Objective. To provide the first population-based data on deafness and hearing impairment (OR = 12.55;

O estudo visou avaliar a taxa de utilização dos serviços odontológicos especializados de quatro CEOs da Bahia, Brasil, identificando fatores relacionados. Trata-se de uma pesquisa avaliativa onde a etapa quantitativa foi conduzida através de um estudo transversal utilizando dados secundários do Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA-SUS) e a qualitativa foi a partir de vinte entrevistas semi-estruturadas junto aos coordenadores e executores, além de observação in loco do serviço. O estudo revelou bons resultados na oferta desse serviço na percepção dos profissionais, mas há uma baixa taxa de utilização. A baixa taxa de utilização revela barreiras de acesso do próprio serviço de saúde, como a ausência de padrões e metas de desempenho por especialidade, a falta dos pacientes, que não são substituídos, além das diferentes tecnologias utilizadas por cada especialista. Sugerem-se estudos que analisem diferentes formas de organização do serviço que tenham possibilitado maior utilização da oferta disponível, como diferenças de remuneração, articulação com atenção primária e adequação da oferta às necessidades de saúde populacionais.

OBJECTIVE:To analyze the factors associated with comprehensiveness in oral health care in Centers of Dental Specialists, according to the guiding principles of the Brazilian Oral Health Policy. METHODS:An exploratory cross-sectional study, based on an interview with 611 users of four specialized dental care centers, was performed in the state of Bahia, Northeastern Brazil, in 2008. The dependent variable was described as "comprehensiveness in oral health care", corresponding to having a primary dental care performed before specialized treatment or concomitantly with it. The main covariables referred to the level of coverage of the family health strategy in the city, users' sociodemographic characteristics, and organizational and geographic accessibility to the service, in addition to the type of specialized care required. RESULTS:Residents of the cities where the Family Healthcare Program had a coverage ≥50% were more likely to conclude their dental treatment (PR=2.03, 95% CI: 1.33;3.09), compared to those who lived in places with lower coverage. Individuals who sought endodontic treatment were more likely to receive comprehensive oral health care than users who were seeking other types of specialized care (PR=2.31, 95% CI: 1.67;3.19). Users with better geographic accessibility to specialized services (PR=1.22, 95% CI: 1.03;1.41), with a reference guide from primary care (PR=2.95, 95% CI: 1.82;4.78) and coming from primary health care services (PR=3.13, 95% CI: 1.70;5.77) were more likely to achieve comprehensiveness in oral health care than other users. CONCLUSIONS:Users with better geographic accessibility, lower age and need of endodontic services were more likely to receive comprehensive health care. Implementation of Centers of Dental Specialists in cities where primary healthcare is not adequately structured is not recommended, because secondary health care would meet the free demand and perform basic procedures, thus not fulfi lling the expected principle of comprehensiveness.

Though periodontitis was highly prevalent in Kiriri Indians, only few teeth showed advanced disease, and periodontitis was associated with higher age, male sex and diabetes. A public health action that includes programs of prevention and treatment targeting high-risk groups is vital to improve the periodontal status of this population.