The precarious living conditions of the collectors in this study revealed an unexpected and insightful influence on their perception of health, noting that oral diseases are not a condition accepted. This result endorses the so-called critical geopolitical populations attribute, which is the understanding that every perception, value and observed practice should be analyzed both in the context of social inequality and space as in power structures [15] [16] . But this result is shown in odds with the perception that oral health for adults and elderlies, which, for the most part, say they are satisfied with their oral health despite the precariousness of their clinical conditions [17] :

“Oh, I think my mouth health is bad. I thought I’m poor and collectors of recyclable materials, my mouth doesn’t need to be like this.”

“... Mine neither, there are many ugly things. Everyone deserves good tooth, right?”

Although the health assessment by lay people in general, show disparity with the clinical condition found [11] [17] , it was observed among respondents, a perception that links the need for clinic dental treatment for oral health condition, though, considering different from those analyzed by the dentist, as social values, beliefs and perceived vulnerabilities:

“There is a tooth here that needs treatment, I know it’s just like my husband’s. But for us, who are poor and lives with garbage is really complicated have beautiful teeth. I think it really influences, it’s difficult.”

“(...) When it leaves those hard wounds in my mouth, I know I have to look for the dentist, I leave the service only if have no way, because the money of the day fouls.”

“(...) It seems that we’re with a brick in our mouth, the tooth gets high... so, we need to go to the dentist. I think it might be messing with such dirty thing... but I never go to the dentist.”

Problems associated with oral health have been increasingly recognized as important causes of negative impacts on daily performance and quality of life of individuals and society [3] . The absence of dental elements with significant aesthetic value and strong impact on masticatory function, as well as the experience of pain or oral discomfort are often cited in the literature [3] [18] and it also supports the results of this study.

The collectors of recyclable materials clearly exposed the association between missing teeth, their social status and barriers in everyday life:

-At work:

“I think it (missing teeth) interferes with work, because if you don’t have good teeth, you can not get good service (...). But with so many things that we need, where is the money to pay the dentist?”

“That (missing teeth) counts a lot, if you want a fix servisse, you have to take care of your appearance, especially of your teeth. With this work we can’t take care (...).”

“... They think if they don’t take care of that appearance as well, you can’t take care of the office they will give you... else who is poor and lives of garbage has no chance”.

“And the worst is that the same thing happens with our children... well, we wanted, but we can’t take good care of their teeth... so without good teeth, our children who were created here in the trash can’t arrange a better job and end up working for right here, and we didn’t want it for them.”

-In communication skills and social contacts:

“When I see a party I close the face, when I felt my teeth were better, I took the pictures, giggled... felt better, despite the poverty. Then I looked in the mirror and saw that wasn’t good, I started to take pictures with my mouth closed, people look and say I was with the bad guy, brave face. But what will I do? Hide the teeth.”

“We will talk and already give up, huh? We ourselves feel that we have bad breath in the mouth... Also, working with the garbage all day I think the smell gets on us.”

-Masticatory function:

“It’s hard to eat without the teeth, right? We’ll eat anything hard and we can’t. And here we eat everything, no luxury.”

“We want to eat an apple and we can’t because is expensive, but when we purchase, we have to eat kust like a child, shaving with spoon.”

The relationship between pain variable or oral discomfort and impact on daily activities was not directly mentioned by the respondents of this survey, despite showing is closely associated with teeth loss and exposure to physical and social risks:

“I took them all (teeth) because my entire pregnancy I suffered with toothache and now I’m out of sheets... most here do it to avoid the risk of suffering pain and the risk of having no way to pay the dentist.”

“I also pulled everything (teeth) because toothache makes me want... I don’t know what, right? I have no condition to be fixing my tooth and buying expensive thing to wear in the mouth.”

With regard to the aspects related to the lack of maintenance of teeth, most respondents believe that they are guided mainly on individual responsibility, self-care, habits adopted lifelong and precariousness of their living conditions. This result corroborates previous studies [21] [22] .

“... I think my tooth has spoiled because of coffee and cigarette, because I smoke and drink coffee enough... I learned to smoke early, is common smoking here.”

