Qualidade de vida, necessidade de tratamento ortodôntico e traumatismos dentários: estudo comparativo em uma população com Transtorno do Espectro Autista

Abstract

The main objectives of this study consisted of evaluating the perception of parents and guardians about the Quality of Life-Related to Oral Health, its impact on family dynamics, and the socio-psychological need for orthodontic treatment, in addition to systematically reviewing the literature on dental trauma in children and adolescents. with and without autism. To this end, a cross-sectional study was carried out comparing two groups of patients between six and 14 years old, with and without autism, followed in three health institutions in the city of Campina Grande, Paraíba, and their parents/guardians. After the calibration and pilot study stages, those responsible answered the following questionnaires: Parental Caregiver Perceptions Questionnaire, Family Impact Scale, sociodemographic, and about habits (oral hygiene and deleterious). The esthetic component of the Index of Orthodontic Treatment Need was answered by a calibrated researcher and guardians. The outcomes of the cross-sectional studies were the scores of the instruments used and the independent variables were related to sociodemographic and habit issues. Data were analyzed based on descriptive and inferential statistics. The normality of the variables was evaluated, finding a non-Gaussian distribution. Chi-square, Fisher's exact, Chi-square with the linear trend, and Mann-Whitney tests were used to verify possible associations between variables. For the systematic review, the MEDLINE/PubMed, Cochrane, Scopus, and Web of Science databases were used as a source for the search for studies. Observational and quantitative studies in English were included. The meta-analysis verified the frequency of traumatic dental injuries between groups. A representative sample of 144 pairs of subjects comprised the study (72 in each group). The patients' mean age was 8.09 (SD: 2.15), 74.3% were male, and the main respondents were mothers. The means of the Quality of Life instruments were higher in the group with ASD (p < 0.001). In the final model, the following variables were associated with a greater perception of impact on the Quality of Life Related to Oral Health: young people with higher ages (RE = 1.06; 95%CI: 1.01-1.10), younger years of study of guardians (RE = 1.43; 95%CI 1.10-1.85), high IOTN scores (RE = 1.04; 95%CI 1.01-1.08), tooth clenching (RE = 1.20; 95%CI 1.01-1.41) and lip sucking (RE = 1.23; 95%CI 1.02-1.47). No significant difference was observed between the orthodontic treatment need scores between the groups with and without ASD. As for dental trauma, only the variables subluxation (OR: 3.32; 95% CI: 1.14-9.67) and lateral dislocation (OR: 3.45; 95% CI: 1.42-841) were associated with the autistic group. It is concluded that those responsible for autistic children noticed greater impacts of the studied conditions on the Quality of Life Related to Oral Health of these young people. The same interpretation is possible for the family impact. Proportionally, the perception of the socio-psychological need for orthodontic treatment was greater in the group with autism. Similarly, even without observing statistical significance, dental trauma was more frequent in the autistic population. With this, the need for planning multidisciplinary actions aimed at this group is highlighted.