Qualidade de vida relacionada à saúde bucal de crianças e adolescentes com e sem câncer

Abstract

Children and adolescents undergoing cancer treatment face several challenges, including adverse effects that affect the oral cavity and negatively impact their Quality of Life (QoL). This study aimed to evaluate the influence of cancer treatment, presence of dental caries and sociodemographic factors on the QoL and Oral Health-Related Quality of Life (OHRQoL) of children and adolescents with and without a diagnosis of cancer. This is a cross-sectional study with two groups: the first group comprised 103 children and adolescents undergoing cancer treatment, treated at the Borges da Costa Outpatient Clinic of the Hospital das Clínicas of UFMG and welcomed at the Aura Support Home; the second group comprised 50 participants without systemic diseases. Data were collected through structured questionnaires administered to mothers or caregivers, covering sociodemographic information, aspects of treatment, and oral hygiene care. QoL was assessed using the Brazilian version of the PedsQL™ Generic Core Scales, and OHRQoL was assessed using the PedsQL™ Oral Health Scale. The questionnaires were answered by mothers/caregivers of children aged 2 years and older, and by self-reporting by the children and adolescents aged 5 years and older. In these instruments, lower scores indicate worse quality of life. In addition, a clinical examination for diagnosis of dental caries was performed using the ceo-d and CPO-D indexes by trained and calibrated dental surgeons. The sample was mostly composed of male participants (54.4%) and aged between 1 and 7 years (55.3%). Regarding oral health, 53.4% had up to two teeth with caries. The QOL scores indicated, according to the mothers' reports, that children aged 1 to 7 years had lower averages in the “physical capacity” domain (73.79 ± 26.40). Among participants aged 8 to 18 years, the most affected domains were “school activity” (54.98 ± 31.76) and “physical capacity” (66.30 ± 24.69). Children’s self-report also reflected a negative impact on the same domains, regardless of age group. Regarding OHRQoL, the most affected domains were “tooth sensitivity”, “bleeding gums” and “darkened teeth”, with variations according to age and type of report (maternal or self-report). In the multivariate analysis, among participants with cancer, the presence of dental caries experience (OR = 5.38; 95% CI: 1.13–25.60) and older maternal age (OR = 4.51; 95% CI: 1.91–22.40) were associated with worse OHRQoL. In the group without cancer, no variable showed a significant association. Regarding overall QoL, children and adolescents aged 8 to 18 years (OR = 7.12; 95% CI: 11.98–25.51) and those placed in support homes (OR = 4.05; 95% CI: 1.19–3.31) had lower scores. Maternal reports reinforced that institutional care was associated with a greater negative impact on QoL, compared to participants who returned to their homes (OR = 9.43; 95% CI: 1.74 50.87). It is concluded that the presence of dental caries experience and advanced maternal age negatively influence OHRQoL, while overall QoL is especially compromised among older children and those placed in support institutions.