Implementation of the Brazilian National Oral Health Policy and its influence on oral health conditions in Brazilian state capitals in the first decade of the 21st century

The study aimed to analyze strategies for the implementation of the Brazilian National Oral Health Policy (PNSB) and its influence on oral health conditions in state capitals in the first decade of the 21st century. This is a policy assessment study. Data on oral health conditions were obtained from the databases of the Brazilian National Oral Health Surveys in 2003 and 2010 (SBBrasil 2003 and SBBrasil 2010), calculating the annual percent change in variables pertaining to oral health conditions as dependent variables for Brazilian state capitals. The PNSB was analyzed according to its conceptual foundations: oral healthcare model, organization of the supply of oral health services, implementation of oral health promotion strategies, and existence of fluoridation of the public water supply. Data were obtained from the national health databases and face-to-face interviews with oral health coordinators in 13 state capitals. The analyses were controlled and adjusted by the target population’s socioeconomic conditions. An association was observed between the characteristics of oral health promotion, services supply, and model of care, indicating that the public services’ dynamic is dependent on the management priorities and the policy’s conduction. In conclusion, the PNSB is implemented differently in Brazil’s state capitals according to the ways its guidelines are conducted in each capital and whether it favors best practices and strategies in oral healthcare. However, the influence of the PNSB is still not clear on the modification of oral health indicators from 2003 to 2010.

本研究旨在分析巴西国家口腔卫生政策（PNSB）的实施策略，及其在21世纪头十年对巴西各州首府口腔健康状况的影响。本研究属于政策评估类研究。口腔健康状况相关数据取自2003年与2010年巴西全国口腔健康调查（SBBrasil 2003、SBBrasil 2010）的数据库，研究以巴西各州首府的口腔健康状况相关变量作为因变量，计算其年度百分比变化。本研究基于概念框架对PNSB展开分析，涵盖口腔医疗服务模式、口腔卫生服务供给的组织机制、口腔健康促进策略的实施情况，以及公共供水氟化措施的落实情况。研究数据来源于全国卫生数据库，以及对13个州首府口腔卫生协调员开展的面对面访谈。分析过程针对目标人群的社会经济状况进行了控制与调整。研究观察到口腔健康促进、服务供给与照护模式的特征之间存在关联，表明公共服务的运行逻辑取决于管理优先级与政策推进方式。综上，巴西各州首府对PNSB的实施方式存在差异，差异源于各首府对政策指南的落实路径，以及是否采纳口腔医疗领域的最佳实践与相关策略。但2003年至2010年间，PNSB对口腔健康指标变化的影响仍未明确。