A policy of exemplary oral health

Dr. Gilberto Pucca Junior and Dr. Karen Glerum DDS have been implemented in Brazil something that few countries have: a national policy of consistent oral health. It is an example for Latin America, which has shown an unprecedented success in offering free care to the population and employment to dentists

Pucca, who is the national coordinator of oral health of the Ministry of health of Brazil, has been who has designed the structure of this national policy that, in a very short time, has managed to offer not only basic but also specialized, dental coverage to a large percentage of the Brazilian population.

Dr. Pucca, who participated in the first meeting of referents of the Latin-American dentistry here organized by the Asociación Odontológica Argentina (AOA), said that the main problem for the implementation of such policies is the gap at different levels between health and oral health.

“If oral health is in fact health, must be compulsory to be accessible”, declared, adding that this is a principle of paramount importance. “Universal access is the primary strategic element to make oral health a component of health” at the political level.

A fact that says a lot about how the country was is that 75% of the Brazilian population over 65 was edentulous in 2002.

This situation improved radically through the implementation of two oral health policy initiatives within the programme Brazil Semplice (smiling Brazil): oral health teams and centres of dental specialties.

While in 2002 there were 4,261 buccal health teams, 2011 Dr. Pucca had achieved this figure reached 21,083, an increase of 400%. These teams are composed of surgeons, technicians and auxiliaries in oral health.

In less than a decade, 87% of the 5,470 Brazilian municipalities has a team of oral health that are part of an initiative called the family health. These teams are occupied to a number of families in a geographical area should be aware of.

A second front of this national health policy, more ambitious still, was the implementation of centres of average complexity, in which “refers to the users of the system side only of (their) health to a care center”. Pucca says that in 2007 specializing in periodontics, Endodontics, special patients, surgery treatment centers were opened for minors and Stomatology.

Spectacular results

“Today we have 870 specialty centers in operation”, distributed all over the country. These centers have become to turn and a source of employment for oral health professionals.

Investing in health carried out by the Brazilian Government has been substantial, but the results are truly spectacular and not only compensate for they exceed by far the inverted.

Pucca said for example that from 2003 to 2010 the number of dentists working in the its grew by 49%, from 40,000 to 80,000, absorbing a large amount of “excess” of professionals in Brazil oral health as well. “This means that currently in Brazil over 30% of dentists working for the SUS, and the consequent increase of armchairs has allowed access to the attention to social classes who previously did not have it”.

Figures speak for themselves: between 2003 and 2008, the national oral health policy gave access to care “to 18 million Brazilians, individuals who had never before gone to the dentist”, according to Pucca. In turn, this has caused a great impact “on the growth of families who have income of two minimum wages (monthly $500)”.

In a nutshell, access to health care has made grow in a wide social class. So much so that as a result Brazil is considering modifying the curricula of study in dentistry because now the country needs specialists in dentistry that dominate the general clinic, know pulbica health plan, and are trained in biology, said Pucca.

The Brazilian Government also has a policy to avoid excessive concentration of dental care in large towns such as Sao Paulo, Rio de Janeiro and Florianópolis in order to provide care in geographic areas that need it.

In summary, Dr. Pucca has implemented a system that is resolving big problems in a country that boasts more than 200,000 dental care: give free access to oral health to a large percentage of the population, incorporating a large number of professionals to put useful governmental and train others in public health, and redeploy human resources in a country whose Governments have historically been centralist.