ABSTRACT Objective: To assess the comprehension of dentists in Primary Health Care (PHC) regarding the interplay between obesity and periodontitis and evaluate the presence of practical approaches for managing these patients. Material and Methods: For this cross-sectional study, 187 general dental practitioners from different regions of Brazil were selected by convenience. A specific instrument was developed to assess the knowledge and practices of PHC dentists concerning this topic. The data underwent descriptive and analytical statistical analyses, followed by Poisson regression analysis with robust variance to test associations. Results: Regarding knowledge, most dentists have a limited understanding of the link between obesity and periodontitis, despite 43% recognizing the higher susceptibility of individuals with obesity to oral issues. About 20% of professionals considered their knowledge “adequate." Better knowledge was observed among dentists who worked only in the public sector, which has concluded some post-graduation (p<0.05). Regarding the professional's practical conduct, around 57% of the dentists do not diagnose obesity, and 64% of the professionals do not refer these patients to a nutritionist. Conclusion: The study's outcomes underscore the prevailing lack of awareness among this sampled group of dental practitioners concerning the association between obesity and periodontitis. Furthermore, it was observed that multidisciplinary treatment for obese patients within the realm of PHC is generally underperformed. Objective (PHC Methods crosssectional cross sectional study 18 convenience topic analyses associations Results 43 issues 20 adequate. adequate “adequate. sector postgraduation post graduation p<0.05. p005 p p<0.05 . 0 05 (p<0.05) professional s conduct 57 64 nutritionist Conclusion studys Furthermore underperformed 1 4 2 “adequate p00 p<0.0 (p<0.05 5 6 p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

ABSTRACT Objective: To evaluate the cost-effectiveness of single-tooth rehabilitation options with dental implants associated with a prosthetic crown (I+C) compared to a fixed partial denture (FPD). Material and Methods: A rapid review was carried out to identify the costs (expressed in US$) and effectiveness (expressed through success rate). Bibliographic searches retrieved 1,447 records, of which 19 studies of type randomized clinical trials were selected to collect cost and effectiveness data. Markov economic models were used to simulate hypothetical 15-year cohorts with 2000 patients using cost and effectiveness data from the rapid review under the perspective of private practice. Results: The average costs of I+C and FPD treatments were US$ 3,432.23 and US$ 3,322.52, respectively. The average effectiveness of I+C was 88.33%, with a mean follow-up time of 9.33 years, and FPD had an average yearly success rate of 82.14%, with a mean follow-up time of 11.89 years. The I+C treatment has an incremental cost-effectiveness ratio (RCEI) of US$ 170.88 compared to FPD. Conclusion: Both I+C and FPD rehabilitation options are cost-effective; I+C rehabilitation has a higher cost and greater effectiveness, being the recommended option if the patient with no contraindication. Objective costeffectiveness singletooth single tooth IC I C (I+C . (FPD) Methods expressed US rate. rate) 1447 1 447 1,44 records 15year year 15 200 practice Results 343223 3 432 23 3,432.2 332252 322 52 3,322.52 respectively 8833 88 33 88.33% followup follow up 933 9 9.3 years 8214 82 14 82.14% 1189 11 89 11.8 RCEI (RCEI 17088 170 170.8 Conclusion costeffective effective cost-effective contraindication (FPD 144 44 1,4 20 34322 43 2 3,432. 33225 32 5 3,322.5 883 8 88.33 93 9. 821 82.14 118 11. 1708 17 170. 4 1, 3432 3,432 3322 3,322. 88.3 82.1 343 3,43 332 3,322 88. 82. 34 3,4 3,32 3, 3,3

Aim This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures’ effectiveness to return clinical activities in the following months. Methods perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil. MarchAugust March August 2020 COVID19 COVID 19 COVID-1 SeptemberFebruary September February 2020/2021 20202021 2021 +64.2%, 642 +64.2% , 64 2 (+64.2%) 9235 9 235 9,23 so consequently 202 COVID1 1 COVID- 2020/202 2020202 +64.2 (+64.2% 923 23 9,2 20 2020/20 202020 +64. (+64.2 92 9, 2020/2 20202 +64 (+64. 2020/ +6 (+64 + (+6 (+ (

