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OBJECTIVE: Development and evaluation of a mobile application for remote monitoring and guidance of pediatric patients diagnosed with cleft lip and/or palate (CL ± P) and their caregivers. DESIGN: This is a pilot cross-sectional, applied, and quantitative study. SETTING: The study was conducted in two tertiary care treatment centers in Brazil. PARTICIPANTS: The participants included 20 caregivers and infants undergoing treatment with nasoalveolar molding (NAM) for CL ± P. INTERVENTIONS: The intervention involved using the TeleCleft mobile application for remote monitoring and guidance of caregivers and infants during NAM treatment. MAIN OUTCOME MEASURE(S): The main outcome measures included usability and satisfaction of users with the TeleCleft application. RESULTS: The results showed high usability and satisfaction ratings among users of the TeleCleft application. Most participants found remote monitoring to be effective and expressed positive opinions about its convenience and usefulness. CONCLUSION: TeleCleft could be a viable tool for remote monitoring and guidance, reducing the need for patients and caregivers to travel to treatment centers, which could potentially alleviate the burden of care faced by families during the journey of CL ± P treatment.

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This analytical cross-sectional study aimed to analyze the access of patients with special needs (PSN) in Brazilian municipalities to hospital dental care of the Unified Health System (Sistema Único de Saúde - SUS), based on data from the Hospital Information System of the Unified Health System (Sistema de Informações Hospitalares do SUS- SIH/SUS - SIH), from 2010 to 2018. The Kolmogorov-Smirnov normality test was performed; the Poisson regression was used to verify factors associated with the variable total number of hospitalization authorizations with the main procedure of dental treatment for PSN ("Total de Autorizações de Internação Hospitalar" - AIH), the Spearman correlation test with a significance level of 5% was used to characterize the relationships between the Municipal Human Development Index per municipality - (Índice de Desenvolvimento Humano Municipal - HDI) and the Oral Health Coverage in the Family Health Strategy by municipality (Cobertura de saúde bucal na estratégia saúde da família por município - SBSF Coverage), and the relationship of the AIH with SBSF Coverage. A total of 127,691 procedures were performed, of which 71,517 (56%) were clinical procedures, such as restorations, endodontic treatments, supra and subgingival scaling, among others. Municipalities in the Midwest (PR=5.117) and Southeast (RP = 4.443) regions had more precedures than the others. A weak correlation was found between AIH and SBSF Coverage (r = -0.2, p < 0.001) and HDI and SBSF Coverage (r = -0.074, p < 0.001). Population size, region, health coverage, oral hygiene, and number of dentists in hospitals affected the availability of dental procedures in PSN.

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BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .

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BACKGROUND: The Brazilian Dental Specialty Centers (CEO, in Portuguese) represent the strategy of the National Oral Health Policy to provide secondary-level dental care. They offer more complex procedures, such as the treatment of periodontitis. This study aims to investigate the factors associated with the performance and the achievement goals of specialized procedures and the achievement gols of periodontics in CEO. METHODOLOGY: Analytical and cross-sectional study using secondary data. The database of the second cycle of the External Evaluation of the National Program for Improving Access and Quality in CEO (PMAQ-CEO, in Portuguese), was utilized, which assessed 1,042 CEO on-site in 2018. The data were analyzed using multiple Poisson regression, estimating the prevalence ratio (PR) (p < 0.05). RESULTS: A third of the CEO (n = 305) performed all specialized procedures, with a higher prevalence observed in those with more than one bicarbonate jet prophylaxis unit (RP = 2.12; 95% CI: 1.160-3.881; p = 0.015) and when they had a higher percentage of specialist professionals (RP = 1.004; 95% CI: 1.002-1.006; p < 0.001). The periodontics goal was achieved by 617 (59.2%) CEO, with a higher prevalence among those who had a manager with supplementary training (PR = 1.21; 95% CI: 1.100-1.335; p < 0.001) and with a higher workload for the periodontist dentist (PR = 1.15; 95% CI: 1.103-1.201; p < 0,001). CONCLUSION: Although most CEOs do not perform allspecialized periodontics procedures, more than half achieved the established goals. The provision of specialized periodontics services in CEO and the achievement of goals are influenced by the quantity and professional qualifications, as well as the availability of equipment.

