Provision of dental prostheses in the oral health care network: a mixed methods study, Goiânia, Brazil, 2019

Abstract Objective To analyze the provision of dental prostheses by the oral health care network (OHCN) of Goiânia, capital city of Goiás state, Brazil. Methods This was a convergent mixed methods study, with semi-structured interviews, thematic analysis and schematic representation of the OHCN. Monthly data on dental prosthesis placements in 2016 and 2019 were extracted from the Outpatient Care Control System of both the Goiânia City Health Department and the Goiás State Health Department, and their averages were calculated. Results 22 individuals participated; seven service users, eight dentists from primary health care (PHC), five from dental specialty centers (DSC) and two from oral health administration/appointment coordination. The Goiás state DSC provided an average of 24.5 denture placements/month in 2016, and 27.16 in 2019, while the Goiânia city DSC provided 8.25 placements in 2016 and 2.66 in 2019. The only type of prosthesis provided was the conventional complete denture. Quantitative-qualitative data integration adjustment at the methods level (comparison and merger) confirmed the findings that the OHCN fulfills the requirements for reception in PHC and referral to the DSC, where dental prosthesis procedures were performed. The local network proved slow in providing dental prostheses, whereby meeting prosthetic demands fell short of targets (12.4%). Conclusion Despite low productivity, the OHCN ensures conventional complete dentures for service users. According to the interviewees, adequacy of material resources, expansion of monthly appointments for dental prostheses, including in PHC, diversification of other types of prostheses, strengthening the use of counter-referral, and improvement of appointment coordination are measures necessary for improving dental prosthesis provision.