Abstract This analytical cross-sectional study aimed to analyze the access of patients with special needs (PSN) in Brazilian municipalities to hospital dental care of the Unified Health System (Sistema Único de Saúde - SUS), based on data from the Hospital Information System of the Unified Health System (Sistema de Informações Hospitalares do SUS- SIH/SUS - SIH), from 2010 to 2018. The Kolmogorov-Smirnov normality test was performed; the Poisson regression was used to verify factors associated with the variable total number of hospitalization authorizations with the main procedure of dental treatment for PSN (“Total de Autorizações de Internação Hospitalar” – AIH), the Spearman correlation test with a significance level of 5% was used to characterize the relationships between the Municipal Human Development Index per municipality - (Índice de Desenvolvimento Humano Municipal - HDI) and the Oral Health Coverage in the Family Health Strategy by municipality (Cobertura de saúde bucal na estratégia saúde da família por município - SBSF Coverage), and the relationship of the AIH with SBSF Coverage. A total of 127,691 procedures were performed, of which 71,517 (56%) were clinical procedures, such as restorations, endodontic treatments, supra and subgingival scaling, among others. Municipalities in the Midwest (PR=5.117) and Southeast (RP = 4.443) regions had more precedures than the others. A weak correlation was found between AIH and SBSF Coverage (r = -0.2, p < 0.001) and HDI and SBSF Coverage (r = -0.074, p < 0.001). Population size, region, health coverage, oral hygiene, and number of dentists in hospitals affected the availability of dental procedures in PSN. crosssectional cross sectional (PSN Sistema SUS, SUS , SUS) SIHSUS SIH SIH, SIH) 201 2018 KolmogorovSmirnov Kolmogorov Smirnov performed Total Hospitalar AIH, AIH) 5 Índice Cobertura Coverage, Coverage) 127691 127 691 127,69 71517 71 517 71,51 56% 56 (56% restorations treatments scaling others PR=5.117 PR5117 PR 117 (PR=5.117 RP 4.443 4443 4 443 r 0.2, 02 0 2 -0.2 0.001 0001 001 0.074, 0074 074 -0.074 0.001. . size region coverage hygiene 20 12769 12 69 127,6 7151 7 51 71,5 (56 PR=5.11 PR511 11 (PR=5.11 4.44 444 44 0.2 -0. 0.00 000 00 0.074 007 07 -0.07 1276 1 6 127, 715 71, (5 PR=5.1 PR51 (PR=5.1 4.4 0. -0 0.0 0.07 -0.0 ( PR=5. PR5 (PR=5. 4. PR=5 (PR=5 PR= (PR= (PR

ABSTRACT Objective: To measure the costs of preventive and therapeutic protocols of Photobiomodulation (PBM) for oral mucositis (OM) and their budgetary impact on Brazil’s Ministry of Health (BMH). Material and Methods: A partial economic analysis was performed to estimate the costs using a bottom-up approach from a social perspective. Monetary values were assigned in Brazilian reais (BRL). The costs of the preventive protocol were calculated for five, 30, and 33 consecutive PBM sessions, depending on the antineoplastic treatment instituted. The costs of the therapeutic protocol were calculated for 5 or 10 sessions. The annual financial and budgetary impact was calculated considering the groups of oncologic patients with a higher risk of development of OM, such as those with head and neck and hematological cancer and pediatric patients. Results: The cost of a PBM session was estimated at BRL 23.75. The financial impact of providing one preventive protocol per year for all oncologic patients would be BRL 14,282,680.00, 0.030% of the estimated budget for hospital and outpatient care of the BMH in 2022. The financial and budgetary impacts of providing one treatment for OM for all patients in one year would be BRL 2,225,630.31 (0.005%, most optimistic scenario) and BRL 4,451,355.63 (0.009%, most pessimistic scenario). Conclusion: The budgetary impact of implementing PBM protocols in the Brazilian Healthcare System is small, even in a pessimistic scenario. Objective (PBM (OM Brazils Brazil s BMH. . (BMH) Methods bottomup bottom up perspective BRL. (BRL) five 30 3 sessions instituted 1 Results 2375 23 75 23.75 1428268000 14 282 680 00 14,282,680.00 0030 0 030 0.030 2022 222563031 2 225 630 31 2,225,630.3 0.005%, 0005 005 (0.005% scenario 445135563 4 451 355 63 4,451,355.6 0.009%, 0009 009 (0.009% Conclusion small (BMH (BRL 237 7 23.7 142826800 28 68 14,282,680.0 003 03 0.03 202 22256303 22 2,225,630. 0.005% 000 (0.005 44513556 45 35 6 4,451,355. 0.009% (0.009 23. 14282680 14,282,680. 0.0 20 2225630 2,225,630 0.005 (0.00 4451355 4,451,355 0.009 1428268 14,282,680 0. 222563 2,225,63 0.00 (0.0 445135 4,451,35 142826 14,282,68 22256 2,225,6 (0. 44513 4,451,3 14282 14,282,6 2225 2,225, (0 4451 4,451, 1428 14,282, 222 2,225 ( 445 4,451 142 14,282 2,22 44 4,45 14,28 2,2 4,4 14,2 2, 4, 14,

