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Dental pain and associated factors in Brazilian preschoolers

Abstract

Objective:

To describe the prevalence of dental pain in Brazilian preschoolers, as well as its associated factors, considering a representative sample of that population group in Brazil.

Methods:

Cross-sectional study that used the analytical data from national oral health survey (SB Brazil) carried out in 2010. A representative sample of Brazilian preschoolers aged 5 years was considered. Interviews were carried out (answered by parents/tutors), as well as clinical examinations in children. Descriptive, bivariate and mutiple analyzes were performed, described in odds ratios and 95% confidence interval (OR/95%CI).

Results:

7280 preschoolers were included. Of these, 1520 (21.1%) had dental pain in the last 6 months. The chance of the occurrence of dental pain was higher among those who used dental services (1.51/1.02–2.23), with tooth decay (3.08/2.08–4.56), that self-perceveid the need for dental treatment (3.96/2.48–6.34), whose parents reported dissatisfaction by children with their teeth and mouth (1.47/1.04–2.10) and those who reported impact of oral problems on quality of life (5.76/3.90–8.49).

Conclusions:

The prevalence of dental pain among Brazilian preschool children was relatively high, being associated with the use of dental services and the normative and subjective oral health status.

KEYWORDS
Pain; Child; Tooth decay; Oral health

Resumo

Objetivo:

Descrever a prevalência da dor dentária em pré-escolares brasileiros, assim como seus fatores associados, considerando uma amostra representativa desse contingente populacional no Brasil.

Métodos:

Estudo transversal, analítico, que usou os dados do Inquérito Nacional de Saúde Bucal (SB Brasil) feito em 2010. Considerou-se uma amostra representativa de pré-escolares com 5 anos. Foram feitas entrevistas (respondidas pelos responsáveis) e exames clínicos nas crianças. Conduziram-se análises descritivas, bivariadas e múltiplas, descritas em odds ratio e intervalo de confiança de 95% (OR/IC95%).

Resultados:

Foram incluídos 7.280 pré-escolares. Desses, 1.520 (21,1%) tiveram dor dentária nos últimos 6 meses. A chance da ocorrência de dor dentária foi maior entre aqueles que usaram serviços odontológicos (1,51/1,02-2,23), com cárie dentária (3,08/2,08-4,56), perceberam a necessidade de tratamento odontológico (3,96/2,48-6,34), os que os pais relatavam insatisfação por parte das crianças com seus dentes e sua boca (1,47/1,04-2,10) e os que relataram impacto dos problemas bucais na qualidade de vida (5,76/3,90-8,49).

Conclusões:

A prevalência da dor dentária entre pré-escolares brasileiros foi relativamente alta e associada ao uso de serviços odontológicos e às condições normativas e subjetivas de saúde bucal.

PALAVRAS-CHAVE
Dor; Criança; Cáries dentárias; Saúde bucal

Introduction

Dental pain has been considered the most common symptom or consequence of the presence of oral diseases, such as dental caries and gum disease.11 Peres MA, Iser BP, Peres KG, Malta DC, Antunes JL. Desigualdades contextuais e individuais da prevalência de dor dentária em adultos e idosos no Brasil. Cad Saude Publica. 2012;28:S114-23.

