Environmental sustainability related to dental materials and procedures in prosthodontics: A critical review.

This article aims to review the status, challenges, and directions of environmentally sustainable oral healthcare by focusing on the dental materials and procedures used in prosthodontics. Sustainable development is a global priority and requires a systemic, integrative approach from all sectors of society. The oral healthcare sector is responsible for substantial greenhouse emissions throughout its value chain, including raw material extraction, industrial production, supply distribution, clinical practice, and management of waste. Of all dental specialties, prosthodontics has been one of the main generators of carbon emissions by fabricating a single product such as dentures or crowns in multiple steps. Dental prosthetic procedures involve chemicals and materials such as polymers, ceramics, metals, gypsum, and wax, which are often used in large quantities and for a single use. Thus, environmental risks and socioeconomic burdens can result from residuals and improper disposal, as well as waste and the embedded costs of unused materials retained by manufacturers, retail suppliers, dental laboratories, and dental clinics. To mitigate the environmental impact generated by conventional prosthodontics, we urge awareness and the adoption of sustainable good practices in the daily routine of dental clinics and laboratories. Capacity building and investment in a circular economy and digital technology can reduce the carbon footprint of prosthetic dentistry and improve the quality of life for present and future generations.

Do network centrality measures predict dental outcomes of Indigenous children over time?

BACKGROUND: Centrality measures identify items that are central to a network, which may inform potential targets for oral interventions. AIM: We tested whether centrality measures in a cross-sectional network of mothers' baseline factors are able to predict the association with children's dental outcomes at age 5 years. DESIGN: A network approach was applied to longitudinal data from a randomised controlled trial of dental caries prevention delivered to 448 women pregnant with an Indigenous child in South Australia. Central items were identified at baseline using three centrality measures (strength, betweenness, and closeness). Centrality values of mothers' outcomes were regressed with their predictive values to dental caries experience and dental service utilisation at child age 5 years. RESULTS: Items of oral health self-efficacy and oral health literacy were central to mothers' baseline network. Strength at baseline explained 51% and 45% of items' predictive values to dental caries experience and dental service utilisation at child age 5 years, respectively. Adjusted and unadjusted values of node strength for the children's oral health network were highly correlated. CONCLUSION: Strength at baseline successfully identified mothers' items with greater importance to dental caries experience and dental service utilisation at child age 5 years.

Factors associated with utilisation of dental services by the elders from São Paulo, Brazil.

BACKGROUND: Population ageing in Brazil is rapid and is likely to place additional pressure over the Brazilian public health system. OBJECTIVE: This study aims to examine the factors associated with utilisation of dental services in the previous year among a representative sample of older adults from São Paulo, Brazil. METHODS: The sample included 5951 older adults who participated in the SBSP-15 study, an epidemiological survey conducted in 2015 in the State of São Paulo, Brazil. The outcome "utilisation of dental services" was defined as having visited a dentist in the previous year. Chi-square tests were employed in the bivariate analyses and Poisson regressions with robust variance in the multilevel analysis. RESULTS: Only 30.5% of the participants had their last dental appointment within the previous year. Number of teeth and dental pain presented the strongest effects on the investigated outcome. Education, income, age, ethnicity, living alone, higher Family Health Strategy coverage and the Metropolitan area were associated with having visited a dentist in the previous year. Older adults who rated their oral health as positive did not report treatment need nor prosthodontic need, presented negative oral health-related quality of life, had their last dental appointment in the public health system and sought treatment due to pain or extraction also were more likely to report the utilisation of dental services in the previous year. CONCLUSION: Regional, sociodemographic and subjective factors are associated with utilisation of dental services in the previous year among the elders from the State of São Paulo, Brazil.

Oral health of 12-year-old children in Quito, Ecuador: a population-based epidemiological survey.

