Percepção dos pais sobre a influência do tratamento ortopédico e ortodôntico na qualidade de vida relacionada à saúde bucal de crianças respiradoras bucais: um estudo misto

Abstract

Respiratory function should preferably occur through the nose. When there is some impediment to nasal breathing, there is mouth breathing, which can cause multiple changes. Breathing problems can affect quality of life, causing numerous physical and psychological changes. The aim of the present study was to evaluate and understand the perception of parents about the influence of orthopedic and orthodontic treatment on oral health-related quality of life (OHRQoL) in mouth breathing children. A mixed study was performed in the city of Bagé/RS-Brazil, using a convenience sample that included parents of children between 4 and 12 years old. The diagnosis as mouth breathers was obtained through clinical evaluation, anamnesis and complementary exams. All treatments were performed in a private office. Patients who underwent orthodontic/orthopedic treatment between May 2022 and January 2023 were included. In the quantitative phase, those responsible answered sociodemographic questions and the outcome of the study, the OHRQoL, which was measured using the reduced version of the Parental - Caregiver Perceptions Questionnaire (P-CPQ) after at least 8 months of orthodontic or orthopedic treatment. The qualitative phase was carried out after the quantitative phase. The qualitative questions were based on the dimensions of the OHRQoL questionnaire and on the questionnaire on mouth breathers proposed by Popoaski. The interviews were carried out in person at the dental office in an individual room. All interviews were conducted by a trained interviewer. The interviews were interrupted after data saturation. Descriptive analysis of quantitative data with relative and absolute frequencies was performed in the Stata 13.0 program and thematic analysis for qualitative data, proposed by Braun and Clark. In all, 12 guardians participated. Most aged between 41-47 years (66.7%), with high school education (83.3%) and female (91.7%). As for the P-CPQ questionnaire, the general average was 3.0 (SD 2.55), the oral symptoms domain 1 (SD 1.20), functional limitation 1.25 (SD 1.36), emotional well-being 0, 5 (SD 0.67) and social well-being 0.25 (SD 0.62). From the qualitative analysis, 2 interview themes emerged: 1- reason for seeking treatment and 2- impact of treatment. Qualitative results showed an improvement in patients' sleep and self-esteem, which is directly related to the improvement in learning and attention of these patients. Quantitative data showed a low average in the P-CPQ, which denotes a low impact on OHRQoL, the questionnaire being applied after the treatment. The qualitative data demonstrated that orthodontic and orthopedic treatment reduces alterations in the mouth breathing and improves the patients' OHRQoL due to the improvement in sleep, bruxism, speech, aesthetics, self-esteem and social relationships, concentration and in school performance. Therefore, the the improvement in QVRSB after orthodontic and orthopedic treatment was demonstrated by the parents' reports, which importance of carrying out preventive consultations in the first years of life, for the diagnosis and early treatment of mouth breathing children.