Associate Professor. Departament of Public Health, pediatric dentistry and orthodontics. Faculdade de Odontologia de Piracicaba. Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP)
Dentistry, Public Health, Environmental and Occupational Health
128
Scopus Publications
Scopus Publications
Digital Health Literacy in Dentistry: A Critical Review João Paulo Santana da Silva, Guilherme Gonzalez Klefenz, Fábio Luiz Mialhe Pesquisa Brasileira Em Odontopediatria E Clinica Integrada, 2026 ABSTRACT Objective: To investigate the current research on digital health literacy (DHL) in dentistry to better understand its associations with dental outcomes and gaps in the literature. Material and Methods: The methodology followed the PRISMA-ScR checklist. A critical review was conducted by selecting articles from the online databases PubMed, Web of Science and Latin American and Caribbean Literature on Health Sciences Database (LILACS) and searches were also carried out in Google Scholar to identify articles in the gray literature published until February 2025. Studies on DHL in dentistry were analysed and only full-text, peer-reviewed articles were selected for analysis. Results: The bibliographical search identified 1855 articles, of which 15 were selected for qualitative synthesis. All of the included studies had a cross-sectional design, the majorityof the studies was carried out in Brazil and most of them used the eHealth Literacy Scale (eHEALS) to measure DHL levels. The research gaps identified concerning DHL in dentistry point to the need for further research in diverse sociodemographic groups and settings to better understand the impact of DHL in this area of knowledge. Conclusion: This review has shown that few articles published to date have focused on digital health literacy in dentistry, indicating that the relationships between digital literacy, oral health, and health literacy needs to be further explored.
Dental Caries in Preschoolers and Parental Level of Oral Health Literacy in Tocantins Marlon Brendo da Silva Benigno, Juliana Bastoni da Silva, Maria Andréia Garcia de Avila, Hélio Rubens de Carvalho Nunes, Fábio Luiz Mialhe Pesquisa Brasileira Em Odontopediatria E Clinica Integrada, 2025 Objective: To investigate the association between dental caries in preschoolers and parental oral health literacy (OHL) levels. Material and Methods: A cross-sectional study was conducted with 448 dyads of five-year-old preschoolers in all public preschools in the urban area of Porto Nacional city (Tocantins, Brazil) and their respective primary caregivers. Caries experience with deciduous teeth was measured through the decayed, missing, and filled teeth (dmft) index. OHL level was calculated using the Brazilian Portuguese version of the Health Literacy in Dentistry (HeLD-14) instrument and categorized into tertiles. Sociodemographic data were collected. Associations between variables were evaluated by Poisson’s regression in bi and multivariate models. Results: A total of 190 (42.41%) children had dental caries in at least one tooth, and 243 (54.2%) of the primary caregivers showed an OHL level below the sample median (49 points). Analyses revealed that an OHL level at the upper fertile was considered a protective factor for caries in the evaluated preschoolers (RP=0.660; 95% CI = 0.480-0.910). Conclusion: Parental oral health literacy level was significantly associated with early childhood caries. Promoting oral health literacy among parents can be important in preventing tooth decay in preschoolers.
Factors associated with internet use to obtain oral health-related information Canadian Journal of Dental Hygiene Cjdh Journal Canadien De L Hygiene Dentaire Jchd, 2025
Oral health among drug addicts and associated variables: a multivariate approach using a canonical correlation analysis Tais Cristina Nascimento Marques, Karin Luciana Migliato Sarracini, Vanessa Gallego Arias Pecorari, Karine Laura Cortellazzi, Marcelo de Castro Meneghim, Luciana Estevam Simonato, Fábio Luiz Mialhe, Gláucia Maria Bovi Ambrosano Brazilian Journal of Oral Sciences, 2025 Aim: To evaluate the association between oral health conditions with sociodemographic variables and the use of psychoactive substances by drug addicts assisted by Psychosocial Care Centers for Alcohol and Drugs (CAPS-ADs). Methods: This is an analytical cross-sectional study with a sample of 262 drug addicts assisted by CAPS-ADs in three cities in the state of São Paulo, Brazil. Participants were evaluated through intraoral clinical examinations (DMFT and CPI indexes) and they answered a socioeconomic questionnaire. The intensity of use of psychoactive substances was assessed through ASSIST questionnaire. Associations between variables were performed using the canonical correlation analysis method. Results: It was observed that the mean DMFT index was 13.9; 60.2% of the sample used cocaine/crack and 46.5% used marijuana. Regarding the analyses, the canonical correlation coefficient of the highest possible correlation between the combination of variables of oral health problems and the combination of variables of intensity of drug use was 0.4642 (p=0.0005). In addition, the canonical correlation formed by the combination of socioeconomic condition variables and the combination of oral health was statistically significant (canonical correlation coefficient=0.4533; p<0.0001). Thus, it was observed that the high consumption of drugs, mainly cocaine/crack and marijuana, was associated with oral health problems; in addition, worse socioeconomic conditions, mainly lower level of education of the mother and father, were associated with oral health problems in drug users. Conclusion: Both the type of psychoactive substance addiction and sociodemographic variables affected the oral health of drug addicts.
