Fluorose dentária tem impacto na qualidade de vida relacionada à saúde bucal de crianças peruanas?

CALDERÓN, Zaida Moya de; ABANTO, Jenny; Sá OLIVEIRA, Gabriela; HADDAD, Ana Estela; BÖNECKER, Marcelo

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Sumário

Original • Rev Gaúch. Odontol. 69 • 2021 • https://doi.org/10.1590/1981-8637202100023412 copiar

Fluorose dentária tem impacto na qualidade de vida relacionada à saúde bucal de crianças peruanas?

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivos

Os objetivos deste estudo foram avaliar a prevalência e a gravidade da fluorose dentária e avaliar o impacto da fluorose dentária na qualidade de vida relacionada à saúde bucal (QVRSB) de crianças residentes em duas cidades peruanas com diferentes níveis de flúor de água.

Métodos

Uma amostra de 292 crianças entre 11 e 14 anos de idade e ambos os sexos foram selecionada nas escolas públicas e privadas de ensino fundamental nas duas cidades. O exame oral clínico foi realizado utilizando-se o índice de Dean para avaliar a prevalência e a gravidade da fluorose dentária e o Questionário de Percepção Infantil 11-14 (CPQ 11-14) para avaliar a associação entre fluorose dentária e QVRSB.

Resultados

A prevalência de fluorose dentária foi de 75% e o escore moderado foi o mais frequente (36%). As duas cidades têm baixo nível socioeconômico e predominam as crianças de escolas públicas (74%). Não houve impacto da fluorose na QVRSB. É possível que os adolescentes que vivem em um contexto social em que a aparência dentária seja muito semelhante entre as pessoas tenham um senso de identidade diferente de outras sociedades, o que pode influenciar em sua percepção de QVRSB.

Conclusão

Embora a prevalência de fluorose dentária tenha sido muito alta, não teve impacto na QVRSB.

Termos de indexação
Fluorose dentária; Saúde bucal; Prevalência; Qualidade de vida

Variables		n (%)
*Sociodemographic conditions*
Child’s age
	11 years old	91 (31.16)
	12 years old	69 (23.63)
	13 years old	76 (26.03)
	14 years old	56 (19.18)
Child’s gender
	Female	135 (46.23)
	Male	157 (53.77)
Type of School
	Public	216 (73.97)
	Private	76 (26.03)
City
	Congata	202 (69.18)
	Uchumayo	90 (30.82)
Number of siblings
	≤ 2 children	109 (37.33)
	> 2 children	183 (62.67)
Father’s education level
	≤ 6 years	49 (16.84)
	> 6 years	242 (83.16)
Mother’s education level
	≤ 6 years	71 (24.32)
	> 6 years	221 (75.68)
Family structure
	Nuclear family	196 (67.12)
	Non-Nuclear family	96 (32.88)
*Clinical conditions*
‘Would you say that the health of your teeth, lips, jajajaws and mouth is. . .?’ jaws and mouth is…?’
	Excellent	13 (4.45)
	Very good	25 (8.56)
	Good	93 (31.85)
	Fair	154 (52.74)
	Poor	7 (2.40)
‘How much does the condition of your teeth, lips, jaw
jaws or mouth affect your life overall’?
	Not at all	51 (17.47)
	Very little	68 (23.29)
	Some what	126 (43.15)
	A lot	36 (12.33)
	Very much	11 (3.77)
Fluorosis prevalence
	Absence (normal an questionable)	73 (25.0)
	Presence	219 (75.0)
Fluorosis severity
	Normal and questionable	73 (25.0)
	Very mild and mild	91 (31.16)
	Moderate	105 (35.96)
	Severe	23 (7.88)
Fluorosis sector
	Anterior teeth (canine to canine)	38 (13.01)
	Posterior teeth (molar teeth)	16 (5.48)
	Both sectors	188 (64.38)
Dental Caries Experience
	Absence (DMFT = 0)	120 (41.10)
	Presence (DMFT ≥1)	172 (58.90)

CPQ11-14 (variances)	Means(SD)	Range Observed
Total Score	25.02 (15.43)	0-84
Oral symptoms	6.01 (3.16)	0-16
Functional limitations	6.16 (4.36)	0-26
Emotional well-being	7.30 (5.96)	0-36
Social well-being	5.54 (5.91)	0-34

	ORAL SYMPTOMS		FUNCTIONAL LIMITATIONS		EMOTIONAL WELFARE		SOCIAL WELFARE		Total Score
Independent variables	RR^* * Calculated by Chi-square test; RR: Robust Rate Ratio. (95% IC)	p	RR (95% IC)	p	RR (95% IC)	p	RR (95% IC)	P	RR (95% IC)	p

