Trends in Periodontitis by Socioeconomic Status in Brazil: National Surveys 1986–2023

AIM: To describe trends in periodontitis and trends in socioeconomic inequalities in periodontitis in Brazil from 1986 to 2023. METHODS: Representative data were obtained from the SBBrasil surveys of 1986, 2002/2003, 2010 and 2022/2023. Periodontitis was assessed by the community periodontal index (CPI), including clinical attachment loss (CAL) at index teeth. The prevalence of individuals with at least one tooth with periodontal probing depth (PPD) ≥ 4 mm was estimated for 16 capitals and CAL ≥ 4 mm for the whole country according to age group, sex, dental visit in the previous year and household income. Trends were estimated using log-binomial models, using the sampling design. Interactions were tested by covariates and survey year. RESULTS: There was a significant decline in the prevalence of periodontitis in all age groups (p < 0.01). From 1986 to 2023, the regression-estimated decline in PPD prevalence during that period was 43% among teenagers and 36% among adults. CAL-estimated prevalence reduction was 51% from 2003 to 2023. The decline in prevalence was stronger and statistically significant among adults of higher income groups for PPD and CAL, indicating increasing relative inequalities in age groups. Trends did not differ by sex or dental visit. CONCLUSIONS: Periodontal health improved overall, but it was unequally distributed, favouring higher income and younger age groups.