BACKGROUND: There is a paucity of population-based surveys on oral health conditions in Ecuador. Thus, the aim of this study was to conduct an epidemiological survey with a representative sample of children aged 12 years from public schools of Quito, Ecuador. The aim of this initial report was to describe the methodology used in the survey, as well to present results regarding calibration procedures and prevalence of oral-health related outcomes. METHODS: We invited 33 public schools' coordinators from the urban area of Quito, and 1100 children (12 years old) to take part in this study. Six trained and calibrated examiners conducted clinical examinations using oral mirrors and ball-ended probes to assess: dental caries, traumatic dental injuries, malocclusion, gingival bleeding, presence of calculus and fluorosis. Children also responded a questionnaire on Oral Health-Related Quality of Life (OHRQoL). Individual sociodemographic data was collected through a questionnaire sent to parents. Moreover, some contextual data on school environment (infrastructure conditions, promotion of health practices and negative episodes) were also evaluated. Prevalence values, crude and weighted by sampling weights, and 95% confidence intervals (95%CI) were calculated. RESULTS: Nine hundred and ninety-eight children from 31 schools were examined from March to May 2017. The adjusted prevalence values (95%CI) for the six outcomes evaluated were: dental caries = 60.3% (55.3 to 65.0%); traumatic dental injuries = 20.7% (17.2 to 24.8%); dental fluorosis = 63.7% (58.5 to 68.5%); gingival bleeding = 92.0% (87.1 to 95.2%); presence of calculus = 69.9 (60.5 to 77.9%); and malocclusion = 25.8% (21.8 to 30.3%). Adjusted mean of number of decayed, missed or filled permanent teeth (DMF-T) was 1.61 (1.37 to 1.84). Results on OHRQoL and other contextual variables will be reported in other articles. CONCLUSION: The prevalence of the majority of oral health problems in 12-year-old children from public schools in Quito-Ecuador was compatible with those observed in other similar cities. However, periodontal health and fluorosis seem to be highly prevalent in children from Quito.

Discriminant analysis of mandibular measurements for the estimation of sex in a modern Brazilian sample.

The present study aimed to evaluate the accuracy of mandibular measurements for sex determination in a Brazilian population. The sample was composed of 100 mandibles, of which 53 were female and 47 were male, and the average age was 57.03 years. The mandible measurement protocol was composed of 15 measurements, of which six were bilateral and nine were unique. Mandibles were directly measured using a digital caliper and a protractor. The descriptive analysis of the present study revealed higher mean values for male mandibles compared to those for female mandibles with the exception of the left mandibular angle. Among the 21 measures analyzed in this group, 15 were statistically significant (p < 0.05). Univariate discriminant analyses produced a mean percentage of correct predictions that varied between 49 and 79%. The association of variables increased the percentage of correct prediction of sex to vary from 76 to 86%. The receiver operator characteristic (ROC) curve analysis indicated that the best variable for estimating sex was bigonial breadth (BGB; area under the ROC curve (AUC) = 0.764) followed by the right maximum ramus height (MRHr; AUC = 0.763). A reference table for estimating sex in a Brazilian population using mandible measurements was developed based on the ROC curve analysis. Mandibular measures provide a simple and reliable method for sex discrimination in Brazilian adults due to the sexual dimorphism revealed by analysis of the metric variables and the satisfactory results demonstrated by discriminant formulas, ROC curve analysis, and the reference table.

Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation.

Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost-effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM. Clinical information was gathered on 167 patients undergoing HSCT and divided according to the presence (n = 91) or absence (n = 76) of laser therapy and oral care. Cost analysis included daily hospital fees, parenteral nutrition (PN) and prescription of opioids. It was observed that the group without laser therapy (group II) showed a higher frequency of severe degrees of OM (relative risk = 16.8, 95% confidence interval -5.8 to 48.9, p < 0.001), with a significant association between this severity and the use of PN (p = 0.001), prescription of opioids (p < 0.001), pain in the oral cavity (p = 0.003) and fever > 37.8°C (p = 0.005). Hospitalization costs in this group were up to 30% higher. The introduction of oral care by a multidisciplinary staff including laser therapy helps reduce morbidity resulting from OM and, consequently, helps minimize hospitalization costs associated with HSCT, even considering therapy costs.

