Pandemic-related disruption and post-pandemic recovery of dental service production in Brazilian Primary Health Care, 2015-2025.

OBJECTIVE

To analyze changes in dental service production in Brazilian Primary Health Care from 2015 to 2025 and characterize pandemic-associated disruption and post-pandemic recovery by procedure type and Federative Unit.

METHODS

This ecological interrupted time-series study used secondary data on primary health care dental procedures recorded in the Brazilian Unified Health System. Six indicators were evaluated: scheduled consultations, health promotion and prevention activities, and surgical, endodontic, periodontal, and restorative procedures. Annual rates per 100,000 inhabitants were calculated. Three periods were defined: pre-pandemic (2015-2019), pandemic (2020-2021), and recovery (2022-2025). National percentage changes were calculated using selected annual rates, whereas the proportion of the pandemic-related decline recovered was calculated using period means. Interrupted time-series analyses were performed using segmented regression with Newey-West standard errors.

RESULTS

Dental service production declined during the pandemic across all indicators, and mean recovery-period levels remained below pre-pandemic means. The largest reductions between 2019 and 2021 occurred in health promotion and prevention activities (-79.6%), periodontal procedures (-62.5%), scheduled consultations (-58.8%), and surgical procedures (-53.8%). Recovery remained incomplete across all indicators, ranging from 7.6% for scheduled consultations to 68.8% for restorative procedures. Total procedure rates showed a significant pre-pandemic annual decline of 21.4% (95%CI=-24.9% to -17.7%), an immediate reduction of 56.1% in 2020 (95%CI=-71.4% to -32.6%), and a positive post-2020 annual change of 14.8% (95%CI=1.2% to 30.2%). Marked territorial heterogeneity was observed in both the magnitude of decline and the pattern of recovery.

CONCLUSION

Dental service production in Brazilian Primary Health Care declined substantially during the COVID-19 pandemic and recovered only partially during 2022-2025, with persistent territorial disparities in recorded service production.