Restorative procedures and extractions of permanent teeth in Brazil’s public dental services (2008–2024)

Objective: to assess the proportion between restorative procedures and extractions of permanent teeth (R:E) in Brazil's public dental services from 2008 to 2024. Method: a time series was constructed within this timeframe using data from the ambulatory productivity reports. Restorative procedures included direct restorations of anterior and posterior teeth, as well as pulpectomies (including retreatments). The ratio was calculated in relation to the number of extractions (per permanent tooth). The significance level was set at 5% for all inferential analyses. Results: throughout the entire period, the R:E ratio was approximately 2.49, with 1.37 as the lowest and 3.33 as the highest value. The person-year incidence of restorations was 150,427 per 100,000; of pulpectomies was 5,394 per 100,000; and of extractions was 62,695 per 100,000. Moreover, there was a significant reduction in the R:E ratio between 2008 and 2024 (p-value = 0.011; APC = -2.95% [95% CI: -4.94%, -0.46%]). When comparing the pre-pandemic interval, the R:E ratio was lower during each of the first four years following the onset of the COVID-19 outbreak (all p-values <0.05). Furthermore, the person-year incidence in the Central-West region was significantly higher than the national estimate (p-value <0.001), with no significant differences observed between the other regions and this parameter. Conclusion: it was possible to conclude that the R:E ratio declined over the last 17 years in Brazil's public dental services, indicating changing treatment patternspatterns.