Importance of phytotherapy for oral health care and quality of life in adults: A scoping review.

Medicinal plants and herbal medicines are used as integrative and complementary practices to provide comprehensive care, disease prevention, health promotion, and to improve quality of life (QoL). This scoping review aimed to identify and describe the use of phytotherapy in oral health care by adults and their outcomes, with a focus on perceptions of oral health-related QoL, healthcare access, and costs. A systematic search was conducted in six databases and supplemented in grey literature. According to a PRISMA-ScR protocol and eligibility criteria, publications were assessed for final inclusion, data charting, and narrative synthesis. Out of 4124 records, 542 publications were selected for full-text reading. A total of 32 studies were included: 21 studies assessed QoL, 7 reported access issues, and 11 reported costs issues. Herbal mouthwashes to prevent or treat non-infectious oral conditions were the most frequent treatment. Efficacy of phytotherapy was usually better than placebo or control treatment. Most studies reported QoL improvement, but several instruments were used with heterogeneous results. Limited healthcare access and high costs favoured traditional folk herbal medicine in underserved populations. It can be concluded that phytotherapy for oral health is used by adults worldwide, following modern clinical pharmacology and traditional knowledge concepts. Further studies should incorporate assessment of QoL, access, and costs in addition to clinical efficacy and safety, which are complementary aspects for delivering a comprehensive and efficient health care for all people.

Comparative study of sex estimates in adult skulls using direct measurement and tomographic image reconstruction.

Sex estimation is an important procedure in forensic anthropology for human identification. The development of new technologies, such as three-dimensional computed tomography (CT), has provided excellent alternatives for this purpose. This study examined and compared a morphological method for sex estimation using two different approaches - direct measurement of physical structures and tomographic analysis using 3D images. A total of 111 skulls from the Museum of Human Anatomy at the University of São Paulo (MAH-USP) were used, (60 males and 51 females). All specimens were scanned by Philips Brilliance 64 CT scanner equipment and their corresponding images were reconstructed in three-dimensional (3D) models. The morphological characteristics of the skulls were analyzed by an observer who was blinded to the sex of the specimens. Five cranial structures were analyzed: external occipital crest, mastoid process, supraorbital margin, glabella, and mental eminence. The structures were scored 1 to 5 according to Buikstra and Ubelaker and validated by Walker. The success rates of the sex estimates obtained through direct measurement of the dry skulls ranged from 67.4% to 70.4% as compared to 60.2% to 68.1% for CT reconstruction. When analyzed separately, the maximum accuracy of the method was 68.33% in males and 88.24% in females in the physical analysis of structures. The glabella and mastoid process were the most effective structures to estimate sex through both techniques, respectively. Our results show that 3D CT images can be accurately used in the morphological analysis for sex estimation, representing a viable alternative in forensic anthropology.

Structure and replicability of oral health-related quality of life networks across patients with schizophrenia and the general community.

OBJECTIVES: Schizophrenia is a disabling mental disorder associated with severe social dysfunction. Individuals with long-term mental conditions have poorer Oral Health-Related Quality of Life (OHRQoL) compared to the general population, but little is known about the measurement properties of OHRQoL instruments in this group of patients. This study aimed to examine the replicability of OHRQoL networks across samples of the general community (GC) and patients with schizophrenia (PWS). METHODS: Data were obtained from 603 community-dwelling participants and 627 patients with schizophrenia. OHRQoL was measured using the short form of the Oral Health Impact Profile (OHIP-14) questionnaire. A regularized partial correlation network was estimated for each sample. The number of dimensions and structural stability were assessed using Exploratory Graph Analysis. Global strength, edge weights and centrality estimates were compared. Network replicability was examined fitting the PWS data to the GC network structure. RESULTS: A single OHIP-14 dimension was identified in the GC sample, whereas three dimensions were detected in the PWS sample. Structural consistency was perfect in the network of GC participants (1), and considerably low in at least two dimensions of the PWS network (0.28; 0.65; 0.16). A moderate correlation for node strength estimates was observed (τ: 0.43; 95% CI: 0.13, 0.72), although edge weights were not correlated (τ: 0.025; 95% CI: -0.11, 0.16). The fit of the PWS data to the GC network structure was deemed unacceptable. CONCLUSION: Network models of OHRQoL did not replicate across samples of the general community and outpatients with schizophrenia. Prudent use of OHIP-14 to compare measures of OHRQoL between groups with significant cognitive impartment and the general population is recommended.