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Aim: This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures' effectiveness to return clinical activities in the following months. Methods: perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results: There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion: measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil

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ABSTRACT Objective: To measure the costs of preventive and therapeutic protocols of Photobiomodulation (PBM) for oral mucositis (OM) and their budgetary impact on Brazil's Ministry of Health (BMH). Material and Methods: A partial economic analysis was performed to estimate the costs using a bottom-up approach from a social perspective. Monetary values were assigned in Brazilian reais (BRL). The costs of the preventive protocol were calculated for five, 30, and 33 consecutive PBM sessions, depending on the antineoplastic treatment instituted. The costs of the therapeutic protocol were calculated for 5 or 10 sessions. The annual financial and budgetary impact was calculated considering the groups of oncologic patients with a higher risk of development of OM, such as those with head and neck and hematological cancer and pediatric patients. Results: The cost of a PBM session was estimated at BRL 23.75. The financial impact of providing one preventive protocol per year for all oncologic patients would be BRL 14,282,680.00, 0.030% of the estimated budget for hospital and outpatient care of the BMH in 2022. The financial and budgetary impacts of providing one treatment for OM for all patients in one year would be BRL 2,225,630.31 (0.005%, most optimistic scenario) and BRL 4,451,355.63 (0.009%, most pessimistic scenario). Conclusion: The budgetary impact of implementing PBM protocols in the Brazilian Healthcare System is small, even in a pessimistic scenario.

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Abstract This analytical cross-sectional study aimed to analyze the access of patients with special needs (PSN) in Brazilian municipalities to hospital dental care of the Unified Health System (Sistema Único de Saúde - SUS), based on data from the Hospital Information System of the Unified Health System (Sistema de Informações Hospitalares do SUS- SIH/SUS - SIH), from 2010 to 2018. The Kolmogorov-Smirnov normality test was performed; the Poisson regression was used to verify factors associated with the variable total number of hospitalization authorizations with the main procedure of dental treatment for PSN ("Total de Autorizações de Internação Hospitalar" - AIH), the Spearman correlation test with a significance level of 5% was used to characterize the relationships between the Municipal Human Development Index per municipality - (Índice de Desenvolvimento Humano Municipal - HDI) and the Oral Health Coverage in the Family Health Strategy by municipality (Cobertura de saúde bucal na estratégia saúde da família por município - SBSF Coverage), and the relationship of the AIH with SBSF Coverage. A total of 127,691 procedures were performed, of which 71,517 (56%) were clinical procedures, such as restorations, endodontic treatments, supra and subgingival scaling, among others. Municipalities in the Midwest (PR=5.117) and Southeast (RP = 4.443) regions had more precedures than the others. A weak correlation was found between AIH and SBSF Coverage (r = -0.2, p < 0.001) and HDI and SBSF Coverage (r = -0.074, p < 0.001). Population size, region, health coverage, oral hygiene, and number of dentists in hospitals affected the availability of dental procedures in PSN.

