Aspectos relacionados ao traumatismo dentário e às consequências da cárie dentária não tratada (PUFA) em pré-escolares

Abstract

OBJECTIVE: to evaluate the impact of dental trauma on Oral Health-Related Quality of Life (OHRQoL) and the association between the Sense of Coherence (SOC) of parents/caregivers, socioeconomic factors and consequences of untreated dental caries (pufa) in preschool children. METHODS: It was a cross-sectional study with complex sample and preschool based sample with a total of 769 children of five years old from public and private preschools in Campina Grande, Brazil. Two examiners underwent a training process which involved the determination of inter- examiner and intra-examiner agreement for the diagnosis of dental trauma (K = 0.88- 0.90; K = 0.82-0.87), dental caries (K = 0.89-0.90; K = 0.87-1.00), malocclusion (K = 0.86-0.91; K = 0.94-1.00) and the consequences of untreated dental caries (K = 0.90 -1.00; K = 1.00). The Scale of Oral Health Outcomes for 5-year-old children (SOHO- 5) was used to evaluate the impact of dental trauma on the quality of life of preschoolers and the sense of Coherence (SOC) of parents/caregivers was obtained from a validated instrument. Statistical analysis varied according to each goal. Descriptive analyses were conducted, followed by logistic regression for complex samples (α = 5%) in the first analysis plan and an inductive decision tree was built through J48 Algorithm (α = 5%) for the second analysis plan of this study. RESULTS: the impact of oral problems on the OHRQoL of preschool children was 32.9% and 42.2% according to parents∕caregivers and children respectively. The presence of one (OR = 1.59; 95% CI 1.01 - 2.49) or more traumatized teeth (OR = 1.95; 95% CI 1.27 -3.00), dental pain (OR = 3.78; 95% CI 2.41-5.91) and a low educational level of parents (OR = 1.57; 95% CI 1.04 -2.38) exerted an impact on preschool OHRQoL of children according to self-report. The characteristics which remained associated with the final model for parents/caregivers‟ reports were the presence of toothache (OR = 9.86; IC 95% 16.48 - 5.90) and a lower monthly household income (OR = 1.75; 95% CI 1.11 -2.75). It was found a prevalence of 13.8% of the consequences of untreated dental caries (pufa) among the preschoolers. Parents/caregivers with a weak sense of coherence accounted for 41.7% of the sample. The factors associated with the consequences of untreated dental caries were: toothache (RP = 12.34; IC 95%: 7.87- 19.35), children from public preschools (RP = 2.38; IC 95% 3.09-1.83; p 0.001), parents/caregivers under the age of 30 years old (RP = 1.44; IC 95% 1.68-1.26; p 0.001), parents/ caregivers with more than two children (RP = 1.47; 95% CI 1.28- 1.69; p 0.001) and parents/caregivers with a weak sense of coherence (RP = 1.13; 95% CI 1.01-1.28; p < 0.001). CONCLUSION: the impact of oral health problems on preschoolers OHRQoL was high. A greater number of traumatized teeth, the presence of toothache and socioeconomic factors were associated with a worse OHRQoL in preschoolers and varied according to parents/caregivers and children reports. The prevalence of the consequences of untreated dental caries (pufa) was low and associated with social factors (type of school, age of parents/caregivers, and number of children) and a psychological factor (SOC).