Objective Compared indicators of potential access to oral health services sought in two cycles of the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB), verifying whether the program generated changes in access to oral health services. Methods Transitional analysis of latent classes was used to analyze two cross-sections of the external evaluation of the PMAQ-AB (Cycle I: 2011–2012 and Cycle II: 2013–2014), identifying completeness classes for a structure and work process related to oral health. Consider three indicators of structure (presence of a dental surgeon, existence of a dental office and operating at minimum hours) and five of the work process (scheduling every day of the week, home visits, basic dental procedures, scheduling for spontaneous demand and continuation of treatment). Choropleth maps and hotspots were made. Results The proportion of elements that had one or more dentist (CD), dental office and operated at minimum hours varied from 65.56% to 67.13 between the two cycles of the PMAQ-AB. The number of teams that made appointments every day of the week increased 8.7% and those that made home visits varied from 44.51% to 52.88%. The reduction in the number of teams that reported guaranteeing the agenda for accommodating spontaneous demand, varying from 62.41% to 60.11% and in the continuity of treatment, varying from 63.41% to 61.11%. For the structure of health requirements, the predominant completeness profile was "Best completeness" in both cycles, comprising 71.0% of the sets at time 1 and 67.0% at time 2. The proportion of teams with "Best completeness" increased by 89.1%, the one with "Worst completeness" increased by 20%, while those with "Average completeness" decreased by 66.3%. Conclusion We identified positive changes in the indicators of potential access to oral health services, expanding the users’ ability to use them. However, some access attributes remain unsatisfactory, with organizational barriers persisting.

BackgroundBrazilian Primary Care Facilities (PCF) provide primary care and must offer dental services for diagnosis, prevention, and treatment of diseases. According to a logic of promoting equity, PCF should be better structured in less developed places and with higher need for oral health services.ObjectiveTo analyze the structure of dental caries services in the capitals of the Brazilian Federative Units and identify whether socioeconomic factors and caries (need) are predictors of the oral health services structure.MethodsThis is an ecological study with variables retrieved from different secondary databases, clustered for the level of the federative capitals. Descriptive thematic maps were prepared, and structural equations were analyzed to identify oral health service structure’s predictors (Alpha = 5%). Four models with different outcomes related to dental caries treatment were tested: 1) % of PCF with a fully equipped office; 2) % of PCF with sufficient instruments, and 3) % of PCF with sufficient supplies; 4) % of PCF with total structure.Results21.6% of the PCF of the Brazilian capitals had a fully equipped office; 46.9% had sufficient instruments, and 30.0% had sufficient supplies for caries prevention and treatment. The four models evidenced proper fit indexes. A correlation between socioeconomic factors and the structure of oral health services was only noted in model 3. The worse the socioeconomic conditions, the lower the availability of dental supplies (standard factor loading: 0.92, P = 0.012). Estimates of total, direct and indirect effects showed that dental caries experience observed in the Brazilian population by SB-Brasil in 2010 did not affect the outcomes investigated.ConclusionMaterial resources are not equitably distributed according to the socioeconomic conditions and oral health needs of the population of the Brazilian capitals, thus contributing to persistent oral health inequities in the country.

Introduction: Tuberculosis (TB) is an infectious and contagious disease caused by Mycobacterium tuberculosis. TB emerged in the 21st century as an unsolved public health problem. This study aimed to analyze the relationship between the characteristics of basic health units (BHUs) and the number of TB cases detected in Maranhão, Brazil. Methods: An ecological, analytical study was conducted using the municipalities in the state of Maranhão as the unit of analysis. Data regarding the number of detected TB cases was obtained from the Sistema de Informação de Agravos de Notificação database, and the characteristics of the BHUs were obtained from the first cycle of data collection for the Program to Improve Access and Quality of Basic Care. The BHU structure was classified as adequate (80%-100%), partially adequate (60%-79%), poorly adequate (40%-59%), or inadequate (<40%) according to the presence of specified items. The number of BHUs per municipality in each adequacy category was estimated. Inflated Poisson regression analysis was performed to estimate the incidence density ratios (IDRs) and the 95% confidence intervals (95% CIs). Results: Municipalities with a higher level of BHU adequacy had a higher number of detected TB cases (IDR = 1.61, 95% CI: 1.01-2.60). Conclusions: Better structured health services in primary care may be associated with better detection and/or notification of TB cases.

