Severe traumatic dental injuries and oral health related quality of life of preschool children

PAULI, Laís Anschau; COSTA, Francine dos Santos; AMARAL, Cassia Cardozo; ARDENGHI, Thiago Machado; DEMARCO, Flávio Fernando; GOETTEMS, Marília Leão

doi:10.1590/1981-863720200004820190044

Laís Anschau PAULI Correspondence to: LA PAULI. E-mail: laisanschaupauli@hotmail.com.

Universidade Federal de Pelotas, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia. Rua Gonçalves Chaves, 457, Centro, 96015-560, Pelotas, RS, Brasil.

https://orcid.org/0000-0002-4165-5463

Francine dos Santos COSTA

Universidade do Vale do Taquari, Centro de Ciências Biológicas e da Saúde. Lajeado, RS, Brasil.

https://orcid.org/0000-0001-9558-937X

Cassia Cardozo AMARAL

Universidade Federal de Pelotas, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia. Rua Gonçalves Chaves, 457, Centro, 96015-560, Pelotas, RS, Brasil.

https://orcid.org/0000-0001-9957-8731

Thiago Machado ARDENGHI

Universidade Federal de Santa Maria, Faculdade de Odontologia, Programa de Pós-Graduação em Ciências Odontológicas. Santa Maria, RS, Brasil.

https://orcid.org/0000-0002-5109-740X

Flávio Fernando DEMARCO

Universidade Federal de Pelotas, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia. Rua Gonçalves Chaves, 457, Centro, 96015-560, Pelotas, RS, Brasil.

https://orcid.org/0000-0003-2276-491X

Marília Leão GOETTEMS

Universidade Federal de Pelotas, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia. Rua Gonçalves Chaves, 457, Centro, 96015-560, Pelotas, RS, Brasil.

https://orcid.org/0000-0002-6512-2602

Correspondence to: LA PAULI. E-mail: laisanschaupauli@hotmail.com.

Collaborators

LA PAULI participated in data collection, analyzing the data and writing of the manuscript. FS COSTA and CC AMARAL participated in data collection and writing of the manuscript. TM ARDENGHI and FF DEMARCO conceived the study and analyzed the data and ML GOETTEMS conceived the study, analyzed the data and wrote the manuscript and all authors reviewed the manuscript.

Variables	Categories	n	%
Sex
	Male	295	49.3
	Female	304	50.7
Age (months)
	24-35	171	28.5
	36-47	183	30.5
	48-53	197	32.9
	54	48	08.1
Family income^* * There was data loss for the variables ‘family monthly income’ (n=10), ‘maternal schooling’ (n=2) and ‘anterior open bite’ (n=12).
	1^st tertile	268	45.5
	2^sd tertile	133	22.6
	3^rd tertile	138	31.9
Maternal schooling^* * There was data loss for the variables ‘family monthly income’ (n=10), ‘maternal schooling’ (n=2) and ‘anterior open bite’ (n=12).
	= 8 years	258	43.2
	> 8 years	339	56.8
Anterior open bite^* * There was data loss for the variables ‘family monthly income’ (n=10), ‘maternal schooling’ (n=2) and ‘anterior open bite’ (n=12).
	Absent	326	55.5
	Present	261	44.5
Dental trauma
	Absent	423	70.6
	Enamel fracture	131	21.9
	Enamel and dentine fracture	11	01.8
	Fracture with pulp involvement	11	01.8
	Discoloration and/or fistula	15	02.5
	Avulsion	8	01.3
Dental caries
	Absent	365	60.9
	Present	234	39.1

