Condições bucais, psicológicas e comportamentais associadas ao bullying e a disfunção orofacial em escolares de 8 a 10 anos

Abstract

The objective of this study was to investigate the oral, psychological and behavioral conditions associated with bullying and orofacial dysfunction in schoolchildren aged 8 to 10 years. A cross-sectional study was carried out in which 739 children from public and private schools in Campina Grande-PB participated, chosen at random. Children answered a question about episodes of bullying related to oral health, The Revised Children’s Manifest Anxiety Scale (RCMAS) questionnaire on childhood anxiety, and the Nordic Orofacial Test-Screening (NOT-S) to assess orofacial dysfunction. Parents/guardians answered a socioeconomic questionnaire, the Sleep Disturbance Scale for Children (SDSC) about child-related sleep disorders, the Family Adaptability and Cohesion Evaluation Scales (FACES-III) family cohesion instrument and the Oral Health Literacy-Adults Questionnaire (OHL-AQ) on health literacy. Four duly calibrated examiners evaluated the children for the diagnosis of dental caries using the International Caries Detection and Assessment System (ICDAS), malocclusion using the Dental Aesthetic Index (DAI), orofacial dysfunction using the Nordic Orofacial Test-Screening (NOT-S) and trauma. dental according to the classification of Andreasen et al., 2007 (Kappa>0.80). Contextual variables were type of school and income in the school district. Data organization and analysis were performed using SPSS Statistics software (SPSS for Windows, version 25.0; IBM Inc., Armonk, NY, USA). Descriptive statistics were used to characterize the sample. Multilevel unadjusted and adjusted Poisson regression models were used to describe the association between outcome and predictor variables. The result of this study generated two articles. In article 1, the prevalence of bullying was 13.3%. In the adjusted analysis, after insertion of individual and contextual determinants, malocclusion (PR= 1.59; 95%CI: 1.03-2.44) and anxiety (PR= 1.79; 95%CI: 1.10-2.93) remained associated with bullying in children. Regarding the context, the lowest monthly income in the school district (PR= 1.75; 95%CI: 1.12-2.72) was associated with bullying. In article 2, the prevalence of orofacial dysfunction was 33.3%. In the adjusted analysis, after insertion of individual and context determinants, a lower monthly family income (PR=1.10; 95%CI: 1.04-1.15); a greater number of decayed teeth (PR= 1.04; CI95%: 1.04-1.05); the presence of dental trauma (PR= 1.05; 95% CI: 1.01-1.11); the presence of definite malocclusion (PR=0.76; 95%CI: 0.71-0.81); very severe/severe malocclusion (PR= 1.27; CI95%= 1.21-1.32); presence of sleep disorders (PR= 1.63; CI95%: 1.56-1.70) and anxiety (PR=1.19; CI95%: 1.13-1.25) remained associated with orofacial dysfunction. Regarding context, type of public school (PR=1.08; 95%CI: 1.02-1.14) was associated with orofacial dysfunction. It was concluded that anxiety and malocclusion influenced the presence of bullying and the lower family income in the school neighborhood was considered an important contextual determinant for the increase in the prevalence of bullying. Lower family monthly income, higher number of decayed teeth, presence of dental trauma and malocclusion, sleep disorders and anxiety influenced the occurrence of orofacial dysfunction. Regarding contextual determinants, the type of school played a significant role in increasing orofacial dysfunction.