOI: 10.1590/1807-3107bor-2023.vol37.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/24/2023] [Indexed: 09/08/2023] Open
Abstract
This ecological study assessed the impact of the COVID-19 pandemic on completed treatments (CTs) and referrals during urgent dental visits to primary health care units in Brazil, and their associations with socioeconomic, geodemographic, and pandemic index factors in Brazilian municipalities. The difference in rates of procedures 12 months before and during the pandemic was calculated. Data were extracted at baseline from health information systems of all municipalities that provided urgent dental care (n = 5,229 out of 5,570). Multiple logistic regression predicted the factors associated with referrals and CTs. The number of dental urgencies increased from 3,987.9 to 4,272.4 per 100,000 inhabitants. The rates of referrals decreased in 44.1% of the municipalities, while 53.9% had lower rates of CTs. Municipalities with a greater number of oral health teams in the primary health care system (OR = 1.52, 95%CI:1.21-1.91) and with specialized services (OR = 1.80, 95%CI:1.50-2.16) were more likely to decrease referrals during the pandemic. Higher HDI and GDP per capita were associated with a larger decrease in referrals and smaller decrease in CTs. The calamity generated by the long pandemic period resulted in a greater demand for urgent visits. Less developed and larger cities seem to have been more likely to not complete treatments during urgent visits in primary dental care units in times of calamity. Primary dental care offices in smaller and less developed municipalities should be better equipped to provide appropriate assistance and to improve the problem-solving capacity of dental services during emergencies.
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Affiliation(s)
- Luciéli Andréia Zajkowski
- Universidade Federal do Rio Grande do Sul - UFRGS, Graduate Program in Dentistry, Porto Alegre, RS, Brazil
| | | | - Heloisa Grehs E Silva
- Universidade Federal do Rio Grande do Sul - UFRGS, Graduate Program in Dentistry, Porto Alegre, RS, Brazil
| | - Roger Keller Celeste
- Universidade Federal do Rio Grande do Sul - UFRGS, Graduate Program in Dentistry, Porto Alegre, RS, Brazil
| | - Patrícia Maria Poli Kopper
- Universidade Federal do Rio Grande do Sul - UFRGS, Graduate Program in Dentistry, Porto Alegre, RS, Brazil
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Aimond G, Thivichon-Prince B, Bernard-Granger C, Gisle C, Caron T, Jiokeng AV, Majoli S, Maurin JC, Ducret M, Laforest L. Oral Health of Rural Cameroonian Children: A Pilot Study in Bamendou. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1396. [PMID: 37628396 PMCID: PMC10453488 DOI: 10.3390/children10081396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023]
Abstract
Access to dental care in Cameroon is a public health issue, particularly for children living in rural areas. Given the lack of recent data, the investigation of children's oral health along with their oral hygiene behavior, needs in terms of care, and access to oral hygiene materials were investigated. This cross-sectional pilot study was conducted in Bamendou, Western Region of Cameroon. The study population included 265 children aged 3-18 years who completed a questionnaire about their oral hygiene practices. A clinical examination assessed dental caries, calculus, gingivitis, and oral hygiene. The Chi-squared test was used to identify potential factors influencing caries prevalence rates (significance threshold: p < 0.05). Among the 265 children (females: 41.5%, mean age 9.3 years), caries prevalence (ICDAS ≥ 2) was 78.5% and significantly increased with age: 62.2% (3-6 years), 80.9% (7-11 years) and 84.1% (12-18 years, p = 0.01). Virtually no children (95.1%) had ever visited a dentist. While only 23.4% of children brushed their teeth at least twice a day, 14% worryingly reported the use of products other than toothpaste (ash, soap, salt, or bicarbonate) and 13.6% no brushing product. The present study revealed a high prevalence of dental caries in this population and inadequate toothbrushing habits, which highlights the need for preventive oral health education and intervention to address these issues.