2 Lacerda JT, Simionato EM, Peres KG, Peres MA, Traebert J, Marcenes W. Dor de origem dental como motivo de consulta odontológica em uma população adulta. Rev Saude Publica. 2004;38:453-8.
-33 Nomura LH, Bastos JL, Peres MA. Prevalência de dor de dente e associação com cárie e condições socioecônomicas em escolares, sul do Brasil, 2002. Braz Oral Res. 2004;18:134-40. The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience caused by tissue damage.44 Task Force on Taxonomy of The International Association for the Study of Pain. Part III: Pain terms, a current list with definitions and notes on usage. Seatle: IASP Press; 1994. Among the types of orofacial pain, those of dental origin have been reported as the most frequent,55 Borges CM, Cascaes AM, Fischer TK, Boing AF, Peres MA, Peres KG. Dor nos dentes e gengivas e fatores associados em adolescentes brasileiros: análise do inquérito nacional de saúde bucal SB-Brasil 2002-2003. Cad Saude Publica. 2008;24:1825-34. may affect social interaction, daily activities,66 Locker D, Grushka M. The impact of dental and facial pain. J Dent Res. 1987;66:1414-7. and may have a negative impact on quality of life.77 Wandera MN, Engebretsen IM, Rwenyonyi CM, Tumwine J, Astrøm AN. Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: a cross-sectional study. Health Qual Life Outcomes. 2009;7:89.,88 Clementino MA, Gomes MC, Pinto-Sarmento TC, Martins CC, Granville-Garcia AF, Paiva SM. Perceived impact of dental pain on the quality of life of preschool children and their families. PLoS One. 2015;10:e0130602. It should be noted that the perception of pain may be influenced by knowledge and beliefs of the individuals, as well as by the cultural and social environment in which they live.99 Bastos JL, Nomura LH, Peres MA. Dental pain, socioeconomic status, and dental caries in young male adults from southern Brazil. Cad Saude Publica. 2005;21:1416-23.,1010 Dworkin SF, Chen AC, Schubert MM, Clark DW. Cognitive modification of pain: information in combination with N2O. Pain. 1984;19:339-51. Different factors have been associated with the presence and perception of dental pain, such as low socioeconomic status,99 Bastos JL, Nomura LH, Peres MA. Dental pain, socioeconomic status, and dental caries in young male adults from southern Brazil. Cad Saude Publica. 2005;21:1416-23. dental caries,1111 de Lacerda JT, de Bem Pereira M, Traebert J. Dental pain in Brazilian schoolchildren: a cross-sectional study. Int J Paediatr Dent. 2013;23:131-7. food-related difficulties, and sleep disorders.66 Locker D, Grushka M. The impact of dental and facial pain. J Dent Res. 1987;66:1414-7. Moreover, its occurrence has been identified as one of the main reasons for seeking dental care.22 Lacerda JT, Simionato EM, Peres KG, Peres MA, Traebert J, Marcenes W. Dor de origem dental como motivo de consulta odontológica em uma população adulta. Rev Saude Publica. 2004;38:453-8.,99 Bastos JL, Nomura LH, Peres MA. Dental pain, socioeconomic status, and dental caries in young male adults from southern Brazil. Cad Saude Publica. 2005;21:1416-23.

The prevalence of dental pain varies widely among different studies and age groups. International studies have addressed the prevalence of episodes of dental pain and observed results ranging from 9% in Japan1212 Karibe H, Shimazu K, Okamoto A, Kawakami T, Kato Y, Warita-Naoi S. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey. BMC Oral Health. 2015;15:8. (11-15 years) to 40% in districts of Manchester, England (up to 12 years).1313 Milsom KM, Tickle M, Blinkhorn AS. Dental pain and dental treatment of young children attending the general dental service. Br Dent J. 2002;192:280-4. In Brazil, the prevalence is also variable, with rates between 11% and 39% (subjects aged 5-60 years).11 Peres MA, Iser BP, Peres KG, Malta DC, Antunes JL. Desigualdades contextuais e individuais da prevalência de dor dentária em adultos e idosos no Brasil. Cad Saude Publica. 2012;28:S114-23.,55 Borges CM, Cascaes AM, Fischer TK, Boing AF, Peres MA, Peres KG. Dor nos dentes e gengivas e fatores associados em adolescentes brasileiros: análise do inquérito nacional de saúde bucal SB-Brasil 2002-2003. Cad Saude Publica. 2008;24:1825-34.,1111 de Lacerda JT, de Bem Pereira M, Traebert J. Dental pain in Brazilian schoolchildren: a cross-sectional study. Int J Paediatr Dent. 2013;23:131-7.,1414 Bastos JL, Peres MA, Peres KG, Araujo CL, Menezes AM. Toothache prevalence and associated factors: a life course study from birth to age 12 yr. Eur J Oral Sci. 2008;116:458-66.

