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de Carvalho AA, de Almeida TF, Cabral MBBDS, Cangussu MCT. Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-Sectional Questionnaire Study. EPIDEMIOLOGIA 2024; 5:275-288. [PMID: 38920754 PMCID: PMC11202454 DOI: 10.3390/epidemiologia5020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
This study aims to describe the prevalence of malocclusion and identify associated factors in preschool children. Completed in 2022-2023, this cross-sectional study included 523 children aged 26 to 80 months in municipal schools in Salvador. An oral examination was carried out on the children, and a questionnaire was self-administered by the parents. Descriptive analyses and multivariate logistic regression (the backward method, p-value ≤ 0.05, 95% CI) were conducted. The majority of children were female (51.82%), over 54 months old (52.2%), Black or mixed race (90.63%), and not affected by COVID-19 (92.35%). The prevalence of malocclusion was 43.21%, with open bite as the most common condition. There was a significant association between malocclusion and screen time (OR: 1.34; p: 0.116; CI: 1.0-1.94), physical/psychological aggression (OR: 2.55; p: 0.031; CI: 1.0-5.98), consumption of ultra-processed foods (OR: 1.77; p: 0.003; CI: 1.22-2.57), digital suction (OR: 3.1; p: 0.001; CI: 1.56-6.16), and the habit of biting objects (OR: 1.56; p: 0.121; CI: 1.0-2.73). The promotion of comprehensive health in early childhood and psychosocial interventions are recommended, aiming to reduce screen time, aggression, consumption of ultra-processed foods, thumb sucking, and the habit of biting objects to prevent malocclusion.
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Affiliation(s)
| | | | | | - Maria Cristina Teixeira Cangussu
- Departamento de Odontologia Social e Pediátrica, Universidade Federal da Bahia (UFBA), Araújo Pinho Street, 6º Floor, 62 Canela, Salvador 41110-150, BA, Brazil; (A.A.d.C.); (T.F.d.A.); (M.B.B.d.S.C.)
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Chang MC, Chen HL, Huang ST, Wang HP, Liu HY. Relationship between orofacial dysfunction and orofacial features, oral function, and eating performance among preschool children. J Dent Sci 2024; 19:1044-1051. [PMID: 38618088 PMCID: PMC11010608 DOI: 10.1016/j.jds.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/22/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Orofacial (OF) development is influenced by multiple factors. This study aimed to explore the relationship between OF dysfunction (OFD) and OF features, oral function, and eating performance among preschool children. Materials and methods There were 243 preschool children and their parents who participated in this cross-sectional study. Participant demographic information and eating performance were obtained from questionnaires completed by their mothers. OF features and functions were assessed using oral examinations. OFD assessments were performed using Nordic Orofacial Test-Screening (NOT-S). Results Approximately 80% of participants had at least one domain of NOT-S affected. The main OFD in a structured interview was chewing and swallowing (64.61%). Dysarthria (40.38%), weak bite force (53.85%), inability to effectively chew (45.19%), and taking longer than 30 min to eat meals (75.00%) were significantly more prevalent among participants with OFD than among those without OFD (all P < 0.05). Also, compared with participants born full-term, those born prematurely and who had OFD had higher rates of V-shaped dental arch (42.11%), high-arched palate (31.58%), small mouth opening capacity (7.89%), dysarthria (65.79%), preference to eating soft-textured food (42.11%), and weak cough strength (21.05%). Taking longer than 30 min to eat meals (adjusted odds ratio (AOR = 8.87, P < 0.001) and not effectively chewing food (AOR = 8.81, P < 0.001) were significantly associated with OFD. Conclusion Chewing and swallowing and habits are common among preschool children and associated with OFD. OFD is associated with OF features, and presented in oral function and eating performance.
