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This cross-sectional study aims to describe the primary dental care procedures performed by Oral Health Teams (OHTs), adhering to the third cycle of the "National Program for Improving Access and Quality of Primary Care" (PMAQ-AB) in Brazil. A descriptive analysis was performed through 26 dental procedures, including spontaneous, preventive, restorative/prosthetic and surgical procedures, and actions of cancer monitoring. Each conducted procedure assigned a score to the OHT, the final score being the sum of the number of procedures performed by the OHTs. These scores were then compared among the geographic regions of the country. Most OHTs perform basic dental procedures, such as supragingival scaling, root planning and coronal polishing (98.1%), composite filling (99.0%), and permanent tooth extraction (98.6%). The frequency related to dental prosthesis and monitoring of oral cancer decreased. Only 12.9% of the OHTs carries out biopsies, 30.9% monitor patients undergoing biopsy, 15.1% carry out impression for prostheses, and 13.6% carry out prostheses' installation. The scores reveal that OHT's performed, on average, 19.45 (±3.16) dental procedures. The OHTs in the South, Southeast, and Northeast had a higher number of primary dental procedures, while the teams in the North and Midwest performed, on average, fewer procedures. The Brazilian regions with the highest dental need have the lowest number of dental procedures. It is necessary to increase the range of procedures offered by OHT and reduce regional inequalities, adapting to the needs of the population in order to achieve comprehensive oral health. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37-0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07-2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11-1.40), periodontal health (OR = 1.80; 95%CI = 1.04-3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96-12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions. [ABSTRACT FROM AUTHOR]

This study aimed to describe the structure of oral health services in primary health care in Brazil with centers participating in the second cycle of the 'National Program for Improving Access and Quality of Primary Care' (PMAQ-AB), the largest health service evaluation program ever instituted in the country. This cross-sectional study evaluated 16,202 oral health services, regarding 22 pieces of dental equipment and 25 dental supplies. The presence of each piece of equipment/dental supply generated a score for services. The sum of these scores was compared among different regions in Brazil. Quantitative data were described by quartiles and categorical data by frequencies, using the SPSS, version 25. Most of the evaluated centers presented adequate equipment in good using conditions and sufficient dental supplies for primary oral health care. Data also showed a lack of some equipment, such as X-rays, bicarbonate jet, and ultrasound devices, while for dental supplies, a lack of amalgam (capsule and manual preparation), anesthesia without vasoconstrictors, and intracanal medication was found. The services presented a median of 14 pieces of equipment and 22 dental supplies. Of the Brazilian regions, the South presented the highest median, while the North and Northeast regions presented the lowest one. The oral health services presented dental offices with good availability of equipment and dental supplies to perform clinical activities. However, differences in the structure of services among the Brazilian regions was still observed. [ABSTRACT FROM AUTHOR]

Objectives: Item response theory (IRT) is a method used to design, analyze, and score tests, questionnaires, and similar instruments measuring abilities, attitudes, or other variables. The aim of this study was to assess the psychometric properties of dental care questions in the "Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica-PMAQ-AB," Brazil, using IRT.Methods: Dentists in primary health care units in Brazil (n = 12,403) were interviewed face-to-face using a structured questionnaire. The questions were primarily dichotomous, with a no answer/do not know option. The items about dental care from a Brazilian national evaluation survey were analyzed using the IRT model (20 items). Oral health teams (OHTs) received scores that varied from the lowest performance level to the highest performance level. Scores for the Brazilian states and the Federal District were calculated to evaluate the regional distribution of OHT performance.Results: The questions about dental care exhibited higher discrimination power for OHTs with below average performance. In general, the teams, including those with low performance, performed the actions, and procedures included in the questionnaire. Actions such as making prostheses and tracking and monitoring oral cancer cases characterized the high-performing teams. The performance of the teams distributed throughout the Brazilian states indicated that OHTs in the south and southeast performed better than OHTs in the rest of the country.Conclusions: Although the analyzed items are insufficient to determine the performance of OHTs, the items related to prosthesis and oral cancer tend to discriminate high-performing OHTs from other OHTs. [ABSTRACT FROM AUTHOR]

Objective: This study aims to describe the primary care services carried out by Oral Health Teams (OHTs) in Brazil, and to understand the nuances that lead to different levels of OHT performance. Material & methods: A mixed-methods study with a sequential explanatory design was developed. In the quantitative phase, secondary data from a national survey (PMAQ-AB) was used to describe the work of 12,403 OHTs. Item response theory (IRT) was applied, to evaluate the psychometric qualities of 20 oral health questions from PMAQ-AB and to identify the performance of OHT. The quantitative results guided the selection of the qualitative sample. An extreme case sampling strategy was used (opposite results). OHTs were selected from Belo Horizonte metropolitan region in Brazil using scores measured by IRT. Data were collected through semi-structured interviews. Data analysis was conducted using deductive and inductive thematic analysis. Results: Quantitative results showed that there are OHT with high and low performance in Brazil. The IRT analysis showed that items related to prostheses and oral cancer tend to discriminate high-performance OHTs from other OHTs. Qualitative results deepened the understanding of accessing oral health services and found several access barriers, such as the insufficient number of OHTs for the population, and a very long waiting time for dental consultations other than urgency. The qualitative results confirmed that high-performance OHTs tend to emphasize oral cancer surveillance and deliver prostheses in PHC services. Conclusion: Despite the expansion of oral health in PHC in Brazil in recent years, OHTs still face many challenges such as: access barriers; failures in prevention, early diagnosis and follow-up of oral cancer cases; and insufficient rehabilitation with prostheses. [ABSTRACT FROM AUTHOR]

