Ten Years of a National Oral Health Policy in Brazil

Abstract

Brazil is the only country in the world to propose a universal health care system with the aim of guaranteeing delivery of all levels of health care, free of charge, to a population of over 200 million inhabitants by means of a unified health system ("Sistema Único de Saúde" [SUS]). The national policy of oral health, also known as Smiling Brazil ("Brasil Sorridente"), was implemented in 2004. Oral health was designated as 1 of the 4 priority areas of the SUS, transforming oral health care in Brazil, with the objective that the SUS achieve the integrality of care envisaged at its creation. The aim of this article is to share part of this experience in order to prompt reflection about the inclusion of oral health care in other health care systems around the world. The most significant results of Smiling Brazil can be seen in 3 areas: (1) oral health epidemiological indicators, (2) financial investment and professional development, and (3) the building of an oral health care network throughout the 10 y of the policy. The "Discovery!" article presented here portrays 10 y of evolution; however, it is important to point out that this is a process undergoing construction and that the oral health care network needs to be further expanded, refined, and solidified so that over time and through changes in the political parties in power, Smiling Brazil prevails as a perennial policy and not merely an action by a single government.

Family Health Strategy associated with increased dental visitation among preschool children in Brazil

“…In Brazil, a universal health care system (SUS, Sistema Único de Saúde) began development in 1988 to provide health care as a fundamental right, following implementation recommendations from the Pan American Health Organization 12 . While significant challenges persist, this approach has been credited with substantial advances, including health workforce expansion and 100% coverage of vaccination and prenatal care 12,13 .…”

“…While significant challenges persist, this approach has been credited with substantial advances, including health workforce expansion and 100% coverage of vaccination and prenatal care 12,13 . Oral health was named one of four federal SUS priorities in 2004, leading to the Smiling Brazil initiative (“Brasil Sorridente”) that aimed to integrate oral health care into SUS.…”

“…Oral health was named one of four federal SUS priorities in 2004, leading to the Smiling Brazil initiative (“Brasil Sorridente”) that aimed to integrate oral health care into SUS. This program greatly increased federal investment in oral health and expanded the number of dental professionals affiliated with SUS 12 . One component of Smiling Brazil has been to integrate oral health teams into Basic Health Unit (UBS, Unidade Básica de Saúde) public primary care health centers throughout the country 12,14 .…”

“…This program greatly increased federal investment in oral health and expanded the number of dental professionals affiliated with SUS 12 . One component of Smiling Brazil has been to integrate oral health teams into Basic Health Unit (UBS, Unidade Básica de Saúde) public primary care health centers throughout the country 12,14 . While large-scale surveys following Smiling Brazil implementation showed oral health indicators improve among older children and adults 15 , relatively little information is available related to dental service use among preschool children.…”

Oral Cancer Screening in Elderly in Sao Paulo State, Brazil (2001 to 2009)

“…In the earlier period of the campaign it was observed a yearly increase of benign and malignant lesions incidence. This could be explained by the repressed demand until that historical moment, considering that neither the elderly nor any other adults were covered by oral health care programs in Brazil [24]. Until that time, these programs were exclusively for maternal and child care.…”