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Background: This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self-reported school performance (SRSP) in adolescents enrolled in public schools in Brazil. Methods: This was a cross-sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self-administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self-rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models. Results: The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC. Conclusions: OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health-related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC.

Objectives: In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics. Methods: The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified. Results: The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas. Conclusion: This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self‐reported school performance (SRSP) in adolescents enrolled in public schools in Brazil. METHODS: This was a cross‐sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self‐administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self‐rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models. RESULTS: The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC. CONCLUSIONS: OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health‐related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the replicability of oral health literacy (OHL) network models across the general community and a sample of older adults from Brazil.Methods: Data were obtained from two oral health surveys conducted with a total of 1138 participants. OHL was measured using the short form Health Literacy in Dentistry scale (HeLD-14). A regularized partial correlation network was estimated for each sample. Dimensionality and structural stability were examined via exploratory graph analysis. Network properties compared included global strength, edge weights, and centrality estimates. Model replicability was examined fitting the general community model to the older participants' data.Results: Six dimensions with the exact same item composition were detected in both network models. Only the Receptivity domain in the older adults sample yielded low structural stability. Strong correlations were observed between edge weights (τ: 0.68; 95% CI: 0.62-0.74) and between node strength estimates (τ: 0.63; 95% CI: 0.36-0.89). No statistically significant differences were found for global strength. The fit of the older adults sample to the HeLD-14 network structure of the general community sample was satisfactory.Conclusion: Network models OHL replicated across the general community and a sample of older adults. The psychometric network approach is a useful tool to evaluate the measurement equivalence of OHL instruments across populations. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate associations of sociodemographic, lifestyle, medical conditions, and caries experience with oral health‐related quality of life (OHRQoL) in a large sample of adults with mental disorders. A sample of 753 adults diagnosed with schizophrenia or depression, who were users of 10 public mental health outpatient clinics located in the city of São Paulo, Brazil, participated in the study. Participants provided data on sociodemographic characteristics, psychiatric diagnosis, medication use, and health behaviors. Oral examinations to evaluate dental caries (using the decayed, missing, and filled teeth ([DMFT] index) and dental plaque (using the Silness–Löe plaque index) were conducted. Oral health‐related quality of life was evaluated using the 14‐item Oral Health Impact Profile (OHIP‐14) questionnaire. Log‐Poisson regression was used to evaluate associations between the outcome and independent variables. The prevalence of one or more OHIP‐14 impacts occurring fairly often/often was 72.3%. Physical pain was the OHIP domain with the highest prevalence, followed by psychological discomfort. Multivariable analysis showed that higher prevalence of the reponses 'fairly often/often' in the OHIP‐14 was associated with being female, aged 35 to 54 years, having a low family income, a diagnosis of depression, a smoking habit, and fewer than 20 teeth. Adults with mental disorders had a high prevalence of impacts on their OHRQoL, which were associated with caries experience, sociodemographic characteristics, type of psychiatric diagnosis, and behavioral risk indicators. [ABSTRACT FROM AUTHOR]

