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O objetivo deste artigo foi discutir o processo histórico da integração ensino/serviço em Odontologia no Brasil. Foi realizada uma revisão de literatura a partir de um levantamento bibliográfico nas bases SciELO e LILACS utilizando as palavras-chave Integração ensino/serviço; Estágio curricular; Odontologia; Programa de Educação pelo Trabalho para a Saúde; PET-Saúde; Atenção primária à saúde; e Práticas profissionais, limitada a artigos publicados entre os anos de 1970-2014, em português. Também foi realizada uma pesquisa documental, contemplando as legislações existentes. A análise evidenciou que a integração ensino-serviço no Brasil, por muitas décadas, se deu de forma lenta, embora atualmente haja uma política de incentivo para favorecer esta integração. Foram identificadas experiências exitosas a partir da integração ensino-serviço em Odontologia, embora se destaque que ainda exista dificuldades e fragilidades, principalmente porque o sistema de saúde vigente no Brasil está em construção. Considera-se que os incentivos para a consolidação da parceria entre universidade e serviços de saúde devem ser mantidos e ampliados, com o objetivo de favorecer a formação profissional em Odontologia no aspecto mais amplo de saúde e trazer benefícios reais para os serviços de saúde.

Objective To describe the methodological aspects of a Prospective Cohort Study of adult oral health in Piracicaba, Brazil. Results This Prospective Cohort Study evaluated adults (20–64 years old) between the years of 2011 and 2015, in Piracicaba, São Paulo, Brazil. The main objective was to evaluate the risk factors for tooth loss in adults. Data were collected at households and selected via probabilistic sampling, through clinical examination of caries, considering as variables the decayed, missing and filled permanent teeth index, need for caries treatment, periodontal disease (Community Periodontal Index and Periodontal Attachment Loss), use and need for dental prosthesis, and presence of visible biofilm. A questionnaire about demographic, socioeconomic and health habits, use of dental services, self-perceived quality of life (Oral Health Impact Profile-14) and health literacy (14-item Health Literacy Scale) was also employed. In 2011, 248 adults participated, and in 2015, 143 (follow-up rate = 57.7%). Despite the follow-up sample loss, most sociodemographic characteristics remained in the participant sample: for example, women (72.0%) (p = 0.534), family income between R$545,00 and R$1090,00 (63.9%) (p = 0.920), above 11 years of education (53.1%) (p = 0.200) and belonging to middle class (67.1%) (p = 0.909).

Summary 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.

Objective To verify the incidence of tooth loss in extended age group of adults in 4 years. Materials and Methods The prospective cohort study assessed adults (20–64 years old) between 2011 and 2015, from Piracicaba, São Paulo, Brazil. The dependent variable was cumulative incidence of tooth loss, assessed by difference between missing teeth (M) of decayed, missing, and filled tooth index (DMFT) in 2011 and 2015. Participants were stratified into young (20–44 years old) and older (45–64 years old) adults. Mann–Whitney U test (p < 0.05) was used to compare the means of incidence of tooth loss between age groups. Results After four years, 57.7% (n = 143) of adults were followed up and the mean incidence of tooth loss was 0.91 (SD = 1.65); among these, 51 adults (35.7%) who lost their teeth showed mean tooth loss of 2.55 (SD = 1.86). In older adults, incidence of tooth loss was higher (p = 0.008), but no difference between age groups was found when only adults with incidence of tooth loss were assessed (p = 0.844). Conclusion There was higher incidence of tooth loss in older adults after four years, however, without difference between age groups when only those who lost teeth were evaluated.