15 Moure-Leite FR, Ramos-Jorge J, Ramos-Jorge ML, Paiva SM, Vale MP, Pordeus IA. Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors. Eur Arch Paediatr Dent. 2011;12:293-7.
-1616 Schuch HS, Correa MB, Torriani DD, Demarco FF, Goettems ML. Perceived dental pain: determinants and impact on Brazilian schoolchildren. J Oral Facial Pain Headache. 2015;29:168-76. Among the population groups investigated regarding this issue are children, especially those at pre-school age.88 Clementino MA, Gomes MC, Pinto-Sarmento TC, Martins CC, Granville-Garcia AF, Paiva SM. Perceived impact of dental pain on the quality of life of preschool children and their families. PLoS One. 2015;10:e0130602.,1515 Moure-Leite FR, Ramos-Jorge J, Ramos-Jorge ML, Paiva SM, Vale MP, Pordeus IA. Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors. Eur Arch Paediatr Dent. 2011;12:293-7.

In Brazil, the oral health status of preschoolers is worrisome. Despite the modest improvement observed in the last two epidemiological population surveys, conducted in 2002/20031717 Secretaria de Atenção à Saúde - departamento de atenção básica. Projeto SB Brasil 2003: condições de saúde bucal da população brasileira 2002-2003: resultados principais. Brasília, Brasil: Ministério da Saúde; 2004. and 2010,1818 Secretaria de Atenção à Saúde - departamento de atenção básica. Coordenação Nacional de Saúde Bucal. Projeto SB Brasil 2010: condições de saúde bucal da população brasileira - resultados principais. Brasília, Brasil: Ministério da Saúde; 2011. such as the approximately 6% increase in the number of children under 5 years free of caries, this population group is still affected by a high prevalence of oral diseases, such as dental caries and malocclusion.1818 Secretaria de Atenção à Saúde - departamento de atenção básica. Coordenação Nacional de Saúde Bucal. Projeto SB Brasil 2010: condições de saúde bucal da população brasileira - resultados principais. Brasília, Brasil: Ministério da Saúde; 2011. This may result in high prevalence of dental pain and, consequently, a negative impact on their daily life.

However, population-based studies with a representative sample of Brazilian preschoolers addressing dental pain are scarce. Therefore, this study aimed to describe the prevalence of dental pain in Brazilian preschoolers and its associated factors.

Method

This was a cross-sectional study that used the database of the National Survey on Oral Health Conditions (SB Brasil), conducted by the Brazilian Ministry of Health in 2010.1818 Secretaria de Atenção à Saúde - departamento de atenção básica. Coordenação Nacional de Saúde Bucal. Projeto SB Brasil 2010: condições de saúde bucal da população brasileira - resultados principais. Brasília, Brasil: Ministério da Saúde; 2011. Following the criteria proposed by the World Health Organization in 1997,1919 World Health Organization. Oral health surveys: basic methods. 4ªed. Geneva: ORH/EPID; 1997. a representative sample of the population in the index age ranges was interviewed and examined at their homes regarding their oral health, demographic, and socioeconomic data, as well as use of dental services and subjective issues of oral health. This study considered the sample of preschool children, which in the SB Brazil 2010 included only children aged 5 years.

Residents of 177 cities were interviewed and assessed, including the 27 capitals of the five geographical regions (North, Northeast, Mid-West, Southeast, and South). Subjects were selected by multi-stage probability cluster sampling, with probability proportional to size and considering a design effect (deff) equal to 2. The 30 municipalities in each region and the 30 census sectors for capitals and the Federal District were drawn by the technique of probability proportional to size.2020 Roncalli AG, Silva NN, Nascimento AC, Freitas CH, Casotti E, Peres KG, et al. Aspectos metodológicos do Projeto SB Brasil 2010 de interesse para inquéritos nacionais de saúde. Cad Saude Publica. 2012;28:s40-57.