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Affiliation(s)
- Guillaume Aimond
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Pôle D’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Béatrice Thivichon-Prince
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Pôle D’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, Institut de Biologie et Chimie des Protéines, UMR CNRS 5305, 69367 Lyon, France
| | - Célia Bernard-Granger
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Pôle D’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Coline Gisle
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Pôle D’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Tatiana Caron
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Pôle D’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Andre Valdese Jiokeng
- Solidarité Sans Frontières, Yaounde P.O. Box 4260, Cameroon
- Groupe Médical St-Hilaire (GMSH) Bastos, Yaounde P.O. Box 5123, Cameroon
| | - Stefano Majoli
- Independent Researcher, 1212 Lancy, Switzerland
- Département de Prévention et Pathologie Buccale, Division de Stomatologie et Chirurgie Orale, Université de Genève, 1202 Genève, Switzerland
| | - Jean-Christophe Maurin
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Pôle D’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, Institut de Biologie et Chimie des Protéines, UMR CNRS 5305, 69367 Lyon, France
| | - Maxime Ducret
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Pôle D’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Laurent Laforest
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, 69008 Lyon, France; (B.T.-P.); (C.B.-G.); (C.G.); (T.C.); (J.-C.M.); (M.D.); (L.L.)
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon, 69622 Villeurbanne, France
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Conceição KLO, Soares KDA, Bragança RMD, Correa MB, Moraes RR, Faria-E-Silva AL. Prevalence of lectures about dental esthetics and female speakers in three Brazilian conferences. Braz Dent J 2023; 34:101-110. [PMID: 37466517 PMCID: PMC10355261 DOI: 10.1590/0103-6440202305349] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/15/2023] [Indexed: 07/20/2023] Open
Abstract
This study analyzed the prevalence of lectures involving esthetics in the scientific program of Brazilian dental conferences and the gender distribution of speakers. All lectures presented in three dental conferences (Bahia, São Paulo, and Goiás states) held from 2016 to 2020 were evaluated. Three investigators individually divided the lectures according to the specialties recognized by the Brazilian Federal Council of Dentistry (FCD) based on their titles. The lectures were also classified as involving or not esthetics, and the speaker`s gender was recorded. Descriptive statistical analyses were performed, and Chi-square tests assessed possible associations between factors. The words most cited in the titles of the lectures were "esthetic" (13.6%), "dentistry" (9.9%), and "treatment" (8.1%). Oral diseases were barely mentioned in the titles (up to 1.3%). The highest number of lectures was observed for the specialty of Restorative Dentistry (22.3%), followed by Prosthodontics (18.5%). Approximately one-third of lectures involved some aesthetic aspect, but this percentage ranged from 71.9 to 78.6% for the two specialties with more lectures. Regarding the speaker`s gender, the inequity was higher for lectures involving esthetics (81.6% of males) than for topics unrelated to esthetics (66.7%). More male speakers than females were observed for all specialties. The highest gender gap was observed for Pediatric Dentistry with 62.4% male speakers, although only 10.6% of FCD registered specialists were men. In conclusion, the Brazilian dental conferences analyzed seemed to favor offering lectures dealing with esthetic topics and male speakers.
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Affiliation(s)
| | | | | | - Marcos Britto Correa
- Graduate Program in Dentistry, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Rafael Ratto Moraes
- Graduate Program in Dentistry, Universidade Federal de Sergipe, Aracaju, SE, Brazil
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Amaral JHLD, Vasconcelos M, Gomes VE, Werneck MAF, Gaspar GDS, Lopes AL, Pinheiro EL, Ferreira RC. User satisfaction with the secondary dental care services: Is there an association between structure and work process? Community Dent Oral Epidemiol 2021; 50:27-37. [PMID: 34967968 DOI: 10.1111/cdoe.12716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/28/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the association between user satisfaction in relation to secondary dental care services and the structure and process of Brazilian Dental Specialty Centers (CEO, in Portuguese). METHODS This study used nationwide secondary data from two CEO evaluation cycles. Ten users from each CEO answered questions on the self-perception of healthcare quality and satisfaction with health services. Latent class analysis (LCA) was performed to identify subgroups of satisfied and dissatisfied users (outcome). The CEO structure included equipment, supplies, instruments, ambience and type of CEO (type I, II or III, according to the number of dental chairs and dental professionals). The work process referred to the planning/monitoring of actions, collaborative care, characteristics of the demand for medical care /the organization of scheduling, and continuing education for employees. Covariables concerned user profiles. A multilevel logistic regression model was used (p-value <.05). RESULTS Seven thousand nine hundred and ninety-seven users in 794 CEOs, together with 10056 users in 911 CEOs, participated in the 1st and 2nd evaluation cycles, and satisfied users corresponded to 85.3% and 87.1%, respectively. In both cycles, the CEO's structural characteristics explained most of the variance in satisfaction. CEOs with more favourable structural characteristics showed higher satisfaction. Users from CEOs, type II and III, and those who received dental care where there was an interruption of services due to a lack of equipment or instruments reported a lower level of satisfaction. CEOs that organize their demand through referrals received from primary care dentists who have participated in continuing education actions for dental professionals presented a higher frequency of satisfied users. CONCLUSIONS Characteristics of the process and structure were associated with user satisfaction, but a quality of care was perceived by users, mainly due to structural characteristics.
