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de Jesus-Filho E, de Barros SG, Vianna MIP, Cangussu MCT. Public Dental Service Access Policies for People with Autism Spectrum Disorder (ASD) in Salvador, Bahia, Brazil: A Pre-Evaluation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:555. [PMID: 38791770 PMCID: PMC11120991 DOI: 10.3390/ijerph21050555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
This study sought to carry out a systematic and preliminary evaluation of the policies on access to public dental services for people with ASD in a Brazilian city. The study, conducted between November/2019 and February/2020, was developed through document analysis, the design of the theoretical logical model of the policies, and seven semi-structured interviews with key informants. The sample was intentionally selected. We also considered the answers to 108 questionnaires from a pilot study on the access of people with ASD to dental services applied to caregivers, dentists, and non-dental professionals. No refusals were recorded. The availability study showed that the policies' objectives were not being achieved in terms of care network organization: there were no institutional flows, personal contacts were used between professionals to guarantee access to secondary attention, there was no specific training for the dentists about ASD, and the oral health care network was unknown to non-dentist professionals and caregivers. Most people with ASD have visited the dentist at least once in their lives, but a large percentage of those within this study did not do so in the last year. This study identified difficulties in implementing policies and suggested possible strategies for overcoming them as dimensions and subdimensions for evaluation.
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Affiliation(s)
- Ednaldo de Jesus-Filho
- Family Health Unit of Alto das Pombas, Municipal Health Department of Salvador, Salvador 40226-500, Brazil;
| | - Sandra Garrido de Barros
- Department of Social and Pediatric Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador 40110-912, Brazil; (M.I.P.V.); (M.C.T.C.)
| | - Maria Isabel Pereira Vianna
- Department of Social and Pediatric Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador 40110-912, Brazil; (M.I.P.V.); (M.C.T.C.)
| | - Maria Cristina Teixeira Cangussu
- Department of Social and Pediatric Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador 40110-912, Brazil; (M.I.P.V.); (M.C.T.C.)
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Teixeira CNG, Pereira SMDS, Hilgert JB, Oliveira NMAD, Ribeiro CCC, Neves M, Thomaz EBAF, Hugo FN, Alves CMC. [The use of dental services in the past year in the brazilian population: a systematic review with meta-analysis]. CIENCIA & SAUDE COLETIVA 2023; 28:1087-1100. [PMID: 37042890 DOI: 10.1590/1413-81232023284.11452022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 09/20/2022] [Indexed: 04/13/2023] Open
Abstract
The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.
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Affiliation(s)
- Cinthia Nara Gadelha Teixeira
- Universidade de Fortaleza. R. São Mateus 1.650, 402, Vila União. 60410-642 Fortaleza CE Brasil.
- Universidade Federal do Maranhão. São Luís MA Brasil
| | | | | | | | | | - Matheus Neves
- Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Muniz FWMG, Fernandez MDS, Pacheco KE, Martins MW, Trevisan TC, Zatt FP, Colussi PRG. Use of dental implants among older adults of two southern Brazilian cities: A population-based cross-sectional study. SPECIAL CARE IN DENTISTRY 2023; 43:56-66. [PMID: 35666997 DOI: 10.1111/scd.12736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/17/2022] [Accepted: 05/13/2022] [Indexed: 01/21/2023]
Abstract
AIM To assess the prevalence and associated factors with use of dental implants among older adults. METHODS This cross-sectional study was performed with home dwelling older adults from the cities Cruz Alta and Veranópolis, Brazil. The main outcome was obtained by a clinical oral examination, considering those with at least one dental implant. Independent variables were collected by a structured questionnaire. Crude and adjusted analysis was performed by Poisson regression with robust variance estimation; results are presented in prevalence ratio (PR) and 95% confidence interval. RESULTS It was included 569 participants. The overall prevalence of using at least one dental implant was 16.7%. Higher PR for the use of dental implants was observed in white individuals (PR:5.147; 95% CI:2.033-3.034), in those with at least medium income (PR:3.202; 95% CI:1.196-5.572) and in those with access to dental care in the last 12 months (RP:1.595; 95% CI:1.087-2.340). Older adults with a medium level of education (RP:0.484; 95% CI:0.240-0.978) and those that did not use dental floss (RP:0.627; 95% CI:0.240-0.978) demonstrated a significantly lower PR for use of dental implants. CONCLUSION A substantial prevalence of use of dental implants was observed among older adults. In addition, white ones, those with a better financial situation and users of dental floss presented higher use of dental implants.
