Oral health care in the Xingu Indigenous Park, Brazil, from 2004 to 2013: an analysis based on evaluation indicators

In 2011, the Brazilian National Oral Health Policy redefined its model of care for indigenous peoples, recommending the use of epidemiology and follow-up of the impact of activities using adequate indicators. The current study aimed to analyze trends in these indicators, proposed by the Brazilian Ministry of Health, in the Xingu Indigenous Park, Brazil, from 2004 to 2013. This was a quantitative study using secondary data from the Xingu Special Indigenous Health District and the Xingu Project of the Federal University of São Paulo. The coverage rate for first dental visit exceeded 60% in all the years analyzed except 2009 and 2010 (44.7% and 53.4%, respectively). The basic dental treatment indicator showed a significant increase, from 44.9% to 79.9%, between 2006 and 2008. The proportion of tooth extractions decreased from 24.3% in 2004 to 3.8% in 2011. Mean coverage of supervised collective toothbrushing showed the highest variation (1.2 to 23.3%). Access to oral health showed good coverage, and the indicator for completed treatment showed a higher percentage when compared to other indigenous peoples during the same period. Better performance on the tooth extractions indicator may have been due to the change in focus of care through partnerships with universities, although the indicators for supervised toothbrushing suggest the need to prioritize preventive measures. Changes in indigenous healthcare management, with weakening or absence of partnerships, may have negatively influenced the program's indicators.