Abstract in English:In spite of decades of research on fluoride and the recognition of its role as the cornerstone of dental caries reduction in the last fifty years, questions still arise on its use at community, self-applied and professional application levels. Which method of fluoride delivery should be used? How and when should it be used? How can its benefits be maximized and still reduce the risks associated with its use? These are only some of the challenging questions facing us daily. The aim of this paper is to present scientific background to understand the importance of each method of fluoride use considering the current caries epidemiological scenario, and to discuss how individual or combined methods can be used based on the best evidence available.
Abstract in English:The central idea of the Brazilian health system is to prevent the establishment of disease or detect it as early as possible. Prevention and treatment of dental caries are related to behavioral factors, including dietary and oral hygiene habits, which are related to many chronic diseases. Dental health promotion therefore should be fully integrated into broadly based health-promoting strategies and actions such as food and health policies, and general hygiene (including oral hygiene), among others. For decades, a linear relationship between sugar consumption and caries has been observed. Recent data has indicated that this relationship is not as strong as it used to be before the widespread use of fluoride. However, diet is still a key factor acting in the carious process. Oral hygiene is a major aspect when it comes to caries, since dental biofilm is its etiological factor. Oral hygiene procedures are effective in controlling dental caries, especially if plaque removal is performed adequately and associated with fluoride. An alternative to a more efficient biofilm control in occlusal areas is the use of dental sealants, which are only indicated for caries-active individuals. If a cavity is formed as a consequence of the metabolic activity of the biofilm, a restorative material or a sealant can be placed to block access of the biofilm to the oral environment in order to prevent caries progress. The prevention of dental caries based on common risk-factor strategies (diet and hygiene) should be supplemented by more disease-specific policies such as rational use of fluoride, and evidence-based dental health care.
Abstract in English:This article discusses the model of oral health care implemented in the Unified Health System of Brazil in the last decade. This model was conceived as a sub-sector policy that, over the years, has sought to improve the quality of life of the Brazilian population. Through a chronological line, the study presents the National Policy on Oral Health as a counter-hegemonic patient care model for the dentistry practices existing in the country before this policy was implemented. The reorganization of the levels of oral health care, the creation of reference facilities for secondary and tertiary care, through Centers of Dental Specialties and Regional Dental Prosthesis Laboratories, and the differential funding and decentralized management of financial resources were able to expand the actions of oral health for more than 90 million inhabitants. The evolution shown after the deployment of the National Oral Health Policy, as of 2004, demonstrates the greater integration of oral health care under the Unified Health System and provides feedback information to help this policy to continue to be prioritized by the Federal Government and receive more support from the state and local levels in the coming years.
Abstract in English:The mechanical control of supragingival biofilm is accepted as one of the most important measures to treat and prevent dental caries and periodontal diseases. Nevertheless, maintaining dental surfaces biofilm-free is not an easy task. In this regard, chemical agents, mainly in the form of mouthwashes, have been studied to help overcome the difficulties involved in the mechanical control of biofilm. The aim of this paper was to discuss proposals for the teaching of supragingival chemical control (SCC) in order to improve dentists' knowledge regarding this clinical issue. Firstly, the literature regarding the efficacy of antiseptics is presented, clearly showing that chemical agents are clinically effective in the reduction of biofilm and gingival inflammation when used as adjuvant agents to mechanical control. Thus, it is suggested that the content related to SCC be included in the curricular grid of dental schools. Secondly, some essential topics are recommended to be included in the teaching of SCC as follows: skills and competencies expected of a graduate dentist regarding SCC; how to include this content in the curricular grid; teaching-learning tools and techniques to be employed; and program content.
Abstract in English:Investigation in oral cancer comprises many different fields such as epidemiology, risk factors, biological markers, diagnostic testing, screening, treatment and prognosis. Although many researchers have dealt with the oral cancer problem, it is unknown if any public policy is capable of reducing its incidence around the world under the scrutiny of the scientific method. This paper aims to briefly review and discuss the literature regarding oral cancer public policies and to screen the evidence of controlled implementations of oral health policies that have been able to diminish oral cancer incidence around the globe.
Abstract in English:Patients frequently fail to achieve an optimal mechanical plaque control. However, many patients are not confident about using mouthrinses, and many professionals refuse to prescribe them for regular daily use. Aiming at achieving a better understanding of the use and prescription of mouthrinses in periodontics, 24 dentists with different dental educational levels were purposively chosen and interviewed in a qualitative research. Partial data was presented at the 15th Congress of the Brazilian Association for Oral Health Promotion (ABOPREV), and full data was presented at the 88th General Session and Exhibition of the International Association for Dental Research (IADR). The professionals' answers were confirmed or rejected through scientific data analysis. Additionally, scientifically supported answers were provided for the interviewees' most frequent unanswered questions. Around half of the participants (46%) reported that they recommended the use of mouthrinses, although a high percentage (64%) of the dentists answered that they knew very little about the efficacy of mouthrinses and also about the oral benefits (54%) provided by them. All interviewees reported that they were aware of the fact that their patients, and themselves, failed to floss and, less frequently, to brush their teeth, and all of them believed that oral health impacts overall systemic health. Seventy five percent answered that using mouthrinses was safe. Most participants (55%) did not declare themselves as mouthrinse users. We concluded that dentists with different levels of dental education have only partial knowledge related to mouthrinse use in periodontics. The use of effective mouthrinses on a daily basis is justified and can help patients achieve or maintain a healthier mouth. A healthier mouth will positively impact patients' quality of life and could also benefit their overall systemic health.