RESUMO JUSTIFICATIVA E OBJETIVOS: A exodontia de terceiros molares pode acarretar efeitos indesejados, como dor, trismo e edema, sendo necessário ofertar uma terapia preemptiva para amenizá-los. Para tal, realizou-se uma avaliação econômica para analisar o custo-efetividade de fármacos preemptivos utilizados na exodontia de terceiros molares. MÉTODOS: Os custos foram obtidos a partir de uma pesquisa de mercado. As medidas de efetividade foram: limitação da distância interincisal e dor pós-operatória, sendo obtidas em ensaios clínicos randomizados da literatura. Para os dois modelos, uma simulação de Monte Carlo gerou uma coorte hipotética de mil indivíduos, considerando uma variação de 5% das estimativas. As terapias avaliadas foram: dexametasona 8 mg (DX8); metilprednisolona 40 mg (MP); diclofenaco 50 mg associado a tramadol 50 mg (DCTR); e dexametasona 4 mg associada a tramadol 50 mg (DXTR). RESULTADOS: As terapias com MP e DCTR foram dominadas em todos os cenários. Para redução da dor pós-operatória, o tratamento com DXTR apresentou o melhor custo-benefício, com ganho de benefício monetário líquido (NMB) de 31,10% comparado ao tratamento de menor custo (DX, R$ 1,76). Considerando a redução da limitação da distância interincisal, o fármaco DXTR apresentou maior custo-benefício em relação à DX8 (ganho de NMB = 18,25%), sendo uma opção de escolha junto a DX8. CONCLUSÃO: Na exodontia de terceiros molares, a administração preemptiva de dexametasona 4 mg associada com tramadol 50 mg é a opção de escolha, do ponto de vista de custo-efetividade, para reduzir a dor pós-operatória e limitação da distância interincisal após 48 horas. OBJETIVOS indesejados edema amenizálos. amenizálos amenizá los. los amenizá-los tal realizouse realizou se custoefetividade MÉTODOS mercado pósoperatória, pósoperatória pós operatória, operatória literatura modelos indivíduos 5 estimativas DX (DX8) (MP) (DCTR) DXTR. . (DXTR) RESULTADOS cenários custobenefício, custobenefício benefício, (NMB 3110 31 10 31,10 DX, (DX R 1,76. 176 1,76 1 76 1,76) 18,25%, 1825 18,25% , 18 25 18,25%) CONCLUSÃO custoefetividade, efetividade, horas (DX8 (MP (DCTR (DXTR 311 3 31,1 17 1,7 7 182 18,25 2 31, 1, 18,2 18,

ABSTRACT BACKGROUND AND OBJECTIVES: The extraction of third molars can lead to undesired effects such as pain, trismus, and edema, necessitating preemptive therapy to alleviate these effects. For this purpose, an economic evaluation was conducted to analyze the cost-effectiveness of preemptive drugs used in the extraction of third molars. METHODS: Costs were obtained from a market survey. Effectiveness measures were limitation of interincisal distance and postoperative pain, obtained from randomized clinical trials in the literature. For both models, a Monte Carlo simulation generated a hypothetical cohort of a thousand individuals, considering a 5% variation in estimates. The evaluated therapies were dexamethasone 8 mg (DX8); methylprednisolone 40 mg (MP); diclofenac 50 mg associated with tramadol 50 mg (DCTR); and dexamethasone 4mg associated with tramadol 50 mg (DXTR). RESULTS: MP and DCTR therapies were dominated in all scenarios. For the reduction of postoperative pain, DXTR treatment showed the best cost-benefit, with a net monetary benefit (NMB) gain of 31.10% compared to the lowest-cost treatment (DX, R$ 1.76). Considering the reduction in limitation of interincisal distance, DXTR medication presented higher cost-benefit compared to DX8 (NMB gain = 18.25%), being a preferred option alongside DX8. CONCLUSION: In the extraction of third molars, preemptive administration of dexamethasone 4mg associated with tramadol 50mg is the preferred cost-effective option to reduce postoperative pain and limitation of interincisal distance after 48 hours. OBJECTIVES trismus edema purpose costeffectiveness cost effectiveness METHODS survey literature models individuals 5 estimates DX (DX8) 4 (MP) (DCTR) DXTR. . (DXTR) RESULTS scenarios costbenefit, costbenefit benefit, NMB 3110 31 10 31.10 lowestcost lowest DX, (DX R 1.76. 176 1.76 1 76 1.76) 18.25%, 1825 18.25% , 18 25 18.25%) CONCLUSION costeffective effective hours (DX8 (MP (DCTR (DXTR 311 3 31.1 17 1.7 7 182 18.25 2 31. 1. 18.2 18.

