Impacto do traumatismo dentário na qualidade de vida de crianças pré-escolares em Belo Horizonte

Abstract

The aim of the present study was to assess the impact of traumatic dental injury (TDI) on the functional, social and psychological wellbeing of young children and their families as well as to determine the prevalence of TDI in primary teeth and predisposing factors. A cross-sectional study was carried out with 388 male and female children ranging in age from 60 to 71 months. Prior to the main study, a pilot study was carried out with 88 preschool children at a daycare center to test the methods of the study and the use of the instruments as well as to perform the calibration exercise. Data on Oral Health-Related Quality of Life (OHRQoL) were collected using the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). This measure was administered to parents/caregivers to obtain their perception regarding the oral health of their children. The ECOHIS and a form addressing demographic data and history of TDI were sent to theparents/caregivers. Socioeconomic status was determined using the Social Vulnerability Index (SVI), family income, number of people in the household and parents/caregivers schooling. Oral examinations were performed on the children by a single dentist at the preschool or daycare center under natural light in the knee-to-knee position. The criterion for the diagnosis of TDI was the classification proposed by Andreasen et al. (2007). Descriptive statistics,univariate analysis and adjusted multiple Poisson regression were carried out. The prevalence of impact on quality of life was 49.0% among the children and 35.1% among the families. The adjusted Poisson regression model revealed that childrens quality of life was significantly related to the parents/caregivers reporting the occurrence of TDI [PR=1.54, 95% CI=1.22,1.93] and was not related to severity of TDI detected in the clinical examination [PR=1.42, 95% CI=0.93,2.19]. Family quality of life was significantly related to the parents/caregivers reporting the occurrence of TDI [PR=1.63, 95% IC=1.21,2.19] and was not related to severity of TDI detected in the clinical examination [PR=0.82, 95% CI=0.56,1.20]. The prevalence of TDI detected in the clinical was 62.1%. A total of 61.7% of affected teeth had suffered enamel fractures. The prevalence of TDI reported by the parents/caregivers was 28.9%. Statistically significant associations were found between TDI detected in the clinical examination and increased overjet [OR=2.24, 95% CI=1.11,4.55] and anterior crossbite [OR=0.38, 95% CI=0.17,0.87]. No statistically significant associations were found between TDI detected in the clinical examination and number of people in the household, family income, social vulnerability, parents/caregivers schooling, lip competency, overbite, anterior open bite or dental caries. It was concluded that the quality of life of children and their families was not influenced by TDI detected in the clinical examination, but children who had a TDI perceived by the parents/caregivers had a greater chance of experiencing an impact on their quality of life and that of their families. The prevalence of TDI detected in the clinical examination was high, with enamel fracture the most common type of trauma. Children with increased overjet had a greater frequency ofTDI detected in the clinical examination. Socioeconomic factors did not influence the prevalence of TDI detected in the clinical examination.