Maloclusão, qualidade de vida e vulnerabilidade social em crianças brasileiras: estudo de base populacional

Abstract

The present study, presented in the form of two manuscripts, aimed to access in Brazilian preschool children: 1) the association between the malocclusion and oral health-related quality of life (OHRQoL); and 2) the association between social vulnerability, sucking habits and overjet. In the first paper, a population-based case-control study was carried out, in a sample of 425 preschool children (5 years old) in Belo Horizonte. 85 children in the case group (children with negative impact on OHRQoL) and 340 children in the control group (children without negative impact on OHRQoL). This study was nestled in a population-based cross-sectional study. Each preschool child identified as a case was matched to four controls preschool children according to the matching factors: gender and monthly household income. OHRQoL was the outcome variable and was determined using the Child Impact Section of the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) and clinical exams by a calibrated examiner. Descriptive, bivariate and conditional logistic regression analyses were carried out. The results showed that the frequency of children with malocclusion was greater in the case group (52.9%) than the control group (46.8%). The unadjusted conditional logistic regression analysis revealed that were significant association between the presence dental caries (OR=2.43; 95%CI=1.49-3.94) and assessment of parents/caregivers on the child's oral health (OR=2.96; 95%CI=1.78-4.93), results confirmed by the application of multiple conditional logistic regression analysis which demonstrated a significant association between assessment of parents/caregivers on the child's oral health (OR=2.26; 95%CI=1.31-3.91) and OHRQoL, in a significance level of 5%. In the second paper, a population-based cross-sectional study was carried out with 1069 preschool children (5 years old in the city of Belo Horizonte, MG), at public and private preschools. Oral examinations of the children were performed by a single examiner, previously calibrated for the assessment of overjet. Parents/caregivers were asked to complete a form on sociodemographic data. To determine the social conditions the Social Vulnerability Index (SVI) were used. Descriptive and univariate Poisson regression analyses were performed. It was observed that children with accentuated overjet had lesser social vulnerability than those with normal overjet (p= 0.006, effect size= 0.19). Preschool children that parents/caregivers related used bottle feed and pacifier had better social status (p= 0.082, effect size= 0.19, p=0.001, effect size=0.19, respectively). Children whose parents/caregivers reported receiving 5 or more times the monthly minimum wage and have more prevalence of habits of bottle feed (PR: 1.08; 95% CI: 1.02-1.15) than those whose parents/caregivers receive lesser wage. Children whose caregivers present highest level of education (ie. more than eight years of schooling) have more prevalence of habits of bottle feed (PR: 1.11; 95% CI: 1.03-1.20) and pacifier (PR: 1.27; 95% CI: 1.10-1.46) than their counterparts. The findings suggested that malocclusion did not provoked impact on the OHRQoL of preschoolers, and, less social vulnerability were associated with children that present accentuated overjet and whose caregivers related the use of pacifier and bottle feed.