ABSTRACT Objective: To analyze the impact of the COVID-19 pandemic on dentists’ income and to identify associated factors in one of the poorest Brazilian states. Material and Methods: A cross-sectional study including dentists who volunteered to answer an electronic questionnaire in Maranhão. Hierarchical multinomial logistic regression analyses were performed, estimating crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95%CI) (alpha=5%). Results: The COVID-19 pandemic impacted the professionals´ income negatively [55.44% (50.26-60.52%)] and also positively [6.9% (4.55-9.94%)]. The negative impact on income was greater among male dentists (OR=2.54; 95%CI: 1.16-5.53), over 30 years of age (OR=3.03; 95%CI: 1.34-6.87), with family income below two minimum wages (OR=4.63; 95%CI: 1.50-14.30), who worked in the continent instead of in the capital island (OR=2.21; 95%CI: 1.14-4.29) and in the private sector (OR=31.43; 95%CI: 11.59-85.22). Moreover, those who had been tested for COVID-19, with a negative result, had a 21.3-fold greater chance of having an increased household income when compared to those who had not been tested. Conclusion: The COVID-19 pandemic negatively impacted the dentists’ income in Maranhão, especially the older, males, with lower incomes, and who worked in the private sector, living far from the capital. The SUS played an important role in the social protection of dentists during the COVID-19 pandemic, mitigating the economic impacts on the public sector working class.

RESUMO A rede de atenção à Saúde Bucal (SB) se ampliou com a Política Nacional de Saúde Bucal, sendo os indicadores ferramentas para avaliar conquistas ou necessidade de mudanças. Este trabalho objetivou analisar indicadores de SB da Atenção Básica por tipo de organização das unidades de saúde em Recife, 2018. Trata-se de um estudo transversal, de natureza descritiva e analítica com base em dados secundários. Analisou-se a associação entre tipos de organização da Atenção Básica (Unidade de Saúde da Família - USF; Upinha e Unidade Básica Tradicional - UBT) e indicadores assistenciais de SB, através dos testes qui-quadrado e Kruskal-Wallis (p<0,05). A cobertura de primeira consulta odontológica e os procedimentos odontológicos per capita apresentaram mediana maior nas UBT, 31,8% (p=0,00) e 0,6 (p=0,127), respectivamente. A proporção de exodontia e procedimentos clínicos foi maior nas USF com mediana 8,2% (p=0,703). As USF foram as que realizaram o maior número de atividades coletivas de escovação dental supervisionada (45,3%, p=0,082) e aplicação de flúor (44,6%, p=0,174). Conclui-se que as UBT apresentaram melhores resultados nos indicadores relacionados ao acesso ao tratamento clínico e as USF realizaram mais ações coletivas de prevenção.

ABSTRACT The Oral Health care network (OH) has expanded with the National Oral Health Policy, and the indicators are tools to assess achievements or the need for changes. This study aimed to analyze the OH indicators of Primary Care Basic by health units organization type in Recife, 2018. This is a cross-sectional, quantitative, descriptive and analytical study, based on secondary data. The association between organization type of Primary Care (Family Health Unity/USF; Upinha and Traditional Basic Health Unit/UBT) and OH assistance indicators was analyzed using the chi-square and Kruskal-Wallis tests (p<0,05). The first dental appointment coverage and the average number of procedures per capita showed a higher median in the UBT, 31,8% (p=0,00) and 0,6 (p=0,127), respectively. The tooth extraction proportion was higher in the USF, with a median of 8,2% (p=0,703). The USF were the ones that performed the largest number of collective activities of supervised tooth brushing (45.3%, p=0.082) and fluoride application (44.6%, p=0.174). It is concluded that the UBT showed better results in the indicators related to access to clinical treatment and the USF performed more collective activities.