ECOHIS domains	Never n (%)	Hardly ever n (%)	Occasionally n (%)	Often n (%)	Very often n (%)	Mean (SD)	Possible range	Range
Child section
How often has your child had pain in the teeth, mouth, or jaws? *(Symptoms Domain)^ * p-value < 0.05.**	427(71.3)	64 (10.7)	84 (14.0)	12 (2.0)	12 (2.0)	0.53 (0.94)	0-4	0-4
How often has your child…because of dental problems or dental treatments? (Function Domain)							0-16	0-16
Had difficulty drinking hot or cold beverages?	535 (89.3)	13 (2.2)	38 (6.3)	5 (0.8)	8 (1.4)	0.23 (0.72)	0-4	0-4
Had difficulty eating some foods?	506 (84.5)	27 (4.5)	47 (7.8)	11 (1.8)	8 (1.4)	0.31 (0.80)	0-4	0-4
Had difficulty pronouncing any words?	558 (93.2)	6 (1.0)	15 (2.4)	10 (1.7)	10 (1.7)	1.18 (0.7)	0-4	0-4
Missed preschool, daycare, or school?	571 (95.3)	12 (2.0)	11 (1.8)	2 (0.3)	5 (0.6)	0.09 (0.44)	0-4	0-4
How often has your child... because of dental problems or dental treatments? (Psychological Domain)							0-8	0-8
Had trouble sleeping	529 (88.4)	23 (3.8)	35 (5.8)	7 (1.2)	5 (0.8)	0.22 (0.68)	0-4	0-4
Been irritable or frustrated?	449 (75.0)	52 (8.7)	77 (12.9)	13 (2.2)	8 (1.2)	0.46 (0.89)	0-4	0-4
How often has your child ... because of dental problems or dental treatments? (Self-image/social interaction Domain)							0-8	0-8
Avoided smiling or laughing when around other children?	574 (95.8)	7 (1.2)	11 (1.8)	3 (0.5)	4 (0.7)	0.09 (0.48)	0-4	0-4
Avoided talking with other children?	579 (96.7)	1 (0.2)	10 (1.7)	5 (0.8)	4 (0.7)	0.08 (0.49)	0-4	0-4

Family section
How often have you or another family member ... because of your child’s dental problems or dental treatments? (Parent distress Domain)							0-8	0-8
Been upset?	479 (80.0)	32 (5.3)	55 (9.2)	21 (3.5)	12 (2.0)	0.42 (0.94)	0-4	0-4
Felt guilty?	484 (80.8)	19 (3.2)	57 (9.5)	23 (3.8)	16 (2.7)	0.44 (0.99)	0-4	0-4
How often ...?*(Family function Domain)^ * p-value < 0.05.**							0-8	0-4
Have you or another family member taken time off from work because of your child’s dental problems or dental treatments?	561 (93.7)	13 (2.2)	18 (3.0)	6 (1.0)	1 (0.2)	0.12 (0.50)	0-4	0-4
How often has your child had dental problems or dental treatments that had a financial impact on your family? (Family function)	575 (96.0)	9 (1.5)	6 (1.0)	7 (1.2)	2 (0.3)	0.08 (0.46)	0-4	0-4
Total ECOHIS						3.26 (5.42)	0-52	0-42

ECOHIS score		Dental trauma absent/Mild	Severe dental trauma	p- value
		mean (SD)^* * Student t test;	mean (SD)^* * Student t test;
Extent		3.6 (5.5)	3.4 (4.1)	0.835
		n (%)^ Chi-square test to compare proportions.	n (%)^ Chi-square test to compare proportions.
Prevalence		317 (57.2)	33 (73.3)	0.041
Intensity		237 (42.8)	15 (33.3)	0.066
	Never	89 (16.1)	3 (6.7)
	Hardly ever Occasionally	134 (24.2)	19 (42.2)
	Often	55 (9.9)	4 (8.9)
	Very often	39 (7.0)	4 (8.9)

Variables		ECOHIS impact		Crude	p-value	Adjusted	p-value
Variables		N	%	OR (95% CI)	p-value	OR (95% CI)	p-value
Sex
	Male	182	61.7	1.00	0.110	1.00	0.351
	Female	168	55.3	0.77 (0.55-1.06)		0.84 (0.61-1.19)
Age (years)
	2	94	55.0	1.00
	3	109	59.6	1.20 (0.79-1.83)	0.371	-	-
	4	114	57.9	1.12 (0.74-1.70)
	5	33	68.8	1.80 (0.91-3.55)
Family income (tertiles)
	1^st tertile	163	60.8	1.00		1.00	0.330
	2^nd tertile	85	63.9	1.14 (0.74-1.75)	0.053	1.16 (0.74-1.84)	0.330
	3^rd tertile	97	51.6	0.68 (0.47-1.00)		0.81 (0.52-1.26)
Maternal schooling
	= 8 years	143	55.4	1.00	0.189	1.00	0.616
	>8 years	206	60.8	1.26 (0.89-1.72)		1.10 (0.74-1.63)	0.616

