Saúde bucal em crianças e adolescentes com Síndrome de Down: avaliação de indicadores clínicos e da escala de saúde bucal para pessoas com Síndrome de Down

Abstract

To evaluate the influence of clinical indicators and sociodemographic characteristics on the caregivers perception of oral health of individuals with DS through the Brazilian version of the Oral Health Scale for People with Down Syndrome and to compare aspects related to oral health among children and adolescents with DS and children and adolescents without the syndrome. Parents/caregivers of 288 individuals with and without SD aged 4 to 18 years and their children were invited to participate in the study. The parents/caregivers completed a questionnaire containing sociodemographic data and information on the behavioral variables related to the oral health of their children, and answered the Oral Health Scale for People with Down Syndrome. Intraoral oral examination of the children/adolescents was performed to evaluate the experience of dental caries, periodontal disease and malocclusion. After the descriptive analysis, the chi-square test was used to evaluate the association between the Scale of Oral Health for People with Down Syndrome, sociodemographic criteria and clinical indicators. The variables that presented a level of significance (p < 0.25) were incorporated into the final Poisson regression model. The McNemar and Wilcoxon tests were used to compare the variables of oral health behavior and clinical variables between the groups. Among that caregivers 55.1% presented a positive perception of their childs oral health. Caregivers of 4- to 9-year-olds with defined malocclusion were more likely to report a more negative perception of their childs oral health (p = 0.003 and p = 0.047, respectively). The comparison between the groups showed that children/adolescents without DS perform toothbrushing more times a day (p < 0.001), as well as have a higher frequency of daily sugar intake (p = 0.048). Children/adolescents with DS had a greater presence of gingival bleeding during the clinical examination (p <0.001) and presented a greater number of cases of "severe malocclusion" and "very severe malocclusion" (p = 0.045). There was no difference in the prevalence of dental caries disease between the groups. The age and the severity of malocclusion were indicators of a more negative perception of the caregivers regarding the oral health of their sons/daughters. Children/adolescents with DS had a greater presence of gingival bleeding during the clinical examination and presented greater need for orthodontic treatment when compared to children/adolescents without the syndrome.