Availability of Periodontal Instruments, Procedures, and Specialized Referral in Primary Health Care in Brazil

ABSTRACT

Objective:  To analyze the availability of periodontal instruments, services, and specialized referrals in Primary Health Care and compare Brazilian geographical regions.

Material and Methods:  The historical time series analysis was carried out based on secondary data extracted from the 1^st (2012), 2^nd (2014), and 3^rd (2018) cycles of the external evaluation of the Basic Care Access and Quality National Program. A comparison was carried out between the proportion (%) of Oral Health Teams (OHT) and dependent variables (Periodontal instruments, service offered, and specialized referral) and the independent variables of Brazilian geographical regions and years.

Results:  The number of OHT evaluated was 12,562 (2012), 18,333 (2014), and 21,817 (2018). Increase was observed in the availability of periodontal probe, periodontal curette, sharpening stones, and sodium bicarbonate jet for the Brazilian OHT, and in all regions of the country between 2014 and 2018 (p<0.001), and reduction in the availability of dental ultrasound in Brazil, mainly in the Southern (p<0.001), Southeastern (p<0.001), and Midwestern (p=0.008) regions. Supragingival Scaling and Root Planing were the most commonly performed periodontal procedures. At the same time, frenotomy/frenectomy was the least performed procedure by the OHT in Brazil and in all Brazilian regions, with a gradual increase according to the cycle (p<0.001). The offer of periodontal specialist referral increased from 54.6% (2012), 68.3% (2014), to 81.8% (2018) in Brazil and all Brazilian regions (p<0.001).

Conclusion:  Despite the increase in periodontal instruments, procedures, and specialist referrals in Brazil, regional differences were still observed.

Keywords:
Primary Health Care; Outcome and Process Assessment, Health Care; Dental Health Services