EDITORIAL

National oral health survey in 2010 shows a major decrease in dental caries in Brazil

Angelo Giuseppe Roncalli

Projeto SB Brasil 2010, General Coordinator. Universidade Federal do Rio Grande do Norte, Natal, Brasil. roncalli@terra.com.br

In March 2010, Cadernos de Saúde Pública published an editorial on the National Oral Health Survey or SB Brazil 2010 Project, "intended as the principal oral health surveillance strategy in the National Oral Health Policy, in terms of producing primary oral disease data" (Cad Saúde Pública 2010; 26:428).

In December 2010, the Ministry of Health announced the first results of this population survey, with data collection concluded a month before in the State capitals plus an additional 150 municipalities in the country's five geographic regions. Oral health teams from the Unified National Health System (SUS) examined and interviewed approximately 38 thousand children, adolescents, adults, and elderly.

The most significant results include an important reduction in dental caries. At 12 years (the standard age used for international comparisons), the mean DMFT (the total number of decayed, missing, or filled teeth) was 2.1, or 25% less than in 2003 (2.8). For the component on untreated (decayed) teeth, the decrease was 29% (from 1.7 to 1.2). The proportion of "caries-free" children (DMFT = 0) increased from 31% in 2003 to 44% in 2010, indicating that in 12-year-old children there was a significant decrease in the prevalence and severity of oral disease, associated with greater access to restorative dental services.

This important downward trend in tooth decay and the increase in access to dental services also occurred in adolescents (15 to 19 years of age), and was even more striking in adults (35 to 44 years), in whom the mean DMFT in 2003 was 20.1, decreasing to 16.3 in 2010, or a 19% drop. Along with the important decrease in DMFT, there was a proportional increase in the "filled" component, from 4.2 to 7.1 (an increase of 69%), along with a decrease of nearly 50% in the "missing" component. These figures show that in addition to lower caries attack, Brazilian adults are achieving access to adequate dental care.

Although the results are encouraging at the national level, the survey also identified issues that deserve greater attention by government: (a) persistent regional differences in the prevalence and severity of caries, indicating the need for policies focused on equity of care; (b) there was only a small reduction in caries in the deciduous dentition (18%), with 80% of decayed deciduous teeth still untreated; (c) despite the decreasing need for dental prostheses in adolescents and adults, there is still a significant deficit in the elderly; and (d) the prevalence of occlusal disorders requiring treatment is 10% in Brazilian adolescents, suggesting the need to adjust the supply of orthodontic procedures in secondary care.

Thus, the SB Brazil 2010 Project, planned and implemented under the National Health System at the Federal, State, and Municipal levels and by Brazilian universities through Ministry of Health Collaborative Centers, has become a strategic resource for extending knowledge on oral diseases in the country, while making an inestimable contribution to the National Oral Health Policy and the establishment of an oral health model based on health surveillance.