Impacto da saúde mental de mães adolescentes no medo odontológico dos filhos

Abstract

Dental fear is one of the main reasons to avoid dental treatment and therefore could determine worse oral health conditions. Maternal depression can be a trigger of dental fear in children, due to poor interaction between mother and child and the insecurity transmitted, leading to difficulty to confront new situations and stress, as well as the anxiety that is widely transmitted from parents to children and interferes with the way children regard situations. The prevalence of mental disorders tend to be higher when pregnancy occurs during adolescence. This study aims to investigate the relationship between maternal psychiatric disorders such as depression and anxiety with child dental fear, and to determine the influence of socioeconomic, demographic and oral health. Through a systematic review of literature an attempt was made in order to find studies investigating the relationship between maternal depression and dental fear of children. The cross-sectional study nested in a cohort of mothers who had their children in their teens, and were captured during the prenatal held at the National Health System, and their children, now aged between 24 and 36 months.. The data on socioeconomic, demographic and oral health habits were collected using questionnaires, the collection of psychiatric disorders was made using validated instruments: for depression - BDI (Beck Depression Inventory) and MINI, for anxiety - BAI (Beck Anxiety Inventory), for maternal dental anxiety –DAS (Dental Anxiety Scale) and child dental fear using the DAQ (Dental anxiety Question). Mothers and children underwent an oral health examination following the criteria of the World Health Organization (WHO). In total 540 dyads of mothers/children were evaluated from June 2012 to February 2014. The results from the systematic review demonstrated that none study has investigated the role of maternal depression on child dental fear. The authors found that depression in mothers could be a cause of fear and their children and they hypothesized that could in analogy cause also dental fear, but more studies would be necessary to prove such assumption. In the epidemiologic study to evaluate the relationship between depression and maternal anxiety with dental fear, we could find the dental fear was positively associated with the presence of maternal depression (p=0.055), as well as the presence of agoraphobia (p=0.042) and the maternal caries experience (p=0.017). The trajectory of anxiety from pregnancy influenced the children' dental fear (p = 0.004). The results suggest that the presence of maternal depression and the maintenance of anxiety could have a negative impact on the development of dental fear in their offspring. Such observations should be taken in consideration when planning treatments or public oral health policies.