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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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da Costa S, Araujo PG, Frichembruder K, Hugo FN. Brazilian Oral Health Policy: metasynthesis of studies on the Oral Health Network. Rev Saude Publica 2021; 55:105. [PMID: 34932695 PMCID: PMC8664239 DOI: 10.11606/s1518-8787.2021055003454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/06/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Analyze the performance of the oriented oral health care network from its implementation, in 2004 to 2020, according to publications on the subject. METHODS This is a research with a methodological description of metasynthesis. RESULTS The searches resulted in 600 complete publications (586 in the first search and another 14 in the second search), according to the established criteria. 539 articles were excluded: 151 after duplication analysis, 236 after reading the title, 45 by type of publication and 107 after reading the abstract, as they did not fit the research theme. Thus, 61 original publications and another 29 publications in snowball sampling were selected and analyzed, totaling 90 publications. From this selection, we chose to use the model proposed by the Projeto de Avaliações de Desempenho de Sistemas de Saúde (PROADESS - Health Systems Performance Assessment Project). The study will use its guiding principles on the dimension "Health Services Performance". CONCLUSION The analyzed set allowed us to identify that the way the Brazilian State organizes and finances oral health care made it possible to expand access and the number of procedures performed, but not the creation of an effective comprehensive care network, after more than a decade of implementation of Brasil Sorridente (Smiling Brazil).
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Affiliation(s)
- Sylvio da Costa
- Secretaria Municipal SaúdeFlorianópolisSCBrasilSecretaria Municipal Saúde. Florianópolis, SC, Brasil
| | - Pierre Guedes Araujo
- Secretaria Municipal SaúdeFlorianópolisSCBrasilSecretaria Municipal Saúde. Florianópolis, SC, Brasil
| | - Karla Frichembruder
- Universidade Federal do Rio Grande do SulFaculdade de OdontologiaCentro de Pesquisas em Odontologia SocialPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul. Faculdade de Odontologia. Centro de Pesquisas em Odontologia Social. Porto Alegre, RS, Brasil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do SulFaculdade de OdontologiaDepartamento de Odontologia Preventiva e SocialPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul. Faculdade de Odontologia. Departamento de Odontologia Preventiva e Social. Porto Alegre, RS, Brasil
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Menezes LDS, Ceissler CAS, Cavalcanti YW, Figueiredo N, Lucena EHGD. Estudo comparativo entre indicadores assistenciais de saúde bucal na Atenção Básica em Recife, Pernambuco. SAÚDE EM DEBATE 2021. [DOI: 10.1590/0103-1104202112812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A rede de atenção à Saúde Bucal (SB) se ampliou com a Política Nacional de Saúde Bucal, sendo os indicadores ferramentas para avaliar conquistas ou necessidade de mudanças. Este trabalho objetivou analisar indicadores de SB da Atenção Básica por tipo de organização das unidades de saúde em Recife, 2018. Trata-se de um estudo transversal, de natureza descritiva e analítica com base em dados secundários. Analisou-se a associação entre tipos de organização da Atenção Básica (Unidade de Saúde da Família - USF; Upinha e Unidade Básica Tradicional - UBT) e indicadores assistenciais de SB, através dos testes qui-quadrado e Kruskal-Wallis (p<0,05). A cobertura de primeira consulta odontológica e os procedimentos odontológicos per capita apresentaram mediana maior nas UBT, 31,8% (p=0,00) e 0,6 (p=0,127), respectivamente. A proporção de exodontia e procedimentos clínicos foi maior nas USF com mediana 8,2% (p=0,703). As USF foram as que realizaram o maior número de atividades coletivas de escovação dental supervisionada (45,3%, p=0,082) e aplicação de flúor (44,6%, p=0,174). Conclui-se que as UBT apresentaram melhores resultados nos indicadores relacionados ao acesso ao tratamento clínico e as USF realizaram mais ações coletivas de prevenção.
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Martins MMF, Aquino R, Pamponet ML, Pinto Junior EP, Amorim LDAF. [Adolescent and youth access to primary health care services in a city in the state of Bahia, Brazil]. CAD SAUDE PUBLICA 2019; 35:e00044718. [PMID: 30673057 DOI: 10.1590/0102-311x00044718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 09/24/2018] [Indexed: 12/19/2022] Open
Abstract
The study sought to analyze the association between adolescents and young adults' access to primary health care services and Family Health Strategy (FHS) services. It is a cross-sectional study based on a household survey of 812 individuals aged between 15 and 24 years in Camaçari, Bahia State, Brazil, through cluster sampling. Demographic, socioeconomic, health and health service variables were used to describe the population according to primary health care area. The association between primary health care coverage area and access to its services, access barriers and participation in educational activities were estimated through prevalence ratios (PR) using multilevel logistic regression models in the R software. Access to primary health care services was reported by 89.5% of individuals, with no statistically significant differences between this type of access and primary health care coverage area. However, among individuals who reside in areas covered by FHS, there was greater access to harm reduction and health promotion actions (PR = 3.0; 95%CI: 1.68-5.34), but also lower probability of being seen by a health worker on the same day the appointment was scheduled (PR = 0.60; 95%CI: 0.48-0.74) and lower availability of public transportation (RP = 0.59; 95%CI: 0.39-0.90). Study results point to a high prevalence of access to primary health care services among adolescents and young adults. Though we did not observe a difference in access between areas with FHS coverage, young people's greater participation in prevention and health promotion activities reinforces this strategy's importance within Brazilian Unified National Health System (SUS).
