Assessing oral health of crack users in Brazil: Perceptions and associated factors, findings from a mixed methods study.

This study explores associated factors and perceptions of oral health among crack users recruited in open drug scenes in Brazil. A mixed methods approach was used. The quantitative component analysed findings from a large (N = 7381), population-based survey. The outcomes under analysis were 'self-perception of oral health' and 'self-reporting of problems affecting the mouth, teeth and gingiva (gums)'. The qualitative component comprised a focus group, with 12 individuals recruited from a drug treatment clinic. Lower self-perception of oral health problems vis-à-vis a higher prevalence of problems affecting the mouth, teeth, and gingiva were found in users who had a lower level of education, used substances daily, had worse self-perception of physical health, did not receive health care and regularly used alcohol and/or tobacco. The results show an association between substance use and decline in oral health, as well as the lack of health services focusing on such issues. Oral health services should be emphasised as a gateway to the health system. So far, the putative cross-referral between services and professionals working in oral health and other health professionals working in the field of drug dependence has not been observed.

Oral cancer screening for high-risk individuals in the primary healthcare setting using an active approach.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is considered a major public health problem. The diagnosis often occurs in advanced stages, causing high morbidity and mortality, and therefore, prevention strategies should be advocated. This study aimed to investigate a model of OSCC screening for high-risk individuals in the Family Health Strategy's (FHS) scenario. METHODS: Participants were men between 50 and 65 years of age registered in a primary healthcare electronic database and resident in an area with low socioeconomic status in the city of Curitiba (Paraná/Brazil). With the support of an electronic map application, dentistry students visited subjects at their homes. RESULTS: From the 16 391 registered subjects, 981 were men aged between 50 and 65. From 608 available subjects, 233 (38.3%) were identified as smokers and former smokers and 202 (86.6%) were examined. There was a prevalence of 57 (28.2%) potentially malignant lesions and one confirmed case of squamous cell carcinoma. Actual smoking habits, low-income wage, and absence from clinical appointments were the key predictors of leukoplakia in this study sample. CONCLUSION: This study offers evidence of the possibility of applying a high-risk-oriented approach as a secondary prevention measure in the FHS in Brazil or other developing countries.