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巴西全民健康体系中的初级牙科保健:培训与实践面临的挑战。

Brazilian primary dental care in a universal health system: Challenges for training and practice.

机构信息

School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.

Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil.

出版信息

J Dent. 2024 May;144:104932. doi: 10.1016/j.jdent.2024.104932. Epub 2024 Mar 16.

Abstract

OBJECTIVES

To report the challenges for training and practice for the Brazilian primary dental care in a universal health system.

METHODS

Health, education and protection rights against poverty are guaranteed by the 1988 Brazilian Constitution and public health in Brazil is provided by the Unified Health System (SUS), one of the largest public health systems in the world. According to SUS, every Brazilian citizen has the right to free primary oral health care as secondary and tertiary care, offering a unique opportunity to integrate oral care within general health care.

RESULTS

The Brazilian undergraduate Dental curriculum was updated in 2021 aiming to graduate general practitioners with a major in comprehensive health care in primary health care, integrated with public and general health. This curriculum update requires at least 20% of the academic hours to be exercised outside the university walls (extramural or community work), preferably within the SUS.

CONCLUSIONS

Considering the World Health Organization (WHO) agenda, Brazil needs to advance the innovative oral health workforce, the integration of oral health into primary care, the population access to essential dental medicines and optimal fluorides for caries control.

CLINICAL SIGNIFICANCE

It is necessary political action and the engagement of multiple stakeholders, mainly from the health and education sectors, to improve primary health care.

摘要

目的

报告在全民健康体系下,巴西初级牙科保健培训和实践所面临的挑战。

方法

1988 年巴西宪法保障了健康、教育和扶贫权利,而巴西的公共卫生则由统一卫生系统(SUS)提供,该系统是世界上最大的公共卫生系统之一。根据 SUS 的规定,每个巴西公民都有权在二级和三级医疗保健中获得免费的初级口腔卫生保健,这为将口腔保健纳入一般卫生保健提供了独特的机会。

结果

2021 年,巴西本科牙科课程进行了更新,旨在培养初级卫生保健中综合卫生保健专业的全科医生,与公共卫生和一般卫生相结合。这一课程更新要求至少 20%的学时在大学围墙之外(校外或社区工作)进行,最好是在 SUS 内进行。

结论

考虑到世界卫生组织(WHO)的议程,巴西需要推进创新的口腔卫生人力队伍建设,将口腔健康纳入初级保健,使民众能够获得基本的口腔药物,并控制龋齿所需的最佳氟化物。

临床意义

需要采取政治行动并让多个利益攸关方参与,主要来自卫生和教育部门,以改善初级卫生保健。

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