RESUMO OBJETIVO: Analisar o efeito da Política Nacional de Atenção Básica (PNAB) de 2017 no quantitativo de agentes comunitários de saúde, por equipe de atenção primária em saúde. MÉTODOS: Trata-se de um estudo transversal, descritivo e analítico, utilizando dados disponibilizados na plataforma e-Gestor da Atenção Básica, do Ministério da Saúde, sobre os 5.570 municípios brasileiros, entre outubro de 2017 e dezembro de 2019. A sobrevida do número de municípios que não reduziram o quantitativo de agentes comunitários de saúde foi analisada segundo a região do país, índice de desenvolvimento humano (IDH), índice de desigualdade de Gini e porte populacional. A Regressão de Cox foi utilizada para analisar os fatores associados à redução do número de ACS após um mês e, a partir de então, a cada três meses, até completarem os dois anos da publicação da portaria da PNAB 2017, considerando-se p < 0,05. CONCLUSÕES: Após dois anos, a maior redução foi observada em municípios das regiões Centro-Oeste e Sul, que apresentaram IDH alto, menos desiguais e com maior porte populacional. Municípios do Centro-Oeste (HR = 1,256) apresentaram maior chance de redução do número de ACS comparado à região Norte. Municípios com maior IDH (HR = 1,053) e maior porte populacional (HR = 1,186) também apresentaram maior chance de reduzir o número de agentes comunitários de saúde. Portanto, após a PNAB 2017, houve um aumento ao longo dos meses no número de municípios que reduziram a quantidade de agentes comunitários em saúde na atenção primária de saúde.

ABSTRACT OBJECTIVE: To analyze the effect of the 2017 Basic Primary Care Policy (PNAB) on the number of community health agents per primary health care team. METHODS: This is a cross-sectional, descriptive and analytical study using data available on the Ministry of Health platform called e-Gestor da Atenção Básica, about Brazil's 5,570 towns between October 2017 and December 2019. The survival of the number of towns that did not reduce the number of community health agents was analyzed according to region of the country, the Human Development Index (HDI), the Gini Inequality Index and population size. Cox regression was used to analyze the factors associated with a reduction in the number of CHAs after one month and, from then on, every three months until two years had passed since the publication of the 2017 PNAB Ordinance, considering p < 0.05. CONCLUSIONS: After two years, the greatest reduction was observed in towns in the Midwest and South regions, which presented a high HDI, lower inequality and larger populations. Towns in the Midwest (HR = 1.256) had a higher chance of reducing the number of CHAs compared to the North region. Towns with a higher HDI (HR = 1.053) and larger population size (HR = 1.186) were also more likely to reduc the number of community health agents. Therefore, after the 2017 PNA, the number of towns reducing the amount of community health workers in primary health care increased over the months

Resumo Analisou-se a resolutividade da atenção básica em saúde bucal nos municípios do estado da Paraíba, Brasil. Trata-se de um estudo transversal de abordagem indutiva, com procedimento comparativo e técnica de documentação indireta. O indicador de resolutividade (IR) constituiu da razão entre o número de tratamentos concluídos e primeiras consultas odontológicas programáticas dos municípios paraibanos (n = 223) entre 2011 e 2014, utilizando dados coletados da plataforma Datasus/TABNET. Foram consideradas variáveis explicativas: cobertura de primeira consulta odontoló gica programática (CPCOP), cobertura de equipes de atenção básica (CEAB), cobertura de equi pes de saúde bucal (CESB), cobertura de equipes de saúde da família (CESF), percentual de exodontia (PE), Produto Interno Bruto (PIB), Índice de Desenvolvimento Humano Municipal (IDHM) e coeficiente de Gini (CG). Os dados foram analisados por estatística descritiva e regressão múltipla binomial negativa (α = 0,05). As medianas do IR em 2011, 2012, 2013 e 2014 foram, respectivamente, 20,4, 17,5, 15,2 e 15,7. Houve associação positiva do IR com CPCOP (RP = 1,14; IC = 1,02-1,28), CEAB (RP = 1,02; IC = 1,01-1,03), e negativa com ano (RP = 0,83; IC = 0,74-0,94). A resolutividade em saúde bucal na atenção básica é influenciada por fatores relacionados à cobertura.