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Affiliation(s)
- Mei-Chen Chang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Emergency Medicine and Department Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hsiu-Lin Chen
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Neonatology and Department of Pediatric, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shun-Te Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Pediatric Dentistry and Special Needs Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hsiao-Ping Wang
- Division of Pediatric Medicine and Department of Neonatology, Kaohsiung Veterans General Hospital, Taiwan
| | - Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Avrella MT, Zimmermann DR, Andriani JSP, Santos PS, Barasuol JC. Prevalence of anterior open bite in children and adolescents: a systematic review and meta-analysis. Eur Arch Paediatr Dent 2021; 23:355-364. [PMID: 34767190 DOI: 10.1007/s40368-021-00683-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/29/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Anterior open bite is defined by the lack of incisal contact between the teeth in centric relation. The aim of this study was to determine the prevalence of anterior open in children and adolescents. METHODS This systematic review included a search in the databases: PubMed, Scopus, Web of Science, LILACS, Google Scholar, and ProQuest. The acronym PECOS was considered: (P) children and adolescents, (E) presence of anterior open bite, (C) not applicable, (O) prevalence, and (S) observational studies. The risk of bias assessment was carried out using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The prevalence meta-analyses were performed using MedCalc® software. The certainty of the evidence was determined with the GRADE approach. RESULTS 26 studies were included. Eleven studies were judged at low, seven at moderate, and eight at high risk of bias. The overall prevalence of anterior open bite was 16.52% (95% CI 12.34-21.17) in children and adolescents. The prevalence was 19.38% (95% CI 13.77-25.69) in South America. The prevalence of anterior open bite was 22.67% (95% CI 16.56-29.43) among females and 16.99% (95% CI 11.77-22.94) among males. The prevalence of anterior open bite was 18.84% (95% CI 13.88-24.38) in the primary dentition, and 14.26% (95% CI 7.67-22.46) in the mixed dentition. The overall certainty of the evidence was very low. CONCLUSION The overall prevalence of anterior open bite was 16.52% in children and adolescents aged 2-16 years. Giving the limitations of a prevalence meta-analysis, the extrapolation of the results should be cautious. REGISTRATION NUMBER CRD42020183162, 10 July 2020.
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Affiliation(s)
- M T Avrella
- Faculdade CNEC, Santo Ângelo, Rio Grande do Sul, Brazil
| | | | - J S P Andriani
- Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - P S Santos
- Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - J C Barasuol
- Faculdade CNEC, Santo Ângelo, Rio Grande do Sul, Brazil.
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Thijs Z, Bruneel L, De Pauw G, Van Lierde KM. Oral Myofunctional and Articulation Disorders in Children with Malocclusions: A Systematic Review. Folia Phoniatr Logop 2021; 74:1-16. [PMID: 34107494 DOI: 10.1159/000516414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Relationships between malocclusion and orofacial myofunctional disorders (OMD), as well as malocclusions and articulation disorders (AD) have been described, though the exact relationships remain unclear. Given the high prevalence of these disorders in children, more clarity is needed. SUMMARY The purpose of this study was to determine the association between OMD (specifically, bruxism, deviate swallowing, caudal resting tongue posture, and biting habits), AD, and malocclusions in children and adolescents aged between 3 and 18 years. To conduct a systematic review, 4 databases were searched (MEDLINE, Embase, Web of Science, and Scopus). The identified articles were screened for the eligibility criteria. Data were extracted from the selected articles and quality assessment was performed using the tool of Munn et al. [Int J Health Policy Manag. 2014;3:123-81] in consensus. Using the search strategy, the authors identified 2,652 articles after the removal of duplicates. After reviewing the eligibility criteria, 17 articles were included in this study. One of the included articles was deemed to have an unclear risk of bias, whereas all other articles were considered to have a low risk of bias. The articles showed a relationship between anterior open bite and apico-alveolar articulatory distortions, as well as between anterior open bite and deviate swallowing. For the biting habits, bruxism, and low tongue position no clear conclusions could be drawn. Key Messages: The current review suggests a link between specific types of malocclusion and OMD and AD. However, more high-quality evidence (level 1 and level 2, Oxford Levels of Evidence) is needed to clarify the cooccurrence of other OMD, AD, and malocclusions.
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Affiliation(s)
- Zoë Thijs
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth, Texas, USA
| | - Laura Bruneel
- Department of Rehabilitation Sciences, Language, and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Guy De Pauw
- Department of Orthodontics, Ghent University, Ghent, Belgium.,Centre for Congenital Facial Anomalies, Ghent University Hospital, Ghent, Belgium
| | - Kristiane M Van Lierde
- Department of Rehabilitation Sciences, Language, and Hearing Sciences, Ghent University, Ghent, Belgium.,Department of Speech-Language and Audiology, University of Pretoria, Pretoria, South Africa
