Os serviços de saúde bucal do Sistema Único de Saúde durante a pandemia da Covid 19

Abstract

In March 2020, the World Health Organization declared a pandemic for the disease caused by the SARS-CoV-2 virus, COVID-19. It is a viral pathology that can generate a severe acute respiratory syndrome, whose main route of transmission is air through respiratory droplets. Due to continuous contact with contaminating fluids, dental care presents a considerable risk of cross-infection. Therefore, the World Health Organization recommended that elective dental procedures be postponed in all countries where COVID-19 was present until the end of the acute phase of the pandemic. In Brazil, public dental care is guaranteed through the Unified Health System (SUS). The aim of this study was to describe the oral health services of the SUS, in the northern macro-region of Minas Gerais, during the COVID-19 pandemic. The study design was observational, cross-sectional and analytical. The target audience was the municipalities that make up the northern macro-region of Minas Gerais, represented by oral health managers and dentists (DSs) working in the SUS oral health services. Data were collected between August and October 2020 through an online questionnaire, a report from the 14th Special Bulletin of COVID-19 of the Northern Minas Gerais macro-region (SES/MG, 2020) and population data in the public domain through the Brazilian Institute of Geography and Statistics (IBGE, 2020). Data analysis was performed using the Statistical Package for Social Sciences for Windows® (SPSS) version 24.0. For statistical analysis, frequency, percentages, mean and standard deviation were used. Bivariate analysis was performed using Pearson's chi-square test, considering the 5% level as significant. Sixty-four (74.4%) municipalities in the northern macro-region of Minas Gerais participated in this study, the majority (61.9%) of which were below the mean prevalence of COVID-19 calculated for the study sample (Average = 0.0058; Sd: 0.0049 ) at the time of the search. Elective dental procedures were suspended in all municipalities with the maintenance of urgent and emergency care during the acute phase of the pandemic in primary, secondary and tertiary care. There was a shortage of personal protective equipment (PPE) at the beginning of the pandemic in 62.5% of the municipalities. 292 DSs participated in this study, the majority of whom worked in primary care (86%) in person (78.1%) and felt prepared to apply biosafety measures in dental care (55.8%). Actions to fight the pandemic were observed by the DSs, the most frequent being teleorientation (66.8%) and telemonitoring (59.2%). Most DSs reported not having COVID-19 (86.6%). An association was observed between professionals who reported contamination and the occurrence of scarcity/lack of PPE (p=0.02). The COVID-19 pandemic impacted the supply of public dental services in the northern macro-region of Minas Gerais due to the suspension of elective dental care and the lack/scarcity of PPE. This context gave the DS the opportunity to expand its activities with actions of telemonitoring and teleorientation in a multidisciplinary way. In addition, this professional proved to be prepared to maintain biosecurity during clinical care although occurrence of contamination by COVID-19.