Nationwide trends in restorative treatment for primary molars: register-based evidence from Brazil's public dental services

Abstract

Restorative approaches are essential for caries disease control. However, the provision of this type of treatment in primary molars has not yet been analyzed. Therefore, the objective of this study was to evaluate the provision of restorative treatments for primary molars within Brazil’s public dental services. A time-series analysis was conducted over 42 months (from August 2020 to January 2024), using data on monthly counts of restorations in primary molars, standardized per 1,000 procedures. Available dental materials (composite resin – CR, glass ionomer cement – GIC, or amalgam – AMG) and provider types (general dental practitioners or specialists in Pediatric or Special Care Dentistry) were evaluated. Comparisons between provider types and dental materials were tested using generalized linear models, in addition to correlations and trend tests. The significance level was set at 5% in all tests. A total of 1,713,484 restorative procedures were recorded, with 77.6% performed by general practitioners. GIC was the most used dental material across both provider groups (p <0.001). Among general dental practitioners, CR use increased (p <0.001), while GIC (p = 0.001) and AMG (p <0.001) decreased. Among specialized dental practitioners, CR also increased (p = 0.043), AMG decreased (p <0.001), and GIC remained stable over time (p = 0.853). It was possible to conclude that the provision of restorative treatment for primary molars has changed over time in Brazil’s public dental system.

Keywords: Primary Molars; Dental Restoration; Dental Care for Children; Dental Materials; Public Health Dentistry.