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Recent studies have been concerned about the vast amount of misinformation detected on social media that directly hampers the prevention and control of chronic diseases. Based on these facts, the aim of this study was to identify and characterize misinformation about dental caries-related content found on Facebook, regarding the predictive factors of user interaction with posts. Then, CrowdTangle retrieved 2,436 posts published in English, ordered by the total interaction of the highest users. A total of 1,936 posts were selected for inclusion and exclusion criteria to select a sample of 500 posts. Subsequently, two independent investigators characterized the posts by their time of publication, author's profile, motivation, the aim of content, content facticity, and sentiment. The statistical analysis was performed using Mann-Whitney U and χ2 tests and multiple logistic regression models to determine differences and associations between dichotomized characteristics. p values <0.05 were considered significant. In general, posts were predominantly originated from the USA (74.8%), related to business profiles (89%), presented preventive content (58.6%), and noncommercial motivation (91.6%). Furthermore, misinformation was detected in 40.8% of the posts and was positively associated with positive sentiment (OR = 3.43), business profile (OR = 2.22), and treatment of dental caries (OR = 1.60). While the total interaction was only positively associated with misinformation (OR = 1.44), the overperforming score was associated with posts from the business profile (OR = 5.67), older publications (OR = 1.57), and positive sentiment (OR = 0.66). In conclusion, misinformation was the unique predictive factor of increased user interaction with dental caries-related posts on Facebook. However, it did not predict the performance of the diffusion of posts such as business profiles, older publications, and negative/neutral sentiment. Therefore, it is essential to promote the development of specific policies toward good quality information on social media, which includes the production of adequate materials, the increase of the critical sense of consuming health content, and information filtering mediated by digital solutions.

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Abstract This study aimed to evaluate the influence of the number of dentists in the neighborhood on the incidence of dental caries in the children permanent dentition. This cohort began in 2010 (T1) with a random sample of 639 children (1 to 5 years-old) followed for 7 years, in southern Brazil. The follow-up reassessment (T2) took place in 2017. Untreated dental caries was evaluated at T2 through the Decayed, Missing, and Filled surfaces index (DMF-S). The number of dentists in the neighborhood was obtained from the city's official database and used as a contextual variable. Socioeconomic, demographic, and oral health variables at the individual level were evaluated at T1. A multilevel Poisson regression was performed to evaluate the influence of the predictor variables in the incidence of untreated dental caries. From 639 children at T1, 449 were reassessed at T2 (a 70.3% retention rate). The mean of decayed surfaces at T2 was 0.92 (SE 0.01). The greater the number of dentists in the neighborhoods where the children lived, the lower the incidence of dental caries. Children with low socioeconomic status, who have not routinely visited the dentist in the last 6 months, who presented a experience of dental caries, and whose parents perceived their oral health as fair/poor showed a higher incidence of surfaces with untreated dental caries. As conclusion, children who live in neighborhoods with fewer dentists have a higher incidence of untreated dental caries in permanent dentition.

Resumo Este estudo teve como objetivo avaliar a influência do número de cirurgiões-dentistas do bairro na incidência de cárie dentária na dentição permanente. Esta coorte teve início em 2010 (T1) com uma amostra aleatória de 639 crianças (1 a 5 anos) acompanhadas por 7 anos, no sul do Brasil. A reavaliação (T2) ocorreu em 2017. A cárie dentária não tratada foi avaliada no T2 por meio do índice de superfícies cariadas, perdidas e obturadas (CPO-S). O número de dentistas do bairro foi obtido no banco de dados oficial da cidade e usada como uma variável contextual. Variáveis socioeconômicas, demográficas e de saúde bucal no nível individual foram avaliadas no T1. Foi realizada uma análise de regressão de Poisson multinível para avaliar a influência das variáveis preditoras na incidência de cárie dentária não tratada. Das 639 crianças no T1, 449 foram reavaliadas no T2 (taxa de retenção de 70,3%). A média das superfícies cariadas no T2 foi de 0,92 (EP 0,01). Quanto maior o número de dentistas nos bairros em que as crianças residiam, menor era a incidência de cárie dentária. Crianças com baixo nível socioeconômico, que não consultaram rotineiramente o dentista nos últimos 6 meses, que apresentaram experiência de cárie dentária e cujos pais perceberam sua saúde bucal como regular/ruim apresentaram maior incidência de superfícies com cárie dentária não tratada. Como conclusão, crianças que moram em bairros com menos dentistas têm maior incidência de cárie não tratada na dentição permanente.

