Regulation of dental consultations in primary health care and performance of services in dental speciality centers.

OBJECTIVE: This study analyzed the regulation of dental specialty centers (CEOs) coordinated exclusively by Primary Health Care (PHC) in four primary outcomes: access and dental consultation, reception services, bonding and responsibility, and social participation. METHODS: A cross-sectional study was carried out using secondary data from the National Program for the Improvement of Access and Quality of Dental Specialty Centers (PMAQ-CEO): second cycle, using multilevel logistic regression to calculate the odds ratio (OR) and individual covariates. RESULTS: The analytical sample consisted of 9,599 CEO users who had completed all the variables analyzed. Of these, 63.5% were referred to the CEO by PHC. Dental care regulated by PHC was related to better access (OR 1.36, CI 95% 1.10-1.68), better reception (OR 1.33, CI 95% 1.03-1.71), better bonding and responsibility (OR 1.36, CI 95% 0.91-2.04), and social participation (OR 1.13, CI 95% 0.93-1.35) compared to those not regulated by primary health care as the exclusive pathway. CONCLUSION: The regulation of access to the CEO coordinated by PHC presented the best performance. It is suggested that this form of PHC regulation, as a route for dental specialty centers, can be established in the national oral health care policy for better service performance.

Associated factors of prosthetic rehabilitation in specialized dental care in Brazil: a cross-sectional study.

OBJECTIVE: This study aimed to analyze the individual and contextual factors associated with prosthetic rehabilitation in Dental Specialty Centers (DSC) in Brazil. A cross-sectional study, with secondary data from modules II and III of the External Assessment of the 2nd Cycle of the National Program for the Improvement of Access and Quality (PMAQ) of DSCs, was conducted in 2018. Individual variables considered were socioeconomic conditions and perceptions about the structure and service of the DSC. Contextual variables were related to DSC. We considered the region of the country (capital or countryside), geographic location and work process of the DSC for prosthetic rehabilitation. The association between individual and contextual variables and prosthetic rehabilitation in the DSC was analyzed by multilevel logistic regression. RESULTS: Ten thousand three hundred ninety-one users from 1,042 DSC participated. Of these, 24.4% used dental prosthesis and 26.0% performed at the DSC. In the final analysis, performed dental prostheses in the DSC individuals with less education (OR = 1.23; CI95%:1.01-1.50) and residents of the same city as the DSC (OR = 1.69; CI95%:1.07-2.66), at a contextual level, DSCs of the countryside (OR = 1.41; CI95%:1.01-1.97) were associated with the outcome. Individual and contextual factors were associated with prosthetic rehabilitation in the DSC.

Factors associated with the absence of Brazilians in specialized dental centers.

AIM: To identify the individual and contextual factors associated with the absence of Brazilians at a scheduled appointment in Dental Specialties Centers (DSC). METHODS: This cross-sectional design uses the National Program for Improving Access and Quality of Dental Specialties Centers database, 2018. The outcome was the users' lack of at least one of the scheduled appointments. Contextual and individual independent variables were used, considering Andersen's behavioural model. The analyses were performed with the R Core Team and SAS (Studio 3.8, Institute Inc, North Carolina, U.S, 2019) programs. RESULTS: Of the 10,391 patients interviewed, 27.7% missed at least one of the consultations. In the adjusted multivariate model, the interpretation based on the effect size and 95% CI showed that the behaviour individual predisposing factors such as age ≤ 42 years (OR = 1.10; 95%CI:1.01-1.21), individual need factors such as participation in the "Bolsa Família" program (OR = 1,14; 95%CI:1.02-1.27), not being covered by the Family Health Strategy (OR = 1.15; 95% CI:1.02-1.30), and users of periodontics services (OR = 1.22;95%CI:1.05-1.40) were associated with absences. The behavioural factor associated with the outcome was that the DSC facilities were not in good condition (OR = 1.18; 95%CI:1.03-1.34). DSC located in the capital (OR = 1.12; 95% CI: 0.92-1.48) were 12% more likely to have dental absences than those in the interior region. CONCLUSION: There are individual and contextual barriers associated with patients not attending specialised public dental consultations. DSC should offer adequate hours to patients, especially young adults and vulnerable people.