This cross-sectional study evaluated the management and organisation of primary dental care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care (PMAQ-AB) were used. Dentists from 18,114 Oral Health Teams (OHTs) answered a structured questionnaire in 2014. The data were analyzed descriptively and by cluster analysis. Half the Brazilian OHTs (51.0%) undertake planning and programming of activities. The majority of OHTs (66.4%) conducted monitoring and analysis of indicators and oral health information. The majority of OHTs had performed some self-evaluation process in the last 6 months (67.5%) and utilised self-evaluation results for planning and programming actions (71.4%). The OHTs grouped in Cluster 1 demonstrated better management organisation, followed by the teams grouped in Cluster 2. In the Brazilian macro-regions, the more OHTs were grouped in Cluster 1 in the Southeast (87.5%), Northeast (85.4%) and South (82.7%) regions. The majority of OHTs have satisfactory management and organisation. However, some need improvement, mainly in planning and programming actions based on health indicators and self-evaluation. All Brazilian OHTs need to participate in PMAQ-AB and it is important to continue evaluating the data to improve oral health care. [ABSTRACT FROM AUTHOR]

Objectives. To describe dental prosthesis provision in the Brazilian public health service and report the performance of dental prosthesis procedures according to the Brazilian macroregions. Methods. A structured interview was conducted with senior-level health professionals from each of the 18,114 oral health teams (OHT). The dependent variables were performance of removable prostheses and prosthesis procedures, including provision of fixed prostheses by OHT. Descriptive statistics were produced together with performing a cluster analysis using SPSS version 19.0. Results. The manufacture of any type of prosthesis was done by a minority of OHT (43%). The most commonly provided types of dental prosthesis were removable full and partial dentures. Cluster 1 (teams that performed prosthesis procedures the most) was composed of a smaller number of teams (n = 5,531), and Cluster 2 (composed of teams that do not perform prosthetics or that perform them in small amounts) consisted of 12,583 teams. The geographic distribution of clusters reveals that the largest proportion of Cluster 1 teams is located in the Northeast (33.9%) and Southeast (33.6%). Conclusions. A minority of OHT produce dental prostheses. There is an unequal geographical distribution of clusters. [ABSTRACT FROM AUTHOR]

Objective: To assess factors associated with patients’ satisfaction with the treatment by dentists in primary health care (PHC) in Brazil. Materials and methods: The dataset was part of a nationwide cross-sectional survey for evaluating PHC teams conducted by the Brazilian Ministry of Health. Patients from each of 16,202 oral health teams were interviewed. In addition to sociodemographic information, the questionnaire included information about patient experience domains: access and booking of dental appointments, bonding and accountability, welcoming of the patient, and their perception of dental facilities. Statistical analysis: The dependent variable was the answer to the question ‘From 0 to 10, how would you grade your satisfaction with treatment received from the dentist?’ Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios and corresponding 95% confidence interval. Results: The mean patient satisfaction was 9.4 (±2.3). Higher patient satisfaction with PHC was associated with lower education and the patient’s perception of the clinic conditions. Moreover, higher satisfaction was associated with positive reception and hospitality, enough time for treatment, and instructions that met patients’ needs. Lower satisfaction with PHC was associated with patients who have jobs compared to those who do not work. Conclusion: Patient satisfaction is increased with friendly and understanding PHC staff. Moreover, meeting patient expectations by taking time to understand the needs and giving the right instructions is associated with higher satisfaction. [ABSTRACT FROM AUTHOR]

Objective. To provide an overview of the distribution of institutional support in primary care in Brazil and to identify associations between the activities of institutional support and the outcome of the certification of the National Programme for Improving Access and Quality in Primary Health Care (PMAQ). Materials and methods. A cross-sectional study was conducted through interviews with 16 960 professionals in Brazil in 2012. To examine the relationship between the received support and the quality of health care it was made a multiple binary logistic regression. Results. A positive relationship between high-level support and certification in the sub-dimensions analyzed was observed: women and child care, diabetes mellitus/ hypertension and mental health. The support activities which contributed most were: self-assessment, shared assessment, targeted workshops and training. Conclusion. Institutional support activities have helped to improve the quality and access of the population to healthcare in the country. [ABSTRACT FROM AUTHOR]