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In January 2014, taxes on sugar-sweetened beverages and nonessential energy-dense food were implemented in Mexico to discourage the consumption of these products. Published evaluations have shown reductions in purchases of taxed food and beverages associated with the implementation of this fiscal policy. Although there are some studies on the impact on health based on simulation studies, no evaluations with empirical data on changes in oral health have been published. We used administrative records and data from an epidemiological surveillance system to estimate changes in (1) outpatient visits related to dental caries; (2) having experienced dental caries: Decayed, Missing and Filled Teeth (DMFT) >0 for permanent dentition or dmft >0 for primary dentition (dmft); (3) number of teeth with caries experience (DMFT and dmft), (4) cases with DMFT >0 or dmft >0, and (5) the series of mean DMFT or dmft, associated with the taxes. We estimated probit and negative binomial models for outcomes at individual level, and interrupted time series analysis for population-level outcomes. The implementation of the taxes was associated with negative changes in the trends of outpatient visits, as well as for cases with DMFT >0, dmft >0 and mean DMFT. Taxes were also associated with a lower probability of having experienced dental caries and with a lower number of teeth with caries experience in the samples studied. Our results suggest positive impacts of the implementation of taxes on unhealthy food and beverages in the oral health of Mexicans, which are the first health benefits observed, and add to the health benefits predicted by modeling studies.

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OBJECTIVE: To investigate the impact of the family's socioeconomic trajectory on the oral health status of young people in the city of Sobral, Ceará, Brazil, and test the hypotheses of the life course theory. METHODS: This is a cohort study conducted in 2000, 2006, and 2012. In the third wave, 482 individuals between 17 and 21 years of age were examined and interviewed. The outcomes analyzed were the trajectory of tooth decay (decayed teeth in 2012 and cavity reoccurrence) and the trajectory of dental assistance (immediate dental assistance and untreated caries). The socioeconomic trajectory was measured by the mobility of the family's income between childhood and youth and the number of episodes of poverty throughout life. RESULTS: The risk of developing decayed teeth in 2012 was greater for those who had always remained poor. Young people who were never poor had fewer decayed teeth in 2012, but more cavity reoccurrence. Downward mobility resulted in less access to immediate dental assistance. More experience of poverty throughout life implied more decayed teeth in 2012 and less immediate dental assistance. CONCLUSION: The life course hypotheses regarding an influence of socioeconomic mobility and cumulative risk on oral health outcomes in youth were confirmed.

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OBJECTIVE: Advances in geospatial technologies have recognized the role of geographic distance as a barrier to healthcare accessibility. Frequent transportation is supposed to buffer issues with distance, while infrequent services impede the uptake of care. The role of public transportation on the accessibility of health care-including oral health care-is not well elucidated in the context of megacities, such as the municipality of São Paulo, Brazil. This study aimed to compare the supply of public transportation to primary dental clinics and the population between advantaged and disadvantaged areas in São Paulo city. METHODS: A total of 4101 primary dental clinics in São Paulo city were identified and geocoded. Geographic coordinates were also retrieved for the 19 242 bus stops, 56 commuter rail stations and 64 rapid transit stations. Clinic locations and transport points were integrated with the city's 19 128 constituent census tracts-each containing sociodemographic data on the 11 252 204 residents-using Geographic Information Systems (GIS). RESULTS: Almost all clinics were located within 0.5 km of public transportation. Half of all clinics were within 0.5 km of high-frequency transport points, and three-quarters were within 1 km. Likewise, 99% of the population resided within 0.5 km of any public transportation. However, only 22% were within 0.5 km of high-frequency options, and half were within 1 km. Those within 0.5 km of high-frequency points had higher average monthly household incomes and lower illiteracy rates, with lower proportions of children and ethnic minorities, and higher proportions of older people. CONCLUSION: Clinics and populations in sociodemographically disadvantaged tracts have poorer public transportation links in São Paulo city.

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OBJECTIVES: Brazil is one of the largest countries in the world, in terms of geography and population. Most Brazilians reside in the south and south-eastern regions, with notable numbers in the regions' megacities, such as São Paulo city. Healthcare provision in such a complex environment is difficult. Thus, a clear understanding of the distribution - or rather, the maldistribution - of these services is fundamental for optimising the allocation of human and financial resources to areas of greatest privation. The present study aimed to determine the distribution of primary dental clinics in São Paulo city. METHODS: A total of 4,101 primary dental clinics in São Paulo city were identified and geocoded. Clinic locations were integrated with the city's 19,128 constituent census tracts - each containing sociodemographic data for the 11,252,204 residents - using Geographic Information Systems (GIS). RESULTS: Approximately two-thirds (64.8%) of the population resided within 0.5 km of a primary dental clinic, and a further 23.9% were within 1 km. Populations more than 1 km out were typically characterised as sociodemographically disadvantaged. Primary dental clinics were also more sparsely distributed in the city's peripheral census tracts than central census tracts. CONCLUSION: Primary dental clinics are maldistributed in São Paulo city, with disadvantaged populations having less spatial access than their advantaged counterparts.

