Inequalities in access and utilization of dental services: a cross-sectional study in an area covered by the Family Health Strategy

Abstract

This cross-sectional study aimed to investigate the presence of inequalities in the access and use of dental services for people living in the coverage area of the Family Health Strategy (FHS) in Ponta Grossa, Paraná State, Brazil, and to assess individual determinants related to them. The sample consisted of 747 individuals who answered a pre-tested questionnaire. Data analysis was performed by chi-square test and Poisson regression analysis, obtaining explanatory models for recent use and, by limiting the analysis to those who sought dental care, for effective access. Results showed that 41% of the sample had recent dental visits. The lowest visit rates were observed among preschoolers and elderly people. The subjects who most identified the FHS as a regular source of dental care were children. Besides age, better socioeconomic conditions and the presence of a regular source of dental care were positively associated to recent dental visits. We identified inequalities in use and access to dental care, reinforcing the need to promote incentives to improve access for underserved populations.

Family risk as adjunct for organizing the demand for oral health service in the Family Health Strategy

“…Its application is rapid, low cost and uses few resources, because all it requires is a wooden spatula for the clinical exam. Grouping the population into three categories based on individual characteristics (apparently healthy, at risk and really sick), the oral health teams could organize their demand for care of a larger number of persons, mainly respecting the principle of equity, thus optimizing their equipment, and consequently improving the services in primary care [8][9][10][11][12] . The resources necessary for activities with each of the three groups could be more easily provided, and the scheduling of returns for re-evaluation determined with greater consistency.…”

“…In spite of the undeniable decline in the DMF-T, there continues to be a condition of heterogeneity in the distribution of caries, which may be explained by the precarious conditions of existence to which a broad majority of the population is submitted [1][2][3]9,22,23 . Vulnerable families, submitted to poor housing and working conditions receive less information about health, which causes their members to engage more easily in risk behaviors.…”

“…Because of the high demand for this service, there is great difficulty in guaranteeing the universality and equity of the assisted population 8,9 . In the State and Municipality of São Paulo (Brazil), the technical secretaries of oral health have used risk classification criteria for caries disease with the intention of prioritizing and organizing the population's dental care in primary health care [10][11][12] .…”

Uso de serviços odontológicos de forma regular na população de Montes Claros, MG, Brasil

“…Entre finlandeses, pesquisa longitudinal identificou tendência de consulta de serviços odontológicos entre indivíduos jovens 22 . Estudos desenvolvidos em Passo Fundo (RS) 23 , Campinas (SP) 24 e em Ponta Grossa (PR) 25 , também constataram tal tendência, sendo que, na pesquisa rio-grandense, o fato de possuir mais idade foi o que menos se associou à visita ao dentista, o que pode ter impactado pela maior prevalência de edentulismo entre pessoas nessa faixa etária 23 . Entretanto, estudo de base populacional dos fatores associados ao uso regular de serviços odontológicos em adultos de Bambuí (MG) identificou que a idade não estava associada à procura pelo serviço 20 .…”

Política de Saúde Bucal no Brasil 2003-2014: cenário, propostas, ações e resultados

“…These studies have persistently shown regional inequalities 10 and a number of funding challenges 11,12 facing collective actions 13 . In addition, findings highlight the importance of local government in the implementation of oral health policy [14][15][16][17] .…”