Do tobacco and alcohol modify protective effects of diet on oral carcinogenesis?

Recent systematic reviews concluded that the frequent consumption of fruits and vegetables is inversely associated with the risk of oral cancer. We assessed this association, specifically comparing results obtained to nonsmokers and smokers, as well to nondrinkers and drinkers. We conducted a case-control study involving 296 patients with oral squamous cell carcinoma (cases) attended in 3 major hospitals of São Paulo, Brazil, paired with 296 controls, recruited from outpatient units of the same hospitals. Multivariate models assessed the effect of fruits and salads according to smoking and drinking. The intake of fruit was associated with the prevention of the disease in the specific assessment among light [odds ratio (OR) = 0.46; 95% confidence interval (CI) = 0.27-0.78) and heavy (OR = 0.30; 95% CI = 0.14-0.65) smokers. The same was observed for vegetables consumption. For nonsmokers, no fruit (OR = 50; 95% CI = 0.22-1.12) or vegetable (for tomato, OR = 0.53; 95% CI = 0.31-0.93) was associated with reduced risk of oral and oropharyngeal cancer. Similar results were found in the stratified analysis according to drinking status with OR = 0.51 (95% CI = 0.30-0.87) and 0.18 for fruits (95% CI = 0.07-0.45), respectively, for light and heavy drinkers. This observation suggests that the protective effect of fruit and salad intake may modulate the deleterious effects from tobacco and alcohol.

Relationship between oral health-related quality of life and the position of the lower third molar: postoperative follow-up.

PURPOSE: The aim of this study was to verify possible associations between oral health-related quality of life (QoL) and the position of the lower third molar among patients undergoing lower third molar surgery during the first postoperative week. MATERIALS AND METHODS: We performed an interventional prospective study of 86 patients for whom the preoperative treatment plan included the removal of 2 third molar teeth from the same side in a 1-time procedure. The patients were divided into 2 groups depending on the position of the lower third molar. QoL was evaluated before and after the surgical procedure (during the first 7 days) with the Oral Health Impact Profile (OHIP) 14 questionnaire. Data were treated according to Stata 10.0 (StataCorp, College Station, TX). Variables were evaluated by use of split-plot analysis of variance for the repeated-measures analysis to identify the association between QoL and the position of the lower third molar. RESULTS: Patients can have deterioration in their QoL immediately after surgery, especially during the first and second postoperative days, and subsequently show rapid improvement. The variation in the total OHIP score during the days after surgery was significant, whereas a decrease in QoL was observed immediately after the procedure (P = .001), which returned to initial value (preoperative) levels after the sixth postoperative day. The OHIP domains with higher scores (ie, those that had an impact) were physical pain, psychological discomfort, and physical disability (domains 2, 3, and 4, respectively). CONCLUSIONS: Teeth considered to be associated with technical difficulties for extraction based on their position had a higher score on the OHIP-14 questionnaire and worse health-related QoL score. QoL outcomes may be as important as clinical signs in decisions regarding third molar extractions.

[Consumption of animal-derived foods and mouth and oropharyngeal cancer]. / Consumo de alimentos de origem animal e câncer de boca e orofaringe.

