Evolution of socioeconomic inequalities in oral health and use of dental services in adult population of Brazil between 2013 and 2019.

The Brazilian National Oral Health Policy has increased access to dental services for the Brazilian population. However, it is not clear whether there has been a reduction in oral health inequalities in the country. The aim of the study was to investigate the evolution of socioeconomic inequalities in oral health, the use of oral hygiene products, and the use of dental services in the adult population of Brazil between 2013 and 2019. Data from the Brazilian National Health Survey conducted in 2013 (n = 60,202) and 2019 (n = 88,531) were used to calculate the slope index of inequality (SII) and relative index of inequality (RII) in terms of schooling and family income per capita. The dependent variables were the use of a toothbrush, toothpaste, and dental floss, functional dentition, use of dental services at least once in life, use of dental services in the previous year, and use of dental services for preventive care. Inequalities in the use of oral hygiene products and the use of dental services reduced between 2013 to 2019. However, functional dentition maintained the same levels of inequality in terms of schooling (RII = 1.6) and income (RII = 1.3). Schooling inequalities in the use of preventive dental care increased (SII = 33.3 in 2013, SII = 38.9 in 2019). This study underscores the need to reorient the Brazilian National Oral Health Policy in order to reduce tooth loss and improve the use of dental services for preventive care in the most vulnerable groups. Despite improvements in the use of dental services and oral hygiene products, socioeconomic inequalities in oral health persist in Brazil.