Avaliação do escopo de práticas do Auxiliar de Saúde Bucal na Atenção Primária à Saúde e sua associação com o resultado do serviço

Abstract

Brazil has the largest publicly funded oral health service network with universal access in the world. Within this system, there is a continuous need to optimize resource utilization. The Unified Health System (SUS) undergoes constant transformations to better leverage its workforce. In Primary Health Care (PHC), dental professionals operate within teams linked to Basic Care or the Family Health Strategy (FHS). It is believed that better health outcomes can be achieved without additional resources by addressing the underutilization of network professionals. In dentistry, organized teamwork can enhance productivity. Systematizing work processes is a management strategy that organizes and facilitates workforce actions, resulting in increased access and coverage. This study aimed to analyze the impact of assisted dental work on the productivity of oral health services in PHC. A literature review was conducted using descriptors selected from MeSH terms in MEDLINE. Searches were performed on December 28, 2024, in databases such as BVS, Embase, PubMed, Scielo, Scopus, and Web of Science. After removing duplicates using the Rayyan platform, 395 titles were reviewed, with 86 selected for abstract analysis, and 11 for full-text reading. After consensus between two researchers, only two articles remained in the final sample. These studies indirectly suggested that the presence of auxiliary professionals improves service outcomes. Additionally, an analytical cross-sectional study was conducted to assess the productivity of dental services in PHC, comparing teams with and without Oral Health Assistants (ASB) before and after the onset of the COVID-19 pandemic in Pelotas, RS. Reports from the e-gestor/AB system were analyzed for the 12 months immediately before and the first 12 months during the pandemic. The findings indicated that the CD/ASB team produced more than the CD working alone. This difference was observed before the pandemic in the number of consultations and procedures performed, and in collective activities during the pandemic. Thus, the ASB is a viable alternative for the system to achieve better results. In conclusion, the presence of ASBs did not result in a higher number of consultations, procedures, and collective activities before the pandemic. However, during the pandemic, their presence was associated with better outcomes in collective activities. There is a need for further research on the professional practices of auxiliary and technical oral health workers, as quantitative, financial, and productivity aspects of their joint activities have been underexplored. Investing in studies with robust methodological designs is imperative to provide consistent evidence that can support public policy formulation and continuous improvement of dental services in PhC..