Dental appointments in the primary health care setting for users with toothache: a longitudinal analysis

This study aimed to estimate the morbidity associated with toothache treated in the primary health care (PHC) setting, stratified by the population size of Brazilian municipalities, from 2018 to 2022. This longitudinal ecological study was based on public national data from routine public dental service utilization records within the Health Information System for Primary Care. These data were employed to compute the rate of dental appointments for users with toothache (per 1,000 users) within each municipality throughout 15 four-month periods (P1-2018 to P3-2022), classified by population size. We integrated the databases for population size, denominator, and numerators. A longitudinal data regression model was used to estimate the four-monthly variation before and after P2-2020. Records from 5,332 municipalities (95.72%) were analyzed. The average rate of dental appointments for users with toothache (per 1,000 users) ranged from 9.65 (P2-2020) to 27.24 (P1-2018). Throughout the period, larger municipalities showed the lowest rates. Before P2-2020, the average rate in municipalities with >100,000 inhabitants fell by an average of 20.56% every four months, higher than the 7.25% variation in municipalities with < 5,000 inhabitants. After P2-2020, the rate in municipalities with < 5,000 inhabitants rose by 2.27%, a value lower than the variation in larger municipalities. The rates of dental appointments for users with toothache in the PHC setting indicate the persistent severity of dental conditions among public health service users, with variations across different regions of the country. The COVID-19 pandemic has affected the rate of dental appointments for users with toothache, underscoring the need for dental services to enhance their adaptability and responsiveness to such crises.