OBJECTIVE: Evaluate the relationship between animal-derived foods and mouth and oropharyngeal cancer. METHODS: Hospital-based case-control study matched by sex and age (± 5 years) with data collected between July of 2006 and June of 2008. The sample contained 296 patients with mouth and oropharyngeal cancer and 296 patients without a cancer history who were treated in four hospitals in the City of São Paulo, State of São Paulo, Brazil. A semistructured questionnaire was administered to collect data regarding socioeconomic condition and harmful habits (tobacco and alcoholic beverage consumption). To assess eating habits, a qualitative questionnaire that asked about the frequency of food consumption was used. The analysis was rendered by means of multivariate logistic regression models that considered the existing hierarchy among the characteristics studied. RESULTS: Among foods of animal origin, frequent consumption of beef (OR = 2.73; CI95% = 1.27-5.87; P < 0.001), bacon (OR = 2.48; CI95% = 1.30-4.74; P < 0.001) and eggs (OR = 3.04; CI95% = 1.51-6.15; P < 0.001) was linked to an increased risk of mouth and oropharyngeal cancer, in both the univariate and multivariate analyses. Among dairy products, milk showed a protective effect against the disease (OR = 0.41; CI95% = 0.21-0.82; P < 0.001). CONCLUSIONS: This study affirms the hypothesis that animal-derived foods can be etiologically linked to mouth and oropharyngeal cancer. This information can guide policies to prevent these diseases, generating public health benefits.

Disparities in Excess Mortality Between Indigenous and Non-Indigenous Brazilians in 2020: Measuring the Effects of the COVID-19 Pandemic.

This study aimed to estimate the number of excess deaths among Indigenous Peoples associated with the COVID-19 pandemic in 2020 and to assess the disparities in excess mortality between Indigenous and non-Indigenous Brazilians. A time series analysis of weekly mortality data including all deaths from January 2015 to December 2020 was conducted. The number of expected deaths for 2020 was estimated using an over-dispersed Poisson model that accounts for demographic changes, temporal trends, and seasonal effects in mortality. Weekly excess deaths were calculated as the difference between the number of observed deaths and the expected deaths. Regional differences in Indigenous mortality were investigated. A significant increase in Indigenous mortality was observed from April 1 to December 31, 2020. An estimated 1149 (95% CI 1018-1281) excess deaths was found among Indigenous Brazilians in 2020, representing a 34.8% increase from the expected deaths for this population. The overall increase in non-Indigenous mortality was 18.1%. The Indigenous population living in the Brazilian Amazon area was the earliest-affected Indigenous group, with one of the highest proportional increases in mortality. Disparities in excess mortality revealed a disproportionate burden of COVID-19 among Indigenous Brazilians compared to their non-Indigenous counterparts. Findings highlight the importance of implementing an effective emergency plan that addresses the increased vulnerability of Indigenous Peoples to COVID-19.

Dynamics in oral health-related factors of Indigenous Australian children: A network analysis of a randomized controlled trial.

OBJECTIVES: Network analysis is an innovative, analytic approach that enables visual representation of variables as nodes and their corresponding statistical associations as edges. It also provides a new way of framing oral health-related questions as complex systems of variables. We aimed to generate networks of oral health variables using epidemiological data of Indigenous children, and to compare network structures of oral health variables among participants who received immediate or delayed delivery of an oral health intervention. METHODS: Epidemiological data from 448 mother-child dyads enrolled in a randomized controlled trial of dental caries prevention in South Australia, Australia, were obtained. Networks were estimated with nodes representing study variables and edges representing partial correlation coefficients between variables. Data included dental caries, impact on quality of life, self-rated general health, self-rated oral health, dental service utilization, knowledge of oral health, fatalism and self-efficacy in three time points. Communities of nodes, centrality, clustering coefficient and network stability were estimated. RESULTS: The oral health intervention interacted with the network through self-rated general health and knowledge of oral health. Networks depicting groups shortly after receiving the intervention presented higher clustering coefficients and a similar arrangement of nodes. Networks tended to return to a preintervention state. CONCLUSION: The intervention resulted in increased connectivity and changes in the structure of communities of variables in both intervention groups. Our findings contribute to elucidating dynamics between variables depicting oral health networks over time.

