COVID-19 Pandemic impact on Brazil's Public Dental System

Abstract

The present study aimed to estimate the impact of the COVID-19 pandemic on dental care procedures in the Public Health System in Brazil. A retrospective, ecological study was carried out, comprising 5,564 Brazilian municipalities. The number of dental procedures (per 100,000 inhabitants) performed in the Brazilian Public Health System (SUS) was the outcome. The impact of the pandemic was estimated by comparing the rate of procedures for each month of 2020 with the rates observed in the equivalent months in 2019, considering the period from March to August. Regulatory legislation regarding restrictions on dental care, issued by the state governments of 27 Brazilian federative units, was used for mediation analysis. A 55% reduction was observed in March for all procedures (IRR = 0.45, 95%CI 0.39-0.51), while in the other months, the rate of reduction remained ≥ 88%. The biggest decrease was observed in collective preventive procedures (reduction ≥99%) between April and August. Procedures that were less likely to generate aerosols (tooth extraction and prosthetic) and emergencies showed the smallest reduction. The reduction was not mediated by the restrictions imposed by state governments (p>0.05). The impact of the COVID-19 pandemic was noteworthy in terms of the decrease in the number of dental procedures carried out in the Brazilian Public Dental Service. The lack of access, the delay of elective procedures and the lack of preventive collective procedures could result in an overburdened system, post-Pandemic.

Flipped classroom and the use of role-play in the COVID-19 pandemic

“…Recent data indicate that above 363 million individuals are infected and 5.6 million were dead due to COVID-19 3 . The first case of COVID-19 was confirmed in Brazil in February 2020 with significant growth in cases in the following months; therefore, Brazil became (and remains) one of the epicenters of the pandemic along with the United States of America 1,[4][5][6][7] .…”

Biosafety in Dental Health Care During the COVID-19 Pandemic: A Longitudinal Study

“…Since then, many private and public dental clinics have stopped or reduced the number of appointments due to scarce personal protective equipment (PPE) availability and adapted to the facilities and protocols [ 9 – 11 ], increasing the number of dental emergencies [ 12 ] and affecting dental education [ 13 , 14 ]. The changes suggested by health and professional agencies are significant.…”

Avaliação do conhecimento, conscientização, atitudes e perspectivas de pacientes sobre a COVID-19 e suas medidas de prevenção em consultórios odontológicos

“…Em 11 de março de 2020, a Organização Mundial da Saúde (OMS) decretou estado de pandemia (DOS SANTOS et al, 2021). Desde então, medidas rígidas visando o controle da transmissão da doença foram adotadas por diversos países como a paralisação total ou parcial do comércio, eventos, serviços (incluindo os de saúde), escolas, universidades, restrição da circulação de pessoas, distanciamento social, uso de máscaras faciais e incentivo à hábitos de higiene (CHISINI et al, 2021;DOS SANTOS et al, 2021;MAURAS et al, 2021;VARGA et al, 2021). Desta forma, a pandemia afetou diretamente a economia e as saúdes física e mental de milhares de pessoas (DOS SANTOS et al, 2021;LIU et al, 2020;VARGA et al, 2021).…”

“…Esses fatos levaram órgãos e autoridades de saúde, como a American Dental Association (ADA) e a OMS a recomendarem o adiamento dos procedimentos odontológicos eletivos (ALSAEGH et al, 2021), o que reduziu drasticamente o número de tratamentos odontológicos realizados todos em todo o mundo, causando um impacto negativo significativo na saúde de milhares de pessoas (CHISINI et al, 2021;DOS SANTOS et al, 2021;PETRESCU et al, 2020) e um impacto financeiro negativo para os cirurgiões dentistas (NOVAES et al, 2021).…”

“…No Brasil, em um estudo realizado por Dos Santos et al (2021), foi relatado uma redução de mais de 66% do número total de procedimentos odontológicos (considerando as ações preventivas, os cuidados orais primários e procedimentos em endodontia, cirurgia e periodontia) realizados através do Sistema Único de Saúde (SUS) durante os sete primeiros meses da pandemia quando comparado ao mesmo período do ano de 2019. Já outro estudo (CHISINI et al, 2021) que avaliou o número de procedimentos realizados pelo SUS de março à agosto de 2020, encontrou números ainda mais significativos em que, em alguns meses, a queda foi superior à 88% e, quando considerou-se apenas os procedimentos preventivos coletivos, a redução chegou a 99%.…”