Prevalência de problemas oclusais e fatores associados em crianças de 2 a 3 anos de idade: um estudo numa coorte de mães adolescentes

Abstract

Because of the high prevalence of malocclusion in the population the World Health Organization (WHO) considers as a major oral health problems worldwide. Factors associated with the occurrence of malocclusion can be grouped into primary and secondary: from the primary, we highlight heredity and congenital abnormalities, while secondary consist of oral habits, diet modification and nutritional factors. Non-nutritive sucking habits such as thumb sucking, pacifier use, bottles and early weaning are factors associated with the development of changes in skeletal and muscular balance. Thus, biological and behavioral characteristics may represent risk factors to the development of occlusal problems. The aim of this cross-sectional study nested in a cohort of adolescent mothers in Pelotas - RS, was to evaluate the influence of teenage mothers in the occlusion characteristics of children 2-3 years. Data collection was conducted from July 2012 to March 2014 interview with the mothers and clinical examination of the child's oral health was conducted. In the interview were collected independent variables (socioeconomic status, Apgar scores, head circumference, birth weight, need for ICU, the primary caregiver of the child, pacifier use and breastfeeding). Examination of oral health was conducted by previously trained and calibrated dentists. The assessment of the occlusal condition was evaluated according to the index Foster; Hamilton, 1969 including open bite, increased overjet, canines relationship and crossbite. To evaluate the association between occlusal characteristics and independent variables was performed bivariate analysis using the chi-square test, exact Fisher and chi-square test for linear trend. Multivariate analysis was performed using as outcome the presence of some malocclusion through Poisson regression with robust variance, estimating the prevalence ratios and their 95% confidence intervals. The prevalence of malocclusion in this population was 62.33%, and the most common disorder found, was open bite affecting 47.45% of children. The use of pacifiers, lack of breastfeeding, Apgar score below 7 and need for ICU, they were associated with malocclusion. Multivariate analysis showed that perinatal characteristics may represent risk factors for occlusal development. Children who did not require ICU [prevalence ratio (PR) 0.75; Confidence interval (CI) 0.56-0.99 95%] had a lower risk of developing malocclusion while those who had Apgar scores below 7 had a higher risk [RP 1:32; 95% CI 1.06-1.64]. Children who still use pacifier [RP 3.88 (95% CI 2.65-5.68)] or that have stopped already use (OR 1.82, 95% CI 1:02 to 3:24) is most likely to malocclusion compared to those who never used the beak. Children who still breastfed, had a lower incidence of occlusal disorders (PR 00:59; 95% CI 0.42-0.84). The prevalence of malocclusion was high in this population, suggesting that teenage mothers may have attitudes that contribute to the development of malocclusion, as pacifier use and shorter breastfeeding.