Health literacy on oral health practice and condition in an adult and elderly population.

The objective of this study was to investigate the impact of health literacy (HL) on health practices and oral health outcomes in an adult and elderly population in Brazil. A cross-sectional study nested in a cohort study was followed up over a period of four years (2011 and 2015) and assessed individuals between 23 and 69 years old from Piracicaba, São Paulo, Brazil. Data were collected by means of oral examinations (coronal caries, periodontal disease and visible biofilm) and interviews (socioeconomic, demographic, oral health-related quality of life, health practices and HL). The 14-item Health Literacy Scale (HLS) was used for HL data, which was the main explanatory variable. The result of the sum of the HLS-14 questionnaire for each participant was dichotomized into the median (46 points): 'high' and 'low' HL. Binary/multinomial logistic regressions were performed on health practice and oral health outcomes, controlled by age and sex (Model 1) and age, sex and socioeconomic status (Model 2; p < 0.05). The final sample consisted of 137 subjects and 43.8% (n = 60) presented low HL (LHL). LHL was associated with health practices, such as use of public dental services in Model 1 (odds ratio [OR] = 0.34, 95% CI: 0.14-0.87) and use of dental services for emergency in Model 1 (OR = 2.69, 95% CI: 1.29-5.51) and Model 2 (OR = 2.93, 95% CI: 1.17-7.30). Based on age and sex, LHL was associated with use of public dental service and use of emergency dental visits. Based on age, sex and socioeconomic status, LHL was associated with use of emergency dental visits.

Cariology in curriculum of Brazilian dental schools.

Reasons for the iniquities of caries, globally recognized, may be related to how Cariology has been taught in dental schools. In Brazil, the most important universities, when considering healthcare teaching, are the public ones. The objective of this study was to identify the insertion of the contents of Cariology in the course flowcharts of public dental schools in the country. The survey was conducted in 2013 seeking to identify the realities of different geographical regions, aimed to the census of public dental schools. It was performed a documentary analysis of the menus of disciplines, identifying the following issues: number of dental schools that include content related to Cariology in their curricula; average total workload undergraduate courses and disciplines that contemplate the theme; distribution of disciplines in professional training cycles (basic, clinical and public health); existence of discipline and/or a specific department; verification of bibliographic indication directly related to Cariology. The response rate was 93.6%. All dental schools recommended specific books, and none of them had a Department of Cariology. All dental schools in the country contemplated content related to Cariology in their disciplines, distributed in specific disciplines (except for the Northern region) and disciplines in the three cycles of learning (basic, clinical and public health), with larger workload in the clinical cycle. Although public dental schools in Brazil demonstrated commitment to contemplating the content related to Cariology in their disciplines, the emphasis on the clinical cycle may not be promoting the integrated formation of students, which could be contributing to reflect the inequalities of the disease in the country.

Lead contents in the surface enamel of deciduous teeth sampled in vivo from children in uncontaminated and in lead-contaminated areas.

This study aimed to: (1) measure lead contents in the surface enamel of two populations consisting of 4-6-year-old children, one from an apparently uncontaminated area (Ribeirão Preto, São Paulo State, SP, Brazil, n=247) and the other from an area notoriously contaminated with lead (Bauru, São Paulo State, Brazil, n=26); (2) compare biopsy depths between the two populations; (3) correlate biopsy depth with lead content; (4) stratify samples according to biopsy depth to compare lead contents in samples from similar biopsy depths. A surface enamel acid-etch microbiopsy was performed in vivo on a single upper deciduous incisor for each sample. Lead was measured by graphite furnace atomic absorption spectrometry (GFAAS) while phosphorus was measured colorimetrically to establish biopsy depth. Samples from both populations were classified into categories of similar biopsy depths based on biopsy depth quartiles. Median lead contents were statistically different between the Ribeirão Preto population (206 microg/g, range: 5-1399 microg/g) and the Bauru population (786 microg/g, range: 320-4711 microg/g) (p<0.001); however, biopsy depth did not differ between the Ribeirão Preto (3.9 microm, Standard Deviation, SD=0.9) and Bauru (3.8 microm, SD=0.9) populations (p=0.7940). Pearson's correlation coefficient for biopsy depths versus log10 lead values was -0.29 for Ribeirão Preto and -0.18 for Bauru. Lead contents were statistically different between the two populations for all quartiles of biopsy depth. These findings suggest that lead accumulated in the surface enamel of deciduous teeth is linked to the environment in which people reside, indicating that this tissue should be further explored as an accessible biomarker of lead exposure.

In vivo studies on lead content of deciduous teeth superficial enamel of preschool children.

The amount of lead in the superficial enamel of deciduous teeth from 4- and 5-year-old children was determined by means of an enamel biopsy followed by lead analysis by graphite furnace atomic absorption spectrometry. Children examined in this study (n=329) attended public preschools in the city of Piracicaba, SP, Brazil. The selection of preschools was based on geographical location: some were located in an industrial area of the city, whereas others were located in an area devoid of industries. The objectives of this study were (1) to test whether enamel biopsies were an appropriate method for lead content population screening in young children; (2) to verify the lead content of superficial enamel of preschool children's deciduous teeth and to compare the results obtained from children exposed to different environments; (3) to analyze how biopsy depth correlated with lead content and affected comparisons between groups. An adhesive tape with a central hole (diameter=1.6 mm) was placed on one of the upper central incisors. Five microliters of 1.6 M l(-1) HCl in 70% glycerol (v/v) were applied to this area for 20 s, followed by a rinse with 5-microl ultrapurified water for 10 s. It was shown that the technique was feasible for population studies on young children. The lead concentration in enamel biopsies from the industrial area children (median: 169 ppm Pb) was significantly higher than that from the children living far from industries (118.1 ppm Pb) (P<0.0001). Analysis of the data showed that biopsies deeper than 3.9 microm gave more reliable results for comparisons between groups. To our knowledge, this study is the first to use an enamel microbiopsy to characterize a large sample of young children in vivo for lead monitoring in teeth.