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Affiliation(s)
| | - Mara Vasconcelos
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Viviane Elisângela Gomes
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Amanda Lívia Lopes
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Elisa Lopes Pinheiro
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Uribe SE, Innes N, Maldupa I. The global prevalence of early childhood caries: A systematic review with meta-analysis using the WHO diagnostic criteria. Int J Paediatr Dent 2021; 31:817-830. [PMID: 33735529 DOI: 10.1111/ipd.12783] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/07/2021] [Accepted: 03/01/2021] [Indexed: 12/23/2022]
Abstract
AIM To estimate the global prevalence of early childhood caries using the WHO criteria. DESIGN Systematic review of studies published from 1960 to 2019. DATA SOURCES PubMed, Google Scholar, SciELO, and LILACS. Eligibility criteria were articles using: dmft-WHO diagnostic criteria with calibrated examiners, probability sampling, and sample sizes. STUDY SELECTION Two reviewers searched, screened, and extracted information from the selected articles. All pooled analyses were based on random-effects models. The protocol is available on PROSPERO 2014 registration code CRD42014009578. RESULTS From 472 reports, 214 used WHO criteria and 125 fit the inclusion criteria. Sixty-four reports of 67 countries (published 1992-2019) had adequate data to be summarised in the meta-analysis. They covered 29 countries/59018 children. Global random-effects pooled prevalence was (percentage[95% CI]) 48[43, 53]. The prevalence by continent was Africa: 30[19, 45]; Americas: 48 [42, 54]; Asia: 52[43, 61]; Europe: 43[24, 66]; and Oceania: 82[73, 89]. Differences across countries explain 21.2% of the observed variance. CONCLUSIONS Early childhood caries is a global health problem, affecting almost half of preschool children. Results are reported from 29 of 195 countries. ECC prevalence varied widely, and there was more variance attributable to between-country differences rather than continent or change over time.
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Affiliation(s)
- Sergio E Uribe
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia.,Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia.,School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
| | - Nicola Innes
- School of Dentistry, Cardiff University of Dundee, Cardiff, UK
| | - Ilze Maldupa
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia.,School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
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Ribeiro AGA, Martins RFM, Vissoci JRN, da Silva NC, Rocha TAH, Queiroz RCDS, Tonello AS, Staton CA, Facchini LA, Thomaz EBAF. Progress and challenges in potential access to oral health primary care services in Brazil: A population-based panel study with latent transition analysis. PLoS One 2021; 16:e0247101. [PMID: 33725008 PMCID: PMC7963056 DOI: 10.1371/journal.pone.0247101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 02/01/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Compared indicators of potential access to oral health services sought in two cycles of the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB), verifying whether the program generated changes in access to oral health services. METHODS Transitional analysis of latent classes was used to analyze two cross-sections of the external evaluation of the PMAQ-AB (Cycle I: 2011-2012 and Cycle II: 2013-2014), identifying completeness classes for a structure and work process related to oral health. Consider three indicators of structure (presence of a dental surgeon, existence of a dental office and operating at minimum hours) and five of the work process (scheduling every day of the week, home visits, basic dental procedures, scheduling for spontaneous demand and continuation of treatment). Choropleth maps and hotspots were made. RESULTS The proportion of elements that had one or more dentist (CD), dental office and operated at minimum hours varied from 65.56% to 67.13 between the two cycles of the PMAQ-AB. The number of teams that made appointments every day of the week increased 8.7% and those that made home visits varied from 44.51% to 52.88%. The reduction in the number of teams that reported guaranteeing the agenda for accommodating spontaneous demand, varying from 62.41% to 60.11% and in the continuity of treatment, varying from 63.41% to 61.11%. For the structure of health requirements, the predominant completeness profile was "Best completeness" in both cycles, comprising 71.0% of the sets at time 1 and 67.0% at time 2. The proportion of teams with "Best completeness" increased by 89.1%, the one with "Worst completeness" increased by 20%, while those with "Average completeness" decreased by 66.3%. CONCLUSION We identified positive changes in the indicators of potential access to oral health services, expanding the users' ability to use them. However, some access attributes remain unsatisfactory, with organizational barriers persisting.
