Prevalência do traumatismo dentário e fatores associados em escolares de 12 anos de idade: estudo de base populacional

Abstract

Objective: The aim of the present study was to analyze the prevalence of traumatic dental injuries in 12-year-old schoolchildren as well as associations with clinical factors, socioeconomic status and behavioral factors.Methods: A cross-sectional study was carried out with all 12-year-old students enrolled in public and private schools in urban areas of a medium-sized city in Brazil, totaling 633 adolescents. Data were collected through a clinical exam and self-administered questionnaires. The classification proposed by Andreasen et al. was used for the determination of traumatic dental injuries. The frequency of alcohol consumption in ones lifetime and abusive consumption were determined using the Alcohol Use Disorders Identification Test (AUDITC). The clinical variables (overjet, lip protection and body mass index) were determined through a clinical exam performed by an examiner who had undergone a training and calibration exercise. Socioeconomic data were collected using a questionnaire addressing household income and mothers schooling as well as the ABA-ABIPEME (Brazilian Advertisers Association) questionnaire on the possession of consumer goods. Social capital was measured by the Social Capital Questionnaire for Adolescent Students developed and validated for the present study. Statistical analysis involved frequency distribution and the chisquared test (p < 0.05). Adopted the analysis of Poisson regression to obtain the measures of association of dental trauma with alcohol consumption and multiple logistic regression for the association between the dependent variable and capital.Results: The prevalence of traumatic dental injuries was 29.3%. The prevalence rates of alcohol consumption in life and abusive consumption were 45.6% and 22.64%, respectively. Traumatic dental injuries were more prevalent among 12-year-olds those with accentuated overjet (PR = 1.813; 95% CI: 1.361-2.417), those with inadequate lip protection (PR = 1.560; 95% CI: 1.381-1.762) and who reported abusive alcohol consumption (PR = 1.19; 95% CI: 1.05-1.34). The questionnaire to measure social capital among adolescent students was made up of 12 items. The total scale demonstrated very good internal consistency (Cronbachs alpha: 0.707). Reproducibility was also very good, as the Kappa coefficient was higher than 0.72 for the majority of items (range: 0.63 to 0.97). Factor analysis grouped the 12 items into four subscales: School Social Cohesion, School Friendships, Neighborhood Social Cohesion and Trust (school and neighborhood). The present findings indicate the validity and reliability of the Social Capital Questionnaire for Adolescent Students. In the study population there were no association between social capital and dental injuries (OR = 0.98, 95% CI: 0.93-1.04).Conclusions: Traumatic dental injuries were prevalent among the 12-year-olds surveyed and associated with the abusive consumption of alcoholic beverages. The high frequency of abusive alcohol consumption is worrisome, considering the age of the participants and the vulnerability of this population due to the intense transformations that occur in the transition from childhood to adulthood. The Social Capital Questionnaire for Adolescent Students proved valid, reliable and appropriate for use in epidemiological studies involving other samples of adolescents.