Persistent inequities in complete denture rehabilitation among older adults in Brazil between 2010 and 2023

To analyze the evolution of inequalities in the distribution of complete denture use and need among older adults in Brazil, considering socioeconomic factors in 2010 and 2023.

An analytical study was conducted using data from the Brazilian National Oral Health Surveys SB Brasil 2010 and 2023, with representative samples of individuals aged 65 to 74 years. The outcome integrated information on complete denture use and need, distinguishing need due to edentulism or replacement. Independent variables included sociodemographic and socioeconomic characteristics, with emphasis on the intersectional analysis of gender, race/skin color, and education. Descriptive analyses and the Concentration Index (CI) were performed to measure inequalities, accounting for the complex sampling design.

A slight increase was observed in the proportion of individuals who do not use and do not need dentures, particularly in the South (from 3.8%; 95% confidence interval - 95%CI 2.1-6.8 to 9.1%; 95%CI 5.7-14.3) and Southeast (from 2.3%; 95%CI 1.2-4.2 to 13.9%; 95%CI 9.1-20.7) regions. Nevertheless, around 90% of older adults still required complete dentures, either due to edentulism or replacement needs. Black men with low education concentrated the highest frequencies of need due to edentulism and showed the smallest reduction over the period. Concentration curves revealed the persistence of inequalities according to gender, race/skin color, education, and income.

Despite advances in public oral health policies, improvements in denture use and need occurred unevenly, favoring socially advantaged groups and maintaining gaps in oral health care among older adults in situations of greater vulnerability.