Objective: To estimate the prevalence of edentulism and functional dentition (FD) in Brazil and assess the magnitude of inequalities among older adults, according to education in 2003, 2010, and 2023.
Methods: This study used repeated cross-sectional data from individuals aged 65-74 years who participated in the national oral health surveys (SB Brasil) conducted in 2003, 2010, and 2023. Edentulism was defined as the loss of all permanent teeth, and FD as the presence of 21 or more teeth. Educational level was categorized as: 0 (no schooling), 1-4, 5-8, 9-11, and ≥ 12 years of study. Absolute and relative inequalities in edentulism and FD were assessed using the slope index of inequality (SII) and the relative index of inequality (RII) based on education. Generalized linear models (GLMs) were applied with a logarithmic link function to estimate RII and an identity link function to estimate SII, adjusting for sex and age. The concentration index (CI) was calculated as twice the area between the concentration curve and the line of equality. All analyses accounted for the complex sampling design and sample weights.
Results: The study included 5347 individuals in 2003, 7619 in 2010, and 9745 in 2023. The prevalence of edentulism was 53.33% in 2003 and 53.38% in 2010. In 2023, the prevalence significantly declined to 36.47%. FD prevalence was significantly higher in 2023 (23.94%) compared with 2003 (9.89%) and 2010 (11.45%). A worse oral health status was observed among individuals with lower educational levels. Indicators of absolute and relative inequality showed a significant increase in disparities, confirmed by the CI.
Conclusion: There was an increase in inequalities in edentulism and FD, indicating that the reduction in tooth loss was greater among socioeconomically advantaged groups.
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