Oral health guidelines in the primary care policies of five selected countries: An integrative review

Background: Oral conditions remain a major health problem worldwide. Primary Health Care (PHC) has been recognized as a strategy to construct integrated health systems in order to produce the best health outcomes and reduce inequities through its attributes. Nevertheless, oral health integration in PHC remains unclear due to a lack of systematic knowledge. Aim: To summarize oral health guidelines focused on the comprehensiveness component of PHC in the health system and on the intersectoral component of health promotion and disease prevention actions in five selected countries. Methods: An integrative review of scientific and grey literature was led. Australia, Canada, New Zealand, United Kingdom and Brazil were selected. Content analysis was performed based on the comprehensiveness of care and health promotion and disease prevention categories. Results: Forty-one studies were selected to compose the review. Regarding the comprehensiveness of care, the horizontal dimension was more prominent, suggesting that oral care should be provided in cooperation with other health areas. Health promotion and disease prevention actions in intersectoral contexts are complex but seem to be effective. Programs for spreading access to fluorides and actions with the education sector are the most established ones. Conclusion: The integration of oral health in PHC policies is recommended in the guidelines of all countries, however, it stills represents a major challenge for the health care systems. These guidelines represent an important source to support decision-makers, policy-makers and stakeholders.