Changes in Urgent Dental Care in the Brazilian Unified Health System (SUS) during COVID-19

an integrative review

Abstract

This integrative review synthesizes evidence on how the COVID-19 pandemic changed the frequency, user profile, and diagnoses of urgent dental care within Brazil’s Unified Health System compared with the pre-pandemic period. Searches were conducted in the Virtual Health Library/LILACS, SciELO, and PubMed/MEDLINE (2019–2025), including observational studies carried out in public services. Titles, abstracts, and full texts were independently assessed by two reviewers, with standardized data extraction and narrative synthesis. Twenty records were identified, one duplicate was removed, nineteen proceeded to screening, and nine studies were included. The findings indicate an initial reduction in urgent visits, persistence of pain of odontogenic origin as the main reason for seeking care, and wider use of conservative clinical approaches. The decline was smaller where Primary Health Care was more structured and active triage was adopted, whereas hospital services showed sharper reductions in trauma. From this evidence, operational recommendations are proposed: implement remote triage with a minimal protocol for pain, signs of infection, and trauma; integrate Primary Health Care, Dental Specialty Centers, and hospitals with counter-referral and planned clinical re-evaluation; and establish continuous monitoring using routine indicators such as urgent visits per ten thousand inhabitants, time from arrival to first intervention, proportion of conservative approaches, return within seven and thirty days, and adverse events. Overall, services preserved time-sensitive care through reorganization of patient flows and reinforced biosafety, while persisting differences across regions and levels of care support the need for standardized indicators and periodic evaluations.