Universidade do Vale do Taquari - Univates, Center of Biological Sciences and Health, Lajeado, RS, Brazil.
Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil.
Braz Oral Res. 2021 Jul 16;35:e082. doi: 10.1590/1807-3107bor-2021.vol35.0082. eCollection 2021.
The present study aimed to estimate the impact of the COVID-19 pandemic on dental care procedures in the Public Health System in Brazil. A retrospective, ecological study was carried out, comprising 5,564 Brazilian municipalities. The number of dental procedures (per 100,000 inhabitants) performed in the Brazilian Public Health System (SUS) was the outcome. The impact of the pandemic was estimated by comparing the rate of procedures for each month of 2020 with the rates observed in the equivalent months in 2019, considering the period from March to August. Regulatory legislation regarding restrictions on dental care, issued by the state governments of 27 Brazilian federative units, was used for mediation analysis. A 55% reduction was observed in March for all procedures (IRR = 0.45, 95%CI 0.39-0.51), while in the other months, the rate of reduction remained ≥ 88%. The biggest decrease was observed in collective preventive procedures (reduction ≥99%) between April and August. Procedures that were less likely to generate aerosols (tooth extraction and prosthetic) and emergencies showed the smallest reduction. The reduction was not mediated by the restrictions imposed by state governments (p>0.05). The impact of the COVID-19 pandemic was noteworthy in terms of the decrease in the number of dental procedures carried out in the Brazilian Public Dental Service. The lack of access, the delay of elective procedures and the lack of preventive collective procedures could result in an overburdened system, post-Pandemic.
本研究旨在评估 COVID-19 大流行对巴西公共卫生系统牙科护理程序的影响。进行了一项回顾性生态研究，包括 5564 个巴西城市。巴西公共卫生系统（SUS）中进行的牙科程序（每 10 万人）数量是结果。通过将 2020 年每个月的程序比率与 2019 年同期观察到的比率进行比较，考虑到 3 月至 8 月的时间段，来估计大流行的影响。使用来自 27 个巴西联邦单位的州政府发布的关于牙科护理限制的监管立法进行中介分析。所有程序的 3 月减少了 55%（IRR=0.45，95%CI 0.39-0.51），而在其他月份，减少率仍≥88%。在 4 月至 8 月期间，集体预防程序的减少幅度最大（减少≥99%）。不太可能产生气溶胶（拔牙和义齿）的程序和急诊显示出最小的减少。州政府实施的限制并没有起到中介作用（p>0.05）。COVID-19 大流行对巴西公共牙科服务中进行的牙科程序数量减少产生了重大影响。缺乏准入、选择性程序的延迟以及缺乏预防性集体程序可能会导致大流行后系统负担过重。