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Affiliation(s)
- Maísa Mônica Flores Martins
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil.,Universidade Católica do Salvador, Salvador, Brasil
| | - Rosana Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | | | | | - Leila Denise Alves Ferreira Amorim
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil.,Instituto de Matemática e Estatística, Universidade Federal da Bahia, Salvador, Brasil
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Warmling CM, Baldisserotto J, Rocha ETD. Acolhimento & acesso de necessidades de saúde bucal e o agir profissional na Atenção Primária à Saúde. INTERFACE - COMUNICAÇÃO, SAÚDE, EDUCAÇÃO 2019. [DOI: 10.1590/interface.180398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O objetivo do estudo é compreender o modo como Equipes de Saúde Bucal da Atenção Primária à Saúde articulam, no agir profissional, competências de acolhimento & acesso de necessidades de saúde bucal. Trata-se de estudo de caso do tipo único e integrado com abordagem qualitativa. Um roteiro baseado no agir em competência apoiou a realização de nove grupos focais (16 cirurgiões-dentistas, cinco auxiliares, sete técnicos de saúde bucal e dois cirurgiões-dentistas residentes). Na implantação de protocolos de acolhimento & acesso persiste a priorização de demandas espontâneas e de urgências dos usuários ao consultório odontológico. Práticas inovadoras de acolhimento & acesso relacionam-se com competências subjetivas dos trabalhadores no trabalho coletivo e na renormalização entre protocolos e realidades de saúde. Desenhos de educação permanente em Saúde devem propiciar o debate de valores entre instituições de ensino e serviços.
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Primary Care Dentistry in Brazil: From Prevention to Comprehensive Care. J Ambul Care Manage 2018; 40 Suppl 2 Supplement, The Brazilian National Program for Improving Primary Care Access and Quality (PMAQ):S35-S48. [PMID: 28252501 PMCID: PMC5338883 DOI: 10.1097/jac.0000000000000186] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This cross-sectional study aimed to evaluate the association between sociodemographic characteristics, health care indicators, work process characteristics, and the performance of preventive dental procedures by oral health care teams (OHCTs) assessed during the first phase of the PMAQ in Brazil. A census of 10 334 primary OHCTs was conducted. The outcome included topical application of fluoride, application of sealants, detection of oral lesions, and monitoring of suspected or confirmed cases of oral cancer. The multilevel Poisson regression model was used to obtain crude and adjusted prevalence ratios. The performance of preventive dental procedures was 29.46% (3044/10 334; 95% confidence interval, 28.57-30.33), which was considered low.
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Dalazen CE, De-Carli AD, Moyses SJ. Oral Health in the Family Health Strategy: analysis of articles published in the period 2004-2014. CIENCIA & SAUDE COLETIVA 2018; 23:325-338. [DOI: 10.1590/1413-81232018231.14412015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 01/13/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to conduct an integrative review of scientific literature on the topic of Oral Health in the Family Health Strategy in the period 2004-2014. Articles published in national and international journals (n = 141) were consulted and selected from the electronic Library the Scientific Electronic Library Online (SciELO) and from electronic databases PubMed, Lilacs, BBO and Cochrane. The implementation process of oral health teams in the Family Health Strategy was the most frequent thematic variable (18%) of the 15 variables identified. The Northeast was the Brazilian macro-region where the largest number of published articles originated (n = 61). The studies were predominantly quantitative, and the highest number of publications occurred in 2010 (n = 26). We concluded that there is an increasing interest in investigating the context of oral health implementation in the Family Health Strategy, with particular emphasis on theme categories related to the micro-process work and the redefinition of professional identities arising from multidisciplinary work in primary care.
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Perceptions of primary health care service users regarding dental team practices in Brazil. Prim Health Care Res Dev 2017; 19:309-315. [PMID: 28988564 DOI: 10.1017/s1463423617000639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The Unified Health System (SUS) is the Brazilian set of public health services that offers global access to health care and disease treatments for all citizens. These services have been evaluated by means of a national survey assessing the users' perceptions.AimTo explore and characterize the SUS users' perceptions regarding primary dental team practices in the five Brazilian geographical regions. METHODS Descriptive study. The sample consisted of 37 262 subjects. Data were collected by means of the Ministry of Health survey, conducted between 2012 and 2014. Variables used in the present study are associated with SUS users' perspectives of satisfaction, access, and use of services. The study utilized bivariate data analysis, and dichotomous variables were derived for analysis following 95% reliability.FindingsThis study observed similarities and proportionality of perceptions in the Brazilian territory. In most macro-regions, dental teams did not develop an active search for dental treatment absentees. However, the SUS users reported very good and good perceptions, which were homogeneously distributed across five Brazilian regions, thereby showing an overall positive perception of primary dental treatment.
