Oferta de prótese dentária no brasil: uma análise a partir dos dados do sistema de informação em saúde para a atenção básica

Abstract

Tooth loss remains common in the Brazilian population, with a higher prevalence among adults and the elderly, negatively impacting quality of life, self-esteem, masticatory function, among other aspects. In this context, prosthetic rehabilitation stands out as a necessary service within public oral health care, considering that a portion of the population lacks the financial means to afford treatment. This ecological study aimed to describe the outpatient production of dental prostheses by Primary Health Care (PHC) oral health services in Brazil in 2023, across the 5,570 Brazilian municipalities. It also sought to assess the annual rates of dental prosthesis installation among adults and the elderly in the same year, as well as compare and investigate the association between these two indicators and sociodemographic characteristics: population size and Social Vulnerability Index (SVI), and aspects related to oral health services: presence/number of Dental Specialty Centers (CEO), Regional Dental Prosthesis Laboratories (LRPD), and coverage of Oral Health Teams (eSB) in PHC. The data were publicly available and extracted from SISAB. Municipalities were classified as having or not having prosthesis production based on the presence or absence of records of prosthesis installation. Prosthesis installation rates were calculated per 1,000 users in need of dental prostheses, separately for adults and the elderly. This was done by dividing the number of dental prosthesis installation procedures performed in each municipality in 2023 by the estimated number of users in need of prostheses in that same municipality and year. The denominator of the rate was estimated by applying the prevalence of prosthesis need from SB Brasil 2023 to the adult and elderly populations. Data on the adult (19–59 years) and elderly (>60 years) populations, oral health service coverage, and the number of CEOs and LRPDs were publicly obtained from the websites of IBGE, the e-Gestor platform, and the Secretariat of Primary Health Care. A total of 1,898 municipalities reported dental prosthesis production, with a higher proportion among those with more than 100,000 inhabitants, greater oral health coverage, and the presence of LRPDs. The average rate was 10.76 (±19.74) for adults and 26.89 (±41.05) for the elderly, with higher rates observed in municipalities with up to 20,000 inhabitants, without a CEO, and with low or medium social vulnerability. A negative correlation was observed with population size, SVI, and number of CEOs, and a positive correlation with the number of LRPDs and oral health coverage in PHC. Given this unequal scenario and the low production of prostheses in relation to demand, the importance of epidemiology in monitoring and evaluating oral health services in Primary Health Care (PHC) is reaffirmed, highlighting the relevance of MonitoraSB as a facilitating tool in this context. Then, the technical products developed can be replicated in the future throughout the national territory, supporting decision-making by Oral Health Teams (eSB) and PHC managers.