Patients complain of waiting for dental treatment in São Paulo

Convenience store attendant Poliana Dias Santos, 40, says that her two children have been waiting for more than a year to be screened for dental treatment in the public network of the city of São Paulo.

Alice, 9, has skewed teeth, a kind of misalignment. A professional from the private network evaluated the case and indicated the need for caries elimination and cleaning. Her brother Miguel, 11, is in pain.

The babysitter’s son Gabriele Rosendo de Oliveira, 34, nine years old, has a holed tooth, two broken and three with cavities. The pain is constant and he takes painkillers. The mother claims that she has been applying for a place for her son for about ten months.

According to family members, the three children are followed up at the UBS (Basic Health Unit) Jardim Aracati, in the south zone. “I go to the unit often and the answer is always the same: he’s on the queue and needs to wait. He didn’t even go through the screening. I’ve explained my son’s situation, but it’s no use”, says Oliveira.

Sought, the SMS (Municipal Health Department) stated that there are no complaints formally registered by the family members of the three patients.

After being sought out by the report, the management body Ricardo Nunes (MDB) scheduled the dental evaluation appointments for Alice and Miguel — the girl was seen this Thursday (8). The one for Gabriele’s son will be this week. The mothers confirmed the information.

The folder also said that four dental offices are in the implementation phase at UBS Cidade Ipava, in the Jardim Aracati region. Five dentists will be hired to meet local demands.

The report asked the secretariat, via LAI (Access to Information Law), how many patients were waiting for treatment for caries, root canal, periodontitis or other oral problems. The folder replied that “Primary Care does not work in the logic of a waiting list and that the average time for carrying out dental screenings in the UBSs is 40 days”. Therefore, there is no queue.

Without identifying itself, the report visited and called some UBSs to check access to oral treatment. Officials admitted that there is a queue for screening and that it is not possible to predict the time for service to occur, but that it goes far beyond 40 days.

At UBS Joaquim Antonio Eirado, in Santana (northern zone), there is no dental compressor or plan to install it. The secretariat had stated, in a note, that the installation was scheduled for Monday (5), which had not happened until the morning of this Thursday. At the unit, an employee said that there is no forecast to receive the equipment and, despite the screening being scheduled, the service is only possible with the machine.

At the Bom Retiro UBSs (north zone), Jardim Keralux, in Ermelino Matarazzo, Dr. Carlos Olivaldo de Souza Lopes Muniz and Vila Nova Manchester (all in the east side), the screening takes place once a month.

According to employees, at the Jardim Penha and Engenheiro Goulart UBSs, both in Cangaíba (east zone), there is no screening due to lack of vacancies. This last schedule for attendance in another unit.

At UBS Carlos Gentile de Melo, on the east side, only emergency cases are dealt with.

The Health Department did not comment on the observations made in these UBSs.

The UBS is the gateway to dental treatment in the public network. Of the 470 units in the municipality, 426 (90.6%) have oral health teams, which are responsible for dental care with restorative procedures and prophylaxis.

It is the UBS that refers patients to the CEOs (Dental Specialty Centers), when necessary. These services perform root canal treatment and surgeries, for example.

For public health doctor Adriano Massuda, a professor at the Fundação Getulio Vargas School of Administration of the State of São Paulo, it is necessary to identify whether the high pent-up demand is due to insufficient supply, flow disorganization or the Covid-19 pandemic, a time when many people stopped going to the dentist.

“Today, the municipal manager is quite overloaded. This type of problem should be addressed nationally. In 2020, the decrease in production due to the pandemic for routine procedures, which includes oral health, was 25%, on average. Primary Care, which includes dentistry, were the most affected, with a 60% reduction in production”, says Massuda.

He recommends the hiring of emergency teams to reduce the dammed demand, preventing problems from evolving and costing more to public coffers. “Untreated tooth decay may require a tooth extraction, and treating oral health with tooth extraction is prehistoric public health, but it could happen again.”

Dental surgeon Sidnei Goldmann, who has been working in the oral health field for over 30 years, warns that the tooth is connected to the rest of the body, and that periodontitis — a bacterial infection of the specific tissues, ligaments and bones that surround and support the teeth—is a risk factor for heart and lung disease.

The specialist points out that the visit to the dentist should be regular: every six months, if you have controlled oral health; otherwise, every four months. He recalls that 90% of oral problems occur due to poor brushing.

“We need preventive public policies. It’s cheaper than treating the problem”, he says.