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ABSTRACT BACKGROUND AND OBJECTIVES: The extraction of third molars can lead to undesired effects such as pain, trismus, and edema, necessitating preemptive therapy to alleviate these effects. For this purpose, an economic evaluation was conducted to analyze the cost-effectiveness of preemptive drugs used in the extraction of third molars. METHODS: Costs were obtained from a market survey. Effectiveness measures were limitation of interincisal distance and postoperative pain, obtained from randomized clinical trials in the literature. For both models, a Monte Carlo simulation generated a hypothetical cohort of a thousand individuals, considering a 5% variation in estimates. The evaluated therapies were dexamethasone 8 mg (DX8); methylprednisolone 40 mg (MP); diclofenac 50 mg associated with tramadol 50 mg (DCTR); and dexamethasone 4mg associated with tramadol 50 mg (DXTR). RESULTS: MP and DCTR therapies were dominated in all scenarios. For the reduction of postoperative pain, DXTR treatment showed the best cost-benefit, with a net monetary benefit (NMB) gain of 31.10% compared to the lowest-cost treatment (DX, R$ 1.76). Considering the reduction in limitation of interincisal distance, DXTR medication presented higher cost-benefit compared to DX8 (NMB gain = 18.25%), being a preferred option alongside DX8. CONCLUSION: In the extraction of third molars, preemptive administration of dexamethasone 4mg associated with tramadol 50mg is the preferred cost-effective option to reduce postoperative pain and limitation of interincisal distance after 48 hours.

RESUMO JUSTIFICATIVA E OBJETIVOS: A exodontia de terceiros molares pode acarretar efeitos indesejados, como dor, trismo e edema, sendo necessário ofertar uma terapia preemptiva para amenizá-los. Para tal, realizou-se uma avaliação econômica para analisar o custo-efetividade de fármacos preemptivos utilizados na exodontia de terceiros molares. MÉTODOS: Os custos foram obtidos a partir de uma pesquisa de mercado. As medidas de efetividade foram: limitação da distância interincisal e dor pós-operatória, sendo obtidas em ensaios clínicos randomizados da literatura. Para os dois modelos, uma simulação de Monte Carlo gerou uma coorte hipotética de mil indivíduos, considerando uma variação de 5% das estimativas. As terapias avaliadas foram: dexametasona 8 mg (DX8); metilprednisolona 40 mg (MP); diclofenaco 50 mg associado a tramadol 50 mg (DCTR); e dexametasona 4 mg associada a tramadol 50 mg (DXTR). RESULTADOS: As terapias com MP e DCTR foram dominadas em todos os cenários. Para redução da dor pós-operatória, o tratamento com DXTR apresentou o melhor custo-benefício, com ganho de benefício monetário líquido (NMB) de 31,10% comparado ao tratamento de menor custo (DX, R$ 1,76). Considerando a redução da limitação da distância interincisal, o fármaco DXTR apresentou maior custo-benefício em relação à DX8 (ganho de NMB = 18,25%), sendo uma opção de escolha junto a DX8. CONCLUSÃO: Na exodontia de terceiros molares, a administração preemptiva de dexametasona 4 mg associada com tramadol 50 mg é a opção de escolha, do ponto de vista de custo-efetividade, para reduzir a dor pós-operatória e limitação da distância interincisal após 48 horas.

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OBJECTIVES: To investigate the association between access and delivery of complete dental prosthesis according to the proportion of the black population in Brazilian municipalities and to oral health policies. MATERIALS AND METHODS: Ecological data from 2017 to 2021 relating to the delivery of complete dentures stratified by race was collected in all Brazilian cities. We calculated a racial inequality indicator by subtracting the percentage of the black population from the percentage of complete dental prostheses that were delivered to blacks in each municipality. Logistic and linear regression models were carried out. RESULTS: We found that 49.2% (2737) of municipalities delivered complete prostheses. The service was more frequently available in municipalities where black individuals made up 20-80% (odds ratio [OR] = 1.45, 95% confidence interval [CI] 1.15; 1.81), those with dental specialty centers (DSC) (OR = 3.04, 95%CI 2.50; 3.68), and those with more oral health teams (OHTs) (OR = 3.43, 95%CI 2.81; 4.18). Where dental prostheses were available, racial inequities favored the white population by 7.7 percentage points (p < 0.01). Increased inequality was observed in municipalities with more OHTs and/or a higher proportion of black individuals (>80%). CONCLUSIONS: Although municipalities with a DSC, and with more OHTs offer better access to complete dental prosthesis for blacks, racial inequality still impacts the delivery of the service. Primary and secondary healthcare services may even exacerbate this. CLINICAL RELEVANCE: Policymakers should monitor racial inequities in healthcare services. The currently unmet needs of black people are critical, especially in cities with more OHTs and/or increased proportions of black people.