Prevalência da doença periodontal em mulheres e crianças da Estratégia de Saúde da Família no município de Campo Grande/MS / Prevalence of the periodontal disease in women and children from the Family Health Strategy in Campo Grande city-MS

Objetivo: verificar a prevalência da doença periodontal em mulheres e crianças cadastradas na Estratégia de Saúde da Família no município de Campo Grande/MS. Métodos: realizou-se um estudo quantitativo transversal com mulheres e crianças (5-12 anos) cadastradas na Estratégia de Saúde da Família. A amostra foi calculada segundo idade e regiões do município, e o valor mínimo distribuído proporcionalmente nos quatro distritos sanitários – Norte (n = 40), Sul (n = 56), Leste (n = 26) e Oeste (n = 38). Para obtenção dos dados, foram utilizados os Índice de Higiene Oral Simplificado, Índice Periodontal Comunitário e Índice de Perda de Inserção Periodontal. Os exames foram realizados com sonda periodontal com esfera de 0,5mm em sua ponta, preconizada pela Organização Mundial de Saúde, e abaixador de língua. Os dados obtidos foram tabulados em ficha clínica adaptada do Projeto SB Brasil. Resultados: para o Índice de Higiene Oral Simplificado obteve-se a média de 1,45±0,85 para mulheres e 1,35±0,58 para crianças. No Índice Periodontal Comunitário das mulheres, 43,3% dos sextantes encontravam-se hígidos, 10,42% apresentavam sangramento, 15,21% cálculo, 10,21% bolsa entre 4 e 5mm e 0,83% bolsa de 6mm ou mais. Para o Índice de Perda de Inserção Periodontal, obteve-se os valores de 75,63% para perda de inserção entre 0 e 3mm, 3,75% para perda entre 4 e 5mm e 0,42% para perda entre 6 e 8mm. Já para o Índice Periodontal Comunitário das crianças, 75,63% dos sextantes avaliados encontravam-se hígidos, 12,71% apresentavam sangramento e 8,54% apresentavam cálculo. Conclusão: a prevalência da doença periodontal na população estudada foi considerada baixa.

Objective: To verify the prevalence of the periodontal disease in women and children registered in the Family Health Strategy in the Campo Grande city-MS. Methods: It took place atransverse quantitative study with women and children (5-12 years old) registeredin the Family Health Strategy in Campo Grande-MS. The sample was calculated accordingto age and areas of the municipal district and the minimum value distributed proportionally in the four sanitary districts - North(n=40), South(n=56), East(n=26)and West(n=38). For obtaining the data were used the Simplified Oral Hygiene Index,Community Periodontal Index and Attachment Loss Index. The exams were accomplished withperiodontal probe with a 0,5mm sphere in it's tip, recommended by the World Health Organization, and tongue reducer. The obtained data were tabulated in clinical card adapted from the project SB Brasil. Results: In the Simplified Oral Hygiene Index it wasobtained measurements of 1,45±0,85 for women and 1,35±0,58for children. In the women's Community Periodontal Index, 43.3% of the sextants were healthful, 10.42% presented bleeding, 15.21% calculus, 10.21% pocket among 4 to 5 mm and 0.83% pocket among 6mm or more. For Attachment Loss Index it was obtained the valuesof 75.63% for insert loss among 0 to 3mm, 3.75% for loss among 4 to 5mm and 0,42% forloss among 6 to 8mm. On the other hand, for children's Community Periodontal Index75.63% of the appraised sextants were healthful, 12.71% presented bleeding and 8.54%presented calculus. Conclusion: The prevalence of the periodontal disease in the studied population was considered low.(AU)

[Water fluoridation analysis of Campo Grande (MS) urban zone public supply]. / Análise da fluoretação da água de abastecimento público da zona urbana do município de Campo Grande (MS).

The objective of this study was to analyze the fluoride concentration on the water that flows of the tap in the urban area of the city of Campo Grande (MS). For the fluoride concentration analysis, it was collected water samples of 21 schools placed in the 7 sub districts of the city, in 3 different opportunities, was made by the specific electrode method (using an Orion 9609 BN combined fluoride measuring electrode, coupled with an Orion EA-940 digital potentiometer). The results showed that 63.5% of the water samples presented acceptable fluoride levels (between 0.60 and 0.80 ppm) and 36.5%, unacceptable levels. In relation to the condition of the collect places, 76.2% were considered appropriate and 23.8% were inappropriate.