Associação entre medo odontológico, cárie dentária e hipomineralização molar-incisivo em escolares de 11 a 14 anos de idade

Abstract

The aim of the study was to estimate the prevalence of dental fear and to evaluate its association with dental caries and Molar-Incisor Hypomineralization (MIH) in schoolchildren aged 11 to 14 years old. A cross-sectional study was carried out, involving a representative sample of 375 students enrolled in urban public elementary schools in the city of Campina Grande, Paraíba. Parents/guardians answered a questionnaire addressing socioeconomic characteristics related to guardians – marital status and guardian who lives with the adolescent, schooling, monthly family income and participation in the Bolsa Família financial benefit program – and to adolescent – sex, age, color, presence of intellectual disabilities or neurodevelopmental disorders and presence of neuropsychiatric disorders – in addition to data on the adolescent's previous dental experience and recent history of pain or tooth sensitivity, while dental fear was measured using the validated Brazilian version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The diagnosis of dental caries and MIH was performed by three trained examiners (κ ≥ 0.61) using the International Caries Detection & Assessment System – ICDAS II and the Ghanim et al. index, respectively. Data were analyzed descriptively and using the Chi-Square and Fisher's Exact tests. Poisson Regression, with robust variance, was used for the multivariate analysis, with their respective confidence intervals (95%CI), and variables with p<0.20 were included in the regression model; the significance level adopted was 5%. The prevalence of dental caries was 76.3%, with a predominance of moderate/advanced lesions (96.2%). Adolescents diagnosed with MIH were 43 (11.5%), and most of the defects were classified as severe (53.5%). The prevalence of dental fear was 18.4%, and the average CFSS-DS total score was 28.96 ± 8.92. Most adolescents had low dental fear (67.2%), however 64 (17.1%) revealed having high dental fear. The following CFSS-DS items had the highest mean values: “Having somebody put instruments in your mouth” (2.88 ± 1.40), “Injection” (2.58 ± 1.41), “The dentist drilling” (2.35 ± 1.42), “Having a stranger touch you” (2.24 ± 1.36), and “Choking” (2.18 ± 1.39). In the bivariate analysis, dental fear was associated with non-nuclear family structure (p=0.046), with parents/guardians' education ≤ 8 years of study (p=0.031) and with the presence of dental pain in the last six months (p=0.001). After adjusting for the covariates family structure, education of parents/guardians, type of dental health service consulted and dental pain in the last six months, the prevalence of dental fear was associated with dental pain in the last six months (PR=2.03; 95%CI=1.31-3.16; p=0.002). It was concluded that, although there was no association between dental fear, dental caries and molar-incisor hypomineralization in the examined adolescents, those who experienced dental pain in the six months prior to the collection had a higher prevalence of dental fear.