Physical Activity and Untreated Dental Caries in Brazil: Implications for Population-Based Caries Risk Assessment

Background/Objectives: Oral diseases are a major public health challenge and share behavioral and socioeconomic determinants with other noncommunicable diseases. Although physical activity has been proposed as one of these shared determinants, evidence at the population level remains limited. This study investigated the association between physical activity and oral health indicators using nationwide Brazilian surveillance data. Methods: An ecological study was conducted using aggregated data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) and the Brazilian National Oral Health Survey (SB Brasil) (2022-2023). Physical activity participation and weekly volume were evaluated against untreated dental caries, toothache, pain intensity, tooth loss, and the Decayed, Missing, and Filled Teeth (DMFT) index. Weighted multivariable linear regression models with heteroskedasticity-consistent standard errors were applied. Results: The analysis included 28,707 VIGITEL participants and 14,753 SB Brasil observations. After adjustment, physical activity participation was inversely associated with untreated dental caries, whereas weekly physical activity volume showed no association with any oral health outcome. No significant associations were observed for tooth loss, dental pain, pain intensity, or the DMFT index. Conclusions: Higher population-level participation in physical activity was associated with a lower prevalence of untreated dental caries but not with other oral health indicators. These findings may suggest that physical activity and oral health share common behavioral and social determinants, supporting integrated public health strategies targeting upstream risk factors.