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Hong H, Zeng Y, Chen X, Peng C, Deng J, Zhang X, Deng L, Xie Y, Wu L. Electromyographic features and efficacy of orofacial myofunctional treatment for skeletal anterior open bite in adolescents: an exploratory study. BMC Oral Health 2021; 21:242. [PMID: 33962610 PMCID: PMC8103572 DOI: 10.1186/s12903-021-01605-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the multifactorial aetiology and unpredictable long-term stability, skeletal anterior open bite (SAOB) is one of the most intractable conditions for orthodontists. The abnormal orofacial myofunctional status (OMS) may be a major risk factor contributing to the development and relapse of SAOB. This study is aimed at evaluating the OMS and the efficacy of orofacial myofunctional therapy (OMT) alone for SAOB subjects. METHODS Eighteen adolescents with SAOB (4 males, 14 females; age: 12-18 years) and eighteen adolescents with normal occlusion (2 males, 16 females; age: 12-18 years) were selected. The electromyographic activity (EMGA) associated with mastication and closed mouth state was measured. Lateral cephalography was used to evaluate craniofacial morphology. Wilcoxon signed rank tests and t-tests were performed to evaluate myofunctional and morphological differences. Pearson or Spearman correlation analysis was used to investigate the correlations between EMGA and morphological characteristics. SAOB subjects were given OMT for 3 months, and the EMGA was compared between before and after OMT. RESULTS During rest, anterior temporalis activity (TAA) and mentalis muscle activity (MEA) increased in SAOB subjects, but TAA and masseter muscle activity (MMA) decreased in the intercuspal position (ICP); and upper orbicularis activity (UOA) and MEA significantly increased during lip sealing and swallowing (P < 0.05). Morphological evaluation revealed increases in the FMA, GoGn-SN, ANS-Me, N-Me, L1-MP, U6-PP, and L6-MP and decreases in the angle of the axis of the upper and lower central incisors and OB in SAOB subjects (P < 0.05). TAA, MMA and anterior digastric activity (DAA) in the ICP were negatively correlated with vertical height and positively correlated to incisor protrusion. MEA was positively correlated with vertical height and negatively correlated with incisor protrusion; and the UOA showed a similar correlation in ICP, during sealing lip and swallowing. After SAOB subjects received OMT, MEA during rest and TAA, MMA and DAA in the ICP increased, while UOA and MEA decreased (P < 0.05). CONCLUSION SAOB subjects showed abnormal OMS features including aberrant swallowing patterns and weak masticatory muscles, which were interrelated with the craniofacial dysmorphology features including a greater anterior facial height and incisor protrusion. Furthermore, OMT contributes to OMS harmonization, indicating its therapeutic prospect in SAOB.
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Affiliation(s)
- Hong Hong
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
| | - Yue Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
| | - Xiaomin Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Guangzhou Panyu Central Hospital, Guangzhou, 511400, People's Republic of China
| | - Caixia Peng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Department of Stomatology, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, 518106, People's Republic of China
| | - Jianqing Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, People's Republic of China
| | - Xueqin Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Department of Stomatology, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, 518106, People's Republic of China
| | - Lidi Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China
| | - Yongjian Xie
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
| | - Liping Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China.
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Moraes RB, Knorst JK, Pfeifer ABR, Vargas-Ferreira F, Ardenghi TM. Pathways to anterior open bite after changing of pacifier sucking habit in preschool children: A cohort study. Int J Paediatr Dent 2021; 31:278-284. [PMID: 32949057 DOI: 10.1111/ipd.12725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/21/2020] [Accepted: 08/24/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Pacifier use is a major cause of anterior open bite (AOB), which negatively impacts the quality of life of children affected. AIM To assess the direct and indirect pathways related to pacifier sucking habit and AOB in preschool children. DESIGN This 2-year cohort study evaluated a random sample of preschool children (2-5 years of age) from Southern Brazil. Caregivers answered a questionnaire addressing socio-economic and behavioural characteristics. Anterior open bite was recorded following the criteria recommended by Foster and Hamilton. Structural equation model was performed to assess the direct and indirect pathways among variables at baseline (T1) to predict the AOB at follow-up (T2). RESULTS Regarding the AOB, 407 children were evaluated at T1 and 187 at T2. The prevalence of AOB was 32.9% at baseline and 16.0% at follow-up. The presence of AOB at follow-up was directly affected by the change in pacifier sucking habit from T1 to T2. Considering the indirect paths, the AOB at T1 influenced the AOB in T2 via a change of pacifier sucking habit. CONCLUSION These findings suggest that the non-habit of sucking pacifiers is a fundamental strategy for the prevention of AOB as well as the promotion of health in childhood.
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Affiliation(s)
- Renita Baldo Moraes
- Department of Health Sciences, University of Santa Cruz do Sul, Santa Cruz, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Fabiana Vargas-Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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Esthetic impact of malocclusions in the anterior segment on children in the mixed dentition. Am J Orthod Dentofacial Orthop 2020; 159:53-58. [PMID: 33221094 DOI: 10.1016/j.ajodo.2019.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/01/2019] [Accepted: 11/01/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION To assess the esthetic subjective effect of malocclusions in the anterior segment on children in the mixed dentition. METHODS A cross-sectional study was carried out with a population-based sample of 787 children aged 8-10 years in the late mixed dentition (n = 787). Orthodontic Aesthetic Subjective Impact Score determined the esthetic subjective effect. For assessing the malocclusions in the anterior segment (anterior crowding, anterior spacing, diastema, anterior open bite, and anterior maxillary overjet), the following Dental Aesthetic Index criteria were used. Sex, family income, and education level were used as control variables. The variables were analyzed using a simple logistic regression model, estimating crude odds ratios. The variables with P <0.20 in the simple analyses were tested in multiple regression models, estimating adjusted odds ratios with the respective 95% confidence intervals. RESULTS Increased overjet was 1.54 (95% CI: 1.08-2.17) times more likely to cause greater esthetic concern (P <0.05), especially in girls (P <0.05). CONCLUSIONS Increased overjet negatively affected children's esthetic self-perception in the mixed dentition.
