Impacto da hipomineralização molar incisivo na qualidade de vida relacionada à saúde bucal em escolares de 8 a 14 anos de idade

Abstract

Introduction: Molar incisor hypomineralization (MIH) is a particular pattern of hypomineralization that affects first permanent molars and/or incisors and has gained clinical and scientific importance in recent years. This condition usually causes tooth sensitivity and can affect the quality of life of affected individuals. Objective: To evaluate the impact of MIH and confounding factors (caries experience, malocclusion and other enamel defects) on oral health-related quality of life (OHRQoL) according to the perception of children and their parents / caregivers in a municipality in the northeastern region of Brazil. Methodology: This was a cross-sectional population-based study. The sample was probabilistic by conglomerates, composed of schoolchildren of both sexes aged 8-14 years from public elementary schools of Campina Grande-PB. OHRQoL was measured using the Child Perceptions Questionnaire (B CPQ8-10) and Child Perceptions Questionnaire (B-CPQ11-14ISF: 16) applied to children aged 8 to 10 years and 11 to 14 years, respectively, and the short version of the Parental Caregiver Perceptions Questionnaire (BP-CPQ) applied to parents. MIH diagnosis was performed according to the European Academy of Paediatric Dentistry criteria modified in 2019. Experiences of dental caries (International Caries Detection & Assessment System II Index - ICDAS II), malocclusion (Dental Aesthetic Index - DAI) and socioeconomic and demographic factors were evaluated as confounding factors for impact on OHRQoL. Data were analyzed in a descriptive and inferential manner using the SPSS® software (version 22.0 for Windows, SPSS Inc., Armonk, NY, USA). Cluster analysis was carried out to dichotomize the negative impact into greater and lesser impact. Chi-square tests and Poisson regression with robust variance were performed to verify associations between OHRQoL and independent variables. To enter the final model of the analysis, all variables with p≤0.20 were used in the bivariate analysis, thus carrying out the adjusted analysis. The significance level adopted was 5%. Results: In the sample of schoolchildren aged 8-10 years, the prevalence of MIH was 13.4%, whereas among individuals aged 11-14 years, it was 10.8%. The presence of MIH had no impact on OHRQoL according to the self-perception of children of both age groups. However, according to the perception of parents / caregivers, the presence of MIH on the incisors of children aged 8-10 years had negative impact on the emotional well-being domain (PR = 1.92; 95% CI = 1.16-3.19). Regarding factors considered confounding, dental enamel hypoplasia had a 51.8% higher impact rate in the domain of oral symptoms of B CPQ8-10 (PR = 1.51; 95% CI = 1.03-2.23 ), according to the self-perception of children aged 8 to 10 years. According to the perception of the parents / caregivers of these children, the caries experience had a negative impact on the quality of life of the students, in the domains of emotional well-being (PR = 4.19; 95% CI = 1.06-16.49) and in the total questionnaire score (PR = 3.21; 95% CI = 1.06-9.71). In the sample aged 11 to 14 years old, caries experience had an influence on HRQoL, having an 82.8% higher impact rate in the functional limitation domain (PR = 1.82; 95% CI = 1.20-2.77) and 59% in the total B-CPQ11-14ISF score: 16 (PR = 1.59; 95% CI = 1.00-2.51), according to the students' self-perception, and an impact rate of 57.5% higher in the oral symptoms domain (PR = 3.57; 95% CI = 1.71-7.414), 71.1% in emotional well-being (PR = 1.71; 95% CI = 1.08-2.69) and 67 , 8 in the total BP-CPQ score (PR = 1.67; 95% CI = 1.01-2.76), according to the perception of parents / caregivers. For this group, malocclusion also negatively influenced HRQoL in the social welfare domain (PR = 1.50; 95% CI = 1.07-2.10) and in the total questionnaire score (PR = 1.54; 95% CI = 1.11 - 2.15). Conclusion: According to the children's self-perception, MIH has no impact on their OHRQoL, regardless of age group. However, for parents / caregivers the presence of MIH in the incisors had great negative impact on the emotional well-being domain of OHRQoL. With regard to confounding factors, in the age group 8 to 10 years old, the presence of hypoplasia impacted the children's self-perception of HRQoL and the caries experience influenced the children's QBSRB, under the perception of parents / caregivers. For the 11 to 14 year old age group, the experience of caries and malocclusion were conditions that had a significant impact on the HRQoL of the studied sample.