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Marchi-Alves LM, Freitas D, de Andrade D, de Godoy S, Toneti AN, Mendes IAC. Characterization of Oral Microbiota in Removable Dental Prosthesis Users: Influence of Arterial Hypertension. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3838640. [PMID: 28713826 PMCID: PMC5497639 DOI: 10.1155/2017/3838640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/28/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Studies have described the possible relation between oral infections and atherosclerotic events. OBJECTIVE To characterize the oral microbiota of normotensive and hypertensive users of dental prostheses. METHODS The sample consisted of 41 complete dental prosthesis users, divided into groups: 21 participants with systemic arterial hypertension and 20 normotensive participants. The data collection included the characteristics of the sociodemographic variables and the determination of the microbial load in the saliva. For the descriptive analyses, Statistical Package for the Social Sciences was used. The description of the proportional differences between the groups was based on the application of Mann-Whitney's statistical test. Statistical significance was set at 5% (p < 0.05). RESULTS The analysis of the oral microbiota showed the vast growth of aerobic microorganisms in all samples from both groups. The microbial load of streptococci and staphylococci was significantly higher among hypertensive participants. Candida yeasts were detected in the saliva culture of most samples. The hypertensive participants rank in the category of very high colonization index/high risk of infection related to this microorganism. CONCLUSIONS The mouth of dental prosthesis users, especially when hypertensive, can constitute an important reservoir of pathogens, indicating an established inflammatory or infectious condition or risk for developing this condition.
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Affiliation(s)
| | - Dayana Freitas
- Clinical Hospital, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Denise de Andrade
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Simone de Godoy
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil
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Esposti CDD, Cavaca AG, Côco LSDA, Santos-Neto ETD, Oliveira AE. As dimensões do acesso aos serviços de saúde bucal na mídia impressa. SAUDE E SOCIEDADE 2016. [DOI: 10.1590/s0104-12902016141706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo As informações divulgadas pela mídia contribuem para construir a representação populacional sobre o Siste ma Único de Saúde. Este estudo objetivou analisar a veiculação do tema "acesso aos serviços de saúde bucal" na mídia impressa do Espírito Santo (ES), Brasil. Uma pesquisa de abordagem qualitativa e documental foi realizada, com análise das matérias relacionadas ao acesso aos serviços de saúde bucal veiculadas entre março de 2004 e junho de 2009 nos dois principais jornais do Espírito Santo (A Gazeta e A Tribuna). Para a seleção das matérias utilizamos as palavras-chave: "Dentista", "Odontologia" e "Saúde Bucal". Foram en contradas 392 notícias, sendo 121 delas sobre o tema "acesso aos serviços de saúde bucal". Foram selecio nadas 41 matérias para esta análise, segundo as regras de exaustividade, representatividade, homogeneidade e pertinência. A análise de conteúdo temática dos dados foi realizada seguindo as categorias "disponibilidade", "capacidade de pagar" e "aceitabilidade". A maioria das matérias divulgou serviços odontológicos disponibili zados gratuitamente por prefeituras, faculdades, igre jas e ações maçônicas. Percebeu-se maior divulgação sobre políticas públicas de saúde bucal em 2004, que abordavam o acesso ao tratamento odontológico e à água fluoretada. Constatou-se frequente divulgação sobre a disponibilidade dos serviços de saúde bucal, incisiva sinalização dos problemas do setor público e apresentação da saúde suplementar como alternativa para suprir suas ineficiências. Também se verificou poucas matérias que abordaram a dimensão da acei tabilidade. Considera-se que, apesar da considerável disseminação de informações pelos veículos de comu nicação no período estudado, torna-se fundamental que a imprensa problematize o acesso aos serviços de saúde bucal em suas dimensões.
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Martins AMEDBL, Haikal DS, Souza JGS, Sá MABD, Ferreira EFE, Pordeus IA. Access to information on how to avoid oral health problems among elderly persons registered with the Family Health Strategy. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2015. [DOI: 10.1590/1809-9823.2015.14186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives : To identify the level of access to information regarding how to prevent oral health problems among the elderly, and verify if such levels were higher among members of households registered with the Family Health Strategy Program. Methods : An analytic cross-sectional study was conducted of a probabilistic complex sample of elderly (65-74 years old) members of the population of a large city. The level of access was estimated with adjustment for the design effect, as well as the magnitudes of association. Descriptive, bivariate and logistic regression (OR/CI95%) analysis was performed. Variables related to personal determinants, health services, health-related behavior and health outcomes were considered. Results : Of the 490 participants, 53.4% reported they had access to information about how to prevent oral health problems. This access was higher among elderly persons living in a household registered with the Family Health Strategy Program (2.04/1.14-3.67), and who had at least five years of schooling (2.53/1.67-3.83), regularly used dental services (1.84/1.07-3.17), did not smoke either now or in the past (1.79/1.13-2.82), did not suffer from chronic diseases (2.14/1.34-3.42) and had not suffered social impacts because of their oral health conditions (1.77/1.08-2.91). Conclusion : Most of the elderly persons had access to information about how to prevent oral health problems, with such access being greater among those registered with the Family Health Strategy Program.
