Dental care of Indigenous pregnant women: national ecological study

Introduction Prenatal Dental Care aims to prevent common oral diseases during pregnancy and to empower pregnant women in oral self-care and the care of the baby. Among Indigenous peoples, dental follow-up during pregnancy is particularly challenging, as Indigenous women have been historically subjected to health inequalities. This study aimed to evaluate dental service utilization during pregnancy among Indigenous women across the 34 DSEIs in Brazil, examine its correlation with healthcare variables, and contextualize these findings in relation to prenatal dental care indicator from the broader Brazilian public primary healthcare system (SUS). Methods An ecological study was conducted in Brazil using data from the Indigenous Health Care Information System (SIASI) for the 34 Special Indigenous Health Districts (DSEI) in 2023—the first year this indicator was used. Health care variables included the percentage of Indigenous pregnant women with six or more prenatal visits, the percentage of the Indigenous population with dental appointments, and the percentage of the Indigenous population with completed dental treatment per DSEI. The indicator “Proportion of pregnant women receiving dental care” was also extracted from the Brazilian Primary Health Care Information System (SISAB), referring to pregnant women within the Unified Health System (SUS), for comparison with Indigenous health data. Descriptive analysis was performed, and Spearman correlation tests were applied using R software. Results The mean percentage of Indigenous pregnant women receiving dental care across the 34 DSEIs was 35.81% (±15.89), ranging from 4.6% to 76.5% across districts. The mean percentage of pregnant women receiving dental care within the SUS in the states corresponding to the health districts was 61.31% (±10.64), ranging from 43.7% to 79.7% across Brazilian states. A positive correlation was observed between the percentage of Indigenous pregnant women receiving dental care and the percentage of Indigenous pregnant women with six or more prenatal visits (rho=0.45). Conclusion Prenatal dental care utilization among Indigenous pregnant women varied considerably across DSEIs and in relation to state-level SUS indicators. The positive association with prenatal care attendance highlights the potential importance of integrating oral health into antenatal care to promote more equitable access.