Inequalities in access to and utilization of dental care in Brazil: an analysis of the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL 2009)

Abstract published in English and Portuguese English title: Inequalities in access to and utilization of dental care in Brazil: an analysis of the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL 2009)This study aimed to evaluate access to and utilization of various types of dental services by individuals 18 years or older in Brazil's State capitals. We gathered data from the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL) in 2009 (n = 54,367). More than half of the target population reported the need for dental treatment in the previous year; of these, 15.2% lacked access to dental services when needed. The private sector provided 61.1% of all dental appointments. The share of services provided by the Unified National Health System (SUS) ranged from 6.2% in the Federal District to 35.2% in Boa Vista, in the North. Multivariate Poisson regression models showed higher prevalence of dental treatment needs among women, middle-aged adults, and individuals with more schooling. Lack of access to dental care was more frequent among women, young adults, less educated individuals, and among lightener-skinned blacks. Our findings highlight sharp inequalities in the use of and access to dental services in the Brazilian State capitals.= Pretendeu-se descrever o padrão de utilização, acesso e tipo de serviço odontológico utilizado por adultos e idosos das capitais brasileiras segundo características sociodemográficas. Foram utilizados dados do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL) de 2009 (n = 54.367). Mais da metade da população revelou necessitar de tratamento odontológico no último ano e desta, 15,2% não conseguiram atendimento. O uso de serviço odontológico privado foi de 61,1%. A participação do Sistema Único de Saúde variou de 6,2% no Distrito Federal a 35,2% em Boa Vista. Análises multivariáveis de Poisson revelaram que as maiores prevalências de percepção de necessidades de tratamento ocorreram nas mulheres, nos adultos de meia idade e nos mais escolarizados. Falta de acesso aos serviços odontológicos foram mais prevalentes em mulheres, nos mais jovens, nos menos escolarizados e nos pardos. Os resultados deste estudo revelam a existência de marcantes iniquidades na utilização e acesso de serviços odontológicos nas capitais brasileiras.Marco A. Peres, Betine Pinto Moehlecke Iser, Antonio Fernando Boing, Renata Tiene de Carvalho Yokota, Deborah Carvalho Malta, Karen Glazer Pere

Childhood caries in the state of Kentucky, USA: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Untreated dental caries afflicts almost one third of school-aged children in the United States and many of them are from disadvantaged families. This cross-sectional study was undertaken to investigate the prevalence of untreated caries in north central Kentucky, USA and to examine the relationships between the available demographic variables and untreated childhood caries as reported on the forms from the Smile Kentucky! program.</p> <p>Methods</p> <p>During the fall of 2008, caries status was assessed during the visual oral screening examination component of “SmileKentucky!”– a model of the American Dental Association’s Give Kids A Smile program. Parents had completed brief surveys concerning 3,488 elementary school children aged 5 to 13 years who participated in the program. A secondary analysis was conducted using univariate, bivariate and multivariate statistical methods.</p> <p>Results</p> <p>Untreated caries was reported in 33% of children. Bivariate and logistic regression analyses found that the most significant risk factors for having untreated caries were living in the metropolitan Louisville, Kentucky area, not having had a dental visit in the previous 3 years and not having any form of dental insurance.</p> <p>Conclusions</p> <p>Untreated caries in elementary school children is prevalent in north-central Kentucky despite efforts to improve access to care. The results suggest that additional family and community preventive initiatives are needed to reduce the development of childhood caries in this area of the United States.</p

Comparison of Medicaid and Non-Medicaid Dental Providers

A statewide mail survey of a stratified sample of 640 Michigan general dentists was conducted in 1983, with a response rate of 41 percent, n = 261. An analysis was performed to compare Medicaid and non-Medicaid providers. About half of all respondents reported that they were not seeing any Medicaid patients (Group 1); 29 percent reported that less than 10 percent of their patients were Medicaid-eligible (Group 2), and 22 percent reported that 10 percent or more of their patients were Medicaid-eligible (Group 3). Significant differences existed among the three groups for age of respondent, length of time in practice, and number of new patients seen each month. Respondents with greater percentages of Medicaid patients in their practices were more likely to be in group practice. Stratification of respondents by location suggested that rural providers were more likely than urban respondents to have some Medicaid patients in their practices. Over 40 percent of respondents from all groups reported themselves as being not busy enough. In 1984, more than one million persons in Michigan were eligible for Medicaid dental benefits, but only one-fourth of these individuals were recipients of dental care. Factors that may limit dentists' participation in the Medicaid program, despite the presence of a large eligible population and self-reported lack of busyness, are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65325/1/j.1752-7325.1986.tb03143.x.pd