Insegurança alimentar, fatores psicossociais e comportamentais associados à cárie dentária em adolescentes

Abstract

The aim of this study was to evaluate the association between food insecurity, psychosocial and behavioral factors, and dental caries in adolescents. A cross-sectional study was conducted with 681 twelve-year-old adolescents enrolled in public and private schools in Monteiro, Paraíba, Brazil. Prior to data collection, an examiner was calibrated (Kappa > 0.80) for the diagnosis of dental caries (ICDAS) and dental biofilm (VPI). A pilot study was conducted to assess the methodology. Parents/guardians answered a sociodemographic and economic questionnaire and the Brazilian Food Insecurity Scale (EBIA). Adolescents reported their toothbrushing frequency, completed a food frequency questionnaire (FFQ) for sugar consumption, and responded to instruments assessing anxiety (RCMAS), depressive symptoms (CDI), and family cohesion and adaptability (FACES III). Anthropometric data (weight and height) were also collected. Negative binomial regression models were used to evaluate the association between independent variables and cavitated dental caries (ICDAS codes 3, 5, and 6) (p < 0.05). The prevalence of cavitated dental caries in the sample was 34.9%, with a mean of 0.72 (SD: 1.3) affected teeth. Cavitated caries remained associated with lower household monthly income (RR = 2.38; 95% CI: 1.53–3.69), lower maternal education (RR = 1.97; 95% CI: 1.36–2.84), moderate/severe food insecurity (RR = 1.70; 95% CI: 1.15–2.52), presence of dental biofilm (RR = 2.01; 95% CI: 1.47–2.75), higher daily sugar intake (RR = 1.51; 95% CI: 1.12–2.05), and high food and emotional vulnerability (moderate/severe food insecurity combined with depressive symptoms) (RR = 1.66; 95% CI: 1.20–2.29). In conclusion, dental caries in adolescents is associated with socioeconomic, behavioral, and psychosocial factors, including food insecurity, low maternal education, lower income, presence of dental biofilm, high sugar intake, and high food and emotional vulnerability.