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CARVALHO AAD, ALMEIDA TFD, CANGUSSU MCT. Prevalência de mordida aberta e fatores associados em pré-escolares de Salvador-BA em 2019. REVISTA DE ODONTOLOGIA DA UNESP 2020. [DOI: 10.1590/1807-2577.06820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução A mordida aberta anterior é um dos tipos de má-oclusão mais frequentes em pré-escolares, sendo considerada um dos problemas oclusais mais difíceis de tratar, principalmente por sua etiologia multifatorial e sua íntima relação com hábitos bucais deletérios. Objetivo Identificar a prevalência de mordida aberta anterior nos pré-escolares de Salvador-BA, bem como fatores potencialmente associados à mesma. Material e método Trata-se de um estudo de corte transversal em 1.577 crianças em idade pré-escolar (36 a 71 meses), que frequentavam creches públicas municipais de Salvador-BA. Resultado A média de idade das crianças foi aproximadamente 54 meses. A maioria pertencia ao sexo masculino (50,29%). A população de estudo foi predominantemente composta por negros e pardos (92,02%). A prevalência de má-oclusão foi de 40,46% e, destes, 14,02% possuíam mordida aberta. Com relação à escolaridade, a maior parte das mães (55,86%) e dos pais (50,08%) foi igual ou superior ao Ensino Fundamental II Completo. A sucção digital foi comum em 6,73% das crianças e 10,39% faziam sucção de chupeta. Foram identificados, como fatores de proteção à mordida aberta, a escolaridade do pai maior ou igual ao Ensino Fundamental II completo (RP= 0,62 IC= 0,41-0,95) e a onicofagia (RP= 0,34 IC= 0,21-0,56). Como fatores de risco, identificaram-se o uso de chupeta (RP= 17,98 IC= 10,91-29,62) e a sucção digital (RP= 11,04 IC= 6,0-20,32). Conclusão Medidas educativas direcionadas aos pais e responsáveis se fazem essenciais para a prevenção do desenvolvimento de hábitos deletérios nos pré-escolares. Outros estudos são necessários a fim de aprofundar o entendimento sobre os fatores de proteção identificados neste estudo.
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Gomes MC, Neves ÉTB, Perazzo MF, Paiva SM, Ferreira FM, Granville-Garcia AF. Contextual and individual determinants of oral health-related quality of life among five-year-old children: a multilevel analysis. PeerJ 2018; 6:e5451. [PMID: 30186681 PMCID: PMC6119455 DOI: 10.7717/peerj.5451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/21/2018] [Indexed: 12/11/2022] Open
Abstract
Background Contextual factors may influence oral health-related quality of life (OHRQoL) in children. The aim of the present study was to evaluate the influence of individual and contextual determinants of OHRQoL based on the perceptions of children. Methods A cross-sectional study was conducted with a representative sample of 769 five-year-old children from public and private preschools in a city in the countryside of northeast Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, sociodemographic data and aspects of the child’s oral health. The children answered the child version of the Scale of Oral Health Outcomes for five-year-old children and were submitted to oral examinations. Variables related to the context were obtained from the schools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models were used to investigate associations between variables. Results In the adjusted analysis, parent’s/caregiver’s schooling, household income, parent’s/caregiver’s age, a history of dental pain, dental caries and its consequences and traumatic dental injury were considered individual determinants of OHRQoL according to the children’s self-reports. After the incorporation of the contextual determinants, the association between parent’s/caregiver’s schooling and OHRQoL lost its significance. Type of school was the context variable that remained associated with OHRQoL. Discussion Besides the clinical and sociodemographic individual characteristics, characteristics of the school environment in which the child studies are associated with self-reported impacts on OHRQoL.
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Affiliation(s)
- Monalisa C Gomes
- Departamento de Odontologia, Universidade Estadual da Paraíba, Campina Grande, Paraíba, Brasil
| | - Érick T B Neves
- Departamento de Odontologia, Universidade Estadual da Paraíba, Campina Grande, Paraíba, Brasil
| | - Matheus F Perazzo
- Departamento de Odontopediatria e Ortodontia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Saul M Paiva
- Departamento de Odontopediatria e Ortodontia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Fernanda M Ferreira
- Departamento de Odontopediatria e Ortodontia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Ana F Granville-Garcia
- Departamento de Odontologia, Universidade Estadual da Paraíba, Campina Grande, Paraíba, Brasil
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