Cárie dentária e desordens orais: limitações funcionais e impactos na qualidade de vida de pré-escolares

Abstract

OBJECTIVE: To determine the impact of dental caries and oral disorders on the quality of life and functional limitations of preschool children aged three to five years in the city of Campina Grande, PB, Brazil. METHODS: This was a cross-sectional study conducted with 843 preschool children enrolled in public and private institutions in the city of Campina Grande, PB, Brazil. A pilot study was previously carried out with 40 preschool children, in order to ascertain the methodology used. Parents/caregivers answered a questionnaire on socio-demographic data, and general and oral health statuses of their children. The Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) was applied to determine the impact of dental caries and oral disorders on oral health-related quality of life (OHRQL) of preschool children and their parents/guardians. Clinical examinations were performed on the children by three calibrated dentists (K: 0.85-0.90). As diagnostic criteria, we used the International Dental Caries Detection and Assessment System (ICDAS-II), the criterion for diagnosis of dental trauma proposed by Andreasen et al. (2007) and the criteria for diagnosis of malocclusion proposed by Foster and Hamilton (1969). Descriptive analysis and hierarchical Poisson regression were used to determine the associations between the independent and dependent variables. The level of significance was set as 5%. A multivariate model was conducted at three levels: 1) socio-demographic data, 2) perceived health (general and oral), and 3) dental caries and oral disorders. RESULTS: The prevalence of dental caries, dental trauma and malocclusion was found to be 66.3 %, 33.9 % and 63.2 %, respectively. The prevalence of toothache was 9.4 %. Poor oral health of children perceived by their parents/caregivers and toothache were maintained in the final model for the impact on the child and family, with the following values: PR: 1.406, 95 % CI: 1.0541.876 (perceived oral health) and PR: 5.640, 95 % CI: 3.350-9.493 (toothache), and PR = 3.025, 95 % CI: 1.832-4.993 (perceived oral health) and PR: 5.640, 95 % CI: 3.350-9.493 (toothache), respectively. The prevalence of impact on functional limitations was 24.7% for the function eating/drinking and 8.0 % for the function speaking. Toothache was statistically associated with the impact on the function drinking/eating (PR = 5.381, 95 % CI: 3.209-9.022). High severity of dental caries was statistically associated with the impact on the function speaking (PR = 14.915, 95% CI: 1.980-112.327). CONCLUSION: The poor perception of parents/caregivers of their children's oral health and history of toothache were indicators of a impact on the quality of life of preschool children and their families. Dental caries, trauma and malocclusion were not associated with the functional limitations of drinking/eating. However, toothache was associated with the difficulty in drinking/eating, and severity of dental caries was associated with the difficulty in speaking.