Condição de saúde bucal em adolescentes e fatores associados em município de pequeno porte da Paraíba

Abstract

The oral health status of adolescents is related to the environment and context in which the individual is inserted. The general objective of this study was to investigate the associations of food insecurity and toothache with different social, behavioral and health determinants in adolescents from municipalities in the interior of Brazil. This was an analytical, cross-sectional study with 192 adolescents aged 11 to 14 years from the public school system of the municipality of Juripiranga, Paraíba, Northeast, Brazil. In Analysis Plan (AP) 1, the participants answered the following questionnaires together with their guardians: Brazilian Food Insecurity Scale (EBIA), Strengths and Difficulties Questionnaire for the guardian, Strengths and Difficulties Questionnaire for children and adolescents and sociodemographic questionnaire. Dental caries was assessed through the presence or absence of cavitated lesions. The Thylstrup and Fejerskov index was used to assess dental fluorosis. School learning was observed by calculating the median of the final grades of basic subjects. The prevalence of FI found was 69.19%. FI was associated with income of up to one minimum wage (PR: 1.90; 95% CI: 1.20 - 3.01), non-practice of religion by the guardian (PR: 1.36; 95% CI: 1.05 - 1.76), behavior considered inappropriate by the guardian (PR: 1.35; 95% CI: 1.03 - 1.77) and learning assessment (PR: 1.37; 95% CI: 1.07 - 1.75). PA 2 collected clinical data through oral clinical examination and non-clinical data through two questionnaires: one on socioeconomic and behavioral aspects, and the other was the Brazilian Food Insecurity Scale (EBIA). Dental caries assessment was carried out according to the criteria of the International Caries Detection & Assessment System II (ICDAS II) index. The prevalence of toothache found was 23.0%. Toothache was related as a reason for the last dental consultation seeking treatment (PR: 2.16; 95% CI: 1.21– 3.85; p = 0.01), poor sleep quality (PR: 1.34; 95% CI: 0.79–2.25; p = 0.02), frequent intake of sweets (PR: 1.79; 95% CI: 1.08–2.94; p = 0.02) and the presence of two or more molars with dental caries in adolescents (PR: 1.92; 95% CI: 1.07–3.43; p = 0.002). The study revealed food insecurity as a multifactorial problem requiring intervention in multiple social determinants, as well as a high prevalence of this condition in the studied population (PA 1). In addition to facing several unfavorable conditions, such as food insecurity, the report of toothache in the last six months was observed in a considerable way among adolescents, presenting an association with different aspects, such as the presence of toothache and treatment as a reason for dental consultation, frequent consumption of sweets and having two or more molars with dental caries (PA 2).