Oral Health Policy in Brazil: changes and ruptures during the period 2018-2021

Abstract This study analyzed the implementation of Brazil’s National Oral Health Policy during the period 2018-2021, covering institutional actions, implementation of public dental services, results achieved, and federal funding. We conducted a retrospective descriptive study using documentary analysis and secondary data obtained from institutional websites, government information systems, and reports published by dental organizations. The findings show a significant reduction in funding between 2020 and 2021 and declining performance against indicators since 2018, such as coverage of first dental appointments and group supervised tooth brushing, which stood at 1.8% and 0.02%, respectively, in 2021. Federal funding dropped in 2018 and 2019 (8.45%), followed by an increase in 2020 (59.53%) and decrease in 2021 (-5.18%). The study period was marked by economic and political crises aggravated by the COVID-19 pandemic. This context influenced the functioning of health services in Brazil. There was a sharp reduction in performance against oral health indicators, while performance in primary health care and specialized care services remained stable.

摘要 本研究分析了2018-2021年巴西国家口腔卫生政策的实施情况，涵盖制度举措、公立牙科服务落地成效、已取得的成果以及联邦财政拨款情况。本研究采用回顾性描述性研究设计，通过档案文献分析方法，利用从机构网站、政府信息系统及牙科组织发布的报告中获取的二手数据开展研究。研究结果显示，2020年至2021年间拨款规模大幅缩减，且自2018年起各项口腔健康指标表现持续下滑：2021年首次牙科就诊覆盖率与集体监督刷牙覆盖率分别仅为1.8%和0.02%。联邦拨款在2018年和2019年下降8.45%，2020年增幅达59.53%，2021年又回落5.18%。本研究周期内，巴西同时遭遇经济与政治危机，叠加新冠疫情进一步加剧了局势的严峻性，这一背景对巴西卫生服务的正常运转造成了显著影响。期间口腔健康相关指标表现大幅滑坡，但基层医疗与专科医疗服务的运营则保持稳定。