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Affiliation(s)
- Ana Graziela Araujo Ribeiro
- Dentistry Department, Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brasil
| | | | - João Ricardo Nickenig Vissoci
- Global Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States of America
- Research Design and Analysis Core (RDAC), Duke Global Health Institute, Durham, North Carolina, United States of America
| | | | - Thiago Augusto Hernandes Rocha
- Global Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States of America
- MATH Consortium, Belo Horizonte, Minas Gerais, Brasil
| | | | - Aline Sampieri Tonello
- Department of Public Health, Center of Biological Sciences of Health, Federal University of Maranhão, São Luís, Maranhão, Brasil
| | - Catherine A. Staton
- Global Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Luiz Augusto Facchini
- Department of Social Medicine, Postgraduate Programs in Epidemiology, Nursing and Family Health, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brasil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Graduate Program in Public Health and Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brasil
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Soares A, Ribeiro C, Thomaz E, Queiroz R, Alves C, Ferraro A, Silva A, Bettiol H, Barbieri M, Saraiva M. Socio-environmental determinants of the delay in the first dental visit: results of two population-based cohort studies in Brazil. Braz J Med Biol Res 2020; 54:e10161. [PMID: 33263609 PMCID: PMC7695448 DOI: 10.1590/1414-431x202010161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/24/2020] [Indexed: 12/01/2022] Open
Abstract
The objective of this study was to describe the timing of the first dental visit and investigate the association of socioeconomic and behavioral factors with dental visit delay among 10/11-year-old children from two live-birth population cohorts with extremely contrasting socioeconomic profiles. Follow-up data (2004-2005) from cohorts of Ribeirão Preto (RP) (n=790) and São Luís (SL) (n=673) were evaluated. Delay in dental visit was defined as not visiting a dentist before the age of 7. Covariates included family socioeconomic characteristics, mother-related health behavior, and child-related characteristics. Prevalence ratios with robust standard errors were estimated. In both cohorts, less than 5% of children had visited a dentist before the age of two and about 35% of them had not visited a dentist before the age of seven. Lower mother's schooling and lack of private health insurance were associated with the delay in first dental visit for both cohorts. A small number of mother's prenatal care visits and being from a single-father family or a family without parents were only associated in the RP cohort, while having ≥4 siblings and lifetime dental pain were associated in the SL cohort. The association with dental pain probably reveals a preventive care-seeking behavior. Therefore, the percentage of delayed first dental visit of children was very high even among those with the most educated mothers. Further studies are necessary to analyze recent changes and underlying factors related to access to first dental visit after the implementation of the National Oral Health Policy in 2006.
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Affiliation(s)
- A.L.F.H. Soares
- Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C.C.C. Ribeiro
- Departamento de Odontologia II, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - E.B.A.F. Thomaz
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R.C.S. Queiroz
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - C.M.C. Alves
- Departamento de Odontologia II, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A.A. Ferraro
- Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A.A.M. Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - H. Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M.A. Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M.C.P. Saraiva
- Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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de Lucena EHG, de Lucena CDRX, Alemán JADS, Pucca GA, Pereira AC, Cavalcanti YW. Monitoring of oral health teams after National Primary Care Policy 2017. Rev Saude Publica 2020; 54:99. [PMID: 33206837 PMCID: PMC7593040 DOI: 10.11606/s1518-8787.2020054002075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/06/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To monitor the number of oral health teams implemented in the Family Health Strategy after National Primary Care Policy 2017. METHODS This is a study of quantitative, descriptive and analytical nature that used the data from the public reports of the history of oral health coverage available in the e-Manager platform of Primary Care of the Ministry of Health of all Brazilian municipalities (5,570). The survival rate of the municipalities that did not reduce the number of oral health teams was analyzed according to the region of the country, human development index, Gini inequality index and population size. Cox regression was used to analyze the factors associated with the decrease in the number of teams implanted after 1, 3, 6, 9, 12, 15, 18 and 21 months of publication of the 2017 national policy ordinance, considering the hazard ratio (HR) and p < 0.05. RESULTS After 21 months of publication of the policy, 6.7% of Brazilian municipalities reduced the number of oral health teams. This reduction was higher in the South (6.7%) and Northeast (4.8%), in municipalities with the highest human development index, i.e., greater than or equal to 0.7 (5.6%), more unequal in terms of income distribution (Gini index > 0.62) and larger population size (more than 100,000 inhabitants). Municipalities in the Northeast (HR = 1.220) and South (HR = 1.771) regions had a higher chance of reducing the number of teams compared with those in the North region. More unequal municipalities (HR = 6.405) and with larger population size (HR = 4.273) were also more likely to reduce the coverage of oral health teams. CONCLUSION The municipalities that reduced the number of oral health teams in the Family Health Strategy are from the South and Northeast regions, with greater social inequality and larger population size. This scenario can significantly affect the population's access to dental health services in the Unified Health System, especially among those in need.
