Uso dos serviços odontológicos e fatores associados em jovens do nordeste brasileiro

Abstract

The assurance of universal access defined by the Brazilian Constitution of 1988 and the recent advances achieved with the implementation of the National Oral Health Policy have brought positive results in relation to the access and use of dental services, however this increase occurred unequally between the different population groups all over the country. Although several theoretical models have been trying to explain the influence of several factors on the use of health services, important gaps still persist and require new research with different approaches to a better understanding of the relationships between the social determinants of health and the access and use of dental services. This study aims to assess the use of oral health services and the main associated factors in young people aged 17 to 21 years in the city of Sobral, Ceará, based on different methodological designs. The first design is a cross-sectional approach relating the different outcomes related to the use of dental services with individual determinants. The second one also developed a cross-sectional study, but it addressed the contextual factors and the relationships with the use of oral health services. Thematic maps were also made for a better visualization of the spatial distribution of the contextual variables and the outcomes used. The third study consisted of a cohort study, where trajectory profiles were created regarding the use of dental services and how they are related to individual factors in two different moments of life: childhood and youth. The sample for all the designs was originated from a cohort of oral health performed in the municipality of Sobral with data collected in the years 2000, 2006 and 2012. The results indicate the influence of socioeconomic factors, especially in the first years of life, in the access and use of oral health services, as well as the type of service used. The toothache at some point in life was associated with going to the dental office at some point in life and having been denied access. The presence of dental treatment needs was related to the greater use of dental services and early access to them. A non-regular visit to the dentist seems to increase the likelihood of oral problems in youth. To implement public policies that aim at a better distribution of income and social inclusion, as well as actions of promotion and prevention in oral health, can contribute to the improvement of aspects related to the use of dental services