Curative procedures of oral health and structural characteristics of primary dental care.

OBJECTIVE: To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. METHODS: A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. RESULTS: A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. CONCLUSIONS: A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent permanent education activities.

Curative procedures of oral health and structural characteristics of primary dental care

ABSTRACT OBJECTIVE To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. METHODS A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. RESULTS A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. CONCLUSIONS A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent permanent education activities.

Getting dental services to the rural 85 percent.

For the past 30 years the organization of government dental services in Papua New Guinea has been modelled on the School Dental Service in New Zealand. Although the two most important mouth diseases occur in adults, children have been given priority. The dental work has been done by a workforce of less than 200 dental officers and dental therapists. Dental services are invisible to the mass of Papua New Guineans. Such organization of dental services has been disastrous for the oral health of the rural population. The need is urgent to integrate dental services within the mainstream health services, doing as much as possible at the aid posts, and referring on to health centres only what cannot be done at the local level. Both the present cadre of 2250 orderlies in aid posts plus the planned new 4750 community health workers by the year 2000 need to be trained in basic dental skills. The 2400 aid posts need to be equipped with a kit of basic dental materials and instruments, costing about K250 each. Training in basic dental care can be done in six weeks, and should take place within the province, under conditions as close as possible to real life. The benefits of providing a basic dental service at aid posts are obvious--the population coverage will be much higher, the range of diseases that are preventable or controllable will increase, and many of the deaths that now occur from cancer of the mouth will be prevented or delayed.