Cumulative coffee consumption and reduced risk of oral and oropharyngeal cancer.

We examined the association between coffee consumption and oral cancer in a hospital-based case-control study comprising 143 patients with oral and oropharyngeal squamous cell carcinoma attended at 3 major hospitals in Sao Paulo, Brazil, and 240 controls without cancer, recruited from outpatient units of the same hospitals and matched with cases by sex and age. Associations were assessed by multivariate logistic regression conditioned on sociodemographic and behavioral characteristics. Tobacco smoking, alcohol drinking, and higher intake of bacon and deep-fried foods were directly related to disease; the inverse was observed to family income and salad intake. Coffee consumption and tobacco smoking were partially correlated (Spearman correlation coefficient 0.14 among cases, 0.31 among controls). When adjusted for all covariates, a cumulative coffee consumption higher than 18.0 daily liters × year during lifetime was indicated to be protective against disease (adjusted odds ratio 0.39, 95% confidence interval 0.16-0.94, P = 0.037). This observation may have pharmacological implications for clinical medication of these cancers and is relevant to programs aimed at reducing the burden of disease.

Household food insecurity, dental caries and oral-health-related quality of life in Brazilian Indigenous adults.

Food insecurity is a complex phenomenon that affects the health and wellbeing of vulnerable families. The aim of this study was to investigate the relationship between household food insecurity, dental caries, oral health-related quality of life, and social determinants of health among Indigenous adults. A cross-sectional study was conducted among Kaingang adults aged 35-44 years old from the Guarita Indigenous Land, Brazil. Food insecurity was assessed through the EBIA scale. Dental caries was assessed using the DMFT index. Participants answered the OHIP-14 questionnaire and a structured interview. Descriptive and multivariate analyzes using Poisson regression models were performed. The final sample included 107 adults from 97 households. Approximately 95% lived in food insecure families. Severe food insecurity was present in 58% of the households. The phenomenon was associated to the Bolsa Família benefit, household size, and greater perception of oral health impacts on quality of life. The high number of families affected by food insecurity reveals the social vulnerability of the Kaingang people. Food insecurity in Kaingangs adults is associated to oral health perception and social determinants of health.

Network analysis and psychometric properties of the Brazilian version of the eHealth Literacy Scale in a dental clinic setting.

BACKGROUND: The eHealth Literacy Scale (eHEALS) has become a standard tool for the evaluation of digital health literacy. OBJECTIVES: This study aims to examine the validity and reliability of the Brazilian version of the eHEALS in a sample of patients from a dental clinic setting. MATERIAL AND METHODS: A cross-sectional survey was conducted in a dental setting. The sample included patients from the Dental Clinic of the Dentistry School of the University of São Paulo between September 2019 and March 2020. The underlying structure of the data was exploratorily investigated using Exploratory Graph Analysis, a network analysis method. The internal reliability was assessed using the McDonald's Omega coefficient. Confirmatory Factor Analysis (CFA) was used to assess the fit of the structure identified by the network analysis. Convergent validity was assessed using the Average Variance Extracted, and measurement invariance was examined using nested models in multigroup CFA. Criterion-related validity was examined calculating the latent mean differences between subgroups (genders, age groups, and educational levels). RESULTS: The sample included 132 adults aged 18 to 82 years (mean 44.7 years). The eHEALS network indicated that items form a single-factor structure. The 1-factor model presented adequate fit (χ2 (18) = 29.873, p < 0.039; R-CFI = 0.997; R-TLI = 0.996; R-RMSEA = 0.032, 90% CI [0.000, 0.052]), good internal reliability, and convergent validity. Configural invariance was found for genders, educational levels, and age groups. Scalar invariance was observed for genders and age, whereas partial scalar invariance was confirmed for education. Participants aged 18 to 45 and those with higher education presented greater latent means for eHEALS subscales. There were no differences between genders. CONCLUSION: The BR-eHEALS presented good internal reliability, convergent validity, measurement invariance, and was able to discriminate the levels of eHealth literacy among groups with different ages and educational levels. These findings demonstrate that the tool is valid and reliable for use in a dental setting with the Brazilian population.

