Supplemental dental healthcare in Brazil and Angola: a comparative analysis of access, market, and regulation

Abstract

Access to dental services remains challenging in Brazil and Angola, countries that share social inequalities and structural weaknesses despite distinct geographic contexts. This study conducted a comparative analysis of the two systems, focusing on supplementary health coverage and the organization of dental care through a narrative literature review, analysis of regulatory frameworks, and demographic indicators. In Brazil, the supplementary market is well established and regulated by the National Supplemental Health Agency (ANS), covering about 35 million beneficiaries in exclusively dental plans. In Angola, the sector is emerging, supervised by the Angolan Insurance Regulation and Supervision Agency (ARSEG), and faces critical limitations, such as a shortage of professionals (1 dentist for every 43,460 inhabitants) and the absence of a standardized list of procedures. While Brazil advances structured prevention and health promotion policies, such as Brasil Sorridente, Angola still relies predominantly on curative practices constrained by economic and operational limitations. The differences between the models are also reflected in clinical governance: in Brazil, the central challenge is to mitigate conflicts between insurers and providers; in Angola, the need stands out for training professionals with hybrid competencies and for strengthening ethical and regulatory frameworks. The integration of forensic dentistry tools into Angolan insurers emerges as a decisive step to turn auditing into an instrument of clinical governance, combating fraud and ensuring patient safety and care quality. It is concluded that, although both countries seek to expand access to oral health, their development trajectories, regulatory capacity, and the maturity of their supplementary markets differ substantially.