Fatores associados à perda dentária, à autopercepção da necessidade de tratamento e ao motivo da última consulta odontológica em adolescentes

Abstract

The aim of this study was to evaluate factors associated with tooth loss, self-perceived need for treatment and reason for the last dental appointment in adolescents aged 15- 19 years. A cross-sectional and analytical study was carried out with a representative sample of 753 students from public and private schools of the city of Campina Grande, PB, Brazil. Clinical data were collected at the school environment through oral examination performed by two dentists trained for this purpose (k>0.80). For this, diagnostic criteria for caries and tooth loss of the Nyvad Index were used. Sociodemographic data and the Brazilian Economic Classification Criteria (CCEB) were answered by parents/guardians. Adolescents answered the Family Adaptability and Cohesion Scales (FACES III), the Rapid Estimate of Adult Literacy in Dentist (BREALD-30), the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Oral Health Questionnaire, based on methodology of the national oral health survey (SB BRASIL - 2010). The school context was analyzed using cluster built with type of school and school retention rate, in addition to other information collected from the 2017 school census, and the income of school districts was obtained with data from the Brazilian Institute of Geography and Statistics (IBGE). Multilevel logistic regression (α = 5%) was conducted. Initially, a null model was used to observe data variation; then, a model was built with only individual variables with p-value <0.20 in the unadjusted analysis. Finally, the final study model included individual and contextual variables with p-value <0.20 in the unadjusted analysis. Variables with p<0.05 at the end of this step were considered associated with outcomes. Data were analyzed using SPSS Statistics, version 22.0. Oral health literacy (OR= 0.93; 95% CI: 0.89-0.97), polyconsumption of psychoactive substances (OR= 2.01; 95% CI: 1.09- 3.69) and reason for the last dental appointment for treatment/symptomatology (OR= 3.05; 95% CI: 1.73-5.36) were associated with tooth loss in adolescents. Toothache (OR= 1.08; 95% CI: 1.01-1.16), tooth loss of first molars (OR= 1.09; 95% CI: 1.03- 1.15), family cohesion (OR= 1.15; 95% CI: 1.01-1.31) and public school (OR= 1.17; 95% CI: 1.02-1.33) were associated with self-perceived need for treatment. Maternal schooling (OR= 1.06; 95% CI: 1.01-1.10), oral health literacy (OR= 0.99; 95% CI: 0.98- 0.99), the presence of dental caries lesion (OR= 1.09; 95% CI: 1.01- 1.18) and school environment (OR= 1.07; 95% CI: 1.00-1.15) were associated with the last dentalappointment for treatment/symptomatology. It could be concluded that oral health literacy, polyconsumption of psychoactive substances and reason for the last dental appointment for treatment/symptomatology were associated with tooth loss in adolescents. Toothache, tooth loss of first molars, family cohesion and public school were associated with self-perceived need for treatment. Maternal schooling, oral health literacy, the presence of dental caries lesion and school environment were associated with the last dental appointment.