“... My girl has enough spoiled tooth, because she eats a lot of candy and she doesn’t brush the tooth properly. I advice to toothbrush, but I don’t have enough time to take care if she brushed the tooth or not... and I can’t buy a new toothbrush all the time. I work all day long, the end of the day I just want relax.”

Still, for the subjects of the present study and in agreement with findings of other studies [22] , another important predictor of oral diseases mentions a past without information and knowledge about oral hygiene habits, without encouragement or motivation, and without access to inputs and a oral health professional.

“(...) But I myself have never gone to the dentist, nobody has encouraged me, my mother didn’t tell let’s goto the dentist daughter, I’ll take you there... so, lose everything!”

“I have never heard that mother told us to brush our teeth... there wasn’t a toothbrush where we lived... here nobody talks too much about these things, because they know that to take care of the teeth cost a lots of money.”

Popular culture, the acquired knowledge throughout life and individual or collective beliefs were the factors that mostly permeated the speeches seized in connection with the acquisition and maintenance of oral health. The literature points to similar developments, in particular, at-risk populations with socioeconomic and educational deficit [19] [22] .

“About the salt I know that does not spoil, because my grandfather said when he had toothache, go there and make brine and rinse the mouth, it will kill the microbes. It was his way, he knew it would work... he could never go to the dentist and never brushed too, he didn’t know how to pick up a brush...”

Another related aspect of the subjects were oral hygiene habits, emphasizing the importance of flossing. The perception of collectors reveals the relationship between poor oral health and financial condition again, emphasizing the difficulty on access to dental supplies.

“I don’t have money to pay for a dental floss. I use plastic baggie (...) if there’s not floss I use this, at least I’m doing something.”

“To clean well, it’s necessary to use the toothbrush and to substitute the dental floss, I usually use the stitching yarn.”

The replacement of traditional dental cleaning agents, with a view to improving the quality of care, was also found in the literature [23] .

The usage of dental services is persuaded by different and multiple determinants including sociodemographic factors, perceived need, and importance attributed to oral health [26] . The dental origin pain, considered one of the major causes of human suffering and serious problem for public health [24] fosters these very negative psychosocial and socioeconomic repercussions, causing disabilities, impaired quality of life and work absenteeism [25] . This aspect was addressed in speeches, in particular as to the difficulty in performing daily activities:

“I had to go to the dentist, it was a horrible pain! It swelled, I could not leave the house and could not work. Horrible pain, pan! My husband charges me when I don’t go to work, because I help him to pay all the household bills.”

“I went to boot, it was sore, with root already appearing. I can’t feel pain, because I need to be good to take care of my husband and my kids.”

Although the toothache affects people from different social stratum, some researches suggest higher prevalence of pain in individuals with greater individual and social vulnerability [18] [24] , with the direct social environment or indirectly related to dental pain [25] .

The perception of collectors of recyclable materials on access to public dental services endorse the classical interpretation, linking it strongly to the simple presence of the professional in their field of work, the number of professionals, the availability of an appointment, the severity of their oral condition and being treated well by the dentist:

“(...) We arrive (public health service) with pain and still takes luck that has dentist to boot, he/she always finds a way, and treats us well... but there are people who need to score here for three or four months.”

“A person will not get pain, public health needs to improve, it’s not the lack of the dentist, that’s necessary to have more people working in oral health.”

The ways which are welcomed to step into a unit of the public health service was also cited, exposing a sense of exclusion across their working conditions:

“But there are people who work there (public health service) and don’t like we walked there... is, they think that we’re dirty. But when it hurts (tooth) I’ll go even. But the dentist says nothing, he has no disgust of our work.”

“If I could pay (dental treatment) I wasn’t going there... I know we are talking about we’re garbage. But just because I work with recyclables do I need to have my mouth spoiled?”

Although the few researches in the area of oral health to study the relationship between social exclusion and access to public health services, it is known that the there is the difficulty of access in Brazil and even more evident in groups of vulnerable individuals. To confront this reality it should be worked more with internal policies that eliminate the influence of social stereotypes in the deliberations of the daily work of health professionals [27] . And yet, broad policies that contextualize healthcare access these population groups so they can be watched in full and that the situations experienced risk can be reversed [28] .