Objective: To compare patterns of dental caries, periodontal disease and dental care among Indigenous and non‐Indigenous Central‐West Brazilian subpopulations. Methods: Data were from two population‐based cross‐sectional studies involving 5‐, 12‐, 15‐19‐ and 35‐44‐year‐olds. The first examined were the Guarani, Kaiowá, Terena and Kadiwéu Indigenous groups from Mato Grosso do Sul Brazilian state and the second comprised a non‐Indigenous population. Mean numbers of sound teeth, decayed, missing and filled teeth (dmft/DMFT), prevalence of poor oral hygiene for adults (35‐44 years) and of periodontal disease were estimated. Restorative dental service utilization was measured using the Care Index. Results: The study populations comprised of 1830 Indigenous and 29 395 non‐Indigenous people. The Kaiwoá ethnic group had the lowest DMFT among Indigenous groups for ages 12, 15‐19 years; 0.9 (95% CI 0.7‐1.1) and 2.4 (95% CI 1.9‐2.9), respectively. The highest values were observed among the 12‐year‐old Terena ethnic group and 15‐ to 19‐year‐old Kadiwéo groups; 2.2 (95% CI 1.8‐2.5) and 3.7 (95% CI 3.1‐4.4), respectively. The mean DMFT values were significantly lower among Indigenous than non‐Indigenous people for all age groups. The prevalence of bleeding and calculus was 70.3% (95% CI 64.5%‐75.5%) and 80.1% (95% CI 74.8%‐84.5%), respectively, for Indigenous people and 43.9% (95% CI 34.4%‐50.7%) and 61.5% (95% CI 55.4%‐67.2%), respectively, for the non‐Indigenous population. Restorative services were higher among 5‐year‐old non‐Indigenous children and adults than for Indigenous groups. Among Indigenous groups, the Terena had the highest level of restored teeth (38.0% at 12 years) and Kadiwéu the lowest level (8.8% at 12 years). Conclusion: In our study, Indigenous people had a lower caries burden, but less access to restorative services than their non‐Indigenous counterparts. These disparities likely reflect differences in historical, socioeconomic, cultural, environmental and political determinants that both groups have experienced differently over time. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate associations between oral health literacy (OHL), self‐rated oral health (SROH), and oral health‐related quality of life (OHRQoL) in Brazilian adults. A sample of 523 Brazilian adults completed the short‐form Health Literacy in Dentistry (HeLD‐14) and the Oral Health Impact Profile‐14 (OHIP‐14) instruments that measure OHL and OHRQoL, respectively. The prevalence ratios (PRs) for outcome variables and their 95% CIs were quantified. Multivariable log‐binomial regression models were applied, as the statistical models, to estimate bivariate and multivariable relationships of oral health outcomes with OHL, after adjusting for covariates. No significant association was found between poor SROH (as measured by single items) and OHL (PR = 1.28; 95% CI: 0.87–1.88); by contrast, significant associations were found between poor SROH and income (PR = 1.52; 95% CI: 1.04–2.21), toothbrushing frequency (PR = 1.69; 95% CI: 1.11–2.58), reason for dental visiting (PR = 1.48; 95% CI: 1.03–2.13), and self‐rated general health (PR = 3.44; 95% CI: 2.38–4.97). The OHL level (PR = 1.76; 95% CI: 1.21–2.56), educational level (PR = 0.62; 95% CI: 0.41–0.93), reason for dental visiting (PR = 1.84; 95% CI: 1.30–2.61), and self‐rated general health (PR = 1.51; 95% CI: 1.03–2.23) were associated with poor OHRQoL. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of oral health literacy (OHL) and associated factors on dissatisfaction with oral health (DOH) among older people.Background: Oral health literacy is a recent field of research that has been considered an important mediator between socioeconomic variables and oral health outcomes. However, there are few studies with older people.Materials and Methods: A cross-sectional study was conducted with 535 non-institutionalised older people aged 60-100 years from Brazil. Individuals completed a questionnaire on general health, sociodemographic information and usual reason for dental visit. OHL was assessed using the Health Literacy in Dentistry questionnaire (HeLD-14), validated in Brazil. DOH was the outcome of interest. Poisson regression with robust standard errors was applied as a statistical model to estimate bivariate and multivariable relationships of DOH with OHL after adjusting for sex, age, social characteristics and general health using the P-value of ≤ .05.Results: The overall prevalence of DOH was 21.1%. Multivariable regression analysis showed that older people with low OHL (HeLD-14 score ≤35) had 1.28 times the odds of having DOH than those with high OHL (HeLD14 score >46), after adjusting for sociodemographic, economic and health outcomes.Conclusions: Dissatisfaction with oral health in older people is a complex issue associated with OHL, social and behavioural factors. Health services should give greater attention to developing health literacy competences in older adults in order to empower them to achieve optimal oral health. [ABSTRACT FROM AUTHOR]

This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ11-14 instrument demonstrated acceptable responsiveness properties. [ABSTRACT FROM AUTHOR]

