Most oral conditions have a multifactorial etiology; that is, they are modulated by biological, social, economic, cultural, and environmental factors. A consistent body of evidence has demonstrated the great burden of dental caries and periodontal disease in individuals from low socioeconomic strata. Oral health habits and access to care are influenced by the social determinants of health. Hence, the delivery of health promotion strategies at the population level has shown a great impact on reducing the prevalence of oral diseases. More recently, a growing discussion about the relationship between the environment, climate change, and oral health has been set in place. Certainly, outlining plans to address oral health inequities is not an easy task. It will demand political will, comprehensive funding of health services, and initiatives to reduce inequalities. This paper sought to give a perspective about the role of social and physical environmental factors on oral health conditions while discussing how the manuscripts published in this Special Issue could increase our knowledge of the topic.

The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.

Background/Objectives: Environmental sustainability is increasingly recognized as a key component of healthcare governance, and dentistry represents a high-impact subsector due to its intensive use of materials, resources, and biosafety-driven disposables. Despite rising scientific interest, available evidence remains fragmented and methodologically heterogeneous. This study aims to systematically map the existing review-based evidence on sustainability in oral healthcare services. Methods: The protocol was prospectively registered on OSF. Narrative, scoping, and systematic reviews evaluating sustainability within oral healthcare services were eligible. Comprehensive searches were conducted in Embase, PubMed/MEDLINE, Scopus, Web of Science, LILACS, Cochrane Library, and regional databases (WPRIM, WHOLIS, BBO, BDENF, IBECS, PIE, ColecionaSUS), without language or date restrictions. Two reviewers independently screened studies via Rayyan, resolved discrepancies by consensus, and extracted descriptive and thematic data using a structured Population-Concept–Context eligibility framework. A qualitative inductive synthesis identified recurring domains, and methodological rigor was appraised with a modified 12-item AMSTAR-2 tool. Results: Of 5793 records retrieved, 17 reviews met inclusion criteria (8 narrative, 5 scoping, 4 systematic). Most publications (82.4%) were from the past five years. Three thematic axes were identified: (1) the 4Rs (rethink, reduce, recycle, reuse); (2) waste and effluent management; and (3) barriers, practices, and sustainability policies. Evidence was strongly concentrated in high-income countries, and methodological quality varied widely, with ten reviews scoring below 60% on AMSTAR-2. Conclusions: Review-based evidence on sustainable dentistry is expanding yet remains limited and operational in focus. The literature remains disproportionately centered on operational issues—primarily waste management and material consumption—while broader systemic determinants such as governance, equity, financing, and professional education receive comparatively little attention. Strengthening methodological rigor, harmonizing sustainability indicators, and advancing empirical evaluations are essential for guiding equitable and environmentally responsible oral healthcare systems.

The objective of this study was to describe dental prescriptions of non-steroidal anti-inflammatory drugs (NSAID), opioids, and analgesics dispensed by the Brazilian National Health System (BNHS, SUS in Portuguese) of a Southeastern state from January to December 2017, and to analyze their association with socioeconomic and oral health care services’ characteristics at municipal level. Data were collected from the Brazilian Integrated Pharmaceutical Care Management System. Medicines were grouped according to the Anatomical Therapeutic Chemical Classification System. The total number of Defined Daily Doses (DDD) and DDD per 1,000 inhabitants (inhab.) per year were presented and compared between groups of municipalities. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25.0. The total number of NSAID, opioids, and analgesics prescriptions was 70,747 and accounted for 354,221.13 DDD. The most frequently prescribed medicine was ibuprofen (n = 24,676; 34.88%). The number of dental practitioners in the BNHS per 1,000 inhab. (p < 0.001), first dental appointment coverage (p = 0.010), oral health teams per 1,000 inhab. (p=0.022), and the proportion of rural population (p = 0.014) were variables positively associated with the number of DDD of NSAID per 1,000 inhab. per year. Bolsa Família program coverage per 1,000 inhab. (p = 0.022) was negatively associated with NSAID prescription. Regarding analgesics, first dental appointment coverage (p=0.002) and Bolsa Família program coverage per 1,000 inhab. (p = 0.012) were positively associated with DDD per 1,000 inhab. per year. In conclusion, dental prescriptions of analgesics and NSAID in the BNHS were associated with socioeconomic and oral health care services’ characteristics.

Dental caries remains a major global public health problem characterized by pronounced social inequalities. This study aimed to identify, critically appraise, and synthesize the most recent evidence on the relationship between socioeconomic indicators and dental caries among adults aged 19–60 years, providing an updated systematic review that builds upon our previous reviews from 2012 and 2018. Reported following the PRISMA 2020 guidelines, we conducted a systematic search of eight electronic databases for observational studies published between March 2017 and April 2024 (PROSPERO: CRD42017074434). Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Newcastle–Ottawa Scale. Due to substantial methodological heterogeneity across the 22 included studies, a narrative synthesis was undertaken. The findings demonstrated a strong inverse association between socioeconomic position and caries experience. Lower income, lower educational attainment, and unemployment or employment in manual/unskilled occupations were associated with a higher overall caries experience. Advanced analytical approaches in recent studies, including life-course, reinforced that education and income are key contributors of these oral health inequalities, with persistent social disadvantage conferring the greatest risk. In conclusion, dental caries in adults aged 19–60 years is a social condition reflecting the cumulative effects of socioeconomic inequality across the life course. Addressing adult dental caries requires integrated approaches that combine clinical prevention with social and public policies aimed at reducing structural inequalities.

Objetivo: Investigar a prevalência e os fatores associados ao refluxo gastroesofágico em indivíduos de 0 a 33 anos de idade com deficiências do desenvolvimento. Métodos: 628 prontuários odontológicos foram analisados. Os casos de refluxo foram anotados baseados nos relatos dos responsáveis. Variáveis com valor de p menor do que 0.25 foram incluídas no modelo de regressão logística. Variáveis com valor de p menor do que 0.05 foram consideradas como significativas no modelo final. Resultados: ser respirador bucal, usar “outros medicamentos” e ter histórico de convulsões foram fatores associados ao refluxo gastroesofágico entre pacientes com deficiências de desenvolvimento.