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Background: The aim of the study was to investigate associations between sociodemographic factors and municipal Family Health Strategy (FHS) coverage and oral health promotion (OHP) procedures in Brazil. Material and Methods: Data were obtained using public information systems and by direct request to the Ministry of Health. Clinical and collective OHP procedures performed in 2019 were analyzed, and sociodemographic covariates were associated with FHS coverage (population covered by FHS teams [FHST] and oral health teams [OHT]). Negative binomial regression models associated outcomes with covariates and estimated the prevalence ratio (PR) and confidence intervals (95%CI). Results: A total of 4,913 municipalities were included. Municipalities with low-income inequality (PR=1.04, 95%CI 1.01 to 1.08), high illiteracy rate (RP=1.06, 95%CI 1.00 to 1.13), and population size of 10,001 to 50,000 inhabitants (PR=1.07, 95%CI 1.02 to 1.12) and 50,001 to 100,000 (PR=1.21, 95%CI 1.12 to 1.30) showed a higher frequency of clinical procedures. In contrast, a low frequency of clinical procedures was associated with reduced vulnerability to poverty (PR=0.83, 95%CI 0.78 to 0.89) and low OHT coverage (PR=0.39, 95%CI 0.33 to 0.45). Regarding collective procedures, the final model showed associations between low frequency and reduced income inequality (PR=0.91, 95%CI 0.87 to 0.95), low per capita income (PR=0.84, 95%CI 0.81 to 0.88), and low (PR=0.53, 95%CI 0.35 to 0.80) and medium Human Development Index (PR=0.79, 95%CI 0.71 to 87). Conclusions: Clinical and collective OHP procedures were associated with sociodemographic conditions and OHT coverage in the FHS. Key words:Health Promotion, Oral Health, Social Determinants of Health, Universal Health Coverage.

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BACKGROUND: Teledentistry is considered a good tool in the diagnostic process. In oral medicine, there is a low number of trained professionals and dentists have difficulty in diagnosing and treating oral lesions. OBJECTIVE: We aimed to perform a cross-sectional evaluation based on the mobile application for oral diagnosis using a mobile application in a Brazilian State. METHODS: This is a retrospective, cross-sectional, observational study of the data of the "Telehealth in Stomatology in Paraíba" carried out between May 2021 and November 2022. RESULTS: The app has a team of 16 consultants (Ph.D. professors, postgraduate students, residents, and dentists). In addition, there are 289 registered professionals, with a mean age of 33.7 years, predominantly female (70.2%), working in primary care (79.2%), and general practitioners (42.6%). Regarding the cases, the app has 194 cases, and reactive lesions are the most suggested hypotheses reported by dentists (24.5%) and consultants (22.3%). We had an overall concordance rate of 64.1%. CONCLUSION: The application is easily accessible and has an assistance network that helps with early diagnosis. In addition, it has good coverage with users in more than 50% of the cities in the state. Thus, applications that provide specialized care to distant areas are important for better public health.

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OBJECTIVE: The objective of this review protocol is to map the available evidence regarding all the oral health surveys of Traditional Peoples and Communities (TPCs) in Brazil. METHODS AND ANALYSIS: The review question of the protocol is: 'What evidence is available on the oral health surveys of Traditional Peoples and Communities in Brazil?'. Observational studies that report oral health surveys of TPC in Brazil will be included. The protocol considered the Problem, Concept and Context strategy to guide data collection, as established by the Joanna Briggs Institute. The search strategy will consider Medical Subject Headings terms, synonyms and relevant free terms about epidemiological surveys in oral health and TPC in Brazil, with no limits to data, language, subject or search type, in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Scopus, Web of Science and Embase. Bibliographic searches will be updated until June 2023. The selection will be carried out by two independent, blinded reviewers, following the eligibility criteria, based on the title and abstract identified in the initial search. Potentially eligible studies will be fully read to confirm eligibility and collect relevant information. The categorisation of the studies will consider the author and year of publication, the traditional group studied, the study design, geographic location, age group, sample size, data collection method and the main oral health problem evaluated and its outcome. The data obtained and extracted will be presented in table format and text and presented using the visualisation of similarities method. ETHICS AND DISSEMINATION: The present study does not need ethical approval. The protocol title was registered in the Open Science Framework (DOI 10.17605/OSF.IO/BQ5J3). A final article will be prepared presenting the results of the scoping review, and will be submitted for publication in a peer-reviewed journal. The findings of this review will be presented at national conferences and scientific meetings.