Objective To compare the magnitude of relative oral health inequalities between Indigenous and non-Indigenous persons from Brazil, New Zealand and Australia. Methods Data were from surveys in Brazil (2010), New Zealand (2009) and Australia (2004-06 and 2012). Participants were aged 35-44 years and 65-74 years. Indigenous and non-Indigenous inequalities were estimated by prevalence ratios ( PR) and their corresponding 95% confidence intervals ( CI), adjusting for sex, age and income. Outcomes included inadequate dentition, untreated dental caries, periodontal disease and the prevalence of 'fair' or 'poor' self-rated oral health in Australia and New Zealand, and satisfaction with mouth/teeth in Brazil ( SROH). Results Irrespective of country, Indigenous persons had worse oral health than their non-Indigenous counterparts in all indicators. The magnitude of these ratios was greatest among Indigenous and non-Indigenous Australians, who, after adjustments, had 2.77 times the prevalence of untreated dental caries (95% CI 1.76, 4.37), 5.14 times the prevalence of fair/poor SROH (95% CI 2.53, 10.43). Conclusion Indigenous people had poorer oral health than their non-Indigenous counterparts, regardless of setting. The magnitude of the relative inequalities was greatest among Indigenous Australians for untreated dental decay and poor SROH. [ABSTRACT FROM AUTHOR]

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., (© 2021. W. Montague Cobb-NMA Health Institute.)

Aims: To investigate the factors associated with poor oral health-related quality of life (OHRQoL) in a sample of Brazilian older adults., Methods and Results: A cross-sectional study was conducted with 535 non-institutionalized elders aged 60 years or older from Piracicaba, São Paulo, Brazil. OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Data on sociodemographic characteristics, self-perceived general health status, and health-related behaviors were obtained through a structured questionnaire. Data on chronic diseases were obtained from health records. Associations between exploratory factors and low OHRQoL (% GOHAI score <30) were evaluated using multivariate Poisson regression models to estimate adjusted prevalence ratios (PRs) and confidence intervals. The mean OHRQoL score was 30 (± 4.4). In bivariate analysis, being not married, smoking, and self-rated "fair/poor" general health status were associated with lower OHRQoL. In the adjusted model, self-rated "fair/poor" general health (PR: 1.25; 95% CI: 1.05-1.48), presence of chronic diseases (PR: 1.88; 95% CI: 1.37-2.58), smoking (PR: 1.25; 95% CI: 1.02-1.53), and reason for last dental appointment (PR: 1.34; 95% CI: 1.13-1.59) were associated with poor OHRQoL., Conclusion: Non-institutionalized older adults with a history of chronic diseases, who smoke, have a negative perception of their general health, and had the last dental appointment motivated by pain present significantly higher prevalence rates of poor OHRQoL., (© 2021 Special Care Dentistry Association and Wiley Periodicals LLC.)

This study aims to perform cross-cultural adaptation and validation of the "Self-efficacy scale to brush teeth at night" with a Brazilian adult population. Translation and cross-cultural adaptation to the Brazilian-Portuguese language were done according to the stages recommended in the literature. Construct validity was carried out by mean of exploratory and confirmatory factorial analysis in a sample of 198 adult subjects. The reliability of the instrument was measured by Alpha and Omega indices. The model was observed to have been established as one-dimensional for all indicators, with explained variance of 85.7%; factorial loads between 0.85 and 0.91; and with communalities between 0.72 and 0.83. The goodness of fit of the model shown by the confirmatory model were between 0.98 and 0.99; with factorial loads between 0.85 and 0.93, and regression values between 0.69 and 0.84, all above the minimum indices established for instrument quality. For reliability, the Alpha and Omega values had identical indices of 0.95 showing high levels of reliability of the model. The G-H index replicability was 0.96, indicating the stability of solution in other contexts and samples. We concluded that all indicators represented excellent evidence of scale validity to measure self-efficacy to brush teeth at night.

