Baixo alfabetismo em saúde bucal de pais/ responsáveis está associado à cárie dentária com envolvimento pulpar de seus filhos

Abstract

Oral health literacy is defined as the degree to which individuals have the ability to obtain, process, and understand basic information about oral health, and the services required to make appropriate health choices, such as the right to access to an oral health service. Studies in other countries have identified an association between low levels of oral health literacy in parents and the worse oral conditions of their children. The objective of the present study was therefore to evaluate the association between the oral health literacy of parents/caregivers and the occurrence of untreated tooth decay and its pulp-related consequences in preschool children from Ribeirão das Neves, Minas Gerais. A cross-sectional study was carried out with preschool children aged 4 to 6 years old from Ribeirão das Neves, Minas Gerais, and their parents/caregivers. A total of 449 parents/caregivers responded to a socioeconomic questionnaire and the Brazilian version of the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry (BHKOHLAT-P) which measures functional oral health literacy. The selection of educational institutions and preschoolers was carried out in a randomized, stratified, double-stage form, respecting the proportionality of students in each of the three regions of Ribeirão das Neves (Justinópolis, the Center and Venice), as well as enrolled schoolchildren in the public and private education networks of the city. This study was submitted to and approved by the Ethics Committee in Research involving Human Beings of the Federal University of Minas Gerais (COEP / UFMG), under opinion number: 86759218.0.0000.5149. A Free and Informed Consent Form was sent to the parents/caregivers of preschool children, through which they authorized the participation of their children in the study, while the preschoolers consented through a FICF for children and adolescents. The children were examined on school premises in a private room by two calibrated examiners, with Kappa values ranging from 0.96 to 0.99 for inter-examiner and intra-examiner agreement, respectively, for the diagnosis of dental caries (simplified ICDAS Index) and the clinical consequences of dental caries (PUFA Index) using artificial light (headlamp), a clinical mirror and gauze for drying teeth. The data were analyzed using descriptive statistics, Chi-square, Fisher's Exact and Linear by Linear tests for bivariate analysis, and Multivariate Logistic Regression (p <0.05). The prevalence of cavitated dental caries was 51.0%, while for caries with pulp-related consequences it was 13.6%. The multivariate model adjusted for the variables kinship, preschoolers and parents/caregivers with health insurance and who have already attended the dentist, maternal education, monthly family income, gender and age of preschoolers, showed that literacy was not associated with the presence of untreated caries (OR: 0.97; 95% CI: 0.65-1.46; p=0.890). However, parents/caregivers with lower oral health literacy were 93% more likely to have children with clinical pulp-related consequences of untreated caries (OR: 1.93; 95% CI: 1.01-3.69; p=0.046) than those with higher oral health literacy. It is concluded that the low oral health literacy of parents/caregivers is associated with a greater chance of their children having clinical pulp-related consequences of cavitated dental caries.