The majority of São Paulo’s population uses private clinics for dental consultations and procedures, while a smaller portion uses the Unified Health System. Recent data from ISA Capital (São Paulo City Health Survey) shows that out of 5,472 people interviewed, 38.3% had consulted a dentist in the past six months. Of these, 67.6% paid for counseling and 15.9% attended the public system.
Among the participants, 58.7% rated their oral health as good, and 21.7% as acceptable. Older adults had the lowest percentage of very good ratings (8.5%). The main reason for seeking care was periodic or routine consultation (47.4%).
The first results of ISA Capital 2024 were released by the SMS (Municipal Health Department) in October this year. Developed in partnership with the University of the South Pacific School of Public Health, this research examines the health status, lifestyle habits, and use of health services of São Paulo residents.
This is the fourth edition of the survey, which was also conducted in 2003, 2008 and 2015. Between August 2023 and December 2024, 5,472 interviews were conducted with municipal residents, covering four audiences: adolescents (10–19 years), adults aged 20–59 years, women and men, and older people (60 years or older).
As the cohort is extended to December 2024, reference periods – such as “last six months” or “last 12 months” – correspond to the period immediately preceding the date on which each person was interviewed.
The SMS states that dental care is available in 444 out of 479 basic health units in the capital, São Paulo. Access can be made in person or via the Agenda Fácil app, which provides screening locations.
After assessing the risks, the dentist will schedule treatment when necessary. Cases requiring specialized care are referred through Siga Saúde (integrated healthcare management system), with the schedule able to be monitored through the app.
Urgent cases are treated in UPAs (emergency care units) and other units that provide emergency care. The nearest unit providing dental services can be found on the city hall’s website, in Busca Saúde.
In primary care, preventive, clinical, restorative, surgical and prosthetic procedures are offered, according to the city municipality. Specialized services include orthodontics, endodontics, endodontics, minor oral surgery, periodontal disease, pediatric dentistry, orofacial pain, dental implants, prosthetics, care of persons with disabilities, and procedures under general anesthesia in day hospitals.
When asked about the average wait time for consultations and oral procedures, the city council did not respond.
In the country, the Ministry of Health stated that oral health is one of the priorities of the unified health system, as there are 35,000 oral health teams in 5,282 municipalities. The 1,238 specialist dental centers provided 6.4 million consultations in 2023 and 8.4 million in 2024.
Study coordinator, Professor Marilia Lovison, from the University of the South Pacific School of Public Health, stresses that the provision of dental services at SUS still does not meet demand.
“SUS offers dentistry, but the supply doesn’t keep up with the need. It’s historically an undersized area.”
The increase in chronic diseases poses a public health challenge
ISA Capital also points to an increase in diagnoses of chronic non-communicable diseases. Between September 2024 and September 2025, 114,742 new diagnoses of hypertension and 80,165 diagnoses of type 2 diabetes were recorded in primary care in the municipal network. In total, there are 1,832,597 people with high blood pressure and 892,637 with diabetes in the city, according to the SMS.
Data show that 11% of the population over 20 years of age reported having type 2 diabetes – compared to 7.7% in 2015, 6.4% in 2008, and 4.7% in 2003. Among older people, the prevalence is 28.2%.
Regarding high blood pressure, 26.3% of participants over 20 years of age reported a diagnosis, compared to 23.2% in 2015, 21.7% in 2008, and 17% in 2003. Among those over 60 years of age, 58.5% reported having high blood pressure.
“Severe diseases are a minority,” says Lovison. “What is increasing are conditions that accompany a person throughout their life. For this reason, our system is not yet fully prepared.”
For the municipal health secretary, Luiz Carlos Zamarco, the new version of the survey provides an updated picture of living conditions and illness after the effects of the pandemic. According to him, chronic diseases prevail in all areas of the city, with slight differences, and this scenario guides the department’s planning to reorganize teams, expand specialties, and redistribute services according to demand.
“The survey will show where we need to adjust course,” he says.
The study also assessed the nutritional status of the population aged 20 years and older, as measured by BMI (body mass index). Among adults, 35.7% were overweight, 26.9% were obese, 34.8% were undernourished, and 2.5% were underweight.
Among the elderly, the rate of underweight is higher (21.8%), and overweight is less frequent (11.8%). Obesity appears at similar levels in both groups: 28.4% among the elderly and 26.9% among adults.
Mental health was also highlighted in the research. One in six São Paulo residents experience symptoms of a mental disorder (17% of population), with a greater impact among women.
The public health project is supported by Umane, a civil society association that aims to support initiatives aimed at promoting health.