Oferta de procedimentos ortodônticos nos serviços públicos de saúde no Brasil: estudo ecológico

Abstract

Introduction: Malocclusions represent the third major oral health disease, impacting quality of life and social integration of individuals. Face this epidemiological reality, the Unified Health System has incorporated orthodontic procedures into its range of services, but it distribution of these orthodontic services is widely dispersed and heterogeneous across the national territory. Objective: To analyze correlation of orthodontic production offered by public health services with social and healthcare indicators in Brazilian municipalities. Methodology: We developed ecological observational study conducted with secondary data from the Public Domain reported to Ministry of Health from 2011 to 2022. The data were tabulated in a Microsoft Excel™ 2010 spreadsheet (Microsoft™ Ltd., Washington, USA) and imported into the Jamovi® software for statistical analysis. Descriptive analysis was performed, and after checking for normality assumptions, the Fisher's Exact Test was applied. Results: Data from 212 municipalities showed that access to orthodontic appliances does not show an increasing trend and that supply is not very constant among Brazilian regions. Regarding correlations with care indicators, Space Maintainer and Removable Appliance (in the last two triennium analyzed) showed an inversely proportional correlation with coverage of Primary Health Care and Oral Health. Regarding the social indicators of municipalities, employment, income, and HDI-M showed the highest volume of directly proportional correlations. Conclusion: The supply of orthodontic procedures in public services was irregular across Brazilian regions, does not indicate a clear upward trend and, due to correlations with social indicators, may indicate inequities in access to these procedures.