In Brazil from the turn of the 19th to the 20th century, the concern with health was linked to the economic interests of the elites in keeping the worker healthy to maintain production, mainly in the agrarian context of the time."(...) With the abolition of slavery in 1888, the process of replacing slave labor with salaried labor of European origin was consolidated (...). for Brazil, the government at the time was obliged to adopt some measures to improve this situation" 6. Creating and implementing public health services and programs at the national (central) level. “At the head of the General Directorate of Public Health, Oswaldo Cruz progressively implemented public hygiene and health policies in Brazil. At the same time, it adopted the model of 'sanitary campaigns', designed to combat urban epidemics and, later, rural endemics.”7 In 1923, the Eloy Chaves law was enacted, a milestone in the beginning of Social Security in Brazil. In the period between 1923 and 1930, Caps. (Retirement and Pension Funds).
In the Vargas Era, the Ministry of Health favored health actions, based on the American model, favoring workers, since they were an important productivity factor; of development and economic investment.8 At that time, INAMPS (National Institute of Medical Assistance of Social Security) was created to provide medical assistance to those who contributed to social security and self-employed, however, most of the care was provided by the private sector, with which they established agreements providing for remuneration per procedure, consolidating the logic of caring only for the disease and not for health promotion, as was already the case in England and in other countries.
With the mass movements that originated in the mid-1970s and during the 1980s, which led the country to democratization, the Sanitary Reform movement emerged, which proposed a new conception of public health. The universal right to health was conquered through the National Constitution of 1988, which defines that health becomes the duty of the State and the responsibility of the Unified Health System.
Health Unic System
Article 196 of the Brazilian Constitution describes that: Health is everyone's right and the State's duty, guaranteed through social and economic policies aimed at reducing the risk of disease and other harms and universal and equal access to actions and services for its promotion, protection and recovery.9 From the publication of the constitution, the country legally assumes the responsibility with society regarding the health of Brazilian citizens, starting a new era in Brazilian public health, where health starts to be recognized , as a social right, inherent to each and every citizen.
The Organic Law of Health (No. 8.080/90) regulated and implemented Brazil’s Unified Health System (SUS). The definition of competences and attributions for each governmental sphere sought to facilitate the implementation and execution of the SUS, facilitating the operation of this new public health guideline. Through this Organic Law and the 1988 Constitution, it becomes the duty of the State to formulate, develop, implement, and evaluate economic and social policies aimed at reducing the risk of diseases and other injuries, creating conditions that ensure universal and equal access to actions from health to services for their promotion, protection and recovery.1 This citation of article 2 of the Organic Law diversifies and expands the concept of health and service provision by government spheres, such as: health surveillance, epidemiological surveillance, health of the worker; comprehensive therapeutic assistance, including pharmaceuticals. Thus, inserting, in fact, the worker's health as one of the fields of action of the SUS.
Insertion of the dental surgeon in public health policies
Changes in health practices brought about changes in the way of serving the population, and currently the Family Health Strategy, based on primary care, in an ascribed territory, also sought to change the perception of the profile of diseases; their determinants, to be able to cause impact, reducing the epidemiological conditions of diseases in a population way.
In 1978, from the ordinance 3214 of the Ministry of Labor, with support in the Federal Law n° 6514, it regulated the norms in health and security of the work, whose fulfillment became obligatory. The performance of union movements is decisive for the transformations in the field of workers' health in favor of guaranteeing and applying workers' rights in improving health and work conditions, despite the fact that the process of building public policies in Occupational Health is historical and arising from the constant struggles of the population of workers and their legal representatives, the unions. 10
In history, Dentistry has been distant from public health policies. Brazilians' access to oral health was extremely difficult, limited and expensive. Because of this history, the main service offered has almost always been tooth extraction, perpetuating a vision of mutilating dentistry in Brazilian dentistry. Brasil Sorridente was a project that marked the history of dentistry in public health, constituting a series of measures aimed at guaranteeing actions for the promotion, prevention and recovery of the oral health of Brazilians.
PNSB - National Oral Health Policy
The main differential in its creation was the reorganization of the practice and the qualification of the actions and services offered to citizens of all ages, with increased access to free dental treatment for Brazilians through the SUS. The main lines of action of the program are: the implementation of Oral Health teams in the Family Health Strategy - ESF, the expansion and qualification of Dental Specialty Centers CEO and Regional Dental Prosthesis Laboratories and the feasibility of adding fluoride in public supply water treatment. 11
Primary Care constitutes “a set of health actions, at the individual or collective level, which covers the promotion and protection of health, the prevention of injuries, diagnosis, treatment, rehabilitation and maintenance of health, located at the first level care of the health system. It is developed through the exercise of democratic and participatory management and health practices, in the form of teamwork, directed at populations in well-defined territories, for which it assumes health responsibility. 12
Brasil Sorridente - National Policy for Oral Health is the federal government program that aims to guarantee actions to promote, prevent and recover the oral health of the Brazilian population, Brasil Sorridente brings together a series of actions to expand access to dental treatment free, through the SUS.
Worker's health
Based on the aforementioned history, the health care model for workers in the SUS and adopted in the construction of the Integral Care Network for Workers' Health (RENAST), it is licit that health services for workers, based on organized social movements both in Dentistry and in other branches of Medicine, they offered little impact of oral disorders on the general health and quality of daily life of the worker.
In an attempt to reverse this situation, Reference Centers for Worker's Health (Cerest) were created, which promote actions to improve working conditions and workers' quality of life through prevention and surveillance. There are two types of Cerest: state and regional.
It is up to Cerest to promote the integration of the SUS health service network, as well as its surveillance and management, in the incorporation of Occupational Health in its routine activities. Its attributions include supporting more complex investigations, advising on the implementation of technical cooperation agreements, subsidizing the formulation of public policies, strengthening the articulation between basic, medium and high complexity care to identify and respond to accidents and work-related injuries, in especially, but not exclusively, those contained in the list of work-related or compulsory notifiable diseases.13