Fatores associados a cárie em dente anterior e autopercepção da necessidade de tratamento odontológico em adolescentes

Abstract

Adolescence is a sensitive period of massive biological change, psycossocials and environmental. In this phase, unhealthy behaviors can be acquired and buccal issues such as dental caries show high prevalence. Teenagers value esthetic aspects and the presence of caries in the previous teeth might compromise the appearance of these individuals. Besides, the buccal heath perception, especially the self-perception of the treatment need, can influence the search of odontological services. In that regard, it is important that this measure is recognized among teenagers. The objective of this study was to evaluate the associated factors to caries in previous teeth and the self-perception of the needs odontological treatment. This is a cross-sectional and analytical observational study realized in public and private schools in the city of Campina Grande, Paraiba, with a sample of 746 teenagers between 15 to 19 years old. Two researchers participated in theoretical/practical training and the calibration to the dental carie diagnosis and oral health literacy (K>0,80). The parents/ responsables answered to a socio demographic questionnaire and the teenagers answered about buccal morbid and the use of services and validated instruments about family work (Family Adaptability and Cohesion Evaluation Scales - FACES III) and about functional oral health literacy (ASB) (Brazilian Rapid Estimate of Adult Literacy in Dentistry - BREALD-30). The dental caries was evaluated following the criteria of Nyvad and Baelum (2018). The school's contextual variables were obtained from the 2017 school census of the National Institute of Studies and Research Anísio Teixeira (INEP), municipal health department and the Brazilian Institute of Geography and Statistics (IBGE). Multilevel analysis using robust negative binomial regression adjusted and unadjusted for complex samples and unadjusted and adjusted analysis using robust logistic regression for complex samples were used to assess the association between independent variables and caries in anterior tooth and self-perceived need for dental treatment (p<0.05). The results of this study generated two articles. The mean number of anterior teeth with untreated caries in the sample was 0.95 (SD: 1.77). The prevalence of self-perceived need for treatment among adolescents was 88.6%. In article 1, among the individual factors associated with caries in anterior teeth are male adolescents (RR=1.64; 95%CI: 1.24-2.16), with an inadequate ASB level (RR=2, 03; 95%CI: 1.13-1.63) and marginal (RR=1.87; 95%CI: 1.05-3.33) and who did not have health insurance (RR=1.34; 95%CI: 1.07-1.68). Regarding the contextual factors of the school, the number of students in the classroom (RR=2,64; IC95%:1,78-3,93), the income of the school district (RR=0.99; 95%CI:0 .98-0.99) and the number of public oral health services in the school district (RR=0.14; 95%CI:0.05-0.39) were associated with untreated caries. In article 2, the presence of dental caries (OR = 2.10; 95% CI: 1.22-3.61); loss of permanent teeth due to caries (OR = 15.81; 95% CI: 2.14-116.56); presence of toothache in the last 6 months (OR = 1.87; 95% CI: 1.06-3.31) and enmeshed family cohesion type (OR = 10.23; 95% CI: 3.96-26 ,4) were associated with self-perceived need for treatment. Male gender, inadequate and marginal ASB, not having health insurance and contextual factors at school were associated with caries in anterior teeth. In addition, adolescents with dental caries, loss of permanent teeth, toothache and who presented enmeshed family cohesion type perceived a greater need for dental treatment.