Condições de saúde bucal e qualidade de vida relacionada à saúde bucal em crianças e adolescentes vítimas de maus-tratos

Abstract

Maltreatment in childhood and adolescence is considered a public health problem; there are relatively few studies in the area of dentistry. The purpose of Article 1 was to review the literature about oral conditions among children and adolescents victims of maltreatment. A search in the national and international databases was performed and showed that children with a history of maltreatment may present poor oral hygiene, low search for dental services and, consequently, high rates of untreated decayed teeth compared to children who lived in non-violent contexts. The aim of Article 2 was to assess oral hygiene and describe the prevalence of dental caries and gingivitis in children and adolescents victims of maltreatment. A convenience sample of children and adolescents between 8 and 17 years of age was selected from the Child and Adolescent Center for Psychological Support (NACA), located in Pelotas, RS. A clinical examination was carried out using Simplified Oral Hygiene Index (OHI-S), Decayed, Missing or Filled Teeth index (DMFT/dmft) and Gingival Bleeding Index (GBI). They were questioned about go to the dentist, dental pain in the last semester and dental fear. Socioeconomic, demographic and type of abuse data were collected from the registration form of the center. A total of 106 subjects were examined. The mean DMFT/dmft was 2.68 and the carious component corresponded to 80% of the index, 95% of the individuals had at least one surface with dental plaque. Approximately 90% of the sample presented at least one bleeding point, 51.89% reported having had dental pain in the last semester and 60.38% reported that they have gone to the dentist in the last semester. The purpose of Article 3 was to measure and compare the Oral Health-Related Quality of Life (OHRQoL) in children victims of maltreatment and children not maltreated. The sample of NACA children comprised those from 8 to 10 years (n=48) and a group of schoolchildren from a database in 2010 was used as a comparative group (n=144). To evaluate OHRQoL, the Child Perception Questionnaire 8-10 (CPQ8-10) was used for both groups. Descriptive statistics and multiple linear regression were used to assess the association between maltreated children victims and OHRQoL. Socioeconomic, demographic and clinical variables were used as control variables in the analyses. It was observed that children victims of maltreatment had a higher impact on the OHRQoL in comparison to school students and a higher impact on oral symptoms and functional limitations subscales. It is concluded that the literature points to a worse oral health condition in children victims of maltreatment than those without this experience. The high prevalence of oral diseases among NACA children, as well as higher impact on the OHRQoL compared to students with no history of abuse, suggests tha the dentist is important in the interdisciplinary care of child victims of maltreatment, helping them to tackle problems in a better way.