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Souza JGS, Jones KM, Fonseca ADG, de Barros Lima Martins AME. Consumption profile and factors associated with the ingestion of beer and distilled beverages among elderly Brazilians: Gender differences. Geriatr Gerontol Int 2015; 16:810-20. [PMID: 26246252 DOI: 10.1111/ggi.12556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2015] [Indexed: 11/29/2022]
Abstract
AIM To estimate the prevalence of the consumption of beer and distilled beverages and associated factors among Brazilian older adults residing in a highly populated city in Brazil, highlighting the factors associated with frequent consumption and differences in consumption between men and women. METHODS It was a cross-sectional, analytic study carried out by means of probability samples of conglomerates of older adults (aged 65-74 years). Descriptive analysis, univariate analysis and estimates of multivariate models through logistic regression (OR, 95% CI) were realized. RESULTS 500 of the 736 evaluated seniors were included in the present analysis. 128 (27.3%), 103 (21.3%) and 167 (34.9%) of the seniors indicate past or current use of beer, distilled beverages and frequent use of alcohol, respectively. The consumption of beer was associated with use of tobacco between women; and with marital status and schooling between men. The consumption of distilled beverages was associated with schooling and use of tobacco between women; and age and use of tobacco in men. Daily or weekly use was associated with schooling and use of tobacco between women; age and the use of tobacco between men. CONCLUSION In the elderly population studied, a noteworthy prevalence of the consumption of beer and distilled beverages was identified, and this use was associated with personal and behavioral determinants. Similar associations related to frequent (daily or weekly) consumption were also identified. Significant differences in the profile of consumption were identified between men and women, with more abusive use among men. Geriatr Gerontol Int 2016; 16: 810-820.
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Affiliation(s)
- João Gabriel Silva Souza
- Department of Physical Sciences, Piracicaba Dental School - The State University of Campinas, Montes Claros, Minas Gerais, Brazil
| | - Kimberly Marie Jones
- Center for Research, The Educative Association of Brazil, Montes Claros, Minas Gerais, Brazil
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Martins AMEDBL, Barreto SM, dos Santos-Neto PE, de Sá MAB, Souza JGS, Haikal DS, Ferreira e Ferreira E, Pordeus IA. Greater access to information on how to prevent oral cancer among elderly using primary health care. CIENCIA & SAUDE COLETIVA 2015; 20:2239-53. [PMID: 26132263 DOI: 10.1590/1413-81232015207.15272014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 11/15/2014] [Indexed: 11/22/2022] Open
Abstract
Educative actions are an important component of health promotion in Brazil's primary healthcare program, the Family Health Strategy (FHS). The efficacy of these actions is evidenced by compliance with healthy behaviors and in the reduction of rates of mortality and morbidity. The objective of this study was to identify whether access to information regarding the prevention of oral cancer is greater among elders whose residences are registered with the FHS. SPSS® was utilized to obtain estimates that were corrected for sample design, considering the magnitude of the associations between access to such information with personal determinants, the use and cost of healthcare, health-related behaviors and health outcomes. 58.9% of the 492 participating elders reported having access to such information. We verified that there was a greater chance for access among residents of houses registered by the FHS; those with greater per capita income (2.01/1.183.43); non-smokers (2.00/1.16-3.46); those that realized oral self-examination (6.35/3.46-11.64); and those that did not perceive discomfort in the mouth, head or neck (2.06/1.02-4.17). Access was greater among residents of homes registered by the FHS. Personal determinants of health, health-related behaviors and health outcomes are influenced or influence access to information regarding the prevention and management of oral diseases.
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Affiliation(s)
| | - Sandhi Maria Barreto
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brasil
| | - Pedro Eleutério dos Santos-Neto
- Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil,
| | - Maria Aparecida Barbosa de Sá
- Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil,
| | | | - Desireé Sant'Ana Haikal
- Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil,
| | - Efigenia Ferreira e Ferreira
- Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Brasil
| | - Isabela Almeida Pordeus
- Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Brasil
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Soares FF, Chaves SCL, Cangussu MCT. [Local government and public dental health services: an analysis of inequality in use]. CAD SAUDE PUBLICA 2015; 31:586-96. [PMID: 25859725 DOI: 10.1590/0102-311x00077214] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 10/01/2014] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to identify factors associated with the use of primary and specialized public dental health services and private services. A population-based household survey was conducted in two cities of Bahia State, Brazil. Key informants provided data on socioeconomic variables and use of dental health services. Organization of the local public dental health service was ranked as worse versus better. Univariate and multivariate polytomous logistic regression was performed. Of the total of 1,290 individuals, 38.76% used private services, 33.80% used public primary care, and 17.29% used both primary care and the Center for Dental Specialties. Less use of both primary care and specialized public services was associated with lower education (OR = 1.47; 95%CI: 1.03-2.10) and worse organization of services (OR = 1.74; 95%CI: 1.22-2.48), when compared to the exclusive use of primary care. The study showed inequality in the use of dental services, even when comparing more homogeneous groups, namely users of public services.
