This study evaluated the factors associated with the performance of Brazilian Oral Health Teams (OHTs). This is multilevel research that used data from 12,386 Brazilian OHTs in 2012. The OHTs performance was estimated in previous research by using Item Response Theory model, which employed 20 questions about dental procedures in Primary Care. The first level covariates were based on OHTs procedures such as: the record of pregnant woman dental appointment, provision of dentistry home care, dental appointments scheduled choices, and OHTs in charge for more than 5000 individuals. Moreover, the use of guidelines was accessed concerning delivering prostheses in primary care, referring to secondary care, referring to suspected oral cancer, and providing care towards patients with special needs. Variables included in level 2 were GINI and Human Development Index. Multilevel linear regression models were constructed, estimating linear regression coefficients, 95% confidence intervals, and P values. OHTs performance was different among the 3,613 municipalities analyzed ( P < .001), with 36.7% of the variation in the performance of the OHTs being attributed to the variability between municipalities. The adjusted model showed that higher performance OHTs reported attention to pregnant women, dentistry home care and use of dental care guidelines ( P < .001). There were lower performance scores for those OHTs with more restricted scheduling ( P < .05), compared to those that reported scheduling appointments at any day and time. The best OHTs and population ratio led to a better performance score ( P = .010). At the municipal level, better socioeconomic status was associated with better performance of the OHTs ( P < .001). OHTs with higher performance are associated with oral health services organizations and municipalities’ socioeconomic status.
To evaluate the association between dentists’ profile and health work management with the performance of primary care dental teams in the Brazilian National Health System, both nationally and regionally. Secondary data analysis from a Brazilian National Programme that evaluated 18,114 Brazilian dental teams, working in the public sector, between 2013 and 2014. Twenty-four independent variables taken from dentists’ profile and dental team management characteristics were analysed to assess their influence on reported “dental team performance.” An estimated score was generated from their performance on 20 dental procedures by an item response theory model. Multiple linear regression models were performed for each Brazilian geographical region, separately and for the whole of Brazil. p values ≤ 0.05 were considered significant. Two variables related to dentists’ profile, “having graduate studies” ( β = 0.151 ) and “undertaking continuing professional development training” ( β = 0.101 ), were associated with enhanced dental team performance in all five Brazilian geographical regions and nationally. The dental team management variables of “having a flexible dental appointment list” ( β = 0.218 ) and “monitoring oral health indicators” ( β = 0.132 ) also contributed to improve team performance in each of the regions and nationally. Dentists’ profile influenced the performance of dental teams from south region more than the other regions. The findings suggest that continuing professional development, including postgraduate education, and strategic management characteristics are important for primary dental care performance and should be reflected in health policy initiatives in support of quality care. Regional factors could be considered for health care management.
The study aimed to identify the changes in the provision of dental prosthetics procedures in the Brazilian primary care. Secondary data from the Brazilian “National Programme for Improving Access and Quality of Primary Care” was assessed and three similar questions related to dental prostheses execution that were answered by the same 9,698 oral health teams, in 2011/2012 and 2013/2014, were compared. There was a 4.3% increase in the number of teams that identified individuals with prosthetic needs; a 0.8% increase in the number of teams that performed impression for prosthetic purposes; and the number of teams that reported performing dental prostheses consultations increased by 0.6%. Overall, there was a small modification in the number of teams that provided dental prosthesis procedures in Brazil.
Background Our aim was to identify clinical and sociodemographic factors associated with oral pain and oral health-related productivity loss among US adults. Methods We included adults aged ≥30 years who completed the dental examination, had at least one natural tooth, and provided an answer about their oral pain experience or oral health-related productivity loss in the 2015–2018 National Health and Nutrition and Examination Survey (NHANES). We performed descriptive analyses and multivariable binary logistic regression analyses on weighted data. Results One out of four adults had oral pain and 4% reported oral health-related productivity loss occasionally or often within the last year of the survey. The odds of oral pain were higher among non-Hispanic black (OR = 1.35; 95%CI = 1.08–1.62) and non-Hispanic Asian individuals (OR = 1.38; 95%CI = 1.07–1.78) compared to non-Hispanic white individuals, and individuals with untreated dental caries (OR = 2.06; 95%CI = 1.72–2.47). The odds for oral health-related productivity loss were 13.85 times higher among individuals who reported oral pain (95%CI = 8.07–23.77), and 2.18 times higher among individuals with untreated dental caries (95%CI = 1.65–2.89). The odds of oral pain and reported oral health-related productivity loss decreased as family income increased. Conclusions Factors including non-Hispanic black race/ethnicity, lower socio-economic status, and untreated dental caries are associated with oral pain experience, which increases the odds of oral health-related productivity losses. Identifying factors associated with oral pain and productivity loss will enable clinicians, policymakers, and employers to proactively target and prioritize the higher-risk groups in early interventions and policies.
