Trends in Socioeconomic Inequalities in the Distribution of Dental Caries Among Brazilian Adolescents, 2003-2023.

OBJECTIVE

Analyze trends in socioeconomic inequalities in the distribution of dental caries among adolescents in the years 2003, 2010, and 2023.

METHODS

Longitudinal observational study using data from national oral health surveys. The Decayed, Missing and Filled Teeth (DMFT) index and the number of decayed teeth were analyzed, stratified by income and education. The analyses accounted for the complex sampling design and included measures of absolute inequality (Slope Index of Inequality - SII) and relative inequality (Relative Index of Inequality - RII). Statistical significance was assessed at the 95% confidence level (p < 0.05).

RESULTS

A global reduction in DMFT (Decayed, Missing, and Filled Teeth) and the number of decayed teeth was observed across all socioeconomic strata throughout the period, indicating a general improvement in oral health conditions. However, marked inequalities persisted between groups, maintaining the social gradient, in which adolescents with lower income and education levels presented worse indicators. The SII (Social Income Index) indicated stability in the absolute differences between the social extremes, while the RII (Inequality Index) showed variations over time, suggesting proportional changes in inequalities. For DMFT, an increase in inequalities was observed according to education level and a slight reduction in relation to income; for missing teeth, there was a reduction in inequalities in the most recent years.

CONCLUSION

Despite the overall improvement in caries indicators, socioeconomic inequalities in oral health among adolescents persist, reflecting structural social determinants. The findings reinforce the need for public policies aimed at reducing inequities and promoting equity in oral health.