Faculty of Dentistry, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
Public Health School, Universidade de São Paulo - São Paulo (SP), Brazil.
Rev Bras Epidemiol. 2021 May 26;24:e210028. doi: 10.1590/1980-549720210028. eCollection 2021.
This study investigated the impact of the COVID-19 pandemic on the provision of dental care procedures performed by the Brazilian Unified Health System (SUS) nationally and by regions. Considering that the most underprivileged population disproportionately suffers with the reduction in dental care provision, the study hypothesis suggests the presence of a syndemic nature.
The SUS Outpatient Information System (SIA-SUS) was assessed to gather data on dental care activities and procedures performed between April and July 2018, 2019, and 2020 by dentists registered in the SUS. The 30 most frequent activities and procedures performed by dentists were selected and classified into three categories (urgent dental care, nonemergency dental care, and case-dependent urgency procedures), based on the guidance for dental care during the pandemic published by the American Dental Association.
Results demonstrated a reduction in the provision of dental care of all categories during the pandemic. Urgency dental consultations and procedures in primary and specialized dental care services decreased by 42.5 and 44.1%, respectively, between 2020 and 2019. Non-urgent procedures decreased by 92.3%. Although decreases in dental care activities and procedures were reported in all Brazilian regions, the largest relative decreases in urgent procedures - that should have been maintained during the pandemic - occurred in the North and Northeast regions, which are the poorest regions of the country.
These results suggest that the COVID-19 pandemic has a syndemic behavior. Further investigation into the pandemic-syndemic impacts on oral disease burden is necessary.
本研究旨在调查 COVID-19 大流行对巴西全民健康体系（SUS）全国范围内以及各地区所提供的牙科护理服务的影响。考虑到最贫困人群不成比例地受到牙科护理服务减少的影响，本研究假设存在一种综合征性质。
评估 SUS 门诊信息系统（SIA-SUS），以收集 2018 年 4 月至 7 月、2019 年和 2020 年期间在 SUS 注册的牙医进行的牙科护理活动和程序的数据。选择了 30 种最常见的牙医活动和程序，并根据美国牙科协会发布的大流行期间牙科护理指南将其分为三类（紧急牙科护理、非紧急牙科护理和取决于病例的紧急程序）。
结果表明，大流行期间所有类别的牙科护理服务提供均有所减少。初级和专科牙科护理服务中的紧急牙科咨询和程序分别减少了 42.5%和 44.1%，而非紧急程序减少了 92.3%。尽管所有巴西地区都报告了牙科护理活动和程序的减少，但在该国最贫困的北部和东北部地区，紧急程序的相对减少幅度最大，这些程序本应在大流行期间得到维持。
这些结果表明 COVID-19 大流行具有综合征行为。需要进一步调查大流行对口腔疾病负担的综合征影响。
