Abstract
ABSTRACTOBJECTIVE To analyze oral health work changes in primary health care after Brazil’s National Oral Health Policy Guidelines were released.METHODS A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care.RESULTS Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people’s participation and social control; and intersectorial actions.CONCLUSIONS Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.
Highlights
Brazil has made advancements with its Unified Health System (SUS) by establishing universal and full care as its principles and by increasing the coverage of its Primary Health Care (PHC), through Family Health Care Strategy (FHCS)
Continuing efforts will be required in work management, training, and permanent education fields
These results are associated with the profile of dental practice, characterized by the conduction of eminently clinical actions emphasizing restoring activities and preventive actions focusing on students, which were shown to be insufficient to meet the needs of the population.[31]
Summary
Brazil has made advancements with its Unified Health System (SUS) by establishing universal and full care as its principles and by increasing the coverage of its Primary Health Care (PHC), through Family Health Care Strategy (FHCS). The biomedical health care model prevails, and it guides all professional practices, including dentistry.[4,13,35,48,50,54,55]. Results are nationally satisfactory, some factors call our attention: (a) regional differences in the prevalence and seriousness of caries are distinctive, which indicates a need for policies focused on equal care; (b) small reduction of caries in deciduous dentition (18.0%) and 80.0% of affected teeth remaining untreated; (c) significant deficit for older adults, despite adolescents’ and adults’ need for prosthetics having been decreased; and (d) prevalence of malocclusion requiring treatment in 10.0% of adolescents, which suggests a need for resizing the supply of dental procedures in secondary care.[32,33] These results are associated with the profile of dental practice, characterized by the conduction of eminently clinical actions emphasizing restoring activities and preventive actions focusing on students, which were shown to be insufficient to meet the needs of the population.[31]
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