Experiência de cárie dentária em escolares: fatores associados e influência do cronotipo

Abstract

Among the diseases related to oral health, dental caries remains the most prevalente, representing an important public health issue worldwide. It has a multifactorial aetiology and is influenced by individual and environmental factors. One of the aspects that may play an important role in health behaviours is the chronotype and its associated factors. Human body is ruled by an internal clock, which controls the 24 hours cycle named Circadian Cycle. Circadian rhythm differs among individuals. The chronotype profile is the propensity for an individual to be especially active at a particular time during a 24-hour period, and this characteristic determines if a person belongs to morning or evening-type profile. This cross-sectional study aimed to investigate the association of chronotype, sociodemographic status, oral hygiene and dietary habits, and dental caries among a 12-year-old sample of 245 adolescents, from public and private schools, in the municipality of Brumadinho, southeast Brazil. Adolescents signed an assent form, while their parents/caregivers signed a consent form. Approval from the Human Research Ethics Committee of the Universidade Federal de Minas Gerais was obtained. The Portuguese version of the Puberty and Phase Preference Scale (PPPS) was used to assess chronotype. Information about dietary and oral hygiene habits was collected through a self-reported questionnaire survey. The adolescents parents/caregivers completed a questionnaire to provide information regarding sociodemographics (educational level, area of residence and families monthly income). Two previously calibrated examiners (kappa values for intra-and inter-examiner agreement: 0,74 to 0,82) carried out clinical examination of dental caries at schools, employing the decayed, missed and filled teeth (DMFT) index, according to the World Health Organizations criteria. Anthropometric measures were carried out to further determine the body mass index (BMI). Kruskal-Wallis test and Mann-Whitney U-test were applied, as well as a Poisson regression model, employing the Statistical Packpage for Social Sciences (SPSS for Windows, version 21.0, SPSS). Dental caries was present in 42.0% of the sample, and in the bivariate analyses, it was associated with living in rural areas, (p=0.006), parents/caregivers lower schooling (p=0.008) and not having a daily intake of vegetables (p=0.033). According to the scores in the PPPS scale, 126 (52.3%) adolescents were classified as evening-types, while 115 (47.7%) were classified as morning-types. The final Poisson Regression model showed that adolescents who did not breakfasted regularly (Rate Ratio [RR] = 1.55;95% Confidence Interval [CI]= 1.17 2.08) (p=0.003), lived in rural areas (RR= 2.20; 95% CI= 1.59 3.04) (p<0.001), and did not have a daily intake of vegetables (RR= 1.55; 95% CI= 1.11 2.17) (p=0.009) had considerably more chances to be affected by dental caries in a higher severity. Not having breakfast regularly, living in rural areas and lack of daily intake of vegetables were identified as associated factors for dental caries in this sample.