Impacto da maloclusão na qualidade de vida de escolares brasileiros: estudo de base populacional

Abstract

The aesthetic appearance plays an important role in social interactions and psychological well-being. Thus malocclusion may negatively affect the quality of life of affected individuals. The aim of this study was to evaluate factors associated with malocclusion and the impact on quality of life related to oral health in Brazilian schoolchildren. A case-control study with 510 randomly selected children (102 cases and 408 controls), nested in a population-based cross-sectional study with 1204 childrenaged 8 to 10 years old, who attended elementary schools was conducted in Belo Horizonte, Brazil. The instrument used to measure oral health related to quality of life (OHRQoL) was the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10). The case group consisted of children with high impact (CPQ8-10 16) group consisted of children without and with low impact regarding OHRQoL (CPQ8-10 5) after pairing by gender and type of school (public or private). Oral examinations were performed on the children by two previously calibrated pediatric dentists using the Dental Aesthetic Index (DAI) to diagnose malocclusion. This study received approval from the Human Research Ethics Committee of the Federal University of Minas Gerais (UFMG). Data analysis involved descriptive statistics, bivariate analysis, the Poisson regression model and conditional logistic regression with hierarchical approach, with a significance level of 5%. In the cross-sectional study, anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (p< 0.05). Schoolchildren with malocclusion were 1.30..fold (95%CI: 1.15..1.46) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59..fold (95%CI: 1.35..1.88) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. In the case-control study higher prevalence values of malocclusion were observed in the case group (OR:4,02; 95%CI: 2,55..6,33). The multiple conditional logistic regression analysis with a hierarchical approach demonstrated that children with malocclusion had a 3.6-fold greater chance of being allocated to the case group (OR:3,61; 95%CI: 2,24.. 5,82) and each unit increase in the DAI score denoted a 10% increase in the chance of being in the case group (OR:1,10; 95%CI: 1,06..1,14). Anterior maxillary overjet (OR:3,56; 95%CI:1.18..10.76), one-segment crowding (OR:2,03; 95%CI:1.15..3.57), two-segment crowding (OR:2,79; 95%CI:1.21..6.42) and anterior segment spacing (OR:1,96; 95%CI:1.07..3.61) were statistically significantly different between the case and control groups. The results showed that in Belo Horizonte, schoolchildren with malocclusion were more likely to experience negative impact on OHRQoL than those without malocclusion.