Abstract
This study investigated the social inequities related to dental caries, clinical consequences of untreated caries, and the urgency to treat five-year-old children in Brazil. It is a cross-sectional study that used data from SB Brasil 2023 (n = 7198). The dmft index was used to assess dental caries, the pufa index to assess the pulp consequences of untreated caries lesions, and the need for treatment was identified. It included demographic and context variables: sex, color/race, enrollment in social programs, access to water in the household, and use of dental services. Logistic regression models for complex samples were used to estimate gross and adjusted odds ratio (OR), and confidence intervals (95%CI). The prevalence of early childhood caries (ECC) was 46.83%, with an average of 2.14 affected teeth, and 41.18% had untreated caries lesions. Non-white children and those enrolled in social programs had higher chances of having dental caries. The clinical consequences were associated with non-white children and with the last use of dental services being more than 3 years ago. Mothers with higher levels of education and the presence of piped water in the household were protective factors. This study highlights the high prevalence and inequities related to ECC in Brazil. Non-white children, beneficiaries of social programs, and those with limited use of dental services were more vulnerable to caries, its clinical consequences, and the urgency of immediate treatment. These results reinforce the importance of public policies to reduce inequalities and expand access to preventive dental care.