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Oliveira RCN, Souza JGS, Oliveira CDC, De Oliveira LFB, Pelino JEP, Martins AMEDBL, De Almeida ER. [Access to information about how to prevent oral problems among school children in the public school network]. CIENCIA & SAUDE COLETIVA 2015; 20:85-94. [PMID: 25650601 DOI: 10.1590/1413-81232014201.00032014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 06/14/2014] [Indexed: 11/22/2022] Open
Abstract
The scope of this study is to identify the prevalence of access to information about how to prevent oral problems among schoolchildren in the public school network, as well as the factors associated with such access. This is a cross-sectional and analytical study conducted among 12-year-old schoolchildren in a Brazilian municipality with a large population. The examinations were performed by 24 trained dentists and calibrated with the aid of 24 recorders. Data collection occurred in 36 public schools selected from the 89 public schools of the city. Descriptive, univariate and multiple analyses were conducted. Of the 2510 schoolchildren included in the study, 2211 reported having received information about how to prevent oral problems. Access to such information was greater among those who used private dental services; and lower among those who used the service for treatment, who evaluated the service as regular or bad/awful. The latter use toothbrush only or toothbrush and tongue scrubbing as a means of oral hygiene and who reported not being satisfied with the appearance of their teeth. The conclusion drawn is that the majority of schoolchildren had access to information about how to prevent oral problems, though access was associated with the characteristics of health services, health behavior and outcomes.
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Oliveira RCN, Souza JGS, Oliveira CDC, Oliveira LFBD, Popoff DAV, Martins AMEDBL, Almeida ERD. Acesso a orientações de higiene bucal entre escolares da rede pública de ensino. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/1807-2577.1042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introdução: O acesso à educação em saúde bucal é considerado um importante preditor para avaliação das condições e dos comportamentos em saúde bucal. Crianças com 12 anos estão, em sua maioria, inseridas no ambiente escolar, sendo a escola um ambiente educacional e social propício para que conhecimentos e mudanças de comportamento sejam trabalhados. Objetivo: Propõe-se identificar a prevalência do acesso a orientações de higiene bucal entre escolares da Rede Pública de Ensino e os fatores associados a esse acesso. Metodologia: Trata-se de um estudo transversal, analítico, conduzido entre escolares de 12 anos de idade de um município brasileiro de grande porte populacional. Os exames foram realizados por 24 Cirurgiões-Dentistas treinados e calibrados com auxílio de 24 anotadores. A coleta de dados ocorreu em 36 escolas públicas, sorteadas dentre as 89 escolas do município. Foram conduzidas análises descritivas, univariadas e múltiplas (OR/IC95%). Resultado: Dos 2.755 escolares avaliados, 2.510 foram incluídos. Destes, 2.173 (86,6%) receberam orientações de higiene bucal. O acesso a orientações de higiene bucal foi maior entre escolares do sexo masculino e dentre os que utilizaram serviços odontológicos privados ou por convênio. Foi menor entre os que usaram o serviço odontológico para tratamento e há mais de um ano, dentre os que não recebiam assistência odontológica na escola e entre aqueles que relataram uma frequência de higiene bucal de uma vez por dia. Conclusão: A maioria dos escolares teve acesso a orientações de higiene bucal, estando este acesso associado a variáveis referentes aos determinantes pessoais, ao serviço de saúde e aos comportamentos.
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Rodrigues LAM, Martins AMEDBL, Silveira MF, Ferreira RC, Souza JGS, da Silva JM, Caldeira AP. [The use of dental services among preschool children: a population-based study]. CIENCIA & SAUDE COLETIVA 2014; 19:4247-56. [PMID: 25272133 DOI: 10.1590/1413-812320141910.13382013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 10/13/2013] [Indexed: 11/22/2022] Open
Abstract
The prevalence and factors associated with the use of dental services in a representative, probabilistic, complex sample with two-stage clusters of preschoolers aged 18 to 36 months was estimated. Structured questionnaires were answered by parents/guardians and the preschoolers were assessed by trained and qualified dental surgeons. In the analysis the corrections for the design effect were considered and the magnitudes of the associations based on logistic regression (OR/IC 95%) were estimated. 809 preschool children were evaluated, 15.5% of which had used dental services. Being older (3.27/1.71-6.24), having higher per capita income (2.65/1.50-4.65), having their own house (1.83/104 -3.23), having access to preventive oral health information (5.44/3.00-9.86), flossing (2.75/1.50-5.02) established higher odds of the use of these service. Not having the experience of caries (0.22/0.13- 0.38) and not having basic lesions in soft tissues (0.10/0.01-0.77) reduced these odds. The prevalence of the use of dental services was low, indicating the need for greater provision of such services and the broadening of preventive actions and health promotion and the greater the odds of use among those with better socio-economic conditions suggests inequality.
