The SBBrasil 2010 Project (SBB10) (5, 12, 15-19, 35-44, and 65-74 years).

This article presents an integrative literature review that analyses the advances and challenges in oral health care of the Brazilian primary health care system, based on a political agenda that envisages re-organising the unified health system (SistemaÚnico de Saúde - SUS). It is presumed that the actions suggested by the Alma-Ata Conference of 1978 are still up-to-date and relevant when adapted to the situation in Brazil. Several studies and policies are reviewed, including works demonstrating the importance of primary care as an organising platform in an integrated health-care network, Brazil's strategy for reorganising the primary care network known as the Family Health Strategy, and the National Oral Health Policy. This review discusses results obtained over the last twenty years, with special attention paid to changes in oral health-care practices, as well as the funding of action programmes and assistance cover. The conclusion is that oral healthcare in the Brazilian primary health care system has advanced over the past decades; however, serious obstacles have been experienced, especially with regard to the guarantee of universal access to services and funding. The continuous efforts of public managers and society should focus on the goal of achieving universal coverage for all Brazilians.

Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children Avaliação do papel da atenção primária adequada no uso de serviços de saúde bucal por pré-escolares brasileiros de baixa renda Evaluación del papel de la atención primaria apropiada en el uso de los servicios de salud bucal por parte de preescolares brasileños de baja renta

Oral health in the family health strategy: a change of practices or semantics diversionism Saúde bucal na estratégia de saúde da família: mudança de práticas ou diversionismo semântico ABSTRACT OBJECTIVE: To evaluate public health dentistry practices of two different family health models. METHODS:Qualitative study conducted with data obtained from focus groups consisting of 58 dentists working in the Family Health Strategy for at least three years between August-October, 2006. The Paideia Family Health Approach was used in the city of Campinas and the Oral Health Initiative as part of the Family Health Strategy was implemented in the city of Curitiba, Southeastern and Southern Brazil, respectively. Data was analyzed using the hermeneutic-dialectic method. Analysis indicators were employed to indicate backwardness, stagnation or progress in oral health practices effective from the implementation of the strategies referred. The indicators used were: work process; interdisciplinary approach; territorialization; capacity building of human resources; health promotion practices; and responsiveness to users' demands. RESULTS:There was progress in user access to services, humanization of health care, patient welcoming and patient-provider relationship. The results related to health promotion practices, territorialization, interdisciplinary approach and resource capacity building indicated a need for technical and operational enhancements in both cities. CONCLUSIONS:Both models have brought about important advances in terms of increased access to services and humanization of health care. Universal access to oral health at all levels of complexity was not achieved in both cities studied. Local health managers and oral health program coordinators must bring more weight to bear in the arena that defi nes public policy priorities. The main thematic issue of the present study is to assess changes in oral health practices following the implementation of the FHS in two Brazilian cities. It could be that political and administrative forces have contributed to the expansion of the changes desired, or either that the original essential proposal may have been disfi gured.The fi rst Brazilian programmatic dental policy was developed in the 1950s 7 and targeted exclusively at schoolchildren, and has become enrooted nationwide. RESUMOOBJETIVO: Avaliar práticas de saúde bucal coletiva de dois modelos de atenção à saúde familiar. MÉTODOS:Estudo qualitativo realizado por meio de grupos focais constituídos por 58 cirurgiões-dentistas atuantes em programa de saúde da família há pelo menos três anos. Foram adotados os modelos de atenção Método Paidéia em Saúde da Família (Campinas, SP, 34 profi ssionais) e Estratégia de Saúde da Família (Curitiba, PR, 24 profi ssionais). O estudo foi realizado entre os meses de agosto e outubro de 2006. O referencial teórico utilizado para análise dos dados foi a hermenêutica-dialética. Foram empregados indicadores analíticos visando a indicar retrocesso, estagnação ou progresso nas práticas de saúde bucal ...

It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to “active listening”, while those who prefer to be cared for by male dentists highlight the attributes of “care integration” and “community guidance”. In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.