Abstract in English:

Abstract This study analyzes the methodological aspects of the SB Brasil epidemiological surveys conducted in 2003, 2010, and 2023. The sample plan, fieldwork, sampling process, investigated variables, and operational aspects were examined based on technical documents and relevant publications. All three surveys adopted complex, probabilistic cluster sampling, with different study domains and sample sizes across editions. Data collection was conducted by SUS workers in all three editions, and Community Health Agents (ACS) were included as data collector in 2023. In this edition, the listing process occurred in a separate phase before the interview and examination, in two stages, to update the address list and identify eligible residents. Data collection included oral examinations and household interviews. The health conditions and oral health indices, as well as the criteria for defining the assessed conditions for each age group, remained similar across surveys. SB Brasil 2023 introduced, for the first time, the evaluation of the clinical consequences of untreated dental caries and the intervention urgency. There was an expansion of demographic and socioeconomic variables and subjective aspects of oral health over the editions. Increasing incorporation of technologies for data recording was observed, with automation of the sample selection process and report generation to support fieldwork monitoring. These changes reflect a continuous commitment to producing high-quality data, essential for supporting public policies and strengthening oral health surveillance in Brazil.

Abstract in English:

Abstract This methodological study presents the development and implementation of technological tools for the online training and calibration of dentists participating in the SB Brasil 2023 survey, using the Moodle® platform. The training and in-lux calibration process employed 10 and 25 sets of photographs, respectively. Conditions including dental crown status (dmft and DMFT indexes), caries consequences (pufa/PUFA index), malocclusion (canine relation, overjet, overbite, posterior crossbite, and Dental Aesthetic Index), and dental trauma were evaluated, based on WHO or SB Brasil 2010 criteria. Software was developed to record codes, automated calculations of agreement coefficients (overall percentage, score-specific, and simple and weighted kappa), and generate reports. Examiners were allowed to repeat calibration attempts until they achieved a minimum agreement (Kappa ≥ 0.61). In total, 1,513 examiners used the software, and 728 successfully completed the calibration with substantial or higher agreement across all conditions/indexes. Individual reports described discrepancies and monitored attempts. Occlusal conditions had the lowest percentages of almost perfect agreement and required more attempts to achieve calibration. The technological tools implemented in SB Brasil 2023 enabled online training and calibration, promoting consistency among examiners for fieldwork. These findings demonstrate the feasibility of remote strategies for calibration in epidemiological surveys, particularly in scenarios involving multiple geographically distributed examiners, with potential applications in other contexts and health areas.

Abstract in English:

Abstract This study aimed to compare caries experience, prevalence of caries-free and untreated caries in 12-year-old adolescents, based on data from the national epidemiological surveys of 2003, 2010, and 2023, in Brazil and its regions, and to estimate the clinical consequences of untreated caries in 2023. A probabilistic cluster sample obtained from the three surveys was analyzed. The oral examinations for caries followed the recommendations of the World Health Organization. High caries experience was identified using the Significant Caries Index (SiC). Clinical consequences of untreated caries were measured using the PUFA index. A hypothesis test was conducted to verify differences in the means of DMFT and components, SiC, DMFT=0, and decayed teeth ≥ 1 among the surveys of 2003, 2010, and 2023. The analysis of data from 34,529 (2003), 7,328 (2010), and 6,704 (2023) adolescents revealed a significant reduction in DMFT from 2.47 (2003) and 2.07 (2010) to 1.67 (2023), and for the SiC group the reduction was from 6.30 (2010) to 5.90 (2023). A significant increase in the prevalence of caries-free was observed, from 34.64% (2003) and 43.49% (2010) to 49.88% (2023), and a significant reduction in the prevalence of adolescents with untreated caries from 48.47% (2003) to 36.85% (2023). Adolescents had on average 0.14 teeth with clinical consequences of untreated caries, with pulp involvement being the most frequent (80.02%), and 8.71% had PUFA≥1. Although 12-year-old adolescents showed a decrease in caries experience, the SiC group, untreated caries, and its clinical consequences represent sociodemographic inequities that need to be addressed.

Abstract in English:

Abstract This cross-sectional study investigated the demand for and use of dental services, use of prosthesis, self-perception and clinical evaluation of the need for dental treatment and prostheses in adults aged 35 to 44 years participating in SB Brasil 2023. Demographic and contextual variables were analyzed, as well as clinical variables and self-perception of oral health (treatment and prosthesis). Statistical analysis was conducted using SPSS Statistics 23.0 software. The results showed that the majority of adults used dental services in the past year, mainly in the private and public sectors. Among public service users, 62.3% were actually attended to. The need for prostheses was identified in 49.6% of individuals who do not use prostheses and in 77.7% of those who already use them. It was observed that 86.6% of individuals who self-assessed their need for prosthesis were also clinically evaluated as needing one. Regarding dental treatment, this evaluation coincided in 65.6% of individuals. Disparities in access to and utilization of dental services were identified, as well as a high demand for prosthetic care and rehabilitation. These results emphasize the need for public policies that expand access to and improve the quality of dental services in adult healthcare in Brazil. Furthermore, they suggest that promoting self-perception could be an effective strategy to improve planning and adherence to oral health care.

