Exodontia de dentes permanentes na atenção primária à saúde no Brasil: influência de fatores socioeconômicos e relacionados ao serviço de saúde bucal

Abstract

It is essential to understand how social determinants reflect on the conduct of the type of dental treatment offered to the population. This ecological study aimed to investigate the correlation between socioeconomic and factors related to the health network and the proportion of permanent tooth extractions performed in primary health care (PHC) in Brazil. The proportion of permanent tooth extractions performed by PHC oral health teams (OHT) in each state in 2024 was calculated based on data from the Health Information System for Primary Care (SISAB). The socioeconomic variables (human development index [HDI], Gini index, per capita income, illiteracy rate, and population) were obtained from the Brazilian Institute of Geography and Statistics website. The variables related to the health network (average number of Basic Health Units [BHU], average number of OHT in PHC, and average population coverage per OHT in PHC) of each state were obtained from the e-Gestor AB website. Data were analyzed using Spearman's correlation test (α=5%). The proportion of permanent tooth extractions varied between 4.3% and 20.2% among the states. One-third of Brazilian states met the parameter recommended by the Ministry of Health (≤8%). There were positive, moderate, and statistically significant correlations between the proportion of permanent tooth extractions in PHC and the Gini index (r=0.52), the illiteracy rate (r=0.62), and the population coverage by PHC OHT (r=0.46). The proportion of tooth extractions was negatively correlated with HDI (r= -0.58) and per capita income (r = -0.58). It is concluded that higher proportions of tooth extractions were found with the increase in the Gini index, the illiteracy rate, the population coverage by OHT AB, as well as with the reduction of the HDI, per capita income and population of the Brazilian states.