Advances and challenges in periodontal disease inequalities in Brazil: a population-based comparative analysis, 2010-2023.

OBJECTIVE

To analyze the prevalence of gingival bleeding, dental calculus, and shallow and deep periodontal pockets in the Brazilian National Oral Health Survey (SB Brasil) 2010 and 2023, and to examine their association with socioeconomic determinants.

METHODS

Cross-sectional comparative study based on secondary analysis of nationally representative weighted data from SB Brasil. The sample included adolescents (15-19 years), adults (35-44 years), and older adults (65-74 years). The outcomes were gingival bleeding, dental calculus, and shallow and deep periodontal pockets, analyzed as dichotomous variables (presence/absence). Independent variables were sex, income, schooling, and self-reported race/skin color. Multilevel logistic regression models estimated odds ratios and 95% confidence intervals.

RESULTS

Among adolescents, periodontal indicators remained stable between 2010 and 2023. Among adults, lower prevalences of dental calculus and shallow periodontal pockets were observed, with higher odds among men and black and brown individuals for some outcomes in 2023. Among older adults, the prevalence of gingival bleeding and dental calculus was higher in 2023, with higher odds among men and individuals with lower schooling and black race/skin color.

CONCLUSION

The comparison between SB Brasil 2010 and 2023 reveals heterogeneous changes in periodontal indicators, with stability among adolescents, lower prevalences of dental calculus and shallow periodontal pockets among adults, and higher prevalences of gingival bleeding and dental calculus among older adults in 2023. Differences associated with socioeconomic determinants remained evident, reinforcing the need for continuous monitoring and care strategies throughout life to address persistent inequalities in periodontal health.