Influência das condições bucais e suas consequências em desfechos educacionais e na entrada no mercado de trabalho entre os adolescentes

Abstract

Epidemiological research has focused on understanding and explaining the relationship between health and socioeconomic position. Health is a consequence of social inequities, and these relations can persist throughout life, can thus turn disease into risk factors for educational and economic outcomes. The aim of this research was to investigate the influence of oral health conditions on educational outcomes and labor market entry, through the different phases of adolescence. Therefore, a cohort study was carried out with adolescents from Santa Maria, RS, Brazil. The initial sample consisted of 1,134 11-12-year-old adolescents selected by a two-stage randomized sampling process in 2012. The first cluster comprised a weighted draw of the city's public schools, and in the second cluster, adolescents were invited to participate of the study. At baseline, trained and calibrated dentists applied examinations and questionnaires. Oral examinations corresponded to oral conditions: dental caries and malocclusion. The structured questionnaires contained information about: demographic factors, family’s socioeconomic characteristics, oral hygiene habits, use of dental services variables and subjective measurements, such as oral health-related quality of life (OHRQoL) and bullying related to oral health. Contextual variables were also collected, using official information from the municipality. Two years later, 770 adolescents were reevaluated under the same baseline methodological protocols (retention rate at cohort of 68%). At this time, school official records obtained data regarding the adolescent’s academic performance. In 2018, occurred to the third evaluation of the study, where 768 adolescents with mean age of 17.5 years-old were reevaluated. The methodological protocols followed to baseline standards, except at this time the oral condition, malocclusion, was not collected, and new variables were obtained, which were: school situation, self-report need for dental treatment and employment variables. Multilevel regression models were used to verify the association between socioeconomic variables, oral conditions, bullying and academic performance at 2014. Structural Equations Models were performed to decompose the direct and indirect way between oral conditions and employment outcomes at 2018. Multinomial regression models were performed to assess the influence to dental caries on school leavers. The results showed that men, low household income, low mother’ education, toothache and verbal bullying were associated to adolescents' academic performance. Oral health in early adolescence affects the trajectories of employment, through effects on the OHRQoL, education and earnings from work. In addition, untreated dental caries and mother’s education influenced on school leavers of the adolescents. In conclusion, oral conditions and its consequences can affect education and employment outcomes, during adolescence