Trends in tooth loss among adults and older adults in municipalities participating in oral national surveys 2003, 2010 and 2023.

OBJECTIVE: This study analyzed trends in tooth loss and caries severity among adults and older adults from 2003 to 2023. METHODS: An ecological study using secondary data from the three national oral health Surveys (SB Brasil 2003, 2010, and 2023) in 43 municipalities that participated in all editions. The analysis of trends in caries severity and tooth loss among adults (35-44 years) and older adults (65-74 years) was performed using structural equation modeling. RESULTS: Among adults, a significant association was observed between higher illiteracy rates and increased the decayed, missing, and filled teeth index (DMFT) (β=+0.309; p<0.001). On the other hand, greater coverage by oral health teams and private dental plans were associated with a reduction in these outcomes (β=-0.040 p<0.001 and β=-5.527 p<0.001, respectively). The associations were less evident but pointed in the same direction among older adults regarding illiteracy rates and private dental plan coverage, where the estimated coefficients showed lower magnitude and significance, indicating moderation of contextual effects and stability of the indicators over time. CONCLUSION: The study confirmed a downward trend in tooth loss and DMFT between 2003 and 2023, pronounced in adults and to a lesser extent in older adults in Brazil. The latter are particularly vulnerable to rapid deterioration in oral health, requiring individualized analyses in future studies and the targeting of efforts by policymakers and implementers.