Changes in dental education for primary health care: The Brazilian experience with Prosaude

Dental education in Brazil has been traditionally centered in private practice with a lack of experience in community and service learning. Since dentist was included in Health Family strategy, actually with 18.000 oral health teams, the need for change the undergraduate dental student profile to integrate health team became evident. PROSAUDE, a federal program which offers incentives to medical, dentistry and nursing schools, is working to solve this problem through three vectors of change:
Vector 1 – Scenarios: from University Hospital (school dental clinics) to outpatient centers and community settings;
Vector 2 – Theoretical approach: from rare disease-centered to common diseases and health promotion
Vector 3 - Methodology: from lectures and passive learning to active participation of the students.
Twenty-four schools of dentistry of all brazilian geographic regions were selected to participate, and were encouraged to move toward these vectors. The main result attributable to PROSAUDE is a primary care service-schools of dentistry integration, with an introduction of service learning experience. The degree of integration and the extent of community-based clinical placement vary between schools, but these experiences are now being recognized by many dental educators in Brazil as a useful feature of preparing dental professionals. The benefits to dental education is to foster graduates who where better prepared to work in brazilian National Health System (SUS), and to help them to have a broader concept of their role as a health care provider. Although these results are still a preliminary outcome of the Program, they could be considered as an important movement to advance dental education in Primary Health Care in the country. The conclusion of the authors is that integrating schools of dentistry into the primary care services will add value to learning and services and will improve both of them.