Maxillofacial surgery problems in Primary Health Care. A Systematic Review

ABSTRACT Background: Primary care in maxillofacial surgery concerns maxillofacial trauma and some dental conditions treated in Primary Health Care (PHC) settings. Barriers to access to maxillofacial surgery include financial constraints, lack of insurance coverage, difficulty in travel, lack of subsidized programs, dissatisfaction with the quality of services and organizational issues, and were found to be related to gender and educational level. Aim: The aim of this systematic review was to highlight the care and management of maxillofacial surgical problems in PHC. Methodology: This systematic review was conducted in accordance with the PRISMA guidelines. For the needs of the study, a search was carried out in the Medline/PubMed, Scopus and Google Scholar databases to find articles published from 2015 to 2024, with search terms primary health care AND (teeth OR orthognathic) AND (surgery OR primary surgery care OR day care surgery OR ambulatory surgery). Inclusion criteria were studies directly related to the topic, in English, published in journals with a peer-reviewed evaluation system. During the initial search, 78 articles were found, of which 12 were included in the study. Results: In relation to the factors that prevent attendance at primary health care for maxillofacial surgery problems, it was observed that citizens were unaware of the type of dental services provided to them in these structures, even in countries where primary health care was very developed. Reorganizing primary care around the care of the individual involves moving many surgical procedures, including selected orthodontic procedures, from hospital care to primary care and this should be a major concern for most governments. Conclusions: The results of this review showed the increasing demand for maxillofacial surgeries while it was revealed that the ignorance of citizens about the benefits of primary health care was the main factor in non-attendance at the General Hospitals for maxillofacial surgeries, together with the low socioeconomic status of citizens. At the same time, the geographical area of residence and the distance from the General Hospitals affected the attendance at them.