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da Fonseca DAV, Mialhe FL, Ambrosano GMB, Pereira AC, Meneghim MDC. [Influence of the organization of primary care and the socio-demographic characteristics of the population on the demand for municipal emergency dental care]. CIENCIA & SAUDE COLETIVA 2014; 19:269-77. [PMID: 24473623 DOI: 10.1590/1413-81232014191.2048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/25/2012] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to evaluate the influence of the social determinants and the provision of primary care services in relation to the use of emergency dental care services in a medium-sized municipality. Data recorded for the 57,231 users of emergency care between 2007 and 2009, in accordance with age, gender, date and period of dental care, social exclusion indices of the suburb in which they live and the existence of a benchmark oral health team, were used to perform the analysis. Of the total population, 5.24% on average per year used the service during the period under scrutiny, with the 20-49 year age group (63.84%) showing the highest demand and equality between genders for such care. Surgical procedures (54.90%) were the most prevalent with an increasing trend for restorative procedures (62,8%). Users living in areas of greater social exclusion were 4.15 times more likely to seek dental care (p < 0.05). No statistically significant association was found between gender or the existence of an oral health team of the suburb in which they live and the demand for emergency dental care. In conclusion, there was greater recourse to emergency municipal dental care by individuals living in vulnerable areas, proving the importance of such care in diminishing oral health inequality.
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Silva AER, Langlois CDO, Feldens CA. Use of dental services and associated factors among elderly in southern Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2013; 16:1005-16. [DOI: 10.1590/s1415-790x2013000400020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 09/13/2013] [Indexed: 11/21/2022] Open
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Miranda CDBC, Peres MA. Determinantes da utilização de serviços odontológicos entre adultos: um estudo de base populacional em Florianópolis, Santa Catarina, Brasil. CAD SAUDE PUBLICA 2013; 29:2319-32. [DOI: 10.1590/0102-311x00139912] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 05/27/2013] [Indexed: 11/22/2022] Open
Abstract
Objetivou-se estimar a prevalência da utilização dos serviços odontológicos entre adultos e os fatores associados. Realizou-se um estudo transversal, de base populacional, com 1.720 adultos de Florianópolis, Santa Catarina, Brasil, em 2009. A associação entre a utilização de serviços odontológicos e fatores predisponentes, facilitadores e de necessidade, em nível individual, foi testada. A análise multivariável deu-se por meio de regressão de Poisson e estratificou-se por local da última consulta. A prevalência do uso de serviços odontológicos foi de 66% (IC95%: 62,9-70,7). A prevalência de consulta odontológica foi 20% maior entre as mulheres e 72% entre os mais escolarizados; estes, também foram a maioria nos serviços público e privado. A proporção de pessoas que tinham plano de saúde e utilizaram o serviço foi 13% maior do que as que não tinham. Em Florianópolis, o uso de serviços odontológicos é essencialmente privado e a escolaridade é a variável mais importante. Sugere-se um monitoramento dos fatores associados para que se obtenha uma utilização equitativa dos serviços.
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Chaves SCL, Soares FF, Rossi TRA, Cangussu MCT, Figueiredo ACL, Cruz DN, Cury PR. [Characteristics of the access and utilization of public dental services in medium-sized cities]. CIENCIA & SAUDE COLETIVA 2012; 17:3115-24. [PMID: 23175317 DOI: 10.1590/s1413-81232012001100027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 08/30/2012] [Indexed: 11/21/2022] Open
Abstract
This cross-sectional study sought to describe the main characteristics of access and utilization of primary and specialized public dental services in two medium-sized cities in Bahia with 100% coverage of the Family Health Program. A survey of 952 households and 2.539 individuals aged over 15 years was conducted. The main variables analyzed were: perceived oral health needs, demand for the service, barriers of organizational access and the type of service and procedure utilized. The use of specialized public dental services was of 11.7% and primary care was 26%. In the city where there was greater use of public dental services, there was less use of private services. The main barrier to access remained in primary care (from 5.0% to 15.2%). There was little interface between secondary care a primary care, as only 16.6% of users returned to this level of care. In conclusion, the main barrier to access in cities with specific organizational and geographic realities appears to be in primary dental care. Individual preventive actions were little reported. It is recommended that barriers to access in primary care be eliminated, and also that a protocol (clinical guides) be established to foster the continuity and longitudinality of primary dental care.
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Affiliation(s)
- Sônia Cristina Lima Chaves
- Universidade Federal da Bahia, Departamento de Odontologia Social, Faculdade de Odontologia, R. Araújo Pinho 62, Canela, 40110-912 Salvador BA, Brazil.