Background Social factors are important determinants of health. However, evidence from longitudinal studies on the possible role of changes in socioeconomic circumstances on adult’s oral health is scarce. This study aimed to test whether changes in income and changes in social networks of family members and friends were associated with trajectories of self-rated oral health (SROH) among adults over a 13-year period. Methods A prospective cohort study (Pro-Saude Study) was conducted involving non-faculty civil servants at university campi in Rio de Janeiro, Brazil. Individual data was collected through self-completed questionnaires in four waves (1999, 2001, 2007 and 2012). SROH trajectories between 2001 and 2012 were “Good-stable SROH”, “Changed SROH”, “Poor-stable SROH”. Per capita family income and social networks of family members and friends data obtained in 1999 and 2012 were grouped into “High stable”, “Increase”, “Decrease”, “Low stable”. Ordinal logistic regression using complete data of 2118 participants was used to estimate odds ratio (OR) and 95% CIs of changes in income and changes in social networks with SROH trajectories, adjusted for age, sex, skin colour and marital status. Results Participants in the low income-stable and small social networks-stable groups showed 2.44 (95% CI 1.68–3.55) and 1.98 (95% CI 1.38–2.85) higher odds for worst trajectory of SRHO than those in the respective high-stable groups. Those in the decrease income group and decrease social networks group were 78% (95% CI 1.25–2.54) and 58% (95% CI 1.07–2.34) more likely to worst trajectory of SRHO than those in the high income-stable and high social networks-stable groups. Conclusions Adults reporting low income and low social networks of family members and friends over 13 years and those with income and social networks decrease during the study period were at higher risk of having worsened their self-rated oral health.
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic had quite an impact on dental health care. Concerns about the risk of SARS-CoV-2 transmission through contaminant fluids and droplet formation during several dental procedures highly impacted dental health care, drastically reducing the number of dental practices worldwide. To monitor SARS-CoV-2 contamination in dental clinics, a longitudinal study was carried out during the return of dental practice at university.MethodsDental health care professionals [(DHCPs); teachers, undergraduate dental students, and dental assistants] and patients were screened for SARS-CoV-2 RNA in a dental school clinic environment from 11th January to 12th March 2021 (9 weeks). Serological testing was performed on DHCPs in two-time points. Additionally, samples with low Ct values were sequenced to identify the circulating SARS-CoV-2 variant and possible transmission clusters.ResultsWe found a low number of dental staff (5.8%), patients (0.9%), and environment sites (0.8%) positive for SARS-CoV-2. Most positive cases had asymptomatic to mild symptoms, and two asymptomatic DHCPs presented prolonged infection. In the first week after previous exposure to COVID-19, 16.2% of DHCPs had IgM or IgG antibodies against SARS-CoV-2, and 1/3 of them had undetected antibodies in the last weeks. The variant zeta (P.2) could be detected. No cross-infection was observed between participants.ConclusionOur study suggests that dental practice can be safely executed when adequate control measures and biosafety protocols are applied. DHCP and patient testing, patient telemonitoring, proper use of personal protection equipment, and sanitization of surfaces are essential to avoid SARS-CoV-2 cross-infection in dental practice.
O surgimento do novo coronavírus exigiu a readaptação de diversos sistemas pertencentes à sociedade. Neste contexto, houve a necessidade da reestruturação dos fluxos de grande parte dos serviços de saúde. O presente relato de experiência descreve as ações adotadas pela Farmácia do Paraná (2ª RSM) para minimizar os impactos da pandemia aos pacientes e funcionários. Foram adotadas medidas de caráter administrativo, organizacional e estrutural, incluindo alterações nos processos de dispensação de medicamentos, nas renovações de cadastro e na busca ativa por usuários elegíveis ao serviço “Remédio em Casa”. No panorama inicial da estratégia, foi possível verificar um incremento no envio de medicamentos via SEDEX, refletindo em uma redução na quantidade de atendimentos presenciais. Tais ações, realizadas de maneira coordenada, contribuem para a redução do risco de contágio e exposição à COVID-19, refreando o avanço da contaminação e reforçando a importância das medidas de isolamento social.
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