Fatores contextuais e individuais associados à qualidade de vida relacionada à saúde bucal de adolescentes

Abstract

Adolescence is the period between 10 and 19 years of age, which is constituted by innumerable biological, psychological social, cognitive, and behavioral changes. The literature has shown a significant prevalence of dental caries, gingivitis, malocclusion, tooth loss, and toothache during this phase. Oral health-related quality of life (OHRQoL) is a multidimensional construct used to measure the impact of oral health conditions on everyday life and consequently, it affects the individual’s perception of their life overall. The impact of the contextual aspects on oral health emphasizes the multilevel nature of health outcomes. Attention must be taken to the complex interaction between individual and contextual determinants of oral health. The main of this cross-sectional study was to assess which factors are associated with OHRQoL involving adolescents (n=1202; 15 to 19 years old) in Minas Gerais, Brazil. The outcome OHRQoL was measured by questionnaire “oral Impacts on Daily Performance”. The covariates were: sex, skin color, age, family income, maternal education, household crowding, prevalence of untreated dental caries, gingival bleeding, need for dental treatment and regular use of dental service. The contextual variables were Human Development Index (HDI), Gini Coefficient, illiteracy, unemployment, Half quarter Brazilian monthly minimum wage, Primary Health Care Coverage, oral health team coverage, supervised tooth brushing, allocation factor, gross domestic product, number of emergency dental visits per inhabitant, sanitary sewer, number of tooth extraction between selected dental procedures - these covariates were analyzed at the regional level of the State. A multilevel poisson regression model (rate ratio – RR/95%CI) was carried out to assess the association between the different levels, considering 5% significance. Data were analyzed in the STATA version 16.0 program. The mean (SD) OIDP score was 0.72 (0.05) and the prevalence of outcome was 31.8%. There was an association between supervised tooth brushing average and the outcome (RR 0.95; CI95% 0.91-0.99). Moreover, adolescents who lived in municipalities with the highest average number of emergency dental visits per inhabitant showed a higher OIDP. Sex, maternal education, household crowding untreated dental caries and gingival bleeding were associated with OIDP. Contextual and individual factors were determinants of OHRQoL