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Affiliation(s)
- Edson Hilan Gomes de Lucena
- Universidade Federal da ParaíbaCentro de Ciências da SaúdeDepartamento de Clínica e Odontologia SocialJoão PessoaPBBrasil Universidade Federal da Paraíba . Centro de Ciências da Saúde . Departamento de Clínica e Odontologia Social . João Pessoa , PB , Brasil
| | - Carolina Dantas Rocha Xavier de Lucena
- Fundação Oswaldo CruzInstituto Aggeu MagalhãesPrograma de Pós-Graduação em Saúde PúblicaPernambucoPEBrasil Fundação Oswaldo Cruz . Instituto Aggeu Magalhães . Programa de Pós-Graduação em Saúde Pública . Pernambuco , PE , Brasil
| | - Josiane Aparecida de Souza Alemán
- Universidade Federal da ParaíbaCentro de Ciências da SaúdeNúcleo de Estudo e Pesquisas Interdisciplinares em BiomateriaisJoão PessoaPBBrasil Universidade Federal da Paraíba . Centro de Ciências da Saúde . Núcleo de Estudo e Pesquisas Interdisciplinares em Biomateriais . João Pessoa , PB , Brasil
| | - Gilberto Alfredo Pucca
- Universidade de BrasíliaFaculdade de Ciências da SaúdeDepartamento de OdontologiaBrasíliaDFBrasil Universidade de Brasília . Faculdade de Ciências da Saúde . Departamento de Odontologia . Brasília , DF , Brasil
| | - Antônio Carlos Pereira
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Odontologia SocialCampinasSPBrasil Universidade Estadual de Campinas . Faculdade de Odontologia de Piracicaba . Departamento de Odontologia Social . Campinas , SP , Brasil
| | - Yuri Wanderley Cavalcanti
- Universidade Federal da ParaíbaCentro de Ciências da SaúdeDepartamento de Clínica e Odontologia SocialJoão PessoaPBBrasil Universidade Federal da Paraíba . Centro de Ciências da Saúde . Departamento de Clínica e Odontologia Social . João Pessoa , PB , Brasil
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Public oral health services performance in Brazil: Influence of the work process and service structure. PLoS One 2020; 15:e0233604. [PMID: 32469941 PMCID: PMC7259635 DOI: 10.1371/journal.pone.0233604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 05/08/2020] [Indexed: 11/19/2022] Open
Abstract
The quality of oral health care might be evaluated based on Donabedian’s structure-process-outcome model. This study assessed the association between the oral health public services structure and work process of oral health teams (OHT) and performance indicators (access and problem-solving capacity) in Brazil. Secondary data from a national program obtained through interviews and by observation in 2013/2014 were analyzed. The performance indicators were Coverage of First Scheduled Dental Appointment (FDA) (< or ≥ the mean) and Ratio between Completed Treatments and First Scheduled Dental Appointments (CT/FDA) (< 1 or ≥ 1). The structure was assessed by the sum of available instruments, equipment, and supplies. Latent class analyses were used to identify similar groups (consolidated, developing, and incipient) of OHT according to the work process (planning of actions, health promotion and intersectoral actions, and integral health care). Each OHT was also described regarding the number of the health team in which the OHT operates, whether the primary care unit receives students/teaches, frequency of care provided outside of OHT coverage, and participation in telehealth. Multiple logistic regression models were adjusted for each performance indicator. A total of 16189 (99,8%) and 16192 (99,9%) OHTs located in 4344 (78,0%) municipalities had complete data on the work process and structure. 91.92% of OHTs presenting CT/FDA ≥ 1 and 37.05% presenting FDA ≥ the mean. Consolidated planning of actions and better structural conditions were associated with better performance. A higher frequency of CT/FDA ≥ 1 was observed among OHTs with consolidated integral health care and those that performed telehealth. OHTs that served individuals outside of OHT coverage daily and that worked with two to nine Health Teams presented a higher frequency of FDA ≥ the mean. OHTs with better structural and work process conditions had better performance.
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