O Projeto SBBrasil 2010 (SBB10) foi concebido como um levantamento epidemiológico em saúde bucal, de base nacional, dentro da estratégia de vigilância em saúde. O objetivo deste artigo é apresentar aspectos da metodologia do SBB10 que possam contribuir para ampliar e desenvolver conhecimentos na área de saúde. Com relação ao plano amostral, trata-se de uma pesquisa por conglomerados e com múltiplos estágios. Capitais e municípios do interior das cinco regiões brasileiras compõem os domínios da amostra, cujas unidades amostrais foram, respectivamente, setor censitário e domicílio para as capitais, e município, setor censitário e domicílio para o interior. Nas capitais foram sorteados 30 setores e, no interior de cada região, 30 municípios. A precisão considerou os domínios agrupados segundo o grau de densidade no total da população e a variabilidade interna dos índices. Foram avaliadas as condições de cárie dentária, doença periodontal, oclusopatias, fluorose, traumatismo dentário e edentulismo em cinco grupos etários (5, 12, 15 a 19, 35 a 44 e 65 a 74 anos).

O objetivo deste estudo foi investigar os fatores associados ao uso de serviços odontológicos públicos pela população adulta brasileira. Foram utilizados dados coletados junto a 13.356 adultos (35-44 anos), em um inquérito epidemiológico de saúde bucal, de abrangência nacional (Projeto SB-Brasil 2003). A análise dos dados baseou-se na regressão de Poisson, que produziu estimativas de Razões de Prevalências como medida de associação. A análise dos dados mostrou que o uso de serviços odontológicos públicos por adultos esteve associada com: sexo feminino, baixa escolaridade e renda, residência nas regiões Nordeste e Sul e em municípios de menor porte, queixas de dor de dente ou gengival, necessidades de prótese parcial e total, maior quantidade de dentes permanentes demandando tratamento, procura por serviço motivada por algum problema bucal e avaliação do tratamento recebido como regular. Esses resultados mostraram que a população atendida pelo serviço público era menos favorecida socioeconomicamente e apresentava maiores necessidades de tratamento. A grande necessidade acumulada reflete o histórico apartamento desse segmento populacional da atenção à saúde bucal em nosso país e coloca um grande desafio ao SUS, considerando o seu papel na redução das desigualdades e de provimento de acesso universal ao cuidado integral.

Studying the factors associated with the use of dental services can provide the necessary knowledge to understand the reasons why individuals seek out public healthcare services and the formulation of more appropriate public policies for the present-day reality.

This study compared the experience of dental caries and the prevalence of edentulism in 2003, 2010, and 2023 for individuals aged 65 to 74 in Brazil by region and according to self-declared race/skin color and years of schooling. A probabilistic cluster sample obtained from three national oral health surveys was analyzed. Information from oral health examinations for dental caries, according to the World Health Organization, common to three surveys, were used. The statistical significance of differences between estimates from each survey was evaluated for a linear combination of coefficients after mean or proportion estimation command by subpopulations and two-sided t-tests. Poisson and logistic regression models were employed to estimate changes between surveys while controlling for sociodemographic characteristics. The sampling design and sample weight were considered for the estimates. The analysis of data from 5,349 (2003), 7,509 (2010), and 9,745 (2023) individuals revealed a significant reduction in the DMFT index from 27.60 (2003) and 27.53 (2010) to 23.55 (2023) and in the prevalence of edentulism from 53.34% (2003) and 53.38% (2010) to 36.32% (2023). The number of missing teeth decreased by 14.46% between 2023 and 2010, with the greatest variation among white individuals and those with higher educational levels. The number of filled teeth increased. Adjusted regression models confirmed significant reductions in the DMFT index and the prevalence of edentulism between 2023 and 2003. The elderly Brazilian population is retaining more natural teeth. However, reductions in tooth loss were unequal, occurring primarily among white individuals and those with higher educational levels.

This methodological study presents the development and implementation of technological tools for the online training and calibration of dentists participating in the SB Brasil 2023 survey, using the Moodle® platform. The training and in-lux calibration process employed 10 and 25 sets of photographs, respectively. Conditions including dental crown status (dmft and DMFT indexes), caries consequences (pufa/PUFA index), malocclusion (canine relation, overjet, overbite, posterior crossbite, and Dental Aesthetic Index), and dental trauma were evaluated, based on WHO or SB Brasil 2010 criteria. Software was developed to record codes, automated calculations of agreement coefficients (overall percentage, score-specific, and simple and weighted kappa), and generate reports. Examiners were allowed to repeat calibration attempts until they achieved a minimum agreement (Kappa ≥ 0.61). In total, 1,513 examiners used the software, and 728 successfully completed the calibration with substantial or higher agreement across all conditions/indexes. Individual reports described discrepancies and monitored attempts. Occlusal conditions had the lowest percentages of almost perfect agreement and required more attempts to achieve calibration. The technological tools implemented in SB Brasil 2023 enabled online training and calibration, promoting consistency among examiners for fieldwork. These findings demonstrate the feasibility of remote strategies for calibration in epidemiological surveys, particularly in scenarios involving multiple geographically distributed examiners, with potential applications in other contexts and health areas.

It is important to assess context to explain inequalities in oral health, particularly with regard to the type of service used; thus, this study aimed to identify the social determinants of public dental service use by adults and to assess whether, beyond the level individual, existing inequalities are also expressed in the context in which individuals are embedded. A multilevel analysis with three levels of aggregation of variables was performed. The individual variables were derived from the database of the SB Minas Gerais project—a survey of oral health status of the population of Minas Gerais, a state of the Brazilian Southeast region. The variable at the neighborhood level came from the Census of 2010. The variables at the municipal level were obtained from available public databases relating to oral health services. At the municipal level, the Human Development Index (HDI) variable was chosen to represent quality of life in the municipalities. In the final model, the following individual variables were associated with greater use of public dental services: lower income (PR = 1.98, 95% CI = 1.53; 2.58), higher number of residents at home (PR = 1.37, 95% CI = 1.11; 1.68) and higher number of teeth requiring treatment (PR = 1.49, 95% CI = 1.20; 1.84). With regard to context variables, a poorer infrastructure (PR = 0.62, 95% CI = 0.40; 0.96) leads to a lower use of public services. The use of public services is associated with family income, how this income is divided in households, the need for treatment presented by the individual and the organization of the existing oral health service infrastructure in the municipality.