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This study aims to reevaluate and compare the data from the Brazilian Unified Health System (SUS) on the number of diagnoses of systemic lupus erythematosus (SLE) in the pre-pandemic period with those in the pandemic period, as well as to compare the first year (2020) of the COVID-19 pandemic in Brazil with the last year (2021), to update the data, and to verify whether SLE disease control measures were effective in 2021. There was a consistent and significant increase in the incidence of SLE cases all over Brazil between the first and second pandemic years and between the pre-pandemic triennium and the second pandemic year. Therefore, it is inescapable to have larger clinical studies with different populations to better understand the relationship between these two conditions and find measures to improve the control of this disease.

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ABSTRACT Objective: To analyze the impact of the COVID-19 pandemic on dentists' income and to identify associated factors in one of the poorest Brazilian states. Material and Methods: A cross-sectional study including dentists who volunteered to answer an electronic questionnaire in Maranhão. Hierarchical multinomial logistic regression analyses were performed, estimating crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95%CI) (alpha=5%). Results: The COVID-19 pandemic impacted the professionals´ income negatively [55.44% (50.26-60.52%)] and also positively [6.9% (4.55-9.94%)]. The negative impact on income was greater among male dentists (OR=2.54; 95%CI: 1.16-5.53), over 30 years of age (OR=3.03; 95%CI: 1.34-6.87), with family income below two minimum wages (OR=4.63; 95%CI: 1.50-14.30), who worked in the continent instead of in the capital island (OR=2.21; 95%CI: 1.14-4.29) and in the private sector (OR=31.43; 95%CI: 11.59-85.22). Moreover, those who had been tested for COVID-19, with a negative result, had a 21.3-fold greater chance of having an increased household income when compared to those who had not been tested. Conclusion: The COVID-19 pandemic negatively impacted the dentists' income in Maranhão, especially the older, males, with lower incomes, and who worked in the private sector, living far from the capital. The SUS played an important role in the social protection of dentists during the COVID-19 pandemic, mitigating the economic impacts on the public sector working class.

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Abstract This study aims to reevaluate and compare the data from the Brazilian Unified Health System (SUS) on the number of diagnoses of systemic lupus erythematosus (SLE) in the pre-pandemic period with those in the pandemic period, as well as to compare the first year (2020) of the COVID-19 pandemic in Brazil with the last year (2021), to update the data, and to verify whether SLE disease control measures were effective in 2021. There was a consistent and significant increase in the incidence of SLE cases all over Brazil between the first and second pandemic years and between the pre-pandemic triennium and the second pandemic year. Therefore, it is inescapable to have larger clinical studies with different populations to better understand the relationship between these two conditions and find measures to improve the control of this disease.

