The oral health of seniors in Brazil: addressing the consequences of a historic lack of public health dentistry in an unequal society

Objective National epidemiological data on the oral health of elders was analysed to examine relationships between the need for oral treatment and external environment, the dental care delivery system, personal characteristics and subjective conditions of oral health. Background Brazil's universal public healthcare system is theoretically responsible to provide dental care to Brazilians of all ages. However, as dentists were integrated into public primary care facilities only in 2000, Brazilian seniors have accumulated needs. Materials and methods Seniors (65–74 years old) were examined and interviewed by calibrated professionals. The association of overall need for oral treatment and component factors were analysed. Associations with socio‐demographic factors and self‐reported attitudes and behaviours were also calculated. Results A total of 85.9% of Brazilian seniors demonstrated a need for some oral treatment, 83.8% of the dentate needed periodontal treatment and 57.3% of all seniors needed full or partial prostheses. Social inequalities were also evident as Brazilians using free oral care services demonstrated a higher degree of need, as did elders who had not previously accessed dental services, nonwhites and males. Conclusions Our findings demonstrate that the elderly population in Brazil has a very high degree of need in general and that certain subgroups have been especially vulnerable to oral disease.