A presença da ortodontia no SUS: a experiência de CEOs e de outros serviços públicos de saúde bucal

Abstract

Orthodontic care, which has been offered by the SUS, albeit in an incipient manner, was reinvigorated with the creation of the Dental Specialty Centers (CEOs) by the National Oral Health Policy (PNSB), launched in 2004. However, information about data regarding this care remained unknown. This led to the following questions: Where are the centers that include this type of care located? What type of orthodontic care is offered at these locations? What are the problems related to this process? In this sense, the present thesis object was to discover answers to these questions. To investigate the location of the CEOs and other oral health centers throughout Brazil that offer orthodontic care; examine the public health of the municipalities where they are located; observe the modus operandi of these orthodontic actions. Next, in a prospective exercise, the study discussed the ways to increment them to make them more effective. Through the State Oral Health Coordinators (CESB), all public orthodontic services in Brazil were located, and the managers and/or administrators of these services were asked to provide information regarding the intramural orthodontic programming provided. Forty-two public orthodontic services were found in 39 municipalities throughout Brazil. The data obtained referring to orthodontic treatment were analyzed and demonstrated problems in the areas of human resources; financing; triage and reference, in addition to the lack of a broad clinical protocol, to guide these actions. They also pointed to the need to discuss new ideas about these issues. Orthodontics is definitively part of the agenda at the SUS, and since this is a rather incipient experience, it still needs some adjustment. These adjustments have been discussed in a protocol of conduct that can be adapted to the reality of each municipality. In this protocol, elements leading to greater technical effectiveness and increased political and financial feasibility are indicated for the process of inclusion of Orthodontics at SUS.