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Affiliation(s)
| | | | - Karen Eymael Pacheco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Socioeconomic and Demographic Contexts of Brazilian and International University Students Regarding the Use of Dental Services. Int J Dent 2022; 2022:9362257. [PMID: 35401753 PMCID: PMC8989569 DOI: 10.1155/2022/9362257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/10/2022] [Accepted: 03/24/2022] [Indexed: 11/18/2022] Open
Abstract
This article characterizes the different socioeconomic and demographic contexts regarding the use and access to dental services by Brazilian and African students at a Brazilian university of international nature. This is a cross-sectional, analytical, observational study with a quantitative approach, with data produced by 350 students from a public university in the state of Ceará. Sociodemographic and economic factors, participation in educational activities, self-perception of oral health, and use of dental services by academics were analyzed. The results obtained indicated that of the university students participating in the study, 74.0% had already used dental services, of which 57.43% were Brazilian and 42.57% international. There was a significant association between being a Brazilian academic and having already used dental services, having an income less than or equal to the minimum wage, and having used the public dental service. The determination of the prevalence of use of dental services and the different contexts of university students can assist in planning future actions in oral health that prioritize groups of university students with greater difficulties in the use and access of these services.
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Moreira RDS, Mauricio HDA, Monteiro IDS, Marques MMMDR. Use of dental services by the Brazilian elderly: latent class analysis. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210024. [PMID: 34076090 DOI: 10.1590/1980-549720210024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the different profiles of dental service use by the Brazilian elderly and their possible association with sociodemographic factors, comorbidities, functionality and self-perception of oral health. METHODS Cross-sectional population-based study, using secondary data from the National Health Survey (PNS) of 2013. The sample size was 2,969 elderly individuals. Latent Class Analysis was used to construct the dependent variable "profile of dental service use" from questions related to this profile. The independent variables formed 3 blocks: sociodemographic; comorbidities; functionalities and self-perception of oral health. The Rao-Scott Test and Standardized Residue Analysis tested the association. To measure the effect of covariates, Odds Ratio was estimated using a multiple hierarchical model of multinomial logistic regression. Significance level was 5%. RESULTS Three latent classes were identified: Direct Disbursement Profile, Health Plan Profile and the Unified Health System (SUS) Profile. White elderly people were associated with the Direct Disbursement and Health Plans profile. The Health Plan profile was more associated with the married marital status or living with a spouse. In the multiple model, low schooling was associated with the profile of SUS users and elderly people diagnosed with cancer with the Health Plan profile. Self-perceiving oral health as bad or very bad increased the chances of belonging to the SUS profile. CONCLUSION Latent Class Analysis proved to be a powerful strategy for a subtle and detailed understanding of the profile of dental service use and its relationship with associated factors.