The tests and interviews were performed by previously trained dentists and calibrated by the consensus technique; the minimum acceptable kappa value for each examiner, age group, and studied injury was 0.65. Interviews were conducted with the aid of a handheld computer (Personal Digital Assistant).2020 Roncalli AG, Silva NN, Nascimento AC, Freitas CH, Casotti E, Peres KG, et al. Aspectos metodológicos do Projeto SB Brasil 2010 de interesse para inquéritos nacionais de saúde. Cad Saude Publica. 2012;28:s40-57.

In the present study, a database slice was used; the analysis included the preschoolers who answered the question about the presence of dental pain.

The dependent variable - dental pain - was assessed by the question: "in the last six months, did you have toothache?" (No/Yes). Since this was a sample of 5-year-old children, this answer was given by their parents/guardians. Therefore, the presence of dental pain in preschoolers was characterized by the answer "yes".

The independent variables were combined into three groups: sociodemographic conditions, healthcare services, and health outcomes (normative and subjective conditions of oral health). The assessed sociodemographic conditions were sex, self-reported ethnicity, family income, and Brazilian region. Regarding healthcare services, the use of dental care services throughout life was considered. It should be noted that such use, which was defined as having used the service at least once during the lifetime, is not necessarily related to health outcomes or the occurrence of dental pain. Regarding health outcomes, the normative oral health condition assessed was the presence of caries. This assessment was based on the decayed component of the DMFT index, which counts the number of decayed, missing, and filled teeth.1818 Secretaria de Atenção à Saúde - departamento de atenção básica. Coordenação Nacional de Saúde Bucal. Projeto SB Brasil 2010: condições de saúde bucal da população brasileira - resultados principais. Brasília, Brasil: Ministério da Saúde; 2011.,1919 World Health Organization. Oral health surveys: basic methods. 4ªed. Geneva: ORH/EPID; 1997. Regarding the subjective conditions of oral health, the self-perceived need for treatment, satisfaction with teeth and mouth, and the impact of oral health on quality of life were assessed. Due to the age of patients, these data were answered by their parents/guardian. This impact was measured by the instrument Oral Impacts on Daily Performance (OIDP), which assesses the impact of oral conditions on the individual's ability to perform their daily activities.2121 Adulyanon S, Vourapukjaru J, Sheiham A. Oral impacts affecting daily performance in a low dental disease Thai population. Comm Dent Oral Epidemiol. 1996;24:385-9.,2222 Castro RAL, Cortes MIS, Leão AT, Portela MC, Souza IPR, Tsakos G, et al. Child-OIDP index in Brazil: cross-cultural adaptation and validation. Health Qual Life Outcomes. 2008;6:68. The present study considered as impacted those preschoolers for whom involvement was reported in at least one of the nine items that compose the instrument. Therefore, the dichotomized OIDP score (Yes/No) was used.

For data analysis, SPSS Statistics 18.0 software (SPSS, IBM Company, Hong Kong, China) was used. As the study involved complex cluster sampling, the correction was made by the sample design effect, taking into account the cluster effects and assigning weights to the sampled elements. For categorical variables, the descriptive analysis included the distribution of the sample, corrected relative frequency (%), and standard error (SE). To evaluate the factors associated with the outcome (dental pain), bivariate and mutiple analyses were performed. In the bivariate analysis, the raw odds ratios (ORraw) and 95% confidence intervals (95%CI) were estimated, with the correction for the effect of the sample design. Independent variables that presented a descriptive level lower than or equal to 20% (p≤0.20) at this stage of the analysis were selected for multiple analysis. In the multiple analysis of the factors associated with the outcome, based on logistic regression (ORadjusted/95%CI), a significance level of 5% (α=5%) was adopted.

This epidemiological survey was conducted based on the ethical principles of Resolution of the National Health Council No⋅ 196/96 and was approved by and registered at the National Institutional Review Board (Comissão Nacional de Ética em Pesquisa [CONEP]) under No. 15498/2010.

Results

This study included 7280 children aged 5 years. Of these, 1520 (21.1%) had episodes of dental pain in the six months prior to data collection. Most children were male, had already used dental services, and were caries-free (Table 1).

Table 1
Descriptive analysis of dental pain, sociodemographic characteristics, healthcare services, and health outcomes among Brazilian preschoolers in 2010 (n=7280).

The bivariate analysis indicated that variables in all categories (sociodemographic, use of services, and health outcomes) remained associated with dental pain (p≤0.20) and were considered in the multiple analysis (Table 2).

Table 2
Bivariate analysis of factors associated with dental pain in Brazilian preschoolers in 2010.

In the multiple analysis, dental pain in the last six months in children at 5 years was associated with no use of dental services (p=0.037); tooth decay (p≤0.001); perception by parents/guardians of their children's need for treatment (p≤0.001); parents'/guardians' report of their children's dissatisfaction with teeth and mouth (p=0.029); and impact of oral health on quality of life according to the applied instrument (OIDIP - p≤0.001; Table 3).

Table 3
Multiple analysis of factors associated with dental pain among Brazilian preschoolers in 2010.

Regarding the distribution of dental pain among preschoolers, according to the Brazilian states, a lower prevalence of this finding was observed in those living in the South region (Fig. 1).

Figure 1
Distribution of the presence (%) of dental pain in Brazilian preschoolers per state.

Discussion

A high prevalence of dental pain (21.1%) among children aged 5 years was observed. This prevalence was higher than that identified in other studies in Brazil with preschoolers.1515 Moure-Leite FR, Ramos-Jorge J, Ramos-Jorge ML, Paiva SM, Vale MP, Pordeus IA. Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors. Eur Arch Paediatr Dent. 2011;12:293-7.,2323 Camargo MB, Barros AJ, Frazão P, Matijasevich A, Santos IS, Peres MA, et al. Preditores da realização de consultas odontológicas de rotina e por problema em pré-escolares. Rev Saude Publica. 2012;46:87-97. Nevertheless, higher prevalences were observed in national11 Peres MA, Iser BP, Peres KG, Malta DC, Antunes JL. Desigualdades contextuais e individuais da prevalência de dor dentária em adultos e idosos no Brasil. Cad Saude Publica. 2012;28:S114-23.,1616 Schuch HS, Correa MB, Torriani DD, Demarco FF, Goettems ML. Perceived dental pain: determinants and impact on Brazilian schoolchildren. J Oral Facial Pain Headache. 2015;29:168-76. and international1212 Karibe H, Shimazu K, Okamoto A, Kawakami T, Kato Y, Warita-Naoi S. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey. BMC Oral Health. 2015;15:8.,1313 Milsom KM, Tickle M, Blinkhorn AS. Dental pain and dental treatment of young children attending the general dental service. Br Dent J. 2002;192:280-4. studies that included older children (6-12 years), indicating a possibility that advancing age can influence the occurrence of oral health problems and, consequently, pain perception. The prevalence of dental pain among Brazilian preschoolers possibly derives from the high prevalence of some oral problems among these individuals, such as tooth decay.1818 Secretaria de Atenção à Saúde - departamento de atenção básica. Coordenação Nacional de Saúde Bucal. Projeto SB Brasil 2010: condições de saúde bucal da população brasileira - resultados principais. Brasília, Brasil: Ministério da Saúde; 2011. However, considering the prevalence of these problems, a higher prevalence of dental pain was expected, since tooth decay has been identified as the primary cause of dental pain in children.2424 Losso EM, Tavares MC, Silva JY, Urban CA. Cárie precoce e severa na infância: uma abordagem integral. J Pediatr (Rio J). 2009;85:295-300. It is worth noting that the report of pain was made by the preschoolers' parents/guardians, who may have underestimated the occurrence of this event. In addition to its rates, it was observed that dental pain was associated with variables related to the use of dental services and outcomes in oral health (normative and subjective conditions of oral health).

This study observed a higher prevalence of dental pain among those who had been to a dentist. This association is worrisome, considering that a dental consultation should stimulate greater care and treatment of dental issues, resulting in pain relief. Thus, it is possible that the dental services used did not resolve the issues. A previous study, conducted among preschool children in Montes Claros (MG - Brazil), identified a lower chance of using dental services among those who had never had dental caries experience,2525 Rodrigues LA, Martins AM, Silveira MF, Ferreira RC, Souza JG, Silva JM, et al. Uso de serviços odontológicos entre pré-escolares: estudo de base populacional. Cien Saude Coletiva. 2014;19:4247-56. which evidences the possibility that injuries or pain did not occur, leading to non-use of the service.

Dental caries have been identified as the main cause of tooth pain.2424 Losso EM, Tavares MC, Silva JY, Urban CA. Cárie precoce e severa na infância: uma abordagem integral. J Pediatr (Rio J). 2009;85:295-300.,2626 Boeira GF, Correa MB, Peres KG, Peres MA, Santos IS, Matijasevich A, et al. Caries is the main cause for dental pain in childhood: findings from a birth cohort. Caries Res. 2012;46:488-95. The prevalence of dental pain was higher among preschoolers with one or more teeth with caries. This association was to be expected, since pain is one of the symptoms of tooth decay, and was also identified among adolescents55 Borges CM, Cascaes AM, Fischer TK, Boing AF, Peres MA, Peres KG. Dor nos dentes e gengivas e fatores associados em adolescentes brasileiros: análise do inquérito nacional de saúde bucal SB-Brasil 2002-2003. Cad Saude Publica. 2008;24:1825-34. and adults.99 Bastos JL, Nomura LH, Peres MA. Dental pain, socioeconomic status, and dental caries in young male adults from southern Brazil. Cad Saude Publica. 2005;21:1416-23. A previous cohort study, with preschool children aged 5 years in Pelotas (RS - Brazil), observed that individuals with caries had a greater chance (4.8 times) of having dental pain.2626 Boeira GF, Correa MB, Peres KG, Peres MA, Santos IS, Matijasevich A, et al. Caries is the main cause for dental pain in childhood: findings from a birth cohort. Caries Res. 2012;46:488-95. Increased access to dental services, as well as preventive and health education measures, could have a positive impact on reducing caries rates in this population and, consequently, dental pain.

A greater chance of dental pain was observed in preschoolers who were likely dissatisfied with their oral health conditions and required dental treatment, according to the report by their parents/guardians. The presence of dental pain is a result of the presence of dental injuries11 Peres MA, Iser BP, Peres KG, Malta DC, Antunes JL. Desigualdades contextuais e individuais da prevalência de dor dentária em adultos e idosos no Brasil. Cad Saude Publica. 2012;28:S114-23.

2 Lacerda JT, Simionato EM, Peres KG, Peres MA, Traebert J, Marcenes W. Dor de origem dental como motivo de consulta odontológica em uma população adulta. Rev Saude Publica. 2004;38:453-8.
-33 Nomura LH, Bastos JL, Peres MA. Prevalência de dor de dente e associação com cárie e condições socioecônomicas em escolares, sul do Brasil, 2002. Braz Oral Res. 2004;18:134-40. ; these, in turn, can lead to dissatisfaction with oral health and to a perceived need for treatment. It should be noted that the data on subjective issues of oral health were reported by those responsible for the children. Thus, the assessed perception may not fully represent how preschoolers felt affected by their oral problems. However, considering the low age of the sample and the difficulty of assessing their oral conditions, the account of those who live with these children (parents/guardians) is a reliable measure of evaluation. In this sense, dental pain is an important predictor for the search for dental care.

Considering the fact that dental pain negatively impacts people's daily lives66 Locker D, Grushka M. The impact of dental and facial pain. J Dent Res. 1987;66:1414-7. and impairs quality of life,77 Wandera MN, Engebretsen IM, Rwenyonyi CM, Tumwine J, Astrøm AN. Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: a cross-sectional study. Health Qual Life Outcomes. 2009;7:89.,88 Clementino MA, Gomes MC, Pinto-Sarmento TC, Martins CC, Granville-Garcia AF, Paiva SM. Perceived impact of dental pain on the quality of life of preschool children and their families. PLoS One. 2015;10:e0130602. the greater chance of dental pain among those whose oral health impacted their quality of life identified in this study was expected. The subjective nature of pain reporting, as well as of the impacts on quality of life, especially among children, is noteworthy. Regarding the self-perception of oral health and the need for dental treatment, the assessment of the impact on quality of life was answered by the parents/guardians, and may differ from how the child really felt about their dental problems.

Pain is a multidimensional phenomenon: it can be influenced by different factors, and its objective evaluation in preschoolers is a challenge for healthcare professionals. Therefore, the identification of the prevalence of dental pain and its associated factors may allow for improvements and for the implementation of public policies aimed at fostering better oral health and daily life conditions for this population group. Among the limitations of this study are its transverse design, which does not allow for the identification of causes and effects, and the fact that the data was collected in 2010 and that changes in the pain profile may have occurred over the years. Moreover, the report of pain, as well as of other subjective matters of oral health, was provided by the parents/guardians, and is a subjective and dynamic measurement. Nevertheless, this study allowed for the characterization of the occurrence of dental pain among Brazilian preschoolers, considering a representative sample of this age group. This characterization also allowed for the identification of the distribution of the occurrence of at least one episode of dental pain in preschoolers among the Brazilian states and their capitals. The variability in the prevalence of pain between capital cities of the same region was noteworthy; in general, a lower prevalence was observed in the South of the country.

Of the preschoolers included in this study, 21.1% had dental pain in the last six months prior to data collection. It is noteworthy that this phenomenon remained associated with the use of dental services, dental caries, need for treatment, dissatisfaction with teeth and mouth, and impact of oral health on quality of life. Therefore, such associations should be considered in health planning by healthcare professionals and managers in order to reduce the occurrence of dental pain among Brazilian preschoolers.

  • Funding
    This study did not receive funding.

