Factors associated with the inclusion of oral health technicians into the public health service in Brazil

Abstract

Background The number of oral health technicians (OHT) in the public health service in Brazil is lower than the number of training school graduates. Thus, the objective of this study was to investigate possible factors associated with the inclusion of OHT in the public health service in Minas Gerais, Brazil, and its implications on oral health indicators. Methods This cross-sectional ecological study used a database (Excel) composed of 122 municipalities that participated in an OHT training course that took place between 2012 and 2013. Municipal contextual variables, including oral health indicators and sociodemographic indicators, related to the organization of health services were incorporated before and after the course. The dependent variable was the entry of graduates into the public health service according to a self-report survey conducted in 2015. A descriptive analysis of the variables was carried out, followed by bivariate analyses between the independent variables and the dependent variable using Pearson’s chi-square test. The independent variables selected for multivariate logistic regression were statistically significant at p < 0.20. In the final model, significant effects were identified for variables with p < 0.05. The statistical software SPSS 18.0 for Windows was used. Results After the course, the variable of the public service organization and the two variables of oral health indicators were associated with the outcome. The organization services variable “presence of oral health team modality II” and the variable “indicator of coverage of first dental programmatic consultation” presented an association tendency with the entry of OHT in the multivariate logistic regression model, but these associations were not statistically significant because they had significance levels of p = 0.075 and p = 0.191, respectively. The variable “collective action indicator supervised dental brushing” was associated with the entry of egress ( p = 0.045) remaining in the final model. Conclusion The model of organization of the oral health service formed through the implementation of modality II oral health teams positively influenced the inclusion of OHT in the public health service in Minas Gerais, with improvement in the oral health indicators of the municipalities.

Processo de trabalho em saúde bucal: disparidade entre as equipes no Brasil, 2014

“…3 OHT actions are based on the Family Health Strategy, its definition of territory and its assigned population, and in their work OHTs should use epidemiology and planning tools, hold team meetings and adopt a multi-professional and intersectoral approach, so as to promote quality in the provision of care to health service users. 8 Evidence suggests that OHT Modality II can lead to increased access and improvements in the quality of oral health care, 9 as well as greater availability of curative dental procedures. 2 In addition to tasks that are common to both the oral health auxiliary and the oral health technician, with regard to health promotion, epidemiological surveys, collective actions in crèches and schools, household visits and taking part in team meetings to plan actions, the oral health technician also has clinical attributions, which include biofilm removal, inserting and condensing restoration materials, with the potential to optimize the work of the dental surgeon and favor better OHT results.…”

“…2 In addition to tasks that are common to both the oral health auxiliary and the oral health technician, with regard to health promotion, epidemiological surveys, collective actions in crèches and schools, household visits and taking part in team meetings to plan actions, the oral health technician also has clinical attributions, which include biofilm removal, inserting and condensing restoration materials, with the potential to optimize the work of the dental surgeon and favor better OHT results. [9][10][11] OHT composition can therefore influence use of instruments most appropriate for solving the population's health needs, reflected in differences in the work process. Comparison of the OHT modalities is part of the scope of oral health policy evaluation, as part of PMAQ-AB.…”