Background. People with disabilities tend to have greater oral health problems compared to those without disabilities. This may be due to barriers they come across in accessing dental services. Objectives. The objective of this systematic review was to provide a critical digest of the scientific literature concerning barriers and facilitators of access to oral health services for people with disabilities. Methods. The electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and Brazilian Library of Dentistry (BBO) were searched using keywords relevant to the subject. The search was not restricted to specific languages or years of publication; all relevant studies were translated and reviewed. Results. Sixteen studies including 14 articles, a doctoral thesis, and a monograph were selected, and their quality was analysed using the Downs and Black assessment tool. Barriers to dental services were divided into physical or nonphysical based on the dentist’s perspective, as per the perception of parents/guardians or by the persons with disabilities. The barriers that emerged included the dentist’s lack of preparation to assist people with disabilities, structural problems of access to dental offices, communication difficulties, and lack of awareness regarding the need for dental treatment for the disabled person. Conclusion. It is concluded that people with disabilities continue to run into complex physical, behavioural, or multidimensional barriers in accessing dental services. Improved training of dentists for the care of this population is hereby emphasized. The legal framework enabling access to dental care for people with disabilities must also be respected in each country.

Early childhood caries (ECC) is a global problem, disproportionately affecting disadvantaged populations. The aim of this study was to evaluate systematically the available scientific evidence on the effectiveness of methods for ECC prevention. Six electronic databases were searched. Two independent reviewers selected the publications and analysed the quality of the included systematic reviews. Thirteen studies were included. Overall, eight reviews were classified with methodological quality critically low using the AMSTAR 2, whereas five reviews achieved a high risk of bias using the ROBIS tool. The methods identified that were positively related to the prevention of ECC were as follows: preventive dental programmes for pregnant women; advice on diet and feeding; prenatal oral health care; integration of maternal and children's oral health promotion into nursing practice; maternal oral health programmes undertaken by non‐dental health professionals; dental health education in combination with the use of fluoride for children; early preventive dental visits; and the use of fluoride varnish and toothpastes with more than 1000 ppm of fluoride. The currently available evidence supporting the effectiveness of methods for prevention of ECC, although suggesting some methods of greater potential, is still lacking due to the methodological quality of the systematic reviews and the included primary studies.

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.

Introdução: as condições crônicas não transmissíveis representam a maior causa de morbimortalidade no Brasil. O Modelo de Atenção às Condições Crônicas foi implantado no estado do Paraná como estratégia de enfrentamento ao cuidado crônico. Objetivo: avaliar a implantação do Modelo de Atenção às Condições Crônicas por meio da percepção dos profissionais de saúde. Materiais e Métodos: estudo exploratório, descritivo, com abordagem qualitativa, realizado em um serviço de atenção primária à saúde e um serviço de atenção ambulatorial especializada em uma região de saúde do estado do Paraná. Participaram do estudo sete profissionais da atenção especializada e onze profissionais da atenção primária. Os dados foram coletados por meio de seis encontros de grupos focais, cujas discussões foram norteadas pelo instrumento de avaliação do modelo de atenção às condições crônicas (IEMAC ARCHO 36), sendo submetidos à análise de conteúdo temática proposta por Bardin. Resultados: os relatos dos profissionais permitiram analisar a estratégia de implantação de acordo com as seis dimensões propostas pelo modelo: organização do sistema de saúde; saúde compartilhada; modelo assistencial; autocuidado; apoio à tomada de decisão; e sistemas de informação. Identificou-se que a implantação do modelo apresenta fragilidades quanto aos indicadores de saúde, mapa de ações interprofissionais, plano de autocuidado apoiado e sistemas de informação. E, também, avanços relacionados à organização da rede de atenção, estratificação de risco e desmedicalização de idosos. Conclusão: para atingir a efetividade do Modelo de Atenção às Condições Crônicas, faz-se necessário o completo desenvolvimento de suas dimensões para a garantia da qualidade e a melhoria do cuidado crônico.

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