A pilot study of an automated personal identification process: Applying machine learning to panoramic radiographs.

PURPOSE: This study aimed to assess the usefulness of machine learning and automation techniques to match pairs of panoramic radiographs for personal identification. MATERIALS AND METHODS: Two hundred panoramic radiographs from 100 patients (50 males and 50 females) were randomly selected from a private radiological service database. Initially, 14 linear and angular measurements of the radiographs were made by an expert. Eight ratio indices derived from the original measurements were applied to a statistical algorithm to match radiographs from the same patients, simulating a semi-automated personal identification process. Subsequently, measurements were automatically generated using a deep neural network for image recognition, simulating a fully automated personal identification process. RESULTS: Approximately 85% of the radiographs were correctly matched by the automated personal identification process. In a limited number of cases, the image recognition algorithm identified 2 potential matches for the same individual. No statistically significant differences were found between measurements performed by the expert on panoramic radiographs from the same patients. CONCLUSION: Personal identification might be performed with the aid of image recognition algorithms and machine learning techniques. This approach will likely facilitate the complex task of personal identification by performing an initial screening of radiographs and matching ante-mortem and post-mortem images from the same individuals.

Brazilian Oral health teams in primary care and oral cancer: Results of a national evaluation.

Oral cancer is one of the most prevalent cancers in Brazil. An understanding of how public policies are implemented to address this problem can contribute to the construction of solutions. The "Programa de Melhoria do Acesso e da Qualidade" (PMAQ-AB and PMAQ-CEO) at the level of primary and secondary care are evaluations that also collect data on prevention and monitoring strategies for oral cancer. This study aimed to analyze the results of the incorporation of oral health teams to evaluate the strategies adopted by Brazil regarding the impact on the diagnosis of oral cancer. Of the 17,202 family health teams evaluated, 72.10% had oral health teams (OHT). Considering the strategies for prevention, screening, campaign, and follow-up of suspected cases, 72.27% of the campaign teams and 59.09% of the teams who accompanied suspected cases had OHT. In secondary care, more than 65% of the teams in the Southeast and South regions registered cases of oral cancer, and the referral network was more represented. The inclusion of OHT had a positive impact on campaign actions, follow-up, referral to specialists, and registration of suspected cases throughout Brazil.

National survey of the incidence of missing anterior teeth: potential use in bite mark analysis in the Brazilian context.

Bite mark analysis in forensic dentistry presupposes that the human dentition is unique and that its characteristics can be transferred precisely to several materials. The aim of the present study was to register the frequency of missing anterior teeth in the Brazilian adult population, discussing its potential importance in bite mark analysis. Data from the Brazilian Oral Health Survey were used; 13,431 male and female individuals aged 35 to 44 were examined according to the criteria of the World Health Organization. The analysis of Poisson regression was performed in order to calculate the rating ratios and the respective confidence interval at 95%. A total of 13,431 adults participated in the study. Among male individuals, 2063 (47.00%) were dentate and 2036 (46.40%) had at least one missing tooth. Only 254 (5.83%) were totally edentulous. A significant number of males and females presented 6 missing teeth in the same dental arch, revealing the poor state of oral health of adult Brazilians. Missing teeth were more frequent in the upper dental arch than in the lower arch. In the upper dental arch, the incisor group (central and lateral) was missing the most. In the lower dental arch, however, a certain lack of homogeneity was observed among the different dental groups as regards missing teeth. White individuals presented a smaller proportion of missing teeth compared to the other ethnic groups. Females were 1.61 (CI 1.50-1.73) times more likely than males to present missing teeth. The absence of upper teeth and the presence of lower teeth were observed in 16.10% of the individuals. Further research should also include an analysis of different age groups. This would increase the potential of applying this kind of information to bite mark analysis.