Original Research
Utilization of dental services by rural riverside populations covered by a Fluvial Family Health Team in Brazil
AUTHORS
Diego Cordeiro1 MSc, PhD Student *
Fernando J Herkrath2 PhD, Public Health Researcher 
Adrielly C Guedes3 BDS, MSc Student
Luiza Garnelo4 PhD, Public Health Researcher
Ana Paula CQ Herkrath5 PhD, Adjunct Professor
AFFILIATIONS
1, 5 School of Dentistry, Federal University of Amazonas, Av. Ayrão 1539, Praça 14 de Janeiro, Manaus, Amazonas 69025-050, Brazil; and Doctoral Program in Public Health in the Amazon, Manaus, Amazonas, Brazil
2 Doctoral Program in Public Health in the Amazon, Manaus, Amazonas, Brazil; Leônidas and Maria Deane Institute, Oswaldo Cruz Foundation, Rua Teresina 476, Adrianópolis, Manaus, Amazonas 69057-070, Brazil; and Superior School of Health Sciences, Amazonas State University, Av. Carvalho Leal 1777, Cachoeirinha, Manaus, Amazonas 69065-001, Brazil
3 Leônidas and Maria Deane Institute, Oswaldo Cruz Foundation, Rua Teresina 476, Adrianópolis, Manaus, Amazonas 69057-070, Brazil
4 Doctoral Program in Public Health in the Amazon, Manaus, Amazonas, Brazil; and Leônidas and Maria Deane Institute, Oswaldo Cruz Foundation, Rua Teresina 476, Adrianópolis, Manaus, Amazonas 69057-070, Brazil
ACCEPTED: 23 September 2023
early abstract:
Introduction: Rural riverside populations face several difficulties to access health services. The Brazilian National Primary Care Policy implemented the Fluvial Family Health Teams (FFHT), which is a specific primary care team arrangement for these territories. The aim of the study was to assess the use of dental services by adults living in rural riverside areas covered by a FFHT.
Methods: A household-based cross-sectional survey was carried out with the rural riverside population of 38 localities on the left bank of the Rio Negro, Manaus, Amazonas, representative for the area covered by the FFHT. Stratified random sampling was calculated based on the number of adults and households in each riverside locality. An electronic questionnaire was used to obtain information on sociodemographic and oral health conditions and the utilization of dental services. After descriptive analysis, logistic regression analyses were performed to estimate the odds ratios for the outcome ‘use of dental health services over the past 12 months’.
Results: A total of 492 individuals, aged ≥18 years, from 38 rural riverside areas were assessed. The mean age of participants was 43.5 years (±SD=17.0), ranging from 18.0 to 90.7 years. Of these participants, 3.1% had never been to a dentist and 21.9% had been to a dentist three years ago or more. Among those who attended the dental service, 77.31% of appointments occurred in public services. Dental pain over the past 6 months (OR=2.44; 95%CI 1.51-3.96), higher education (OR=2.62; 95%CI 1.23-5.56), last appointment in public services (OR=1.86; 95%CI 1.19-2.93), edentulism (OR=0.38; 95%CI 0.17-0.85) and dissatisfaction with oral health (OR =0.59; 95%CI 0.38-0.93) were associated with the dental services utilization.
Conclusion: The study results revealed that approximately a quarter of the individuals did not use dental services over the past three years or have never used them. Despite the increase in access provided by the FFHT, edentulous individuals, individuals dissatisfied with their oral health, and those with lower levels of education were less likely to use dental services, while individuals who experienced dental pain sought dental services more frequently. These findings suggest that health care model offered to this population must be rearranged.
Keywords: health care utilization, rural health services, dental health services, primary health care