Community oral health index for health agents

Brazilian Unified Health System (SUS) is based on a health team (doctor, dentist, nurse, and several health agents), who are responsible for a specific population. Unfortunately, due to the number of person, the dentist is normally not able to see/assist the whole population nor to identify those in more need in order to prioritize their appointment–enforcing equity.  To help the organization of dental treatment demand, a new index (community oral health index–COHI) was created to be used by health agents (who see all the population assisted by the health team on a regular basis). The aim of this work was to validate this index, which analyzed variable such number of teeth, presence of caries, residual roots and oral lesions. Experimental approach: Two health agents were trained to utilize the COHI, while two dentists were trained to use the COHI and the DMF-T score. Sixty individuals were analyzed by both methods and the results were compared. Results: There was a very strong agreement between the DMF-T and the COHI (collected by dentists). Number of teeth (r_s=0,944, kappa > 0,9), categorized number of caries (Chi-square p <0,001; kappa=0,926), presence of soft tissue problems (Chi-square p <0,001; kappa=0,792). There was also a strong agreement on the results comparing the dentist and the health agents COHI results. Residual roots (r_s=0,933), presence of tartar (Chi-square p <0,001), categorized number of caries (Chi-square p <0,05), need of prosthesis (Chi-square p <0,001; kappa>0,8), demonstrating that the COHI can be use by health agents as a screening tool, helping dental services organization. Conclusion: COHI is a valuable oral health screening tool and can be used by trained health agents to help dentist on their daily tasks.