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Brazil is the only country in the world to propose a universal health care system with the aim of guaranteeing delivery of all levels of health care, free of charge, to a population of over 200 million inhabitants by means of a unified health system ("Sistema Único de Saúde" [SUS]). The national policy of oral health, also known as Smiling Brazil ("Brasil Sorridente"), was implemented in 2004. Oral health was designated as 1 of the 4 priority areas of the SUS, transforming oral health care in Brazil, with the objective that the SUS achieve the integrality of care envisaged at its creation. The aim of this article is to share part of this experience in order to prompt reflection about the inclusion of oral health care in other health care systems around the world. The most significant results of Smiling Brazil can be seen in 3 areas: (1) oral health epidemiological indicators, (2) financial investment and professional development, and (3) the building of an oral health care network throughout the 10 y of the policy. The "Discovery!" article presented here portrays 10 y of evolution; however, it is important to point out that this is a process undergoing construction and that the oral health care network needs to be further expanded, refined, and solidified so that over time and through changes in the political parties in power, Smiling Brazil prevails as a perennial policy and not merely an action by a single government.

O debate sobre a formação universitária passa, atualmente, pelo perfil de profissional que esta sendo formado nas universidades. Este artigo considera, nesta mesma direção, a necessidade de uma revisão na formação dos profissionais nas faculdades de odontologia do Brasil. Esta formação deve estar em interface direta com as reais necessidades de saúde bucal da população, e inserida no paradigma da política pública de saúde e dos princípios do Sistema Único de Saúde. Para se atingir tais objetivos, a capacitação docente deve passar por um processo de revisão de conceitos educativos, que permitam ao aluno se tornar um agente ativo no processo de ensino, com perspectiva crítica em relação à sua própria prática profissional.

Objective: To introduce the main theoretical and methodological aspects of the external evaluation of the 1 st cycle National Program for Quality Evaluation (AE-PMAQ/CEO). Material and Methods: This is an evaluative and quantitative research carried out in all Centers for Dental Specialties-CEO of Brazil, and macro-geographical regions were taken into account for analysis. The general AE-PMAQ/CEO coordination was from the Collaborative Centre for Oral Health Surveillance of the

This study aimed to evaluate the Education through Work for Health Program ("PET-Saúde") that had been instituted at the University of Sao Paulo, Brazil. The subjects were dentistry preceptors and students who took part in the proposal between the years 2009 and 2012. A qualitative approach was used, in which data were gathered through focus groups and evaluated through thematic content analysis. The results show that education through work is capable of assisting in the education process, through expanding students" perceptions of the health/disease process and raising awareness regarding future actions within the sphere of the Brazilian Health System. One of the advantages is the establishment of interdisciplinarity in the education process. The results indicate that the program is a powerful instrument for inducing changes in the concepts among healthcare professionals.

In 2002, the Brazilian Ministry of Education approved the oficial curricular guidelines for undergraduate courses in Brazil to be adopted by the nation's 188 dental schools. In 2005-06, the Brazilian Dental Education Association (BDEA) promoted workshops in forty-eight of the schools to verify the degree of transformation of the curriculum based on these guidelines. Among the areas analyzed were course philosophy (variables were v1: knowledge production based on the needs of the Brazilian Public Health System [BPHS]; v2: health determinants; and v3: postgraduate studies and permanent education); pedagogical skills (v4: curricular structure; v5: changes in pedagogic and didactic skills; and v6: course program orientation); and dental practice scenarios (v7: diversity of the scenarios for training/learning; v8: academic health care centers opened to the BPHS; and v9: participation of students in health care delivery for the population). The subjects consisted of faculty members (n=711), students (n=228), and employees (n=14). The results showed an incipient degree of curriculum transformation. The degree of innovation was statistically different depending on the type of university (public or private) for variables 1, 2, 4, 5, 6, and 7. Private schools reported a higher level of innovation than public institutions. Resistance to transforming the dental curriculum according to the oficial guidelines may be linked to an ideological conception that supports the private practice model, continues to have faculty members direct all classroom activities, and prevents students from developing an understanding of professional practice as targeted towards the oral health needs of all segments of society.

The aim of this study was to estimate the cost of fluoridating the public water supply in the city of São Paulo, Brazil, from 1985 to 2003. Cost calculation for fluoridation of the public water supply used the following: capital cost of initial installation, chemical product (hydrofluosilicic acid), system's operational cost (maintenance, electricity, and human resources), and monitoring fluoride levels. Fluoridation was effective, since there was a decrease of 73% in dental caries in 12-year-olds--mean DMF was 6.47 (6.12-6.82) in 1986, having decreased to 1.75 (1.48-2.92) in 2002. In this age group, 40% of children presented DMF = 0 in 2002. Average cost per inhabitant/year for 2003 was R$ 0.08 (USD 0.03). The accumulated cost for 18 years of implementation and maintenance of the fluoridation system was R$ 1.44 (USD 0.97) per capita.

Background There is a paucity of population-based surveys on oral health conditions in Ecuador. Thus, the aim of this study was to conduct an epidemiological survey with a representative sample of children aged 12 years from public schools of Quito, Ecuador. The aim of this initial report was to describe the methodology used in the survey, as well to present results regarding calibration procedures and prevalence of oral-health related outcomes. Methods We invited 33 public schools’ coordinators from the urban area of Quito, and 1100 children (12 years old) to take part in this study. Six trained and calibrated examiners conducted clinical examinations using oral mirrors and ball-ended probes to assess: dental caries, traumatic dental injuries, malocclusion, gingival bleeding, presence of calculus and fluorosis. Children also responded a questionnaire on Oral Health-Related Quality of Life (OHRQoL). Individual sociodemographic data was collected through a questionnaire sent to parents. Moreover, some contextual data on school environment (infrastructure conditions, promotion of health practices and negative episodes) were also evaluated. Prevalence values, crude and weighted by sampling weights, and 95% confidence intervals (95%CI) were calculated. Results Nine hundred and ninety-eight children from 31 schools were examined from March to May 2017. The adjusted prevalence values (95%CI) for the six outcomes evaluated were: dental caries = 60.3% (55.3 to 65.0%); traumatic dental injuries = 20.7% (17.2 to 24.8%); dental fluorosis = 63.7% (58.5 to 68.5%); gingival bleeding = 92.0% (87.1 to 95.2%); presence of calculus = 69.9 (60.5 to 77.9%); and malocclusion = 25.8% (21.8 to 30.3%). Adjusted mean of number of decayed, missed or filled permanent teeth (DMF-T) was 1.61 (1.37 to 1.84). Results on OHRQoL and other contextual variables will be reported in other articles. Conclusion The prevalence of the majority of oral health problems in 12-year-old children from public schools in Quito-Ecuador was compatible with those observed in other similar cities. However, periodontal health and fluorosis seem to be highly prevalent in children from Quito. Electronic supplementary material The online version of this article (10.1186/s12903-019-0863-9) contains supplementary material, which is available to authorized users.