Trends in the use of dental prostheses among adults and the elderly and the effects of their provision in the Brazilian health system 2003-2023.

OBJECTIVE

This study analyzed trends in the use of dental prostheses among adults and older adults and their availability in the Unified Health System (SUS) in Brazil between 2003 and 2023.

METHODS

Quasi-experimental ecological observational study for impact evaluation using a Difference-in-Differences (DiD) model. The temporal variation was compared between municipalities that implemented Dental Prosthesis Laboratories (LPD) (intervention) and those that did not (counterfactual). Data from 43 municipalities participating in all SB Brasil (Brazil Oral Health) epidemiological surveys from 2003, 2010, and 2023 were used. The outcome variables were the increased use of complete dentures (CD), removable partial dentures (RPD), and fixed dentures in adults (35-44 years old) and older adults (65-74 years old) in these municipalities.

RESULTS

The presence of LPD between 2003 and 2010 was associated with a 311.96% increase in the supply of prostheses (p=0.032), but it remained stable between 2010 and 2023. Changes in government probably impacted the supply of prostheses in these municipalities. The presence of LPD in the period 2003-2010 and having an Dental Specialty Center (CEO) between 2010 and 2023 increased the use of CD among adults by 6.94% (p=0.012) and 10.5% (p=0.032). Among older adults, having LPD increased the use of RPD by 12.42% (p=0.002), and being in a municipality with a CEO increased the use of CD by 12.05% (p=0.05) between 2003 and 2010.

CONCLUSION

The LPD supply had a residual effect. The lower tooth loss may explain the reduced use of dentures in adults and the increased use of RPD in older adults. Future analyses are suggested regarding coverage, access, and different contexts.