Satisfação com os serviços odontológicos, acesso a informações em saúde bucal e autopercepção da cárie dentária entre adultos

Abstract

This dissertation is composed of three manuscripts constructed from secondary data from "SBMOC Project," which investigated a conglomerates random sample of adults (35-44 years) in the city of Montes Claros - MG. In all analyzes, was conducted Binary Logistic Regression with correction for the design effect. In the first study aimed to identify factors associated with dissatisfaction with dental services used (dependent variable). The independent variables were selected according to the theoretical model set forth by Andersen and Davidson (1997). It was found that about 11% of adults were dissatisfied with the dental service. The dissatisfaction was lower among older adults and among smokers. On the other hand, it was higher among adults who self-perceived their chewing as negative, who selfperceived some discomfort in the mouth and head and neck region, and among those who did not have access to information on how to avoid oral problems. In the second study aimed to investigate factors related to the lack of access to information on oral health (dependent variable). The independent variables were gathered into subgroups according to the theoretical model for Health literacy. It was observed that 37.5% of adults had no access to information about oral health. The lack of access was higher among adults who had lower per capita income, were dissatisfied with the dental services provided, did not use dental floss, had unsatisfactory physical domain of the quality of life, and self-perceived their oral health negatively. In the third study aimed to investigate the validity of the self-perceived dental caries (SPDC, dependent variable) as a diagnostic test and associated factors. The independent variables were grouped into Sociodemographic, Use of dental services; Normatives; Self-perceived; and Habits. Logistic regression models were performed with all adults; adults with dental caries and; adults without dental caries. SPDC showed a sensitivity of 77.7%, specificity 58%, accuracy of 65%, positive predictive value of 52%, and negative predictive value of 81%. SPDC was associated with time use of dental services and dissatisfaction with oral health in all models. In the first model, SPDC was associated with access to oral health information, dental flossing, normative DC diagnosis, self-perceived oral treatment need, and oral pain. In the second model, SPDC was associated with self-perceived oral treatment need and dissatisfaction with general health. In the third model, SPDC was associated with access to oral health information, need for oral treatment awareness, and dental flossing. Conclusion: Health services should ensure appropriate information whether quantitatively or qualitatively in order to achieve greater satisfaction among its users, increase Health literacy levels and contribute in increasing the predictive power of self-perceived measures. The provision of information is an essential tool for health services more equitable, as the decreased access to information was related to unfavorable conditions among adults.