A virtual sample of 60 individuals, under caries prevalence of 50%, seems feasible to produce a satisfactory interexaminer agreement at epidemiological conditions. However, epidemiological studies to corroborate or refute this assertion are necessary.

ResumoO objetivo deste estudo transversal foi descrever a prevalência de cárie dentária, hipoplasia, fl uorose e opacidade demarcada de esmalte, assim como relatar as necessidades de tratamento em préescolares de 5 anos e de escolares de 12 anos, do município de Araras, em 2004. A amostra probabilística consistiu de 381 indivíduos, sendo 186 pré-escolares de 5 anos e 195 escolares de 12 anos. Os exames epidemiológicos foram realizados por quatro examinadores previamente calibrados, sob luz natural, utilizando-se espelho bucal sonda ball point, seguindo as recomendações da OMS. Cárie dentária foi registrada utilizando-se os índices ceod e CPOD. As lesões sem cavidades ativas, necessidades de tratamento, hipoplasia e opacidade demarcada também foram avaliadas. A fl uorose foi registrada seguindo o Índice de Dean nos escolares de 12 anos. Os resultados mostraram que o índice ceod aos 5 anos foi 2,07 (dp=3,21) e o CPOD aos 12 anos foi de 2,14 (dp=2,56). Dentre as crianças de 5 e 12 anos examinadas, 52,2% e 42,3% estavam livres de cárie, respectivamente. Aproximadamente um terço dos examinados apresentaram sinais de atividade de cárie. As restaurações de uma face foram as necessidades de tratamento predominantes tanto nos pré-escolares (42,1%) quanto nos escolares (39,0%). A opacidade demarcada esteve presente em 65,1% dos pré-escolares e 14,4% dos escolares; a hipoplasia em 5,9% e 1,5%, respectivamente, e 18% dos escolares de 12 anos apresentaram fl uorose. Pode-se concluir que os pré-escolares e os escolares examinados apresentaram necessidades de baixa complexidade, uma vez que a proporção de livres de cárie foi alta e a atividade da doença foi baixa. Palavras-chave:Cárie dentária, Necessidades de tratamento, Epidemiologia. AbstractThe aim of this cross-sectional study was to describe the prevalence of dental caries and enamel defects, such as hypoplasia, demarcated opacity and fl uorosis, as well as to report the treatment needs in 5-year-old pre-schoolchildren and 12-year-old schoolchildren, from Araras, São Paulo State, Brazil, in 2004. The probabilistic sample consisted of 382 5-year-old pre-schoolchildren (n=186) and 12-year-old schoolchildren (n=196). The epidemiological examinations were performed by four calibrated examiners, under natural light, using mirrors and "ball point" probes, following the WHO recommendations. Dental caries was recorded using dmft and DMFT indexes. Fluorosis was recorded following the Dean index in 12-yearolds. The results showed that the dmft index in 5 year-olds was 1.74 (dp=3.04) and that the DMFT in 12-year-olds was 1.58 (dp=2.39). Among the 5-and 12-year-old children, 52.2% and 42.3% were caries free, respectively. Approximately one third of examined children presented signs of caries activity. The one surface fi lling was the most required treatment in both pre-schoolchildren (42.1%) and schoolchildren (39.0%). The demarcated enamel opacity was detected in 65.4% of pre-schoolchildren and 14.4% of schoolchildren and the hypoplasia in 5.9% and 1.5%, respectively. Regarding fl u...