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Impacto da c?rie precoce severa na inf?ncia na qualidade de vida relacionada ? sa?de bucal de pr?-escolares sob priva??o social

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Previous issue date: 2013-03-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Early childhood caries, especially in its severe form, which is characterized by an acute and
aggressive nature, can have negative impacts on thequality of life of a child, due to effects
such as difficulty in chewing, decreased appetite, weight loss, insomnia, changes in behavior
and a decreased performance in school, among others. Moreover, the quality of life of the
child`s family can also be affected, as the pain and discomfort caused by this type of caries
result in loss of working days of parents, spending on dental treatments, changes in sleep
patterns and stress. The aim of this study was to evaluate the impact of severe early childhood
caries in the Oral Health-Related Quality of Life (OHRQoL) of public daycares`s preschool
children through the Escala de Impacto da Sa?de Bucal na Primeira Inf?ncia, a Brazilian
version of the Early Childhood Oral Health Impact Scale (ECOHIS). A single calibrated
examiner (kappa=1.0) evaluated, through the dmfs index, the oral health of 116 children aged
between 3 and 5, which were included in one of three study groups: "caries-free", "not-severe
early childhood caries" and "severe early childhood caries". The parents responded to
ECOHIS, to assess their perception regarding the OHRQoL of their children, and a
questionnaire on socioeconomic conditions. The OHRQoL was measured through the total
scores and domains of ECOHIS. Descriptive analysis, Mann-Whitney test, Kruskal-Wallis
test, chi-square test and Poisson multiple regression with robust variance were used. Among
the children observed, 38.8% were caries-free, 27.6% showed not-severe early childhood
caries and 33.6% showed severe early childhood caries. Regarding the total score of ECOHIS,
severe early childhood caries had a greater negative impact on OHRQoL, compared to
caries-free and not-severe early childhood caries groups (p <0.001). Regarding the child
subscale, there was significant difference between the "severe early childhood caries" group
and the other groups in all domains, except for theone of self-image / social interaction. In the
family subscale domains, there was statistical significance between the severe early
childhood caries and the caries-free groups in all domains (p <0.001), whereas between the
"severe early childhood caries and not-severe early childhood caries groups there was a
statistically significant difference only in the domain of parental anguish (p <0.001).
Multivariate analysis showed that early childhood caries and the parent`s age were
significantly associated to OHRQoL (p <0.05), independently of the other variables in the
model. The presence of severe early childhood caries resulted in greater negative impact on
OHRQoL (AdjPR= 6.016; 95%CI = 3.12 11.56; p<0.001), while older parents reported
better OHRQoL (AdjPR = 0.603; 95%CI = 0.428 - 0.850; p = 0.004). The presence of severe
early childhood caries had a negative impact on OHRQoL of preschool children and their
families. / A c?rie precoce na inf?ncia, especialmente a sua forma severa, caracterizada pela natureza
aguda e agressiva, pode produzir impactos negativos na qualidade de vida da crian?a, como
dificuldade na mastiga??o, diminui??o do apetite, perda de peso, dificuldade em dormir,
altera??o no comportamento e diminui??o do rendimento escolar, entre outros. Al?m disso, a
qualidade de vida da fam?lia da crian?a portadora desse tipo de c?rie tamb?m pode ser
afetada, pois os quadros de dor e desconforto causados resultam em perdas de dias de trabalho
dos pais, gastos com tratamentos odontol?gicos, altera??o nos padr?es de sono e estresse. O
objetivo deste estudo foi avaliar o impacto da c?rie precoce severa na inf?ncia na Qualidade
de Vida Relacionada ? Sa?de Bucal (QVRSB) de crian?as pr?-escolares de creches p?blicas
por meio da Escala de Impacto da Sa?de Bucal na Primeira Inf?ncia, vers?o brasileira do
Early Childhood Oral Health Impact Scale (ECOHIS). Um ?nico examinador calibrado
(kappa=1,0) avaliou, por meio do ?ndice ceo-s, a sa?de bucal de 116 crian?as entre 3 e 5 anos
de idade, as quais foram inclu?das em um dos tr?s grupos de estudo: livre de c?rie , c?rie
precoce n?o severa e c?rie precoce severa . Os pais responderam ao ECOHIS, para avaliar
sua percep??o em rela??o ? QVRSB de seus filhos, al?m de um question?rio sobre condi??es
socioecon?micas. A QVRSB foi mensurada por meio dos escores total e por dom?nios do
ECOHIS. An?lise descritiva, teste de Mann-Whitney, teste de Kruskal-Wallis, teste do quiquadrado
e regress?o m?ltipla de Poisson com vari?ncia robusta foram utilizados. Dentre as
crian?as avaliadas, 38,8% eram livres de c?rie, 27,6% apresentavam c?rie precoce n?o severa
e 33,6% apresentavam c?rie precoce severa. Em rela??o ao escore total do ECOHIS, a c?rie
precoce severa na inf?ncia teve um maior impacto negativo na QVRSB em compara??o aos
grupos livre de c?rie e c?rie precoce n?o severa (p<0,001). Em rela??o ? subescala da crian?a,
houve diferen?a estatisticamente significativa entre o grupo c?rie precoce severa e os outros
grupos em todos os dom?nios, com exce??o do dom?nio de auto-imagem / intera??o social.
Nos dom?nios da subescala da fam?lia, houve diferen?a significativa entre os grupos c?rie
precoce severa e o livre de c?rie em todos os dom?nios (p<0,001); j? entre os grupos c?rie
precoce severa e c?rie precoce n?o severa , houve diferen?a estatisticamente significativa
somente no dom?nio de ang?stia dos pais (p<0,001). A an?lise multivariada mostrou que a
c?rie precoce na inf?ncia e a idade dos pais foram significativamente associadas ? QVRSB
(p<0,05), independentemente das demais vari?veis do modelo. A presen?a de c?rie precoce
severa na inf?ncia resultou em maior impacto negativo sobre a QVRSB (RPaj=6,016; IC95%
= 3,12 -11,56; p<0,001), enquanto pais mais velhos relataram melhor QVRSB (RPaj = 0,603;
IC95% = 0,428-0,850; p = 0,004). A presen?a de c?rie precoce severa na inf?ncia teve um
impacto negativo na QVRSB de crian?as pr?-escolares e de suas fam?lias

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/17825
Date22 March 2013
CreatorsGomes, Patr?cia N?brega
ContributorsCPF:66427983415, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4704454U5, Garcia, Ana Fl?via Granville, CPF:64688070420, http://lattes.cnpq.br/7659139411442846, Lima, Kenio Costa de, CPF:50337157472, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4723244A9, Pinheiro, Isauremi Vieira de Assun??o
PublisherUniversidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Sa?de Coletiva, UFRN, BR, Sa?de P?blica
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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