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OBJECTIVE: To assess the association between dental fluorosis and maternal education in schoolchildren of medium and low socioeconomic status in a low income region of Mexico. DESIGN: Cross-sectional study. SETTINGS: Public schools in the south-central region of Oaxaca, Mexico where the mean fluoride water concentration was 1.01 mg/L (SD 0.21; range 0.71-1.40). Fluoridated salt (200mgF/kg) was available in the region. PARTICIPANTS: 794 schoolchildren. METHODS: To identify the socioeconomic status of the participants, the Bronfman index was used. Dental fluorosis was assessed applying the Thysltrup-Fejerskov Index, (TF). RESULTS: The children's mean age was 10.4 (SD1.2) years. The prevalence of dental fluorosis (TF⟩0) was high 95.7% and 45.2% of the children showed dental fluorosis of TF≥4. The percentage of children showing TF≥4 was 48.8% where their mothers' education was ⟨6 years of schooling compared to 36.7% among other children (p⟨0.001). The multinomial logistic regression model using as base outcome category TF≤2 showed that severe forms of fluorosis (TF≥4) were associated with the consumption of boiled water, (OR= 1.65, p=0.039) of fluoridated salt (OR= 2.61 p=0.001), high brushing frequency (OR=3.12, p=0.001) and lower maternal education (OR=1.71, p=0.007). CONCLUSIONS: A high prevalence of dental fluorosis was observed in the study region. An unequal burden of fluorosis in aesthetically objectionable categories was found in children exposed to several sources of fluoride and whose mother had lower educational level.

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Introdução: as Redes de Atenção à Saúde (RAS) são organizações que permitem, através de um objetivo único, oferecer contínua e qualitativa atenção de saúde à popula- ção. Objetivo: analisar as condições e extensões da RAS com enfoque no município de Maringá/Paraná, direcionado à saúde bucal pública. Para isso, foi construído um mapa com todos os pontos de atenção em saúde bucal do município em suas diferentes complexidades, trazendo, assim, para o concreto a imagem da Rede de Atenção à Saúde Bucal Pública do município. Metodologia: fundamentou-se em revisão bibliográfica do referencial teórico sobre a RAS, Saúde Pública e Saúde Bucal e entrevista com a gestora municipal de saúde bucal. A coleta de dados caracterizou os pontos de atenção e suas complexidades, perfil epidemiológico da população, fluoretação das águas de abastecimento, para que, dessa forma, fosse construí- do o mapa da rede. Resultados: o município possui uma rede estruturada da atenção em saúde bucal, havendo todos os níveis de complexidade em diferentes regiões do município, possibilitando um maior acesso da população. Conclusão: por meio da estruturação do mapa da rede, constatou-se que há uma grande potência de serviços em saúde bucal, com os três níveis de complexidade e, ainda, parcerias com o consórcio intermunicipal e instituição de ensino superior, podendo beneficiar a população, oferecendo um tratamento integrado aos usuários do sistema e servir de suporte aos profissionais da rede.

Introduction: The Oral Health Care System (OHCS) is a network which, with a single goal, offers continuous and quality care to the public. Objective: This study aimed to analyze the conditions and extent of the OHCS in the city of Maringá, Paraná, with a specific focus on the oral health of the public. A map was carefully created, illustrating all the points in Maringá where the public can receive oral health care, whether it is preventative care or more specific care that needs to be met. This map presents a concrete image of the city's Public Oral Health Care Network. Methodology: The methodology was based on a literature review of the theoretical framework concerning the Health Care System, Public Health, and Oral Health, as well as an interview with the manager of the municipal oral health program. The data collection characterized points of attention and their complexities, the epidemiological profile of the population, and fluoridation of water supplies. Results: Using this data, the citywide network map was created, and from this map, we are able to conclude that the city has a structured network for oral health care needs, which encompasses all the levels of complexity and the various locations in the different municipal regions, allowing greater access for the population. Conclusion: By constructing the network map, we found there is a powerful array of services in oral health, with three levels of complexity, and even partnerships with the inter-municipal association as well as the local institutions for higher education. These relationships can benefit not only the population, by offering users of this network integrated treatment, but also can serve as a support network for the healthcare professionals.

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