Socioeconomic conditions

*Age*
Age	0.94 (0.89-0.99)	0.021	0.93 (0.86-1.01)	0.111	1.03 (0.95-1.11)	0.368	0.98 (0.89-1.08)	0.777	0.97 (0.92-1.04)	0.455
*Gender*
Female
Male	0.93 (0.82-1.05)	0.262	0.84 (0.72-0.99)	0.044	0.79 (0.66-0.96)	0.016	0.92 (0.72-1.18)	0.512	0.86 (0.75-0.99)	0.048
*Type of school*
Public
Private	1.12 (0.99-1.28)	0.054	1.23 (1.04-1.47)	0.014	1.44 (1.19-1.76)	<0.000	1.70 (1.33-2.17)	<0.000	1.36 (1.18-1.58)	< 0,000
*Municipality*
Congata
Uchumayo	0.97 (0.84-1.11)	0.644	0.84 (0.70-1.00)	0.061	0.95 (0.78-1.16)	0.621	0.82 (0.62-1.07)	0.155	0.89 (0.76-1.05)	0,179
*Father’s education*
Up to 6 years
More than 6 years	1.00 (0.87-1.15)	0.928	1.06 (0.85-1.34)	0.564	1.05 (0.82-1.35)	0.655	1.16 (0.84-1.59)	0.361	1.06 (0.89-1.28)	0.474
*Mother’s education*
Up to 6 years
More than 6 years	0.87 (0.77-0.99)	0.046	0.77 (0.65-0.91)	0.003	0.82 (0.66-1.00)	0.062	0.72 (0.55-0.94)	0.018	0.79 (0.68-0.92)	0.003
*Number of children*
Up to 2
More than 2	1.03 (0.91-1.17)	0.602	1.12 (0.94-1.32)	0.182	1.10 (0.90-1.35)	0.329	1.01 (0.78-1.31)	0.904	1.07 (0.92-1.24)	0.364
*Family structure*
Nuclear family
Non-nuclear family	1.02 (0.90-1.16)	0.701	1.02 (0.86-1.21)	0.749	1.07 (0.88-1.29)	0.461	0.94 (0.76-1.22)	0.638	1.02 (0.88-1.18)	0.785
*Oral conditions*
*Dental fluorosis index*
*Dental Fluorosis*
Absence (Normal and Questionable)
Presence	0.90 (0.78-1.02)	0.109	0.99 (0.82-1.20)	0.934	0.98 (0.80-1.21)	0.906	1.03 (0.78-1.38)	0.810	0.97 (0.82-1.15)	0.766
*Severity of Fluorosis*
Absence (Normal and Questionable)
Very mild and mild	0.87 (0.74-1.03)	0.111	0.97 (0.77-1.24)	0.816	0.86 (0.67-1.09)	0.222	1.03 (0.74-1.44)	0.850	0.92 (0.71-1.12)	0.452
Moderate	0.915 (0.79-1.05)	0.234	0.98 (0.80-1.20)	0.863	1.04 (0.82-1.33)	0.714	1.00 (0.72-1.39)	0.981	0.98 (0.82-1.18)	0.896
Severe	0.89 (0.68-1.18)	0.429	1.11 (0.83-1.50)	0.474	1.23 (0.88-1.73)	0.222	1.19 (0.76-1.87)	0.442	1.01 (0.84-1.20)	0.913
*Fluorosis sector*
Anterior sector
Posterior sector	0.94 (0.76-1.17)	0.621	0.99 (0.74-1.34)	0.997	1.25 (0.85-1.85)	0.250	1.11 (0.71-1.74)	0.634	1.07 (0.82-1.40)	0.586
Anterior and posterior	1.06 (0.83-1.35)	0.600	1.00 (0.70-1.43)	0.984	1.26 (0.82-1.94)	0.287	1.12 (0.67-1.87)	0.657	1.11 (0.81-1.51)	0.499
*Dental Caries Index*
Without caries experience (dmfy = 0)
With caries experience (dmft>0)	1.15 (1.02-1.30)	0.020	1.02 (0.87-1.20)	0.802	1.01 (0.84-1.23)	0.854	0.86 (0.67-1.11)	0.257	1.01 (0.87-1.16)	0.866

	ORAL SYMPTOMS		FUNCTIONAL LIMITATIONS		EMOTIONAL WELFARE		SOCIAL WELFARE		Total Score
Independent variables	RR* (95% IC)	p	RR (95% IC)	p	RR (95% IC)	p	RR (95% IC)	P	RR (95% IC)	p
Socioeconomic conditions
*Child’s Age*
Age (count variable)	0.93 (0.88-0.98)	0.008
Gender
Female
Male					0.82 (0.68-0.99)	0.048
Type of school
Public
Private			1.21 (1.02-1.44)	0.026	1.41 (1.15-1.72)	0.001	1.66 (1.30-2.12)	<0.001	1.34 (1.16-1.55)	<0.001
Mother’s education
Up to 6 years
More than 6 years			0.78 (0.66-0.93)	0.006			0.76 (0.58-0.98)	0.039	0.82 (0.71-0.95)	0.008
*Dental Caries Index*
Without caries experience (dmfy = 0)
With caries experience (dmft>0)	1.18 (1.04-1.33)	0.008

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[1] Correspondence to: M BÖNECKER. E-mail: bonecker@usp.br.