Abstract
This study describes the structure of oral health services in primary health care in Brazil and the instruments available for the provision of oral health care and to compare the number of instruments according to organizational characteristics of health services and among the macroregions. Of the 23,251 oral health teams (OHTs) in the Public Health System, 17,513 (75.3%) participated in this study. Trained researchers observed the structures of the health services and determined the presence of and whether a sufficient quantity of 36 dental instruments existed. The score of each oral health service was determined by the sum of the number of dental instruments present in sufficient quantity (0 to 36). Central tendency measures were compared along with the variability in these scores according to the organizational characteristics of the services and according to the Brazilian macroregion. No instrument was found to be present in all evaluated services. Basic, surgical and restorative instruments were the most frequently found. Periodontal, endodontic and prosthetic instruments exhibited the lowest percentages. The mean and median numbers of dental instruments were higher for teams that operated over more shifts, those with an oral health technician and those in the South and Southeast regions. The oral health services were equipped with basic, surgical and restorative instruments. Instruments designed for periodontal diagnosis, emergency care and denture rehabilitation were less frequently found in these services. The worst infrastructure conditions existed in the OHTs with the worst forms of care organization and in regions with greater social issues.
Highlights
Public oral health policies have achieved important advances in recent decades in Brazil
The proposal to create polyarchic health care networks implies the construction of integrated practices in the Brazilian Unified Health System (Sistema Único de Saúde – SUS, in Portuguese) while respecting the characteristics of each region, which will enable the actions of oral health teams (OHTs) to become more effective and strengthen the attributes of first contact, longitudinality, completeness and coordination within Primary Health Care (PHC) [1,2]
To examine a topic that has rarely been researched in the organization of primary oral health care, that is, whether the organizational processes of oral health services affect their infrastructure, this study describes the structure of Brazilian PHC oral health services, focusing on the instruments available for the provision of oral health care
Summary
Public oral health policies have achieved important advances in recent decades in Brazil. Data from February 2016 indicate the existence of at least one OHT in 5,007 Brazilian municipalities (89.9% of the total) Given this scale, it is important to evaluate oral health actions in Brazil. In 2014, the Brazilian Ministry of Health organized a second cycle of a program aiming to evaluate and improve PHC quality This was called the National Program for Improving Access to and Quality of Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica - PMAQ-AB, in Portuguese), which examined, among other factors, the structure of PHC oral health services, [3] as an adequate health equipment and the presence enough instruments should be considered when evaluating PHC quality [4,5].
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