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AIM: To identify the individual and contextual factors associated with the absence of Brazilians at a scheduled appointment in Dental Specialties Centers (DSC). METHODS: This cross-sectional design uses the National Program for Improving Access and Quality of Dental Specialties Centers database, 2018. The outcome was the users' lack of at least one of the scheduled appointments. Contextual and individual independent variables were used, considering Andersen's behavioural model. The analyses were performed with the R Core Team and SAS (Studio 3.8, Institute Inc, North Carolina, U.S, 2019) programs. RESULTS: Of the 10,391 patients interviewed, 27.7% missed at least one of the consultations. In the adjusted multivariate model, the interpretation based on the effect size and 95% CI showed that the behaviour individual predisposing factors such as age ≤ 42 years (OR = 1.10; 95%CI:1.01-1.21), individual need factors such as participation in the "Bolsa Família" program (OR = 1,14; 95%CI:1.02-1.27), not being covered by the Family Health Strategy (OR = 1.15; 95% CI:1.02-1.30), and users of periodontics services (OR = 1.22;95%CI:1.05-1.40) were associated with absences. The behavioural factor associated with the outcome was that the DSC facilities were not in good condition (OR = 1.18; 95%CI:1.03-1.34). DSC located in the capital (OR = 1.12; 95% CI: 0.92-1.48) were 12% more likely to have dental absences than those in the interior region. CONCLUSION: There are individual and contextual barriers associated with patients not attending specialised public dental consultations. DSC should offer adequate hours to patients, especially young adults and vulnerable people.

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BACKGROUND: With the COVID-19 pandemic, thousands of children had their dental care interrupted or postponed, generating a pent-up demand for primary care. To minimize the impact of this outage, information and communication technologies (ICT) could be an alternative. The aim of this study is to elucidate the impact of implementing the ICTs in primary dental care for children on resolving the pent-up demand for primary dental care to children in the national health system service (SUS) due to the COVID-19 pandemic. METHODS: Different research strategies are being proposed to demonstrate such effect and extrapolating findings to a real-world context to guide further research, practice and policies: two clinical trials (one randomized controlled by the waiting list trial (RCT) and a before-and-after study), one simulation study to prospect trial results to a broader population and three economic evaluations using different effects. Children enrolled in a reference dental unit will be invited to participate in the before-and-after study for trials. The first 368 families will be randomized for the RCT to the intervention vs waiting list. All participants will receive the intervention, but the waiting list group will be assessed before the intervention is available for them. The intervention comprises standardized non-face-to-face primary dental care using the V4H platform. The problem-solving and the family's perception will be the primary outcomes set for the before-and-after study and RCT, respectively. They will be measured 2 weeks after randomization. Based on trial findings, we will develop theoretical models to estimate how the intervention could benefit the population included in the national health system.  Three economic evaluations will be carried out considering different trial effects (cost-effectiveness analyses). A societal perspective and the pandemic time horizon will be considered. Possible social impact (inequalities) will also be explored. DISCUSSION: This ongoing trial may be an essential contribution to clarify positive and negative aspects related to the use of technologies for non-face-to-face dental care for children. Trial products may bring relevant contributions to the pandemic context and the post-pandemic period. Potential benefits may be feasible to implement and preserve in the health system even in the post-pandemic period. Trial registration Clinicaltrials.gov registration NCT04798599 (registered March 2021).

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OBJECTIVES: To explore the factors associated with the waiting time for access to specialized care at Dental Specialties Centers (CEO, in Portuguese), by specialty (Stomatology, Surgery, Endodontics, Patients with Special Needs and Periodontology). METHODS: The study was a descriptive and analytic exploratory secondary analysis of data from the 2nd phase of the National Program for Improving the Access to and Quality of CEO (PMAQ-CEO, in Portuguese). All 1097 CEO in Brazil were evaluated in loco in 2018. Binary logistic regression was used to analyse the likelihood of users having a shorter time for assistance at CEO, by specialty. RESULTS: The highest and lowest median waiting times were found for endodontics (30 days) and stomatology (5 days), respectively. Smaller centres (type I CEO) had a shorter waiting list for patients with special needs (95%CI: 1.20-3.37), Endodontics (95%CI: 1.03-3.02) and Surgery (95%CI: 1.04-3.05). As for the specialties with the longest waiting list (Endodontics and Surgery), the direct route of user access to CEO was more effective than that regulated by the Healthcare System. CONCLUSIONS: Factors related to the service, management, and to the form of relationship with primary health care influenced the waiting time for specialized care in CEO. The contact between professionals in the oral health network (primary care and secondary) was associated with a shorter waiting time, regardless of the specialty.

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