Dental trauma
	Absent/mild	317	57.2	1.00	0.031	1.00	0.044
	Severe trauma	33	73.3	2.06 (1.04-4.06)	0.031	2.10 (1.01-4.35)
Dental caries
	Absent	181	49.6	1.00	<0.001	1.00	<0.001
	Present	169	72.2	2.64 (1.85-3.76)	<0.001	2.51 (1.74-3.60)	<0.001
Open bite
	Absent	182	55.8	1.00	0.106	1.00	0.164
	Present	159	60.9	1.1 1 (0.96-1.29)	0.106	1.11 (0.96-1.30)

	Variables	Symptons OR (CI95%)	Function OR (CI95%)	Psychological OR (CI95%)	Self-image OR (CI95%)	Parent distress OR (CI95%)	Family function OR (CI95%)
Sex
	Male	1.00	1.00	1.0	1.00	1.00	1.00
	Female	1.08 (0.74-1.56)	0.88 (0.60-1.30)	0.92 (0.63-1.34)	0.90 (0.44-1.81)	0.86 (0.59-1.26)	0.85 (0.47-1.54)
Age (years)
	2	1.00	1.00	*1.00^ * p-value < 0.05.**	1.00	1.00	1.00
	3	0.98 (0.57-1.59)	0.82 (0.49-1.39)	0.58 (0.36-0.95)	1.06 (0.43-2.66)	1.76 (1.04-2.98)	0.71 (0.33-1.56)
	4	0.86 (0.53-1.48)	0.86 (0.51-1.44)	0.51 (0.31-0.83)	0.62 (0.23-1.67)	1.16 (0.68-1.98)	0.64 (0.29-1.41)
	5	2.13 (0.88-3.86)	1.29 (0.62-2.70)	0.35 (0.16-0.80)	1.31 (0.39-4.44)	1.64 (0.77-3.49)	0.67 (0.20-2.24)
Family income (tertiles)
	1^st tertile	1.00	1.00	1.00	1.00	1.00	1.00
	2^nd tertile	1.59 (0.98-2.56)	1.02 (0.62-1.67)	1.59 (0.58-2.96)	1.04 (0.44-2.44)	0.74 (0.45-1.22)	1.43 (0.69-2.93)
	3^rd tertile	1.19 (0.72-1.96)	0.71 (0.42-1.20)	1.19 (0.72-1.96)	0.74 (0.27-2.01)	0.68 (0.41-1.14)	0.91(0.40-2.09)
Maternal schooling
	= 8 years	1.00	1.00	1.00	1.00	1.00	1.00
	>8 years	1.40 (0.90-2.15)	0.97 (0.62-1.51)	1.40 (0.90-2.15)	1.88 (0.80-4.41)	0.88 (0.56-1.37)	1.38 (0.68-3.76)
Dental trauma
	Absent/enamel fracture only	1.00*	1.00	*1.00^ * p-value < 0.05.**	1.00	1.00	*1.00^ * p-value < 0.05.**
	Severe trauma	2.13 (1.10-4.14)	1.10 (0.54-2.24)	2.13 (1.10-4.13)	1.50 (0.47-4.77)	1.73 (0.88-3.38)	2.79 (1.17-6.61)
Dental caries
	Absent	1.00*	*1.00^ * p-value < 0.05.**	*1.00^ * p-value < 0.05.**	1.00	*1.00^ * p-value < 0.05.**	1.00
	Present	2.33 (1.57-3.45)	1.96 (1.30-2.95)	2.33 (1.57-3.45)	1.43 (0.61-3.01)	3.55 (2.38-5.28)	1.82 (0.97-3.40)
Open bite
	Absent	1.00	1.00	1.00	*1.00^ * p-value < 0.05.**	1.00	1.00
	Present	1.05 (0.92-1.21)	1.03 (0.90-1.18)	1.05 (0.92-1.20)	1.23 (1.05-1.45)	1.00 (0.87-1.15)	0.84 (0.60-1.18)

[1] Correspondence to: LA PAULI. E-mail: laisanschaupauli@hotmail.com.

Brasil

Brasil

Severe traumatic dental injuries and oral health related quality of life of preschool children

Traumatismos dentários severos e qualidade de vida relacionada à saúde bucal de crianças pré-escolares

ABSTRACT

Objective:

Methods:

Results:

Conclusion: