Teledentistry in Oral Health Care: A Comparative Overview Before, During, and After the COVID-19 Pandemic in a Large Brazilian Municipality

Authors

  • Isabel de Lima Andrade dos Santos Faculdade de Odontologia de Ribeirão Preto - Universidade de São Paulo Author
  • Luana Pinho de Mesquita Lago Author
  • Ana Elisa Rodrigues Alves Ribeiro Author
  • Igor Henrique Teixeira Fumagalli Author
  • Soraya Fernandes Mestriner Author

DOI:

https://doi.org/10.51137/wrp.ijdht.650

Keywords:

Teledentistry, Primary Health Care, Oral Health Services

Abstract

The use of Information and Communication Technologies (ICTs) has been recommended by the Brazilian Digital Health Strategy and the SUS Digital Program to expand access and improve oral health in Primary Health Care. This study analyzes the use of ICTs, with emphasis on teledentistry, in oral health care in a large Brazilian municipality, comparing the pre-pandemic, pandemic, and post-pandemic periods. An exploratory, observational, and cross-sectional design was applied using secondary data from 44 health units that adopted telemonitoring and teleorientation between 2019 and 2024. The analysis included coverage of the first scheduled dental consultation and emergency dental visits. Statistical methods comprised analysis of variance (ANOVA), Tukey’s post hoc test, and Pearson’s correlation coefficient. The results showed a decrease in the coverage of initial scheduled consultations to 4.01% during the pandemic, followed by a statistically significant increase of 7.10% in the post-pandemic period, associated with the use of telemonitoring. No significant differences were observed in emergency visits between the pre- and post-pandemic periods (p = 0.217), although variations were identified across health districts. These findings indicate that teledentistry has been consolidated as a complementary modality to in-person care, strengthening access and continuity of oral health services. However, its long-term effectiveness depends on standardized documentation and continuous professional training.

Author Biographies

  • Isabel de Lima Andrade dos Santos, Faculdade de Odontologia de Ribeirão Preto - Universidade de São Paulo

    Graduated in Dentistry from the University of Western São Paulo (UNOESTE) in 2019. Certified in Laser Therapy by the São Leopoldo Mandic Dental Research Center in 2022. Completed a Multiprofessional Residency in Comprehensive Health Care at the Ribeirão Preto Medical School, University of São Paulo (FMRP-USP) from 2021 to 2023. Received training in dental care for patients with disabilities at the Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP). Holds a Master’s degree in Science from the University of São Paulo and is currently a PhD candidate in the Graduate Program in Dentistry at FORP-USP.

  • Luana Pinho de Mesquita Lago

    Luana Pinho de Mesquita Lago is a Professor at the Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP), working in the field of Public Health in the Department of Stomatology, Public Health, and Forensic Dentistry. She is also a faculty member of the Graduate Program in Oral Biology at FORP-USP.

    She holds a degree in Dentistry from FORP-USP and participated in the Huka Katu Project – FORP-USP in the Xingu (2005–2008). She completed a Specialization in Family and Community Health at the Federal University of São Carlos (UFSCar) (2009–2011). She served as a tutor in the Specialization Course in Indigenous Health at UAB/UNIFESP and as an advisor in the Specialization Course in Indigenous Health at UNA-SUS/UNIFESP (2011–2013).

    She obtained her Master’s and PhD degrees in Sciences (Public Health) from the Ribeirão Preto School of Nursing, University of São Paulo (EERP-USP) (2014–2019). During her doctoral studies, she completed a doctoral research internship at Université Cergy-Pontoise, France, with a focus on the Institutional Analysis framework (2018).

    She is a member of the International Francophone Interdisciplinary Network Recherche avec, the Brazilian Association of Collective Health (ABRASCO), the Brazilian Association for Dental Education (ABENO), and the Brazilian Network for Interprofessional Education and Work in Health (ReBETIS).

    Her research focuses on health professional education, teaching–service integration, institutional analysis, and interprofessional education. She is also a collaborating faculty member in the project “Building Bridges: Health Care for the Homeless Population” (FMRP/FORP) and the project “Building Bridges: Oral Health Care for the Homeless Population” (FORP).

    Additionally, she serves as coordinating tutor of Tutorial Group 5, Axis 3, of the PET-Saúde Program (11th edition of the Education through Work for Health Program), titled “Strengthening the integration between education, health services, and community: PET-Saúde Ribeirão Preto, SP – Equity for SUS female workers.” She is also a faculty member in the training course for eMulti health professionals (ABRASCO/ENSP/Fiocruz).

  • Ana Elisa Rodrigues Alves Ribeiro

    Ana Elisa Rodrigues Alves Ribeiro is a Full-Time Professor (Teaching and Research Dedication Regime) at the Department of Stomatology, Public Health, and Forensic Dentistry at the Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP), with a focus on Teledentistry.

    She holds a degree in Dentistry from the Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP) (2011) and a degree in Pedagogy (Licentiate) from the Federal University of Lavras (UFLA) / Open University of Brazil (UAB) (2021). She obtained a Master’s degree in Sciences from the Graduate Program in Dentistry (Oral Rehabilitation), concentration area: Oral Biology, at FORP-USP (2015). She holds a PhD in Health Promotion from the Stricto Sensu Graduate Program in Health Promotion at the University of Franca / Cruzeiro do Sul Educational Group (ACEF S.A.) (2021).

    She completed a Specialization in Homeopathy at the François Lamasson Homeopathic Institute (IHFL) (2013); a Specialization in Endodontics at the Ribeirão Preto Dental Association (AORP) (2018); a Specialization in Indigenous Ethnology at Faculdade Venda Nova do Imigrante (FAVENI) (2021); and a Specialization in Public Health Management at the University of Campinas (UNICAMP) (2023).

    She also completed advanced training in Permanent Health Education Facilitation at the Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation (Fiocruz) (2015). She has additional training in Integrative and Complementary Practices, including Bach Flower Therapy (Bach Foundation Practitioner, Brazil, 2005) and Auriculotherapy for Primary Health Care professionals at the Federal University of Santa Catarina (UFSC) (2023).

    She completed the Germinar Program for the Development of Facilitator Leaders at the EcoSocial Institute (2013) and training in Clinical Research at the Oswaldo Cruz German Hospital, São Paulo (2016).

    She worked in Specialized Oral Health Care as a scholarship student and graduate researcher in the DAPE service, contributing to the demystification of dental care for patients with special needs (2009–2011; 2013–2015). She also worked as a dentist in Primary Health Care within the Indigenous Health Care Subsystem, at the Xingu Special Indigenous Health District (DSEI Xingu), Pavuru Base Pole (2012).

    From 2019 to 2024, she served as a faculty member in the Dentistry program at the University of Franca (UNIFRAN / Cruzeiro do Sul Educational Group), teaching courses in Public Health and University Extension. She coordinated a project focused on oral health care for vulnerable populations in the municipality of Franca, São Paulo (2021–2022). She also maintained private clinical dental practice from 2013 to 2024.

    She served as an advisor in the Specialization Course in Indigenous Health at the Federal University of São Paulo / Open University of Brazil (UAB-UNIFESP) (virtual modality, 2022). She was a temporary faculty member at the Department of Stomatology, Public Health, and Forensic Dentistry at FORP-USP (2021–2023). She was also a tutor of Tutorial Group 04 – Continuing Health Education Management (EPS) in the PET-Saúde Program (Education through Work for Health Program) 2022–2023.

    In 2024, she served as a faculty tutor in the Specialization Course in Indigenous Health at the Open University of the Unified Health System (UNA-SUS/UNIFESP) for the More Doctors Program for Brazil, in the virtual modality.

    She is a researcher affiliated with the CNPq research groups “Social Vulnerability, Technologies and Health Promotion” and “Policies and Practices in Health Promotion.”

  • Igor Henrique Teixeira Fumagalli

    He holds a degree in Dentistry from the Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP) (2017), where he conducted undergraduate research in the field of Social and Preventive Dentistry. He has participated in several extension and community outreach projects, including PET-Saúde (2013), the 50th Anniversary of the Rondon Project with the Brazilian Ministry of Defense – Operation Cachimbo (2017), Learning and Teaching in Indigenous Communities (2021), and the Huka Katu Project – FORP-USP in the Xingu (2023).

    He is a Specialist in Public Health from the Ribeirão Preto Medical School, University of São Paulo (FMRP-USP) and the Brazilian Federal Council of Dentistry, through the Multiprofessional Residency Program in Comprehensive Health Care (2020). He obtained both his Master’s and PhD degrees in Health Sciences from the Public Health Program at the Ribeirão Preto School of Nursing, University of São Paulo (EERP-USP).

    He served as a temporary faculty member at the Ribeirão Preto School of Dentistry (FORP-USP) in 2023 and as faculty member and internship coordinator of the Dentistry program at Estácio Ribeirão Preto from 2022 to 2024. He also worked as a dentist for the Municipal Health Departments of Altinópolis (2022–2023) and Igarapava (2024).

    He is currently a Professor in the Public Health area at the Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP), a member of the Center for Studies and Research in Public Health “Prof. Dr. Maria Cecília Puntel de Almeida”, and a graduate advisor in the Postgraduate Program in Dentistry (Periodontology).

         
  • Soraya Fernandes Mestriner

    She holds a degree in Dentistry from the Federal University of Bahia (UFBA) (1988), a Specialization in Restorative Dentistry from the University of São Paulo (USP) (1993), and a Specialization in Change Process Facilitation in Higher Education from the Oswaldo Cruz Foundation (Fiocruz) (2006). She obtained her Master’s degree (2000) and PhD (2004) in Dentistry (Oral Rehabilitation) from the University of São Paulo and completed her Habilitation (Livre-Docência) at the Department of Stomatology, Public Health, and Forensic Dentistry at the Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP) in 2021.

    She is currently an Associate Professor at the Department of Stomatology, Public Health, and Forensic Dentistry at FORP-USP, working in the field of Public Health Dentistry. She is a faculty member of the Graduate Program in Pediatric Dentistry at FORP-USP and serves as a faculty member and tutor in the Multiprofessional Residency Program in Comprehensive Health Care at USP.

    She serves as alternate chair of the Committee for Culture and University Extension (CCEx) at FORP-USP and as a faculty representative in the School Congregation, the Committee for Culture and University Extension (CCEx), and the Department Council of Stomatology, Public Health, and Forensic Dentistry at FORP-USP.

    She is the coordinator of the Multiprofessional Residency Program in Comprehensive Health Care at the USP Ribeirão Preto Campus and a full member of the Educational-Assistive Core (Núcleo Docente Assistencial Estruturante) of the Multiprofessional Residency Program at the Ribeirão Preto Medical School (FMRP-USP), responsible for the Dentistry area.

    She is also the faculty coordinator of the FORP-USP agreement with the Municipality of Sertãozinho for non-mandatory internships, and coordinator of the Multiprofessional Residency Program in Comprehensive Health Care (RMAIS-USP) established between the Municipality of Ribeirão Preto and the University of São Paulo.

    She coordinates the project “Building Bridges: Health Care for the Homeless Population” and is the faculty coordinator of the project “Building Bridges: Oral Health Care for the Homeless Population.” She is also an evaluator of higher education courses and institutions for the Brazilian Ministry of Education (MEC/INEP).

    She has extensive experience in Dentistry, particularly in Public Health Dentistry, working mainly in the following areas: integration of education and health services in professional training, interprofessional education, oral health in primary health care, oral health of older adults, Indigenous oral health, and health promotion.

References

Alavi, S. E., Gholami, M., Malik, L., Al-Bazi, A., Garg, A., & Oyebode, O. (2025). Assessment of teledentistry in improving access to dental care: A systematic review. Australian Dental Journal, 70(1), 4–41. https://doi.org/10.1111/adj.13045

Alhalal, E., Alkhair, Z., Alghazal, F., Muhaimeed, F., & Halabi, R. (2022). Fear of contamination among older adults in the post-COVID-19 era. Geriatric Nursing, 48, 1–7. https://doi.org/10.1016/j.gerinurse.2022.08.010

Brazil. (2022). Law No. 14,510, of December 27, 2022. Diário Oficial da União. https://www.in.gov.br/en/web/dou/-/lei-n-14.510-de-27-de-dezembro-de-2022-454624324

Brazil. (2023). Decree No. 11,358, of January 1, 2023. Diário Oficial da União. https://www.gov.br/saude/pt-br/composicao/seidigi

Brazil. Ministry of Health. (2018). Manual de urgências odontológicas na atenção básica. https://bvsms.saude.gov.br/bvs/publicacoes/manual_urgencias_odontologicas.pdf

Brazil. Ministry of Health. (2020). Ordinance No. 526, of June 24, 2020. https://bvsms.saude.gov.br/bvs/saudelegis/saes/2020/prt0526_02_07_2020.html

Brazil. Ministry of Health. (2022). Telessaúde Brasil Redes: Manual de operações. https://aps.saude.gov.br/ape/telessaude

Brazil. Ministry of Health. (2024). Manual instrutivo do Programa SUS Digital. https://www.gov.br/saude/pt-br/composicao/seidigi/sus-digital

Brazil. Ministry of Health. (2025). Ordinance GM/MS No. 6907, of May 8, 2025. https://www.in.gov.br/en/web/dou/-/portaria-gm/ms-n-6.907-de-8-de-maio-de-2025-587413215

Brazil. Department of Informatics of the SUS (DATASUS). (2022). Manual prático para uso da teleodontologia: Versão preliminar. https://aps.saude.gov.br/biblioteca/visualizar/MjEzNg==

Caetano, R., Silva, A. B., Guedes, A. C. C. M., Paiva, C. C. N., Ribeiro, G. D., Santos, D. L., & Silva, R. M. (2020). Desafios e oportunidades para telessaúde em tempos da pandemia pela COVID-19. Cadernos de Saúde Pública, 36(5), e00088920. https://doi.org/10.1590/0102-311x00088920

