Theorizing oral health management in the COVID-19 scenario: a qualitative study in the municipalities of Minas Gerais, Brazil

Souza, Leiriane Alves de; Leonel, Lorena Maria Evangelista; Bulgareli, Jaqueline Vilela; Herval, Álex Moreira

doi:10.1590/1413-81232026314.05032024

THEMATIC ARTICLE • Ciênc. saúde coletiva 31 (4) • Apr 2026 • https://doi.org/10.1590/1413-81232026314.05032024EN linkcopy

Theorizing oral health management in the COVID-19 scenario: a qualitative study in the municipalities of Minas Gerais, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

The study sought to build a theorization on the management of oral health services in the context of the COVID-19 pandemic, based on the meanings produced by oral health managers. A qualitative study was carried out in municipalities in Minas Gerais with primary and specialized dental services. Data was collected through semi-structured remote interviews. The data was analyzed using Grounded Data Theory and theorized based on the National Humanization Policy. The theorizing emerging from the study made it possible to understand that the health crisis acted as a destabilizing phenomenon in the traditional management process, promoting changes in the understanding of oneself in the role of manager. However, the lessons learned during this period were related to the acquisition of new knowledge, but not to changes in the verticalized management model. This result was evidenced by the absence of social participation, with only the lack of complaints ombudsmen being considered. In addition, it was understood that managers were committed to the political-institutional recognition of dentistry, but there was not the same commitment to recognizing the social relevance of oral health in public health services.

Key words:
Dental Health Services; Dental Care; Dental Specialties; Health Management; COVID-19

Managers	Sex	Age	Highest Academic Qualification	Time in position	Employment Relationship
MM.1	Male	42	Graduate Diploma (Public Health)	2 years	Statutory
MM.2	Female	53	Graduate Diplomas (Public Health; Family Health; Higher Education Teaching) Master’s Degree (Education and Society)	>5 years	Statutory
MM.3	Female	36	Bachelor’s Degree	2 years	Commissioned Position
MM.4	Female	55	Graduate Diplomas (Public Health; Micropolitics and Work Management; Auditing)	>5 years	Statutory
MM.5	Female	31	Graduate Diploma (Dental Prosthetics)	4 years	Statutory
MM.6	Female	63	Master’s Degree (Public Health)	>5 years	Statutory
MM.7	Male	25	Bachelor’s Degree	2 years	Commissioned Position
MM.8	Male	43	Graduate Diplomas (Public Health; Management and Evaluation of Health Technologies; Primary and Family Health Care) Master’s Degree (Management and Public Health)	2 years	Statutory
MM.9	Female	44	Master’s Degree (Health Promotion)	4 years	Permanent Employment Contract

Examples from interviews	Codes	Categories
MM.3: It wasn’t calm [...] at the beginning, everyone was very scared, no one knew anything [...] it seemed like everyone was kind of lost.	Uncertainty and insecurity	You had to instill confidence in the professionals, even though you were feeling very scared
MM.1: [...] the process caught everyone by surprise [...] and we had no knowledge of the microorganism, the transmission process, and it was, I think, a discovery for everyone [...].	Misinformation and doubts
MM.2: The fear was really about the disease [...] at that moment there was fear and a refusal to attend [...].	Fear of contamination
MM.7: So, we were all really desperate, everyone, scared [...].	Despair and fear
MM.1: [...] when the guidelines were established, and those guidelines allowed for the organization of the work [...] it somewhat eased our nerves and the [sense of] despair [...].	Technical support for decision-making	Factors intervening in the management process during the pandemic
MM.3: [...] but I think the first year for me was the most critical, until the vaccine arrived and started to provide some confidence, both for the professionals and for the population.	Vaccination as facilitating management
MM.1: [...] I think everyone understood the needs of the population that couldn’t be left without care and the need to share the work with colleagues [...].	Commitment to serving the population	Participation of healthcare professionals in management
MM.7: [...] I see that others took advantage of the moment, still take advantage, to do the bare minimum, to do the least possible, and don’t care much about the population, you know?	Complacency and excuses on the part of the workers
MM.4: [...] some healthcare centers returned immediately, followed the guidelines, understood. And others kept saying they were only taking emergencies [...] We had to make sporadic visits to healthcare centers or districts [...].	Horizontalization of the management process
MM.5: [...] I’m very understanding of each person’s individuality, you know? [...] it builds trust, you see [...] with clear and open dialogue, without hiding anything, I’ve never had difficulty with professionals [...]	Vision and positions of the managers
MM.7: [...] we assigned the rest of the dentists to do that flu syndrome screening, which they didn’t like very much. If they felt undervalued [...], they realized they are too much for that.	Relocation of professionals
MM.4: The population was very scared because of the aerosols created [...]. Many didn’t want to make an appointment [...]	Patients’ refusal to take up treatments	“The population seems to have understood more than the professionals”
MM.9: We didn’t have any complaints. Can you believe that? I thought that when I returned, there would be a lot of complaints. We hardly have any ombudsman [cases]. I think before the pandemic people even complained more [...]	Understanding on the part of the population
MM.5: But the population in general, some understand, others don’t understand; there are some political legacies you have to accept, but we’ve managed to control and address them.	Reflection of politicization in services
MM.9: I learned a lot about stepping out of our comfort zone [...] we had to transform, restructure, and reorganize ourselves. And it’s not easy for us to step out of that comfort zone [...] And I think we have to move forward, keep developing.	Learning and skills acquisition during the crisis	“We had to transform, restructure, and reorganize ourselves”
MM.1: [...] the need for the technical professionals, the managers, the representatives of the population, to come [...] together [...] to talk to each other and be aware of the reality and what can be done; it’s necessary to discuss [things] together.	Inclusion of professionals and the population in decision-making
MM.2: [...] Before, it was quite siloed. Everyone kept to themselves. After the pandemic, things came together. That was a positive point, things came together quite a bit. People even became more helpful, the dental staff, the people from the team saw dentistry in a different light [...]	Recognition of dentistry	“Dentistry has to move on like the others; it has to keep pace and not lag behind.”
MM.3: [...] dentistry has to move on like the others, it has to keep pace and not lag behind. I’m not going to tell you it’s easy. Actually, it’s hard. We have to fight for it every day. But when you have a manager with a more open mind, it gets less difficult.	Importance of dentistry
MM.1: What we would like, right, is the issue of expanding the network, having better infrastructure, the issue of physical infrastructure, right? Not having to be in a rented property; having greater comfort for us professionals to provide care and for patients [...]	Necessary advancements

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[TFN3n] Note: MM = Municipal Manager.

[TFN4n] Source: Authors.