Trabalho e poder na Secretaria Municipal de Saúde: implantação da Política de Saúde Bucal em um município - 2007/2008

RESUMO O artigo analisa a organização do trabalho em uma Secretaria Municipal de Saúde (SMS) e a distribuição do poder setorial, com suas implicações para a implantação da Política de Saúde Bucal, utilizando, para tanto, a tipologia do poder setorial proposta por Mario Testa (1992). Os dados foram coletados por meio de entrevistas e observações realizadas nos momentos de avaliação da implantação do Plano Municipal de Saúde. Os resultados do estudo evidenciaram que a organização do trabalho na SMS favoreceu a concentração de poder técnico e administrativo na Coordenação de Saúde Bucal, constituindo-se empecilho para a implantação da Política Nacional de Saúde Bucal no município de Salvador

The legislative and the regulation of dental assistants professions in Brazil

ABSTRACT Objective: To analyze the conditions of possibilities and contributions of the legislative power to the regulation of oral health assistants (in Portuguese “Auxiliar de Saúde Bucal” – ASB) and oral health technicians (in Portuguese “Técnico de Saúde Bucal” – TSB) in Brazil. Methods: This socio-historical study used Bourdieu´s theoretical framework. Twelve legislative processes were included. Information about their objects, similarities and differences, main stakeholders, their social and professional trajectories and their relationship with oral health were sought. An interview with two key informants was conducted. The multiple correspondence analysis investigated the association between the variables and their intensity of contribution. Results: This issue remained in dispute between 1977-2008 and was regulated by Law 11.889/2008, after the incorporation of Oral Health Teams in the Family Health Strategy. The restrictive practice was related to parliamentarians from the southeast region, linked to the pole of the private market, without training in the health area. The defense of clinical practice under dentist´ supervision was related to health and human sciences agents. Conclusion: The ASB profession has always been a consensus in regulation. The issue in dispute was the activities of Oral Health Technicians. It prevailed in the Law text a more progressive and broader view

Constructing public oral health policies in Brazil: issues for reflection

This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from both Market Dentistry and Preventive and Social Dentistry in Brazil. Among the state activities that have been set into motion, the following stand out: the drafting of a law to regulate the fluoridation of the public water supply, and the fluoridation of commercial toothpaste in Brazil; epidemiological surveys to analyze the status of the Brazilian population's oral health; the inclusion of oral health in the Family Health Strategy (Estratégia de Saúde da Família - ESF); the drawing up of the National Oral Health Policy, Smiling Brazil (Brasil Sorridente). From the literature consulted, the progressive expansion of state intervention in oral health policies is observed. However, there remains a preponderance of hegemonic "dental" practices reproduced in the Unified Public Health Service (Sistema Único de Saúde - SUS) and the Family Health Strategy