Determinantes para dor de dente em pré-escolares avaliada através do Discomfort Questionnaire-B

coorte de três anos

Abstract

Introduction/Justification: Dental pain is a public health problem that negatively impacts children's quality of life¹. Understanding the factors that determine its occurrence is important for establishing priorities and strategies aimed at physical and emotional well-being in childhood. However, carrying out investigations in this direction has limitations when directed at preschool children, due to the difficulty in identifying dental pain in this age group. Thus, the Dental Discomfort Questionnaire (DDQ) was developed in Holanda² and later validated in Brazil³, a tool designed to overcome measurement limitations and minimize imprecision in pain assessment in this population. Added to this is the scarcity of prospective cohort studies, which represent the most appropriate research approach to identify risk factors associated with dental pain in preschoolers.
Objectives: To determine risk factors for the incidence of dental pain in a prospective longitudinal study involving preschool children.
Methodology: A prospective cohort study was conducted with a random sample of 151 children aged one to three years and their parents/caregivers over a three-year period in Diamantina, Minas Gerais, Brazil. The study was conducted in accordance with the ethical precepts stipulated in the Declaration of Helsinki and was approved by the Ethics Committee for Research with Human Beings of the Universidade Federal dos Vales do Jequitinhonha e Mucuri (certificate number: 1.921.084). The baseline of this study included children selected by simple draw from a list provided by the Municipal Secretary of Health. The children were allocated into two groups according to the main exposure adopted in this study (presence of dental caries at baseline). Children who had dental caries at baseline were allocated to the exposed group and those who did not have dental caries at baseline to the unexposed group. Three years after baseline, children were invited for follow-up. Data collection involved clinical oral examinations of the children and application of a questionnaire in the form of an interview to parents/guardians. Toothache was assessed using the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B) at baseline and at follow-up to calculate incidence. The participants were clinically examined for dental caries, using the criteria of the International Caries Detection and Assessment System (ICDAS II) and for dental trauma, using the criteria proposed by Andreasen⁴ (2007). Parents/guardians were asked to answer a questionnaire applied in an interview format addressing sociodemographic and economic characteristics and frequency of food consumption that were investigated at baseline and at a three-year follow-up. The results obtained were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 22.0. Data analysis included descriptive analysis and Poisson regression analysis. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were calculated.
Results: A total of 151 children participated in all stages of the study. The mean age was 28.5 months (standard deviation: 10.8) at baseline and 66.6 months (standard deviation: 11.9) at follow-up. At baseline, 54 children (35.8%) had dental pain, with a follow-up incidence of 14.6%. In the univariate Poisson regression analysis, the incidence of caries (p = 0.013) and the absence of dental treatment during the follow-up period (p = 0.001) were associated with the incidence of dental pain. After adjusting for confounding variables, caries incidence (PR = 3.47; 95% CI: 1.04-11.59) and absence of dental treatment during follow-up (PR = 2.60; 95% CI %: 1.14-5.94) remained associated with higher incidence of dental pain.
Conclusion: Incidence of dental caries and lack of dental treatment at follow-up were risk factors for a higher incidence of dental pain in preschoolers.

Keywords: Toothache; dental caries; Child, Preschool.

References:

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