References

  • 1
    Peres MA, Iser BP, Peres KG, Malta DC, Antunes JL. Desigualdades contextuais e individuais da prevalência de dor dentária em adultos e idosos no Brasil. Cad Saude Publica. 2012;28:S114-23.
  • 2
    Lacerda JT, Simionato EM, Peres KG, Peres MA, Traebert J, Marcenes W. Dor de origem dental como motivo de consulta odontológica em uma população adulta. Rev Saude Publica. 2004;38:453-8.
  • 3
    Nomura LH, Bastos JL, Peres MA. Prevalência de dor de dente e associação com cárie e condições socioecônomicas em escolares, sul do Brasil, 2002. Braz Oral Res. 2004;18:134-40.
  • 4
    Task Force on Taxonomy of The International Association for the Study of Pain. Part III: Pain terms, a current list with definitions and notes on usage. Seatle: IASP Press; 1994.
  • 5
    Borges CM, Cascaes AM, Fischer TK, Boing AF, Peres MA, Peres KG. Dor nos dentes e gengivas e fatores associados em adolescentes brasileiros: análise do inquérito nacional de saúde bucal SB-Brasil 2002-2003. Cad Saude Publica. 2008;24:1825-34.
  • 6
    Locker D, Grushka M. The impact of dental and facial pain. J Dent Res. 1987;66:1414-7.
  • 7
    Wandera MN, Engebretsen IM, Rwenyonyi CM, Tumwine J, Astrøm AN. Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: a cross-sectional study. Health Qual Life Outcomes. 2009;7:89.
  • 8
    Clementino MA, Gomes MC, Pinto-Sarmento TC, Martins CC, Granville-Garcia AF, Paiva SM. Perceived impact of dental pain on the quality of life of preschool children and their families. PLoS One. 2015;10:e0130602.
  • 9
    Bastos JL, Nomura LH, Peres MA. Dental pain, socioeconomic status, and dental caries in young male adults from southern Brazil. Cad Saude Publica. 2005;21:1416-23.
  • 10
    Dworkin SF, Chen AC, Schubert MM, Clark DW. Cognitive modification of pain: information in combination with N2O. Pain. 1984;19:339-51.
  • 11
    de Lacerda JT, de Bem Pereira M, Traebert J. Dental pain in Brazilian schoolchildren: a cross-sectional study. Int J Paediatr Dent. 2013;23:131-7.
  • 12
    Karibe H, Shimazu K, Okamoto A, Kawakami T, Kato Y, Warita-Naoi S. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey. BMC Oral Health. 2015;15:8.
  • 13
    Milsom KM, Tickle M, Blinkhorn AS. Dental pain and dental treatment of young children attending the general dental service. Br Dent J. 2002;192:280-4.
  • 14
    Bastos JL, Peres MA, Peres KG, Araujo CL, Menezes AM. Toothache prevalence and associated factors: a life course study from birth to age 12 yr. Eur J Oral Sci. 2008;116:458-66.
  • 15
    Moure-Leite FR, Ramos-Jorge J, Ramos-Jorge ML, Paiva SM, Vale MP, Pordeus IA. Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors. Eur Arch Paediatr Dent. 2011;12:293-7.
  • 16
    Schuch HS, Correa MB, Torriani DD, Demarco FF, Goettems ML. Perceived dental pain: determinants and impact on Brazilian schoolchildren. J Oral Facial Pain Headache. 2015;29:168-76.
  • 17
    Secretaria de Atenção à Saúde - departamento de atenção básica. Projeto SB Brasil 2003: condições de saúde bucal da população brasileira 2002-2003: resultados principais. Brasília, Brasil: Ministério da Saúde; 2004.
  • 18
    Secretaria de Atenção à Saúde - departamento de atenção básica. Coordenação Nacional de Saúde Bucal. Projeto SB Brasil 2010: condições de saúde bucal da população brasileira - resultados principais. Brasília, Brasil: Ministério da Saúde; 2011.
  • 19
    World Health Organization. Oral health surveys: basic methods. 4ªed. Geneva: ORH/EPID; 1997.
  • 20
    Roncalli AG, Silva NN, Nascimento AC, Freitas CH, Casotti E, Peres KG, et al. Aspectos metodológicos do Projeto SB Brasil 2010 de interesse para inquéritos nacionais de saúde. Cad Saude Publica. 2012;28:s40-57.
  • 21
    Adulyanon S, Vourapukjaru J, Sheiham A. Oral impacts affecting daily performance in a low dental disease Thai population. Comm Dent Oral Epidemiol. 1996;24:385-9.
  • 22
    Castro RAL, Cortes MIS, Leão AT, Portela MC, Souza IPR, Tsakos G, et al. Child-OIDP index in Brazil: cross-cultural adaptation and validation. Health Qual Life Outcomes. 2008;6:68.
  • 23
    Camargo MB, Barros AJ, Frazão P, Matijasevich A, Santos IS, Peres MA, et al. Preditores da realização de consultas odontológicas de rotina e por problema em pré-escolares. Rev Saude Publica. 2012;46:87-97.
  • 24
    Losso EM, Tavares MC, Silva JY, Urban CA. Cárie precoce e severa na infância: uma abordagem integral. J Pediatr (Rio J). 2009;85:295-300.
  • 25
    Rodrigues LA, Martins AM, Silveira MF, Ferreira RC, Souza JG, Silva JM, et al. Uso de serviços odontológicos entre pré-escolares: estudo de base populacional. Cien Saude Coletiva. 2014;19:4247-56.
  • 26
    Boeira GF, Correa MB, Peres KG, Peres MA, Santos IS, Matijasevich A, et al. Caries is the main cause for dental pain in childhood: findings from a birth cohort. Caries Res. 2012;46:488-95.

Publication Dates

  • Publication in this collection
    Jul-Sep 2016

History

  • Received
    17 Aug 2015
  • Accepted
    2 Dec 2015
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