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Affiliation(s)
- Rafael da Silveira Moreira
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz - Recife (PE), Brasil.,Faculdade de Medicina, Universidade Federal de Pernambuco - Recife (PE), Brasil
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Constante HM. Racial inequalities in public dental service utilization: Exploring individual and contextual determinants among middle-aged Brazilian adults. Community Dent Oral Epidemiol 2020; 48:302-308. [PMID: 32237080 DOI: 10.1111/cdoe.12533] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 02/24/2020] [Accepted: 03/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate differences between Pardos (mixed) and Blacks with their White counterparts in the use of public dental service among a sample of Brazilian adults taking into consideration the role of individual and contextual characteristics. METHODS A total of 6196 adults aged 35-44 years were sampled from the 2010 Brazilian National Oral Health Survey and nested in one of 27 Brazilian State Capitals. Binary multilevel logistic analyses were conducted. Use of public dental service in the last visit was the outcome, and self-reported colour/race (Pardo, Black, White) was the explanatory variable. Individual covariates were sex, level of education, family income, self-reported need for treatment, dental pain in the last 6 months, presence of decayed, filled and missing teeth. The State Capital covariates were proportion of Pardos/Blacks, Human Development Index, Gini coefficient, Integration of dental teams into Brazil Family Health Program and dentist per population rate. RESULTS Pardos and Blacks were 1.25 (95% CI 1.10-1.42) and 1.73 (95% CI 1.41-2.11) times, respectively, more likely to visit the public dental service than Whites. Adjustments for level of education and income were more relevant in affecting the estimates between groups than any other covariate, but differences persisted. Colour/race was independently associated with the type of service used in the last dental visit after fully adjusted for individual and State Capital characteristics. CONCLUSIONS Racial differences in dental service utilization were evident for middle-aged adults in Brazil. The results found highlight the importance of investments in public dental service as Pardos and Blacks relied more on this type of service than Whites.
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Affiliation(s)
- Helena Mendes Constante
- Department of Epidemiology and Public Health, University College London, London, UK.,Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
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Bulgarelli AF, Zacharias FCM, Mestriner SF, Pinto IC. A postmodern perspective regarding older adults’ oral health. CIENCIA & SAUDE COLETIVA 2020; 25:741-748. [DOI: 10.1590/1413-81232020252.14862018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/23/2018] [Indexed: 11/21/2022] Open
Abstract
Abstract This article aims to comprehend meaning assigned to oral health, by means of older adults discourses, supported by a Social Constructionist perspective. This is a qualitative study with a descriptive and comprehensive design based on the Social Constructionism theoretical support conducted by means of interviews with 19 older adults. Data were analysed by means of a Discourse Analysis with identification of Interpretative Repertoires, which structured the meanings proposed to oral health. It were created repertories to disclosure possible meanings assigned to the oral health by older people as: having a clean mouth; having good comprehensive/general health; having a beautiful smile and oral health well-being condition; and suffering in the past and accepting pain. The meaning assigned to oral health by older people, in a social constructionist perspective, allow us to comprehend the subjectivity behind oral health of older people, which can guide health professionals’ approaches to deal with it.
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Bastos TF, Medina LDPB, Sousa NFDS, Lima MG, Malta DC, Barros MBDA. Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22Suppl 02:E190015.SUPL.2. [PMID: 31596386 DOI: 10.1590/1980-549720190015.supl.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/19/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. OBJECTIVE To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. METHODS Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. RESULTS Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. CONCLUSION Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.
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Affiliation(s)
- Tássia Fraga Bastos
- Faculdade de Medicina São Leopoldo Mandic - Campinas (SP), Brazil.,Universidade Estadual de Campinas - Campinas (SP), Brazil
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Fonseca EPD, Fonseca SGOD, Meneghim MDC. Factors associated with the use of dental care by elderly residents of the state of São Paulo, Brazil. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2017. [DOI: 10.1590/1981-22562017020.170095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To investigate factors associated with the use of dental care services. Methods: A cross-sectional study with a representative sample of elderly individuals aged 65 years or older residing in the state of São Paulo in 2015 was performed. Hierarchical multivariate logistic regression analysis was used based on the theoretical model of access determination proposed by Andersen (1995) to predict dental care visits. Results: The prevalence of public service use by the elderly was 1.981 (37.8%), while 3.253 (62.2%) used the private service/ health plan/ other type of service. Hierarchical multiple analysis (p≤0.05) identified that less schooling or never having studied, non-white, lower income and motivated by pain/extraction were associated with the use of public dental services. The study showed a reduced use of public dental care among elderly persons who required some type of upper dentures (except complete dentures), need for some type of lower dentures (including complete dentures) and demonstrated a positive self-perception of oral health condition. Conclusions: A higher prevalence of the use of private dental care/health plan/other type of service was identified. Less schooling or never having studied, non-white skin color, lower income and seeking the dentist with pain or to extract teeth were factors associated with the use of public dental services by the elderly.
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