Inequalities oral health between beneficiaries and non-beneficiaries of the Bolsa Família Program in Brazil: evidence from SB Brasil 2023.

OBJECTIVE

To investigate inequalities in oral health between beneficiaries and non-beneficiaries of the Bolsa Família Program (PBF) in Brazil.

METHODS

This was a cross-sectional household study using data from the 2023 National Oral Health Survey (SB Brasil). Clinical indicators (caries, tooth loss, need for treatment and prosthesis) and subjective indicators (self-perception and dental pain) were evaluated. Associations between beneficiary status and outcomes were estimated using Poisson regression and multinomial logistic regression adjusted for sex, skin color, and dental visit in the last year.

RESULTS

Beneficiaries reported worse self-perception of oral health (PR 1.87; 95%CI 1.19-2.94 to PR 2.30; 95%CI 1.48-2.28) and a higher prevalence of caries, pain, and need for treatment. 12-year-old children reported more dental pain (PR 1.47; 95%CI 1.10-1.95). In adolescents, the greatest inequities occurred in caries severity (PR 2.03; 95%CI 1.45-2.83), need for urgent care (PR 2.29; 95%CI 1.54-3.39), and partial dentures (PR 2.66; 95%CI 1.65-4.29). Among adults, the need for partial (OR 2.11; 95%CI 1.56-2.85) and total (OR 3.38; 95%CI 1.65-3.42) prostheses was more frequent, a pattern that was maintained in the elderly (OR 1.61; 95%CI 1.05-2.47 and OR 2.06; 95%CI 1.36-3.13).

CONCLUSION

Significant inequalities in oral health are observed between beneficiaries and non-beneficiaries of the Bolsa Família Program. Overcoming these inequities requires integration between income transfer policies, primary care, and specialized dental services, guided by the principles of equity and social justice.