ART integration in oral health care systems in Latin American countries as perceived by directors of oral health

Abstract

The aim of this study was to carry out a situation analysis of: a) prevalence of ART training courses; b) integration of ART into the oral healthcare systems and; c) strengths and weaknesses of ART integration, in Latin American countries. Materials and Methods: A structured questionnaire, consisting of 18 questions, was emailed to directors of national or regional oral health departments of all Latin American countries and the USA. For two countries that had not responded after 4 weeks, the questionnaire was sent to the Dean of each local Dental School. The questions were related to ART training courses, integration of ART in the dental curriculum and the oral healthcare system, barriers to ART implementation in the public health system and recommendations for ART implementation in the services. Factor analysis was used to construct one factor in the barrier-related question. Means and percentages were calculated. Results: The response rate, covering 55% of all Latin American countries, was 76%. An ART training course had been given in all Latin American countries that responded, with more than 2 having been conducted in 64.7% of the respondent countries. ART was implemented in public oral health services in 94.7 % of the countries, according to the respondents. In 15.8% of the countries, ART was applied throughout the country and in 68.4%, in some areas or regions of a country. ART had been used for more, or less, than three years in 42.1% and 47.4% of the countries, respectively. evaluation and monitoring activities to determine the effectiveness of ART restorations and ART sealants had been carried out in 42.1% of the countries, while evaluation training courses had taken place in only 3 countries (15.8%). Respondents perceived the “increase in the number of treated patients” as the major benefit of ART implementation in public oral health services. The major perceived barrier factors to ART implementation were “operator opinion” and “high patient load”, followed by “lack in supplies of materials and instruments and operators” and “lack of ART training”. Respondents recommended that the number of ART courses should be increased. Conclusions: The introduction of ART into the public oral health systems in Latin American countries has taken place but is still in its infancy. More ART training courses need to be organized if the approach is to be adopted in oral health service systems in these countries.

Atraumatic restorative treatment - glass ionomer sealants survival after a postgraduate training program in Ecuador: 2-year follow-up

“…Low incorporation of dental services in this region seemed to be a marked reason for these results. A questionnaire applied to the directors of oral health systems in Latin America countries showed the introduction of ART in those services was still incipient and that more ART training courses were needed to disseminate this approach, especially in underserved communities (Ruiz and Frencken 2009). …”

Tratamento restaurador atraumático: percepção dos dentistas e aplicabilidade na atenção primária

“…Porém, mesmo frente aos estudos que apontam os benefícios da estratégia ART para as populações (11,17,18,20), na América Latina essa estratégia tem sido subutilizada (20).…”

“…Dentre os participantes, baixo percentual relata que houve capacitação sobre o tema ART nos últimos três anos, em seus municípios ou em sua região. Diante desta prerrogativa, vários são os estudos que sugerem a organização de cursos de formação em ART voltado para os profissionais como método para incorporar a estratégia de maneira eficaz nos serviços públicos de saúde bucal (4,5,11,15,18,20).…”

“…RUIZ & FRENCKEN (20) realizaram um estudo para analisar a extensão da inserção da estratégia ART nos sistemas públicos de saúde bucal e os pontos facilitadores e limitantes de sua implementação em países latino-americanos. De acordo com este estudo, a introdução do ART nos serviços públicos de atenção odontológica em países latino-americanos ocorreu, mas ainda encontra-se em fase incipiente.…”

“…Tem sido observado que a aplicação das restaurações atraumáticas no serviço público odontológico permite a minimização do número de extrações, a maximização do número de restaurações dentárias e selantes e o aumento da cobertura do tratamento odontológico em populações que necessitam de cuidados (17,18,20).…”