Epidemiological pattern of severe malocclusions in Brazilian
          adolescents

Peres, Karen Glazer; Frazão, Paulo; Roncalli, Angelo Giuseppe

doi:10.1590/S0034-8910.2013047004366

OBJECTIVE:

To describe the distribution of malocclusion and its associated factors in Brazilian adolescents.

METHODS:

Data from 7,328 subjects aged 12 years and 5,445 adolescents aged 15-19 years were analyzed. The adolescents took part in the Brazilian Oral Health Survey (SBBrasil 2010). The outcome was severe malocclusion according to the dental aesthetic index. The independent variables were sex, skin color, monthly household income, possessions, number of individuals in the household, untreated dental caries, missing teeth and dental appointments or lack thereof, frequency, and reason. Logistical regression analysis was carried out, considering the complex sampling cluster design, based on a hierarchical model.

RESULTS:

The prevalence of severe malocclusion was 6.5% and 9.1% in the 12-year-olds and the 15-19-year-olds, respectively. After adjustment, those with lighter- skinned black or black skin were 1.59 (95%CI 1.08;2.34) times more likely to present the outcome compared with those with white skin. The loss of one or more first molars increased 2.66 (95%CI 1.26;5.63) the chance to present severe malocclusion by the age of 12. Adolescents aged 15-19 whose household income was below R$ 1,500.00 (OR 2.69 [95%CI 1.62; 4.47]) and those who had seen a dentist for treatment (OR 2.59 [95%CI 2.55;4.34]) had the greatest chance of having severe malocclusion compared with those with higher incomes and those who visited the dentist for prevention.

Adolescent; Malocclusion, epidemiology; Socioeconomic Factors; Health Inequalities; Dental Health Surveys; Oral Health

[TFN01t01_en] ^Source
: Drawn up by the authors based on data from the SBBrasil 2010 Project.

[TFN02t01_en] R$ 1.00 = US$ 1.97 (02/08/2013)

[TFN03t01_en] ^DAI
: Dental Aesthetic Index

Variável	Sample				Prevalence of very severe malocclusion (DAI ≥ 36)

	12 years old		15- 19 years old		12 years old			15- 19 years old

	n	%	n	%	P (%)	95%CI	p	P (%)	95%CI	p

Sex
Male	3,639	49.7	2.497	45.9	6.80	4.70;9.70	0.706	9.80	7.40;12.70	0.395
Female	3,689	50.3	2.948	54.1	6.30	4.70;8.30		8.40	6.70;10.60
Skin color / race
White	2,897	40.7	2.203	41.6	5.00	3.60;7.10	0.019	7.30	5.20;10.10	0.061
Brown/black	4,225	59.3	3.089	58.4	7.80	5.70;10.50		10.80	8.50;13.60
Household crowding
Below 1.5	3,414	46.7	2.812	51.7	5.70	4.50;7.20	0.242	8.00	6.10;10.50	0.209
Over 1.5	3,894	53.3	2.630	48.3	7.20	4.90;10.60		10.30	7.80;13.40
Number of goods
More than 6	3,542	48.7	2.874	53.1	5.80	3.80;8.70	0.323	8.00	6.20;10.20	0.091
6 or fewer	3,724	51.3	2.539	46.9	7.40	5.40;10.10		10.60	8.20;13.50
Household income* (R$)
Above 1,500.00	1,838	26.5	1.609	31.4	5.10	2.30;10.80	0.398	4.50	2.90;6.90	< 0.001
Below 1,500.00	5,091	73.5	3.516	68.6	7.10	5.40;9.40		11.50	9.50;13.90
Lost first molar
None	6,965	95.0	4.585	84.2	6.20	4.70;8.10	0.030	8.30	6.60;10.50	0.027
1 or more	363	5.0	860	15.8	13.70	6.80;25.70		13.90	9.70;19.50
Teeth with caries
None	4,220	58.2	2.663	49.6	6.30	4.30;9.20	0.711	6.70	4.90;9.10	0.006
1 or more	3,027	41.8	2.704	50.4	6.90	5.10;9.40		12.00	9.40;15.30
Dental visit
Yes	5,918	81.6	4.685	86.6	6.20	4.80;8.00	0.238	9.30	7.50;11.40	0.540
No	1,337	18.4	726	13.4	8.40	4.90;13.80		7.70	4.40;13.10
Frequency of dental visits
Less than a year ago	3,570	61.2	2.705	58.4	6.80	4.80;9.60	0.204	8.90	6.70;11.90	0.752
More than a year ago	2,264	38.8	1.925	41.6	4.90	3.30;7.30		9.70	6.70;13.80
Reason for dental visit
Check up	2,172	37.1	1.616	34.8	6.30	4.00;9.80	0.775	4.40	2.90;6.60	< 0.001
Treatment or other	3,690	62.9	3.027	65.2	5.90	4.50;7.80		12.00	9.80;14.70

Variável	Unadjusted analysis*			Adjusted analysis ^a

	OR	95%CI	p	OR	95%CI	p

12 years old
Brown or black skin	1.59	1.08;2.34	0.019	1.59	1.08;2.34	0.019
Lost one or more molars	2.43	1.09;5.40	0.030	2.66	1.26;5.63	0.010
More than a year since last visit to the dentist	0.71	0.41;1.21	0.204	0.64	0.37;1.10	0.106
15 to 19 years old
Brown or black skin	1.54	0.98;2.42	0.061	1.54	0.98;2.42	0.061
Possess 6 or fewer goods	1.37	0.95;1.97	0.091	^b	^b	^b
Income below R$ 1,500.00 ^c	2.78	1.70;4.54	< 0.001	2.69	1.62;4.47	< 0.001
Lost one or more molars	1.78	1.07;2.97	0.027	^b	^b	^b
One or more teeth with dental caries	1.90	1.20;3.00	0.006	1.49	0.91;2.43	0.112
Visited dentist for treatment or other reason	2.95	1.84;4.73	0.001	2.59	1.55;4.34	0.001

Brasil

Brasil

Epidemiological pattern of severe malocclusions in Brazilian adolescents

OBJECTIVE:

METHODS:

RESULTS: