Associação entre fatores biopsicossociais, acesso e utilização dos serviços de saúde bucal e a cárie dentária em adolescentes

Abstract

Dental caries is the most common oral health problem worldwide and remains causing harm to the population despite health public policies and scientific advances. It is important to recognize the factors associated with dental caries in adolescents since this is a dynamic and high risk stage for behaviors that are harmful to oral health. This study aimed to evaluate the association between psychosocial and socio-demographic data, dental visit and dental caries in adolescents. A cross- sectional study was carried out with a representative sample of 769 adolescents aged 15 to 19 years from public and private schools in Campina Grande-PB, Brazil. Parents/guardians answered questionnaires about socio-demographic data. Adolescents answered the questionnaires about family cohesion and adaptability (FACES III), on the consumption of psychoactive substances (ASSIST) and about the use of oral health services. Then, adolescents responded to the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) to provide the level of oral health literacy. Two dentists were trained through a calibration process for dental caries examination in the adolescents using Nyvad criteria (Kappa inter-examiner: 0.89-0.90 and intra-examiner: 0.88-0.90). Descriptive statistics and Poisson regression were performed (p <0.05). Confounding variables were selected to adjust the statistical model using a Directed Acyclic Graph (DAG). The prevalence of cavitated lesions of dental caries was 41.6% and 93% of adolescents have had to the dentist. Regarding Oral Health Literacy (OHL), 37.5% of the adolescents presented marginal level and 33.1% had an inadequate level. Adolescents with 6 or more people at home accounted for 16.9% and 56.9% of the participants were from disadvantaged social classes. Disengaged families were observed for 46.1% of adolescents. After adjustment of individual variables, the number of cavitated lesions of dental caries was associated with social class (RR = 1.85, 95% CI: 1.39-2.47), inadequate OHL (RR = 1.69; 95% CI: 1.18-2.41), marginal OHL (RR = 1.42, 95% CI: 1.01-1.99), the number of people in the house (≥ 6 people) (RR = 1.31; 95% CI: 1.09-1.73), Disengaged family cohesion (PR = 3.14, 95% CI: 1.44-6.87), separated family cohesion (RR = 2.67, 95% CI: 1.22-5 , 86) and connected family cohesion (RR = 3.63, 95% CI: 1.61-8.16). CONCLUSION: A lower socioeconomic status, family cohesion and level of OHL influenced the number of dental caries lesions in adolescents. On the other hand, there was no influence of going to the dentist for dental caries.