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Pereira CRDS, Roncalli AG, Cangussu MCT, Noro LRA, Patrício AAR, Lima KC. [Impact of the Family Health Strategy: an analysis in cities in Northeast Brazil with more than 100,000 inhabitants]. CAD SAUDE PUBLICA 2012; 28:449-62. [PMID: 22415177 DOI: 10.1590/s0102-311x2012000300005] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 11/08/2011] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the impact of the Family Health Strategy (FHS) on oral health in Northeast Brazil, in 12 municipalities with more than 100 thousand inhabitants. The reference was 20 census tracts, 10 of which in areas with oral health covered by the FHS for at least a year, matched with 10 census tracts without oral health coverage. The total sample included 59,221 individuals. Three possible effects were considered: negative, positive, and absence of effect on the outcomes, based on the prevalence ratio adjusted by Poisson regression. The outcomes "access to collective preventive measures" and "treatment of toothache" indicate a positive effect in the FHS oral health model. However, the outcomes "coverage of tooth extraction" and "restorative treatment" showed either a negative effect or no effect in the majority of the municipalities in the sample. Evidence indicates that within the FHS, the results reflect the local organizational models for oral health care.
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Pinto RDS, Matos DL, de Loyola Filho AI. [Characteristics associated with the use of dental services by the adult Brazilian population]. CIENCIA & SAUDE COLETIVA 2012; 17:531-44. [PMID: 22267047 DOI: 10.1590/s1413-81232012000200026] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Accepted: 04/20/2010] [Indexed: 11/21/2022] Open
Abstract
The scope of this study was to investigate the factors related to the use of dental services by Brazilian adults. Data were collected from 13,356 adults (35 to 44 years of age), participating in a nationwide epidemiological survey of oral health (SB-BRASIL 2003 Project). Data analysis was based on Poisson regression, which produced estimates of Prevalence Ratios as a measure of association. Data analysis showed that the use of dental services by adults was associated with: female gender, low education and income, living in the Northeastern and Southern regions and in small cities, complaints of toothache or gum pain, need for partial/total prosthesis, a greater amount of permanent teeth requiring treatment, demand for service due to some dental problems and evaluation of dental care received on a regular basis. These results showed that the population attended by the public service was socio-economically less privileged and had greater need for treatment. This situation reflects an historical abandonment of the adult population by the dental healthcare system in Brazil and poses a major challenge to the Unified Health Service, in light of its intended role to reduce inequalities and provide universal access to comprehensive care.
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Affiliation(s)
- Rafaela da Silveira Pinto
- Diretoria de Saúde Bucal, Secretaria de Estado de Saúde de Minas Gerais, Cidade Administrativa do Estado de Minas Gerais, Belo Horizonte, MG.
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Baldani MH, Antunes JLF. Inequalities in access and utilization of dental services: a cross-sectional study in an area covered by the Family Health Strategy. CAD SAUDE PUBLICA 2012; 27 Suppl 2:S272-83. [PMID: 21789419 DOI: 10.1590/s0102-311x2011001400014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 10/13/2010] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional study aimed to investigate the presence of inequalities in the access and use of dental services for people living in the coverage area of the Family Health Strategy (FHS) in Ponta Grossa, Paraná State, Brazil, and to assess individual determinants related to them. The sample consisted of 747 individuals who answered a pre-tested questionnaire. Data analysis was performed by chi-square test and Poisson regression analysis, obtaining explanatory models for recent use and, by limiting the analysis to those who sought dental care, for effective access. Results showed that 41% of the sample had recent dental visits. The lowest visit rates were observed among preschoolers and elderly people. The subjects who most identified the FHS as a regular source of dental care were children. Besides age, better socioeconomic conditions and the presence of a regular source of dental care were positively associated to recent dental visits. We identified inequalities in use and access to dental care, reinforcing the need to promote incentives to improve access for underserved populations.
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Affiliation(s)
- Márcia Helena Baldani
- Departamento de Odontologia, Universidade Estadual de Ponta Grossa, Ponta Grossa, Brasil.
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Goes PSAD, Figueiredo N, Neves JCD, Silveira FMDM, Costa JFR, Pucca Júnior GA, Rosales MS. Avaliação da atenção secundária em saúde bucal: uma investigação nos centros de especialidades do Brasil. CAD SAUDE PUBLICA 2012; 28 Suppl:s81-9. [DOI: 10.1590/s0102-311x2012001300009] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 10/03/2011] [Indexed: 11/22/2022] Open
Abstract
Este trabalho discorre a respeito da avaliação da atenção secundária no âmbito da vigilância em saúde. Estudo descritivo, de caráter avaliativo normativo. Para análise de desempenho, foram utilizados dados secundários, com base na série histórica da produção de procedimentos odontológicos realizados nos CEO implantados no país e registrados pelo SIA/SUS no ano de 2007, e dados primários, pela visita in loco de 10% dos serviços implantados, com uso de questionários dirigidos à equipe profissional do CEO. Dentre os CEO analisados, observou-se que na maioria das regiões houve dificuldade no cumprimento das metas relativas à quantidade de procedimentos a serem informados no SIA/SUS. Sendo a Região Norte com menor percentual de serviços implantados. O indicador Cumprimento da Atenção Secundária em Saúde Bucal foi de 64,4%. Os CEO tipo III tiveram melhores resultados para o desempenho e cumprimento das metas. Foi evidenciada a necessidade de revisão no marco legal para a implantação dos CEO pela readequação dos critérios e normas, como também definições de novos padrões e cumprimento de metas para avaliação e monitoramento desses serviços.
