Associação entre cronotipo, distúrbio do sono, disfunção orofacial, funcionamento familiar e má oclusão em escolares de 8 a 10 anos

Abstract

This study aimed to investigate the association between chronotype, sleep disorders, orofacial dysfunction, family functioning, anxiety, obesity, tooth decay, tooth loss, non-nutritive sucking habits and malocclusion in schoolchildren aged 8 to 10 years. An observational study was carried out, with a random and representative sample of 739 children aged 8 to 10 years, enrolled in public and private schools in Campina Grande-PB, Brazil. The parents / guardians answered the sociodemographic questionnaires about the child's non-nutritive sucking habits, Circadian Energy Scale (CIRENS), Sleep Disturbance Scale for Children (SDSC) and Family Adaptability and Cohesion Evaluation Scales (FACES III). And the children responded to the Revised Children’s Manifest Anxiety Scale (RCMAS) and Nordic Orofacial Test-Screening (NOT-S). Four examiners were trained and calibrated to diagnose malocclusion using the Dental Aesthetic Index (DAI), dental caries according to the International Caries Detection and Assessment System (ICDAS) and orofacial dysfunction using the Nordic Orofacial Test-Screening (NOT- S) (K> 0.80). Anthropometric data were obtained to assess nutritional status using the AnthroPlus software. A Directed Acyclic Graph was used to select covariates for statistical adjustment. The robust adjusted and unadjusted Logistic Regression analysis for complex samples was performed to obtain the associations between the independent variables and Malocclusion, according to the analysis plans (α = 5%). The prevalence of malocclusion was 49.1%, most had an intermediate chronotype (73.5%), sleep disturbance (58.6%), orofacial dysfunction was present in 33.3% and the level of family functioning was moderately balanced (37.1%). The high anxiety level was present in 34.2% of the children, 21.2% were overweight / obese, 52.8% of the students had cavities caries lesions, 8.4% had tooth loss and 7.7% had deleterious sucking habits. The variables night chronotype (OR = 2.83; 95% CI: 1.12-4.64), sleep disorders (OR = 1.54; 95% CI: 1.08-2.19), orofacial dysfunction (OR = 1.56; 95% CI: 1.13–2.17), type of family at the extreme level (OR = 3.96; 95% CI: 1.06-10.82), having cavitated caries lesions (OR = 1 , 39; 95% CI: 1.03–1.89) and non-nutritive sucking habits (OR = 2.26; 95% CI: 1.25–4.08) were associated with malocclusion. It is concluded that nocturnal chronotype, sleep disorders, orofacial dysfunction, extreme family functioning level, presence of dental cavities and cavities and non-nutritive sucking habits influenced the prevalence of malocclusion.