After all, what is the proper use of Kappa statistics in oral health surveys? What don’t manuals tell us? Andréa Videira ASSAF, Renato Pereira da Silva, Fábio Luiz Mialhe, Antonio Carlos Pereira Brazilian Oral Research, 2025 The aim of this study was to elucidate, unclear points of the “Oral Health Survey: basic methods”, of the World Health Organization (WHO), relative to reproducibility (encompassed reliability and agreement) issues during examiners’ calibration. Thus, Kappa statistics and percent agreement were calculated for a sample of 10 12-year-old schoolchildren examined by 1 gold standard examiner and 5 dentists from Nova Friburgo, RJ, Brazil, in 2018, under the WHO and SB Brasil 2010 Project settings. Weighted Kappa was used to measure reliability between 2 examiners, and Fleiss’ Kappa for 5 examiners. Tooth-to-tooth reliability was also assessed. The results showed that, although the choice of different settings invariably produced different reliability and agreement values, this approach was feasible, coherent and even desirable depending on the purpose of an epidemiological survey conducted. Kappa values were slightly lower in the SB Brasil 2010 Project setting. The results for tooth-to-tooth reliability, in turn, allowed identification of teeth (in this sample, teeth 17, 23, 27, 34, 37, 44, 45, and 47) for which additional examiner calibrations would be necessary. It is concluded that providing additional information for inclusion in the WHO manual, such as the possibility of varying the setting, adopting the tooth-by-tooth unit, and selecting the correct type of Kappa statistic depending on the number of examiners, within a multilevel calibration proposal, may result in more reliable results during the calibration stage.
Weaving fragilities: a scooping review on the COVID-19 pandemic scenario as a risk factor for depression among university students Janaína da Câmara Zambelli, Luiz Eduardo de Almeida, Pedro Henrique Brito da Silva, Fábio Luiz Mialhe, Rosana de Fátima Possobon Physis, 2025 Resumo A pesquisa sobre o aumento do risco de doenças mentais entre estudantes universitários durante a pandemia de Covid-19 é abrangente, mas o foco específico na depressão e ansiedade é difuso. Este estudo buscou entender melhor como a pandemia afetou o risco de ansiedade e depressão entre graduandos e pós-graduandos. Realizamos uma revisão de escopo, analisando estudos que investigaram a relação entre a pandemia e a depressão e/ou ansiedade em estudantes universitários. Encontramos 19 estudos relevantes, a maioria dos quais era do tipo transversal, ou seja, examinavam a situação em um único momento no tempo. Nossos resultados indicam que a pandemia e o contexto (trans)pandêmico aumentaram significativamente o risco de ansiedade e depressão entre os universitários, especialmente entre os estudantes de pós-graduação. Fatores estressantes comuns incluem preocupações sobre o futuro profissional, mudanças na rotina, problemas financeiros, dificuldades nos relacionamentos pessoais e o impacto emocional das notícias negativas relacionadas à Covid-19. Concluímos que a pandemia representou um fator de risco significativo para problemas de saúde mental entre os estudantes universitários. Recomendamos a realização de estudos longitudinais para entender melhor o impacto desses eventos no longo prazo.
Factors associated with psychological stress in oral health teams of the public health system during the COVID-19 pandemic: a cross-sectional study Fábio Luíz Mialhe, Fernanda Maria Rovai Bado, Cristiane Maria Costa Silva, Lais Renata Almeida Cezário, Menachem Ben-Ezra, Eitan Mijiritsky, Maayan Shacham Brazilian Journal of Oral Sciences, 2025 The COVID-19 pandemic has impacted the well-being of all healthcare professionals. However, there are still few studies evaluating this aspect in dental professionals. Aim: To identify the contextual and labor-related factors associated with psychological stress in dental professionals working in public healthcare services during the COVID-19 pandemic. Methods: This is an analytical, cross-sectional, and observational study including 96 dental professionals who worked in public services in the municipalities of Piracicaba-SP and Poços de Caldas- MG from October 2021 to January 2022. A self-administered questionnaire was used to collect data on the independent variables [sociodemographic characteristics, health and professional conditions, self-efficacy (Generalized Self-Efficacy Scale – GSE), subjective work overload (Job Demands scale), and thoughts/feelings related to COVID-19] and the outcome (psychological stress - Kessler Psychological Stress Scale-6 - K-6). Simple and multiple logistic regressions were performed using the Stepwise method to test the associations between independent and dependent variables. Results: In multiple regression, professionals who were not in a relationship (OR=4.61; 95% CI: 1.05–20.17) and those with greater subjective burden (OR: 47.18; 95% CI: 5.39–413.21) were more likely to experience psychological stress (p<0.05). Conclusion: Dental professionals working in public health system with greater subjective work overload were more likely to experience greater psychological stress during the COVID-19 pandemic.
