PREFACE
Contributing to ultimately offering quality oral health care to all Brazilians
Lilian Marly de Paula
President of ABOPREV
The construction of a democratic, universal and integrated health service for the entire Brazilian population is one of the key principles of Brazil's Unified National Health System (SUS - Sistema Único de Saúde). Within this perspective, several strategies that include territorial and epidemiology-based planning, health surveillance programs, effective financial management and regulation policies have been implemented since the past decade, under the National Oral Health Policy. However, due to the complexity of the demographic characteristics in our country, there is still a long way to go. Broad and continuous debate, which includes central and local health system managers, healthcare professionals and representatives of the society, needs to be disseminated in order to expedite the incorporation of these important strategies into daily oral health practice.
Considering the importance of ongoing debate on the oral health care model, its achievements and its difficulties on a daily practice basis, the Brazilian Association for Oral Health Promotion (ABOPREV - Associação Brasileira de Odontologia de Promoção de Saúde) organized a symposium held in Brasília from May 27-29, 2010. Among the topics discussed during the 15th ABOPREV Congress on Oral Health Promotion in a Public and Private Context, we can mention the integration of oral health care into the SUS through the reorganization of the different levels of care, as well as the creation of references in secondary and tertiary care, by establishing Specialized Dental Clinics. In this context, several issues were presented, such as: the rational use of fluoride; the role of health promotion for caries and periodontal disease control; the relation between systemic and periodontal diseases; the importance of early diagnosis and knowledge of risk factors associated with oral cancer; and public policies for oral health.
This special issue of the Brazilian Oral Research (BOR) Journal is dedicated to conveying the proceedings of this symposium. The format of the symposium was based on presentations, in which each presenter was asked to review the literature in a certain field. Each session was followed by a structured discussion. At the end of the symposium, a general discussion was also carried out. A short summary of the discussions is presented at the end of this issue. The purpose of this special issue of the BOR is to make the knowledge gained at the symposium available to as large an audience as possible.
Tenuta and Cury pointed out the role of fluoride in Dentistry. Some scientific background was given on the current fluoride-related state-of-the-art to help understand the importance of different forms of fluoride use. In addition, its use at different levels in the community self-applied and professional application were also discussed, considering the current caries epidemiological and clinical approaches.
Since dental caries diagnosis, control and treatment are major concerns of primary health care (PHC) in Brazil, Maltz et al. thought it relevant to present a review of cariology. Based on scientific evidence, the review covered the issues of diet and biofilm control in promoting health. In the context of biofilm control, the authors reinforced the importance of oral hygiene measures, the use of fissure sealants for the control and treatment of the carious process, and how to arrest deep dentinal caries by the stepwise excavation technique or by partial removal of carious dentine.
The literature has demonstrated the importance of the chemical control of supragingival biofilm. Based on this scientific evidence, Oppermann et al. discussed the efficacy of antiseptics in clinical practice, when used as adjuvant agents to complement mechanical control. For this reason, supragingival chemical control (SCC) should be included in the curriculum of dental schools. The authors also discussed the competencies and skills expected from a graduate dentist regarding SCC; how to include this content in the course curriculum; teaching-learning tools and techniques to be employed; and program content.
Pucca et al. discussed the Oral Health Care model implemented in the National Unified Health System of Brazil in the last decade. The authors showed how oral health was reorganized at the primary and secondary levels. The emphasis was focused on including the dentist in the family health team and on establishing Centers of Dental Specialties (CDS) and Regional Dental Prosthesis Laboratories (RDPL). This specialized oral health network was established for the purpose of performing oral diagnosis, minor oral surgery and endodontic, periodontal and prosthodontic treatments in the National Unified Health System.
Torres-Pereira reviewed the literature on policy-making regarding oral cancer, considering that investigation in oral cancer involves many different areas, such as epidemiology, risk factors, biological markers, diagnostic testing, screening, treatment and prognosis. Based on scientific evidence, it was also discussed whether the implementation of controlled oral health policies have been able to reduce the oral cancer incidence worldwide.
Since many patients frequently fail to control supragingival biofilm, Cortelli et al. considered the benefits of using mouth-rinses in periodontics in order to achieve optimal plaque control. Despite the large variety of antiseptics commercially available, the patient's needs and the cost-benefit ratio should be considered when choosing a product. It was also reported that dentists at different levels of dental education have only partial knowledge related to using mouth-rinses in periodontics.
A symposium was organized for the purpose of further discussing the aforementioned topics. The discussion included evidence-based data concerning the health-disease process, with the definition of risk factors and their repercussion on the individual's general health. In conclusion, the Congress as a whole has reinforced the importance of combining public and private practices in oral health policies. Further discussion is essential to establishing educational practices that consider social disparities and both cultural and regional aspects, issues important for effecting general behavioral health changes, both individually and in the population at large.
Publication Dates
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Publication in this collection
08 Sept 2010 -
Date of issue
2010