Oral health promotion: expanding the boundaries of knowledge.

The following professors participated in the symposium discussions as panelists: Maria Fidela de Lima Navarro (Univ de São Paulo, Bauru, SP, Brazil); Joana Carvalho (Univ de Louvain, Louvain, Belgium); Alexandre Rezende Vieira (Univ of Pittsburgh, Pittsburgh, PA, USA); Mário Taba Júnior (Univ de São Paulo, Ribeirão Preto, SP, Brazil); Tiago Sousa Coelho (Univ de Brasília, Brasília, DF, Brazil); and the following professors participated as moderators: Jaime Aparecido Cury (Univ de Campinas, Piracicaba, SP, Brazil); Nilce Tomita (Univ de São Paulo, Bauru, SP, Brazil); Lilian Marly de Paula (Univ de Brasília, Brasília, DF, Brazil). Jaime Cury: The analysis of the “SB Brazil 2010” National Oral Health Survey shows a steady reduction in the number of caries in our country. Nevertheless, there are still regional disparities, especially when we consider the Northern and Northeastern regions of the country, where the indicators are worse. What solutions, whether genetic, behavioral or political in nature, do the panelists propose to reduce this imbalance? Alexandre Vieira: The disparity problem is mainly related to the unequal allocation of resources and access to services, among other things. Unfortunately, the underlying genetic component does not provide immediate answers to this issue. My studies analyzing individual susceptibility as a risk factor for dental caries are still at an early stage and cannot yet be translated into clinical practice. Joana Carvalho: In my opinion, we have to work together with other health areas, as well as with the families, in order to reduce dental caries and to promote better healthcare in these regions. I think this is the simplest way of working with primary care, i.e., through education and basic oral healthcare measures. These simple actions have proven very effective in promoting long-term qualitative and quantitative improvements in this area. I believe the best thing we can do, practically speaking, is to educate people about the importance of tooth brushing and the use of toothpaste. This would be my recommendation. Maria Fidela: Social determinants are complex. There is no single factor that can determine how people will react. If the population lacks basic understanding about this matter, even the simplest educational actions may be hard to assimilate. It’s a known fact that the low-income populations are more vulnerable to a larger number of diseases, including oral diseases. Oral health cannot be analyzed as an isolated element. It is a part of a person’s overall health condition. In order to change this complex situation, we need sound public policies. In that sense, our country has created the Prouni (University for All Program) and the Bolsa Familia cash transfer program. These initiatives are enabling changes to be Lilian Marly de Paula Nilce Santos de Melo Heliana Dantas Mestrinho (organizers)