Abstract Oral health resolvability in primary care of municipalities in the State of Paraíba, Brazil, was analyzed, and a cross-sectional study was conducted, using an inductive approach, comparative procedure and indirect documentation. The Resolvability Indicator (RI) consisted of the ratio between the number of Completed Treatments and First Programmatic Dental Consultations in municipalities in Paraíba (n = 223), between 2011 and 2014, by using data collected from the DATASUS/TABNET platform. The following explanatory variables were considered: Coverage of First Programmatic Dental Consultation (CFPDC), Coverage of Primary Care Teams (CPCT), Coverage of Oral Health Teams (COHT), Coverage of Family Health Teams (CFHT), Percentage of Tooth Extraction (PTE), Gross Domestic Product (GDP), Municipal Human Development Index (MHDI) and Gini Coefficient (GC). Descriptive statistics and negative binomial multiple regression were performed (α = 0.05). The median RI in 2011, 2012, 2013 and 2014 was, respectively, 20.4, 17.5, 15.2 and 15.7. There was a positive association between RI and CFPDC (PR = 1.14, CI = 1.02-1.28), CPCT (PR = 1.02, CI = 1.01-1.03), in addition to a negative association. between RI and year (PR = 0.83; IC = 0.74-0.94). The resolvability of oral health in primary care is influenced by coverage-related factors.

Resumo Objetivo: Investigar os fatores associados ao não acesso em saúde bucal no Brasil. Métodos: Estudo transversal, sobre dados da avaliação externa do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, em 2014 e 2018, mediante regressão logística multivariada hierarquizada. Definiu-se como ‘não acesso’ quando o usuário não consegue marcar consulta com cirurgião-dentista. Resultados: Foram analisados dados de 37.262 indivíduos do segundo ciclo (2014) e 117.570 do terceiro ciclo (2018). Maior chance de não acesso ocorreu para residentes em municípios mais desiguais e com menor cobertura de saúde bucal, deslocamento para a unidade de saúde superior a 11 minutos, sexo feminino, idade entre 25 e 39 anos e renda de até 1 salário mínimo. Conclusão: O não acesso associou-se a fatores municipais, como maior desigualdade; fatores organizacionais, como menor cobertura e tempo de deslocamento até a unidade; e fatores individuais, como sexo, idade e renda.

Resumen Objetivo: Investigar los factores asociados a la falta de acceso a la salud bucal en Brasil. Métodos: Estudio transversal, con datos de la evaluación externa del Programa de Mejoramiento del Acceso y la Calidad de la Atención Primaria (2014 y 2018), mediante regresión logística multivariable jerárquica. La categoría ‘sin acceso’ se definió cuando el usuario no consiguió concertar una consulta con un cirujano dentista. Resultados: Analizamos datos de 37.262 (2014) y 117.570 (2018) individuos. Se encontró una mayor probabilidad de no acceso para quienes: vivían en municipios con más desigualdad y con menor cobertura de salud bucal, cuyo tiempo de viaje a la unidad era superior a 11 minutos; mujeres, entre 25 y 39 años e ingresos de hasta 1 sueldo mínimo. Conclusión: La falta de acceso se asoció con factores municipales como mayor desigualdad; factores organizacionales como menor cobertura y tiempo de viaje a la unidad; y factores individuales como sexo, edad e ingresos.

Abstract Objective: To investigate factors associated with non-access to oral health in Brazil. Methods: This was a cross-sectional study of data from external evaluations of the National Primary Care Access and Quality Improvement Program (2014 and 2018), using hierarchical multivariate logistic regression. ‘Non-access’ was defined as the service user not being able to make an appointment with a dentist. Results: We analyzed data on 37.262 individuals (2014 sample) and on a further 117.570 individuals (2018 sample). Greater likelihood of non-access was found for those who live in municipalities with greater inequalities and with less oral health coverage, those whose travel time to the health center is more than 11 minutes, being female, being aged between 25 and 39 years and those whose income was up to 1 minimum wage. Conclusion: Non-access was associated with municipal factors such as greater inequality; organizational factors such as less oral health coverage and travel time to the health center; and individual factors such as sex, age and income.