The construction of an authentic, self-determined socioeconomic model, adapted to the regional cultural, geopolitical conditions, has not yet succeeded in Latin America. Very often we find in our populations a dependent attitude, a passivity towards social commitments, with lack of corporate interest for objective actions, thus allowing the rise and establishment of myths such as the technical superiority of other countries which confuses the democratizing options and breeds internal conflicts, not only in the profession itself but also between the profession and the interests of state and society.
A change in this situation began taking place in Brasilia by the end of the 70's. The potential for success of this initiative was originally based, as it is today, on a cooperative union formed between dental associations, governmental and social program directors, popular leadership and, eventually, the academic sector. The program sought to reform traditional processes and means which prevailed in Brasilia, FD at the time.
In spite of the country's political struggles and administrative crises, the democratic orientation and technical mastery embraced by this union were transformed into strategic organizational principles which were refined and assimilated by the following generation of leadership.
In this context of reshaping dental practice, we need to keep in mind the cases of successful national experience in the field of collective Odontology and emulate the lessons of important historical characters, who, in their time, had to fight against elitist interests of some academic and ruling sectors in Brazil.
The evolution of Brasilia's Odontology programs is marked by decisions and achievements, from which we point out the following:
· Demonopolization. Identified with the enlargement of intermediate level personnel: technicians with improved educational, clinical and preventive functions, and the transference of control and organizational know-how to other popular technical segments of the population associated to health actions;
· Equipment and materials technological simplification, at all levels of health care, according to the precepts of appropriate technology, including processes, techniques and methods of easy utilization and better assimilation;
· Privilege to educational, preventive actions directed to massive coverage;
· Community and nonprofessional participation. In an evolutionary process, it started as support to educational and preventive activities; right now, with the New Sanitary Reform, to the management and social control of public health projects;
· Institutional practice permeability. The practice of health care is open to experimentation, and critical participation of teachers in services;
· Election of 5 year guidelines for an unified Odontology care program. This takes place since 1982, in public seminars, with the participation of health, education and users' institutions, as well as popular representatives.
The main theoretical and methodological features of the current Brasilia Program are:
1. Local production, through the promotion of small (usually family) enterprises for production of simplified dental equipment;
2. Development of simple and inexpensive methods for prevention, based on the topical application of fluorides;
3. Universal protection of the school-aged population. Around 400,000 schoolchildren are protected with fluorides: through mouth rinses in rural areas, fluoridated gel in periurban poor communities and drinking water fluoridation in urban areas;
4. Local production of instructional materials for health education (theater, dolls, puppets, etc.), which serve to reach 100% of the children;
5. Provision of positions for intermediate level technicians (clinical, prevention, education) in sufficient numbers to maintain a 3:1 ratio technicians to dentists in the Primary Health Care Services;
6. Regionalization, decentralization and hierarchical organization of the assistance, with wide flexibility and permeability between levels and agencies;
7. In-service training for personnel of all levels, including the academicians. The School of Dentistry of the University of Brasilia is one of the few examples in Latin America that utilizes the public health services for the integrated clinical training of dental students;
8. Interagency cooperation for education and prevention activities;
9. Strong influence of public forums in policy making.