RESUMO
BACKGROUND: People with disabilities tend to have greater oral health problems compared to those without disabilities. This may be due to barriers they come across in accessing dental services. OBJECTIVES: The objective of this systematic review was to provide a critical digest of the scientific literature concerning barriers and facilitators of access to oral health services for people with disabilities. METHODS: The electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and Brazilian Library of Dentistry (BBO) were searched using keywords relevant to the subject. The search was not restricted to specific languages or years of publication; all relevant studies were translated and reviewed. RESULTS: Sixteen studies including 14 articles, a doctoral thesis, and a monograph were selected, and their quality was analysed using the Downs and Black assessment tool. Barriers to dental services were divided into physical or nonphysical based on the dentist's perspective, as per the perception of parents/guardians or by the persons with disabilities. The barriers that emerged included the dentist's lack of preparation to assist people with disabilities, structural problems of access to dental offices, communication difficulties, and lack of awareness regarding the need for dental treatment for the disabled person. CONCLUSION: It is concluded that people with disabilities continue to run into complex physical, behavioural, or multidimensional barriers in accessing dental services. Improved training of dentists for the care of this population is hereby emphasized. The legal framework enabling access to dental care for people with disabilities must also be respected in each country.
RESUMO
The idea that the Holocene is over and a new human-dominated geological epoch, the Anthropocene, is in progress has been widely discussed. The article aims to outline the published definitions and current patterns on the Anthropocene, highlighting an agenda of emerging risks, challenges and possibilities for the health of the world's population in this new era. We performed a review on the complexities of planetary health in the Anthropocene, which generated 42 initial references for full-text reading; we selected 25 of them and carried out analysis and interpretation. Anthropogenic activities have increasing impacts on the environment and a fundamental change in the relationship between humans and the terrestrial system, in many ways that exert intentional and unintentional influences on natural and social processes. The burgeoning literature on health promotion and global public health talks about the anthropogenic forces, claiming a solid critical theory of action to confront, modify and reduce the deleterious effects of such forces. For that reason, the 23rd IUHPE World Conference on Health Promotion, scheduled to be held in New Zealand in 2019, emphasizes the theme 'Promoting Planetary Health and Sustainable Development for All'. It recognizes that the current paradigm of economic unlimited growth and exploitation of limited natural resources is unfair and unsustainable, leading to geopopulational and temporal inequities between generations.
