Abstract
Objective: To evaluate the factors related to the dental emergency care of children and adolescents in Basic Health Units (UBS) and Emergency Care Units (UPA) affiliated with the public dental network of Curitiba, Brazil. Material and Methods: Cross-sectional study that evaluated 1,012 emergency cases in individuals aged up to 17 years old and with a permanent record in the Unified Health System of Curitiba. Demographic data of individuals and of services were taken from electronic medical records. Statistical analysis was performed using the chi-square test and chi-square test for linear trend (α = 0.05), estimating the prevalence ratio (PR) (95%CI). Results: Of the total of emergency cases, 68.2% and 31.8% were of children and adolescents, respectively. UBS accounted for 89.7% of the cases while UPA represented 10.3%, and 12.2% of the treatments were characterized as first access to the system. Adolescents used UPAs for emergency care more often than children (PR = 1.84; 95%CI: 1.28-2.64). Among children, those with more than 1 year since the last appointment used UPAs for emergency care more often (PR = 1.86; 95%CI: 1.09-3.17). Adolescents for whom emergency care was characterized as first access to the system used UPAs more often (PR = 2.16; 95%CI: 1.04-4.46). The proximity between the UBS of origin and the UPA was associated with greater UPA utilization by both groups. Conclusion: UBSs accounted for most of the dental emergency treatments. Children and adolescents with a poorer connection with UBSs and those who lived near an UPA had a higher prevalence of UPA utilization for emergency care.
Highlights
Since 2003, with the advent of the Smiling Brazil Program, oral health has been on the list of priorities of the Brazilian federal government [1]
Emergency care was provided at UPAs for 14.9% of the adolescents and for 8.1% of the children
Emergency care of adolescents at UPAs can be considered a unique opportunity for their connection with the health system as there is a decrease in the search for health services during adolescence [16] and as the presence of toothache is associated with a higher demand for dental care [17]
Summary
Since 2003, with the advent of the Smiling Brazil Program, oral health has been on the list of priorities of the Brazilian federal government [1]. National Policy on Oral Health recommends that the oral health work process be organized so as to guarantee emergency treatment in the primary health care setting and guarantee complementary care in other health facilities (emergency care unit, emergency departments, and hospitals) [3]. This public network of dental emergency services is quite important given the high prevalence of oral disorders in the Brazilian population [4], which are more often than not chronic [5], but likely to become acute. In the pediatric population and among adolescents, toothache is associated with important limitations on activities of daily life and with a strongly negative impact on quality of life [6,7,8,9]
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