Abstract
The Family Health Strategy (FHS) has produced effective results in health indicators. In this cross-sectional study, the impact of the oral health teams (OHT) of the Family Health Strategy was evaluated on the oral health of 2581 adolescent schoolchildren aged 12 and 15-19 years in 36 municipalities (19 with and 17 without OHT/FHS). Four dentists performed oral examinations. Socioeconomic status, the use of and access to health services were assessed via a structured questionnaire. The presence of the OHT in the FHS were the main independent variables. Outcomes were Decayed, Missing, Filled Teeth (DMFT) and its components, toothache, gingival bleeding, and dental calculus. The data were analyzed by means of negative binomial and Poisson regression. Multilevel analysis was conducted to adjust the outcomes to OHT/FHS and individual variables. In the unadjusted model there was no association between the OHT in the FHS and the outcomes analyzed. After adjustment, young people in areas not covered by the OHT/FHS had almost half of the tooth loss of adolescents from the areas covered (RM = 0.64 CI 95%, 0.43 to 0.94).
Highlights
A Estratégia da Saúde da Família (ESF) é a principal política do sistema de saúde brasileiro para operar e estruturar a atenção básica nos sistemas locais de saúde, sendo guiada pelos princípios da Atenção Primária à Saúde (APS)
The Family Health Strategy (FHS) has produced effective results in health indicators. In this cross-sectional study, the impact of the oral health teams (OHT) of the Family Health Strategy was evaluated on the oral health of 2581 adolescent schoolchildren aged 12 and 15-19 years in 36 municipalities (19 with and 17 without OHT/FHS)
Young people in areas not covered by the OHT/FHS had almost half of the tooth loss of adolescents from the areas covered (RM = 0.64 CI 95%, 0.43 to 0.94)
Summary
Para a seleção dos municípios foi mantida a mesma pré-estratificação em portes utilizada no estudo do SB-RS 2002/200313: porte 1 (até 5.000 habitantes); porte 2 (5.001 a 10.000 habitantes); porte 3 (10.001 a 50.000 habitantes); e porte 4(> 50.000 habitantes). Na sequência procedeu-se a seleção dos municípios com e sem ESB/ESF dentro de cada porte, sendo selecionados 18 municípios no porte 1, 12 no porte 2 e 8 no porte 3, totalizando uma amostra de 38 municípios (no porte 4, todos os municípios apresentavam ausência de ESB/ESF, sendo excluídos 7 municípios). A amostra final do estudo totalizou 36 municípios de sete macrorregiões do RS e de três portes populacionais, sendo 19 municípios no grupo 1 (com equipes de saúde bucal na ESF) e 17 no grupo 2 (sem equipes de saúde bucal na ESF). E rurais, públicas e privadas dos 36 municípios da pesquisa segundo dados da Secretaria da Educação do Estado do RS16. Os critérios de inclusão para escolas foram: a) ter ensino fundamental completo; b) ter alunos na faixa etária da pesquisa e; c) localização até 10 km da sede do município (para escolas rurais e por razões de operacionalidade do projeto). Apenas cinco escolas da amostra são de natureza privada, sendo as demais públicas municipais ou estaduais
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