Evolução dos serviços ortodônticos no âmbito do Sistema Único de Saúde: uma análise temporal

Abstract

Although malocclusions represent the third most prevalent condition in oral health, Orthodontics was not included in the set of minimum specialties to be made available by specialty dental centers, being performed optionally only in some municipalities. The objective was to analyze evolution of offer of orthodontic procedures by the Unified Health System (SUS) from 2011 to 2022. This is a cross-sectional observational study of temporal trends on the amount and municipalities that offer orthodontic procedures. The report of the data of this article followed the recommendations of the Reporting of Studies Conducted using Observational Routinely Collected Data (RECORD). Secondary data from 2011 to 2022 were collected from Department of Informatics of the Unified Health System (DATASUS). Orthodontic procedures were organized by year, region, state and municipality. Descriptive analyzes, qualitative analysis of the distribution of municipalities offering orthodontic procedures and Friedman and Durbin Conover tests were carried out with the production of 212 Brazilian municipalities. It was observed that the most municipalities that offer orthodontic services (n=132; 65.67%) have already performed these procedures prior to the formal inclusion of Orthodontics in the SUS. Only the Northeast region showing a consistent expansion of municipalities offering orthodontics procedure in the analyzed period. Statistically increase in the number of orthodontic procedures were observed from 2012 to 2015, characterizing an initial expansion of supply. Significant differences were not observed from 2016 to 2019. Large and statistically significant variations were observed in the number of procedures offered between the years 2020 and 2022, influenced by the COVID-19 Pandemic. The inclusion of Orthodontics in the public health service did not represent a consistent expansion of the specialty among Brazilian municipalities, which may be related to the lack of incentives for this expansion. On the other hand, the first years analyzed that there was an increase in the number of procedures performed, which stabilized in the following years