title: Relationship between Primary and Secondary Dental Care in Public Health Services in Brazil.
abstract: This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients. The specialties with the highest frequencies were endodontics (68.4%), minor oral surgery (65.8%), periodontics (63.0%), radiology (46.8%), oral medicine (40.2%), orthodontics (20.5%) and implantology (6.2%). In all percentiles, the shortest wait time for secondary care was for radiology, followed by oral medicine and the other specialties. In the 50th percentile, the wait for endodontics, periodontics, minor oral surgery and orthodontics was 30 days, while for implantology, the wait was 60 days. Finally, in the 75th percentile, the wait for endodontics, orthodontics and implantology was 90 days or more. Two clusters, with different frequencies of OHT access to specialties, were identified. Cluster 1 (n = 7,913) included the OHTs with lower frequencies in all specialties except orthodontics and implantology compared with Cluster 2 (n = 4,474). Of the Brazilian regions, the South and Southeast regions had the highest frequencies for Cluster 2, with better rates for the relationship between primary and secondary care. This study suggests certain difficulties in the relationship between primary and secondary care in specific specialties in oral health, with a great number of OHTs with limited access to DSCs, in addition to different performance in terms of OHT access to DSCs across Brazilian regions.
authors.affiliation: Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Renata Castro
authors.identifier: http://orcid.org/0000-0002-8911-0040
authors.initials: RC
authors.lastname: Martins
authors.affiliation: Postgraduate Program in Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Clarice Magalhães Rodrigues Dos
authors.initials: CM
authors.lastname: Reis
authors.affiliation: Department of Preventive and Social Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Antonio Thomaz Gonzaga da
authors.initials: AT
authors.lastname: Matta Machado
authors.affiliation: Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: João Henrique Lara do
authors.initials: JH
authors.lastname: Amaral
authors.affiliation: Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Marcos Azeredo Furquim
authors.initials: MA
authors.lastname: Werneck
authors.affiliation: Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Mauro Henrique Nogueira Guimarães de
authors.initials: MH
authors.lastname: Abreu
mesh_terms: D001938:Brazil; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D003729:Dental Care / Q000706:statistics & numerical data*; D015921:Dental Implants / Q000706:statistics & numerical data; D003815:Dentists / Q000523:psychology*; D004708:Endodontics / Q000706:statistics & numerical data; D006801:Humans; D009909:Oral Health / Q000706:statistics & numerical data; D009970:Orthodontics / Q000706:statistics & numerical data; D010517:Periodontics / Q000706:statistics & numerical data; D011320:Primary Health Care; D063127:Secondary Health Care; D011795:Surveys and Questionnaires
chemical_list: D015921:Dental Implants