The influence of socioeconomic and behavioural factors on the caries experience of adults with mental disorders in a large Brazilian metropolis Canadian Journal of Dental Hygiene, 2024
LGBTQ+ related curricular activities in Brazilian Dental Schools: Do institutional and/or deans’ profiles matter? Luiz E. Almeida, Valéria de Oliveira, Fábio L. Mialhe Journal of Dental Education, 2024 PurposeThe aim of this cross‐sectional study was to investigate whether the characteristics of dental schools and the profiles of their deans were associated with curricular activities related to LGBTQ+ in Brazilian dental schools.MethodsA survey was mailed to the deans of all Brazilian dental schools for the purpose of assessing the development of pedagogical activities focused on the topic of oral health of the LGBTQ+ population, and the characteristics of the institutions and profiles of their deans. The data collected were analyzed with hierarchical multiple logistic regression models in order to analyze associations between variables of interest.ResultsOf the deans approached, 156 (response rate of approximately 32.4%) completed and returned the survey. The majority of dental schools (67.3%) of the sample were private institutions and 39% of them developed pedagogical activities directed toward the LGBTQ+. This percentage was much lower in public institutions (18%). The results of the hierarchical multiple logistic regression demonstrated that deans who attributed high relevance to the theme “oral health of the LGBTQ+ population” were more likely to develop pedagogical activities directed toward the LGBTQ+ population (odds ratio = 4.74; 95% confidence interval: 1.65–13.48), than those who attributed low or little importance to this topic (p < 0.05).ConclusionA low percentage of activities aimed at the LGBTQ+ population was observed in the sample of Brazilian dental schools. Deans must be aware of the importance of the topic and be motivated to implement pedagogical activities for this population.
Factors associated with the absence of Brazilians in specialized dental centers Inara Pereira da Cunha, Valéria Rodrigues de Lacerda, Gabriela da Silveira Gaspar, Edson Hilan Gomes de Lucena, Fábio Luiz Mialhe, Paulo Sávio Angeiras de Goes, Hazelelponi Querã Naumann Cerqueira Leite, Rafael Aiello Bomfim BMC Oral Health, 2022
Dental caries diagnostic thresholds: Which one? Why? When? Renato Pereira da Silva, Andréa Videira Assaf, Fábio Luiz Mialhe, Karine Laura Cortellazi Mendes, Marcelo de Castro Meneghim, Antonio Carlos Pereira International Journal of Public Health, 2020
Self-perceived dental treatment need among adolescents: A hierarchical analysis Inara Pereira da Cunha, Fábio Luiz Mialhe, Antonio Carlos Pereira, Sílvia Amélia Scudeler Vedovello, Jaqueline Vilela Bulgareli, Antônio Carlos Frias, Gláucia Maria Bovi Ambrosano, Marcelo de Castro Meneghim Community Dentistry and Oral Epidemiology, 2020
Distribution of dental schools in Brazil, 2015 Emílio Prado da Fonseca, Carla Martins Rocha, Estie Kruger, Marc Tennant, Fábio Luiz Mialhe, Marcelo de Castro Meneghim European Journal of General Dentistry, 2016
Qualitative study on adolescents’ reasons to non-adherence to dental treatment Fabiana de Lima Vazquez, Karine Laura Cortellazzi, Camila da Silva Gonçalo, Jaqueline Vilela Bulgareli, Luciane Miranda Guerra, Elaine Silva Pereira Tagliaferro, Fábio Luiz Mialhe, Antonio Carlos Pereira Ciencia E Saude Coletiva, 2015
Quality of life and socio-dental impact among underprivileged Brazilian adolescents Fabiana de Lima Vazquez, Karine Laura Cortellazzi, Armando Koichiro Kaieda, Luciane Miranda Guerra, Glaucia Maria Bovi Ambrosano, Elaine Pereira da Silva Tagliaferro, Fábio Luiz Mialhe, Marcelo de Castro Meneghim, Antonio Carlos Pereira Quality of Life Research, 2015
Evaluation of the effectiveness of a voice training program for teachers Raquel Aparecida Pizolato, Maria Inês Beltrati Cornacchioni Rehder, Carlos Tadeu dos Santos Dias, Marcelo de Castro Meneghim, Glaúcia Maria Bovi Ambrosano, Fábio Luiz Mialhe, Antonio Carlos Pereira Journal of Voice, 2013
Oral cancer calibration and diagnosis among professionals from the public health in São Paulo, Brazil. Stomatologija Issued by Public Institution Odontologijos Studija Et Al, 2013
Quantitative light-induced fluorescence (QLF) in relation to other technologies and conventional methods for detecting occlusal caries in permanent teeth Brazilian Journal of Oral Sciences, 2011
Reproducibility of adjunct techniques for diagnosis of dental caries in an epidemiological situation Oral Health and Preventive Dentistry, 2011