INEQUALITY IN ACCESS TO DENTAL PROSTHESES IN NORTHEAST BRAZIL: AN INTEGRATIVE REVIEW

Abstract

Despite public health policies aimed at oral health expansion, edentulism and the lack of access to prosthetic rehabilitation remain significant challenges in Brazil, reflecting deep-seated socioeconomic and regional disparities. Therefore, this study aimed to analyze inequalities in access to dental prostheses in Northeastern Brazil and identify the factors associated with disparities in the provision of prosthetic rehabilitation within the Brazilian Unified Health System (SUS). An integrative literature review was conducted through electronic searches in the Brazilian Bibliography of Dentistry (BBO), Latin American and Caribbean Health Sciences Literature (LILACS), and Medical Literature Analysis and Retrieval System Online (MEDLINE) databases between August and September 2024. Original full-text studies published in Portuguese, English, or Spanish were eligible for inclusion, with no restriction on publication date. Of the 230 records identified, 8 studies met the predefined eligibility criteria and were included in the final analysis. The included studies demonstrated that access to dental prostheses in Northeastern Brazil remains strongly influenced by socioeconomic, geographic, and organizational factors. Insufficient infrastructure, unequal distribution of Regional Dental Prosthesis Laboratories, shortages of qualified professionals, and limitations in Primary Health Care were identified as the main barriers to equitable access. Older adults were consistently reported as the population with the greatest unmet need for prosthetic rehabilitation. Furthermore, the COVID-19 pandemic substantially reduced prosthesis production within the SUS, exacerbating pre-existing regional inequalities. Persistent inequalities in access to dental prostheses remain a major public health challenge in Northeastern Brazil. Strengthening Primary Health Care, expanding the availability of prosthetic rehabilitation services, investing in workforce training, and implementing equitable public health policies are essential to improving access to oral healthcare and enhancing the quality of life of socially vulnerable populations.