Brazilian Oral Medicine and public health system: The enormous impact of the COVID-19 Era.

Dear Editor,

Due the coronavirus disease 2019 (COVID‐19), several restrictive measures have been implemented by the government (Chaudhry et al., 2020; Nussbaumer‐Streit et al., 2020; Oliveira et al., 2020; Simões e Silva et al., 2020). In this way, dentistry services underwent forced changes in their operation and function (Machado et al., 2020; Martelli Júnior et al., 2020).

Recent studies highlighted the difficulties and damages from the current COVID‐19 pandemic to dental services in general and Oral Medicine (OM) and Oral Pathology particularly (Alves et al., 2020; Chen et al., 2020; Cunha et al., 2020; Izzetti et al., 2020; Machado et al., 2020). Thus, this investigation aimed to compare Brazilian Unified Healthcare System (SUS)‐oriented OM clinical care in Brazil before and during the pandemic so far.

To measure OM care in the SUS, we evaluated the number of clinical consultations performed between March and July of 2015 to 2020. The data were extracted and analyzed from the public database (DATASUS) (http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sia/cnv/qauf.def). Table 1 shows the damage caused by the COVID‐19 pandemic in OM clinical consultation in the five geographic regions of Brazil. The average number of clinical consultations in the prepandemic period compared with the current period is higher in all Regions. The difference in the number of clinical consultations ranged from 28.97% (Northeast) to 74.49% (Midwest). Brazilian general average deficit, 65.59%, representing more than 21,000 clinical consultations. The impact these indicators have on the diagnosis and treatment of oral diseases in the Brazilian population remains yet unknown.

Table 1

Difference between the mean of clinical consultations in Oral Medicine, performed in geographical Regions by the Brazilian public health system between March and July of 2015–2019 compared with 2020

Regions of Brazil	March–July 2015–2019 (n)	March–July 2020 (n)	Difference n (%)
North	915.4	529	386.4 (42.21%)
Northeast	3,776	2,682	1,094 (28.97%)
Southeast	22,435.2	6,148	16,287.2 (72.59%)
South	3,891.6	1,445	2,446.6 (62.86%)
Midwest	1,478	377	1,101 (74.49%)
Total	32,496.2	11,181	21,315.2 (65.59%)

The number of new cases of oral cavity cancer expected for Brazil for each year of the triennium 2020–2022 will be 11,180 cases in men and 4,010 in women. These values correspond to an estimated risk of 10.69 new cases per 100,000 men, occupying the fifth position. For women, it corresponds to 3.71 for every 100,000 women, being the thirteenth most frequent among all cancers (https://www.inca.gov.br/estimativa).

Considering that the early diagnosis of oral cancer is essential for the effective treatment of the patient, and Brazil does not have legislation that authorizes tele (oral) medicine (Machado et al., 2020; Villa et al., 2020), this reduction in the number of clinical consultations of OM becomes even more worrying. A recent study on oral biopsies during the COVID‐19 pandemic shows an alarming decrease in mouth biopsies performed in all Brazilian Regions in 2020, showing a decline of over 60% in the entire country (Cunha et al., 2020).

Brazil already has approximately 144,600 deaths and more than 4.8 million confirmed cases of contamination (October 1st, 2020) (https://covid.saude.gov.br/), and it is observed that there is a quantitative deficiency of clinical care by OM that significantly compromises the scenario of oral diseases in the SUS. Thus, quick and safe actions are needed to regularize or at least minimize both the critical immediate risks as well as the possible long‐term COVID‐19 pandemic negative impacts over oral diseases COVID‐19 pandemic on oral diseases.

CONFLICTS OF INTEREST

None to declare.

AUTHOR CONTRIBUTION

Nelson Pereira Marques: Conceptualization; Data curation; Formal analysis; Investigation; Methodology; Project administration; Writing‐original draft; Writing‐review & editing. Denise Maria Mendes Lúcio da Silveira: Conceptualization; Data curation; Formal analysis; Investigation; Writing‐review & editing. Petrônio José de Lima Martelli: Conceptualization; Formal analysis; Writing‐review & editing. Daniella Reis Barbosa Martelli: Conceptualization; Formal analysis; Writing‐review & editing. Edson Hilan Gomes de Lucena: Conceptualization; Data curation; Writing‐review & editing. Hercílio Martelli‐Júnior: Conceptualization; Formal analysis; Investigation; Methodology; Project administration; Supervision; Writing‐original draft; Writing‐review & editing.

PEER REVIEW

The peer review history for this article is available at https://publons.com/publon/10.1111/odi.13677.