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Castro SS, Cieza A, Cesar CLG. Problems with accessibility to health services by persons with disabilities in São Paulo, Brazil. Disabil Rehabil 2011; 33:1693-8. [DOI: 10.3109/09638288.2010.541542] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Carnut L, Filgueiras LV, Figueiredo N, Goes PSAD. [Initial validation of the index of oral healthcare needs for oral health teams in the family healthcare strategy]. CIENCIA & SAUDE COLETIVA 2011; 16:3083-91. [PMID: 21808896 DOI: 10.1590/s1413-81232011000800008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 07/02/2009] [Indexed: 11/22/2022] Open
Abstract
This survey set out to validate the Index of Oral Healthcare Needs (IOHN), based on a pre-defined algorithm of the social status of families. The validation process was divided into two phases, namely a face validation and a construct validation. In the latter, data on caries experience, toothache and access to oral health services was collected. To validate the index a random, stratified sample of 412 children aged 3-5 and 7-12 was obtained, based on the IOHCN algorithm, all the children being from the areas of Recife covered by the family healthcare program. The analysis consisted of a descriptive and an analytical phase, adopting a 5% level of significance. The index was considered by an expert committee to have good face validity. The convergent construct validation was associated with a decay component of dmft (p = 0.03) and DMFT (p = 0.01); the divergent construct validation was associated with access to oral care (p = 0.001) and filled component of dmft (p = 0.05), showing no association with the filled component of DMFT. The Index of Oral Healthcare Needs was shown to have good initial validation and canbe used as a useful tool in the planning of dental care at a local level.
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Affiliation(s)
- Leonardo Carnut
- Faculdade de Odontologia, Universidade de Pernambuco, Camaragibe, PE, Brazil.
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Soares FF, Figueiredo CRVD, Borges NCM, Jordão RA, Freire MDCM. Atuação da equipe de saúde bucal na estratégia saúde da família: análise dos estudos publicados no período 2001-2008. CIENCIA & SAUDE COLETIVA 2011; 16:3169-80. [DOI: 10.1590/s1413-81232011000800017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2009] [Accepted: 01/25/2010] [Indexed: 11/22/2022] Open
Abstract
O objetivo do presente estudo foi revisar as publicações no período de 2001 a 2008 sobre a atuação da Equipe de Saúde Bucal (ESB) na Estratégia Saúde da Família (ESF), buscando conhecer o perfil das publicações e os estudos que possam subsidiar a avaliação da inserção da saúde bucal na estratégia. As fontes de publicação consultadas foram artigos publicados em periódicos nacionais e internacionais incluídos nas bases de dados LILACs, MEDLINE e BBO, além de periódicos não indexados. Foram selecionados apenas os artigos que abordavam algum tipo de avaliação da atuação da ESB na ESF (N=20). Os estudos publicados no período analisado apresentam informações importantes, porém as metodologias de avaliação utilizadas na maioria destes não permitem conhecer o impacto das ações da ESB no acesso e na condição de saúde bucal das populações beneficiadas. Os achados indicam ainda que os municípios não têm realizado suas ações de saúde bucal plenamente da forma preconizada pelo Ministério da Saúde. Além disso, barreiras e avanços têm sido identificados no processo de construção em que ainda predominam as práticas do modelo tradicional.
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Baldani MH, Brito WH, Lawder JADC, Mendes YBE, Silva FDFMD, Antunes JLF. Determinantes individuais da utilização de serviços odontológicos por adultos e idosos de baixa renda. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2010; 13:150-62. [DOI: 10.1590/s1415-790x2010000100014] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Accepted: 02/10/2010] [Indexed: 11/22/2022] Open
Abstract
A utilização de serviços odontológicos resulta da interação de determinantes biológicos com fatores socioculturais, familiares e comunitários, bem como de características dos sistemas de saúde. O objetivo deste estudo foi identificar os fatores individuais associados à utilização de serviços odontológicos por parte de adultos e idosos de baixa renda residentes na área de abrangência da Estratégia Saúde da Família, em Ponta Grossa, PR. A amostra constou de 246 indivíduos, com 35 anos de idade ou mais, que responderam a um questionário sobre condições socioeconômicas, necessidade percebida e acesso a serviços odontológicos. A análise dos dados foi realizada por meio de regressão logística, segundo referencial teórico baseado no Modelo Comportamental de Andersen, considerando a consulta odontológica não recente como variável dependente. Verificou-se elevada prevalência de problemas bucais auto-referidos e de perdas dentárias. Cerca de 40% dos adultos e 67% dos idosos não iam ao dentista há mais de três anos. Indivíduos que não residiam em domicílios próprios, realizavam higiene bucal com menor frequência e utilizavam próteses totais apresentaram maiores chances de haver utilizado os serviços odontológicos há mais tempo. O fato de possuir um dentista regular foi identificado como fator de proteção na análise. Concluindo, os determinantes individuais mostraram-se importantes indicadores de acesso aos serviços de saúde bucal. O modelo teórico confirmou a presença de desigualdades sociais e psicossociais na utilização de serviços odontológicos entre os adultos e idosos de baixa renda.
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