Objectives: To perform cross-cultural adaptation and validation of the Health Literacy Dental scale (HeLD) in Brazilian adults., Methods: The HeLD instrument was translated and cross-culturally adapted to the Brazilian Portuguese language to create longer (HeLD-29) and shorter (HeLD-14) versions. The reliability and validity of these versions were assessed in a sample of 603 adults living near six primary care units in the city of Piracicaba, São Paulo, Brazil., Results: Both versions of HeLD demonstrated high internal reliability, acceptable convergent validity and discriminant validity. However, the confirmatory factor analysis showed that only HeLD-14 demonstrated satisfactory goodness of fit. There were associations between HeLD-14 scores and social demographic characteristics, general and oral health and oral health-related behaviours. Higher scores were observed for the total HeLD-14 and/or individual components of HeLD-14 among women, ethnic white subjects, those with high educational attainment, those with higher income, those reporting toothbrushing twice or more daily, regular dental attenders, those who usually attended for dental care for a check-up, those with excellent or very good self-ratings of general health, those with excellent or very good self-ratings of oral health, and those without tooth extraction and oral health impact., Conclusion: The Brazilian version of HeLD-14 was demonstrated to be a reliable and valid instrument for measuring broad aspects of oral health literacy in the adult Brazilian population., (© 2019 FDI World Dental Federation.)

This study aimed to assess the reliability and validity of Brazilian-Portuguese versions of the Health Literacy in Dentistry (HeLD) scale in a sample of elderly Brazilian participants. HeLD was initially translated into and cross-culturally adapted to the Brazilian Portuguese language. The reliability and validity of HeLD were then assessed in a sample of 535 non-institutionalized older persons who also completed a questionnaire containing sociodemographic and health information. Data were then randomly separated into two sub-datasets, and Confirmatory Factor Analysis was performed through structural equation modelling, with a maximum likelihood estimate to test the fit of the data to the factor structure of the long-and short-form HeLD (HeLD-29 and HeLD-14) versions of the instrument. The models were compared using the Akaike Information Criterion to assess goodness-of-fit and to determine which models were preferred. Internal consistency of HeLD was evaluated using Cronbach´s coefficient α. Both versions of HeLD were observed to demonstrate high internal reliability (Cronbach´s α ≥ 0.87 for all seven subscales), acceptable convergent (estimates of ≥ 0.50 for AVE and ≥ 0.70 for CR) and discriminant validity. However, the goodness-of-fit of the confirmatory factor analysis models demonstrated satisfactory results only for HeLD-14 subsamples (x2/df = 1.8-2.3; CFI = 0.97-0.98; GFI/NFI = 0.98-0.99; RMSEA = 0.05 and SRMR = 0.03). In conclusion, HeLD-14 was shown to be a reliable and valid instrument to measure oral health literacy in elderly Brazilian participants.

This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ11-14 instrument demonstrated acceptable responsiveness properties.

Objective: The objective of this study was to investigate the psychometric properties of the Oral Health Literacy Assessment in Spanish (OHLA-S) for the Brazilian-Portuguese language using robust analysis and with the results disclose possibilities to develop a shorter and more valid instrument., Methods: OHLA-S is an oral health literacy instrument comprising a word recognition section and a comprehension section. It consists of 24 dental words. It was translated into the Brazilian-Portuguese language (OHLA-B) and its psychometric properties were evaluated in a random sample of 250 adults aged 20-59 years. To assess the dimensionality and factor structure were tested by means of Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Reliability was assessed using two indicators: Cronbach's alpha and McDonald's Omega., Results: EFA and CFA demonstrated that the OHLA-B with 24 items did not present an adequate adjustment of the model, compromising its validity. In addition, reliability values at 0.50 for Cronbach's alpha and 0.67 for McDonald's omega were below the minimum acceptable rate of 0.70. As no support was found for the original structure, we decided to proceed with the withdrawal of individual items and successive reanalysis of the model until the indicators were adjusted in a shorter instrument. A new structure with 15 items produced an instrument with two dimensions and a better goodness of fit than the original instrument. The Alpha and Omega reliability index values increased to 0.83 and 0.80, respectively, and all scores were better in the OLHA-B with 15 items than in the instrument with 24 items., Conclusion: OLHA-B with the original structure composed by 24 items did not show acceptable construct validity. The shorter version with 15 items showed more promising results for assessing oral health literacy levels in the Brazilian population., Competing Interests: The authors have declared that no competing interests exist.

This overview revealed that substantial oral health inequalities exist between Indigenous and non-Indigenous child and adult populations in the United States, Canada, Brazil, Australia and New Zealand, with evidence suggesting that these inequalities are increasing. Despite the marked differences in geography, culture, language and history experienced by these groups, it is notable how similar the oral health inequalities were. A number of reasons are discussed in the paper.