Abstract in English:

Abstract This study compared the experience of dental caries and the prevalence of edentulism in 2003, 2010, and 2023 for individuals aged 65 to 74 in Brazil by region and according to self-declared race/skin color and years of schooling. A probabilistic cluster sample obtained from three national oral health surveys was analyzed. Information from oral health examinations for dental caries, according to the World Health Organization, common to three surveys, were used. The statistical significance of differences between estimates from each survey was evaluated for a linear combination of coefficients after mean or proportion estimation command by subpopulations and two-sided t-tests. Poisson and logistic regression models were employed to estimate changes between surveys while controlling for sociodemographic characteristics. The sampling design and sample weight were considered for the estimates. The analysis of data from 5,349 (2003), 7,509 (2010), and 9,745 (2023) individuals revealed a significant reduction in the DMFT index from 27.60 (2003) and 27.53 (2010) to 23.55 (2023) and in the prevalence of edentulism from 53.34% (2003) and 53.38% (2010) to 36.32% (2023). The number of missing teeth decreased by 14.46% between 2023 and 2010, with the greatest variation among white individuals and those with higher educational levels. The number of filled teeth increased. Adjusted regression models confirmed significant reductions in the DMFT index and the prevalence of edentulism between 2023 and 2003. The elderly Brazilian population is retaining more natural teeth. However, reductions in tooth loss were unequal, occurring primarily among white individuals and those with higher educational levels.

Abstract in English:

Abstract The oral health surveys conducted in Brazil since the 1980s, aligned with the guidelines of the National Oral Health Policy, have been essential for epidemiological surveillance. Over the surveys, variations in the applied sampling plans have occurred, including changes in the study domains. In SB Brasil 2023, an effort was made to meet the demands of state managers by expanding the domains including Federative Units and capitals. This study presents the sampling plan and assesses the precision of dmft and DMFT estimates for the defined domains. The sampling process was stratified (capitals and interior of the Federative Units) and involved a two-stage cluster design (census tract and households) for the age groups 15–19, 35–44, and 65–74 years, while a single-stage design was used for the ages of 5 and 12 years. The planned sample size was 250 (for ages 5 and 12) or 300 (for the other age groups) in the capitals, with an additional 100 interviews in the interior to obtain estimates for the Federative Units. The number of census tracts in each stratum was determined to achieve 250 interviews for the ages of 5 or 12 years. During the data analysis phase, base weights were adjusted through post-stratification based on sex, age, and education level, using data from the 2022 Continuous National Household Sample Survey, aiming to minimize selection and response biases. The dmft and DMFT estimates were evaluated using the coefficient of variation. Most estimates were precise, both for the capitals and for the Federative Units, with greater precision in the capitals.

Abstract in English:

Abstract This study investigated the social inequities related to dental caries, clinical consequences of untreated caries, and the urgency to treat five-year-old children in Brazil. It is a cross-sectional study that used data from SB Brasil 2023 (n = 7198). The dmft index was used to assess dental caries, the pufa index to assess the pulp consequences of untreated caries lesions, and the need for treatment was identified. It included demographic and context variables: sex, color/race, enrollment in social programs, access to water in the household, and use of dental services. Logistic regression models for complex samples were used to estimate gross and adjusted odds ratio (OR), and confidence intervals (95%CI). The prevalence of early childhood caries (ECC) was 46.83%, with an average of 2.14 affected teeth, and 41.18% had untreated caries lesions. Non-white children and those enrolled in social programs had higher chances of having dental caries. The clinical consequences were associated with non-white children and with the last use of dental services being more than 3 years ago. Mothers with higher levels of education and the presence of piped water in the household were protective factors. This study highlights the high prevalence and inequities related to ECC in Brazil. Non-white children, beneficiaries of social programs, and those with limited use of dental services were more vulnerable to caries, its clinical consequences, and the urgency of immediate treatment. These results reinforce the importance of public policies to reduce inequalities and expand access to preventive dental care.

Abstract in English:

Abstract This study aimed to compare the findings of the SB Brasil 2003, 2010, and 2023 surveys and analyze the evolution of caries experience among Brazilian adolescents (aged 15–19 years). A total of 16,832 adolescents were evaluated in 2003, 5,445 in 2010, and 8,054 in 2023. Although the 2010 sample was numerically smaller, all surveys maintained representativeness for Brazil, its regions, and state capitals, following national epidemiological sampling criteria. The DMFT index (Decayed, Missing, and Filled Teeth) and its components were analyzed at the national, regional, and state capital levels, considering socioeconomic and regional disparities. A significant reduction in the mean DMFT index was observed, from 5.51 (2003) to 4.25 (2010) and 3.41 (2023), with more pronounced declines in the Northeast and South regions. The decayed component showed a decrease between 2003 and 2023, while the filled teeth without decay component consistently decreased. Despite these improvements, regional inequalities persist, with the North and Central-West regions reporting higher caries rates and lower access to dental care. These findings highlight notable advancements in adolescent oral health in Brazil, particularly regarding the reduction in caries experience across some regions. However, persistent disparities underscore the need for targeted public health policies to ensure more equitable access to oral healthcare.