Carrer, F. C. A., Sampaio, A. A., Haddad, A. E., & França, B. N. (2020). Teleodontologia e SUS: Uma importante ferramenta para a retomada da Atenção Primária à Saúde no contexto da pandemia de COVID-19. Universidade de Brasília. http://repositorio.unb.br/handle/10482/38153

Conselho Federal de Odontologia. (2020a). Resolução CFO nº 226, de 4 de junho de 2020. https://sistemas.cfo.org.br/visualizar/atos/RESOLU%C3%87%C3%83O/SEC/2020/226

Conselho Federal de Odontologia. (2020b). Resolução CFO nº 228, de 16 de julho de 2020. https://transparencia.cfo.org.br/atos-normativos

Conselho Federal de Odontologia. (2025a). Resolução CFO-SEC nº 277, de 17 de outubro de 2025. https://sistemas.cfo.org.br/visualizar/atos/RESOLU%C3%87%C3%83O/SEC/2025/277

Conselho Federal de Odontologia. (2025b). Resolução CFO-SEC nº 278, de 25 de novembro de 2025. https://sistemas.cfo.org.br/visualizar/atos/RESOLU%C3%87%C3%83O/SEC/2025/278

Instituto Brasileiro de Geografia e Estatística. (2022). Portal Cidades: Ribeirão Preto (SP). https://cidades.ibge.gov.br/brasil/sp/ribeirao-preto/panorama

Oliveira, A. M., Valadão, M. A. P., & Tabak, B. M. (2024). Public telemedicine policy in the Brazilian Unified Health System. International Journal of Environmental Research and Public Health, 21(6), 657. https://doi.org/10.3390/ijerph21060657

Prefeitura Municipal de Ribeirão Preto. (2020a). Decreto nº 069, de 19 de março de 2020. Diário Oficial do Município de Ribeirão Preto. https://www.ribeiraopreto.sp.gov.br/portal/pdf/saude14a202003.pdf

Prefeitura Municipal de Ribeirão Preto. (2020b). Protocolo de telessaúde para as Unidades de Saúde de Ribeirão Preto. http://apsgestao.fmrp.usp.br/wp-content/uploads/2020/07/Protocolo-de-Telessa%C3%BAde-para-as-Unidades-de-Sa%C3%BAde-de-Ribeir%C3%A3o-Preto.-22.06.20-final.pdf

Prefeitura Municipal de Ribeirão Preto. (2021). Plano de contingência para o enfrentamento da COVID-19. https://www.ribeiraopreto.sp.gov.br/portal/pdf/saude14b202104.pdf

Sarti, T. D., & Almeida, A. P. (2022). Incorporação de telessaúde na atenção primária à saúde no Brasil. Cadernos de Saúde Pública, 38(4), e00025221. https://doi.org/10.1590/0102-311xpt252221

Sarti, T. D., Lazarini, W. S., Fontenelle, L. F., & Almeida, A. P. (2020). Qual o papel da Atenção Primária à Saúde diante da pandemia provocada pela COVID-19? Epidemiologia e Serviços de Saúde, 29, e2020244. https://doi.org/10.5123/s1679-49742020000200024

Sistema de Gerenciamento da Tabela de Procedimentos, Medicamentos e OPM do SUS (SIGTAP). (2022). Tabela unificada: Procedimentos odontológicos. https://sigtap.datasus.gov.br/tabela-unificada/app/sec/procedimento/exibir/0301010250/01/2023

Teixeira, C. N., Rodrigues, M. I., Frota, L. M., Frota, M. M., & Oliveira, A. E. (2018). Panorama situacional da teleodontologia no mundo. Revista ABENO, 18(3), 24–34. https://doi.org/10.30979/rev.abeno.v18i3.455

Downloads

Published

2026-05-08 — Updated on 2026-05-27

Versions

Issue

Vol. 2 No. 1 (2026): IJDHT, Volume: 2, Issue: 1

Section

Original Research Paper

License

Copyright (c) 2026 Isabel de Lima Andrade dos Santos, Luana Pinho de Mesquita Lago, Ana Elisa Rodrigues Alves Ribeiro, Igor Henrique Teixeira Fumagalli, Soraya Soraya Fernandes Mestriner (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

de Lima Andrade dos Santos, I., Pinho de Mesquita Lago, L., Rodrigues Alves Ribeiro, A. E., Teixeira Fumagalli, I. H., & Fernandes Mestriner, S. (2026). Teledentistry in Oral Health Care: A Comparative Overview Before, During, and After the COVID-19 Pandemic in a Large Brazilian Municipality. International Journal of Digital Health and Telemedicine, 2(1). https://doi.org/10.51137/wrp.ijdht.650 (Original work published 2026)