Impacto das alterações bucais na qualidade de vida de pré-escolares e de suas famílias - Estudo de caso-controle

Abstract

The majority of studies that explored the impact of oral disorders on the oral health related quality of life (OHRQoL) of preschool children and their families were cross- sectional, thus there is a need for investigations with design studies with higher strength of evidence. OBJECTIVE: Evaluate the impact of dental caries, traumatic dental injury (TDI) and malocclusion on the OHRQoL of Brazilian pre-schoolers and their families. METHODS: A population-based, matched, case-control study was conducted involving 415 children aged three to five years old enrolled at public and private pre- schools in the city of Campina Grande, Paraiba, Brazil. The case group (impact on OHRQoL) and control group (no impact on OHRQoL) were matched for age, sex and monthly household income at a 1:4 ratio (83 cases and 332 controls). Impact on OHRQoL was assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Dental caries, TDI and malocclusion were determined through clinical oral examinations performed by three previously calibrated dentists (K=0,85-0,90). Data analysis involved descriptive statistics and conditional logistic regression analysis according to the levels of analysis (p ≤ 0.05; 95% CI). RESULTS: The most frequent responses on the child section of the B-ECOHIS were “felt pain” (79.7%) and “difficulty eating” (35.0%), while the most frequent responses on the family section of the B-ECOHIS were “felt guilty” (68.6%) and “been upset” (48.2%). The following variables were significantly associated with impact on the child’s OHRQoL (cases): caries severity (OR = 4.707; 95% CI: 1.474-15.037), history of tooth pain (OR= 31.298; 95% CI: 16.046-61.048) and TDI (OR: 2.084; 95% CI: 1.042- 4.168). The following variables were significantly associated with negative impact on family OHRQoL (cases): caries severity (OR = 6.680; 95% CI: 2.731-16.349), a history of tooth pain (OR= 2.666; 95% CI: 1.492-4.765), parental rating of the child’s oral health as poor (OR: 1.973; 95% CI: 1.072-3.634) and parents/caregiver’s age (OR=2.936; 95% CI: 1.077-3.478). Anterior open bite was a protective factor for OHRQoL (OR=4.050; 95% CI: 1.333-12.314). CONCLUSION: Caries severity, history of tooth pain and TDI negatively impacted the OHRQoL of pre-schoolers. Caries severity, a history of tooth pain, parental rating of the child’s oral health as poor and younger parents/caregivers were associated with impact on the OHRQoL of the families of pre-schoolers. Malocclusion did not exert an impact on the OHRQOL of the child and the family, however, anterior open bite was a protective factor for family impact.