Desenvolvimento cognitivo na infância e cárie dentária aos 5 e 12 anos: um estudo na coorte de nascimentos de 2004

Abstract

Despite a decline in the occurrence of dental caries, the high prevalence of the disease is an important public health problem. Dental caries is unevenly distributed in the population, generates substantial costs to health systems and impacts the quality of life related to oral health. As it is a behavioral and preventable disease, it is important to investigate factors that early in life can predict or explain its occurrence. In this sense, the objective of this thesis was to investigate whether the child's cognitive stimulation early in life can be a predictor of caries at 5 years of age, in addition to identifying whether there is a causal association between the child's cognitive ability at 6 years of age with the occurrence of caries dentistry in early adolescence. The thesis was developed through a critical review of the literature and hypothesis formulation, which gave rise to the first article. The original articles were developed with data collected in the 2004 birth cohort in Pelotas. Data from perinatal follow ups, 24 months, 48 months and six years of the complete cohort were used and data at 5 and 12-13 years of oral health follow-up. The first article of this thesis discussed the possible ways to explain how stimulation of children in early life could be associated with oral health in the future, under the perspective of two theories of the life cycle: risk chair and risk accumulation. In this article, it was observed that the evidence seems to converge to the idea that early childhood stimulation may be associated with future health problems related to parental behavior and care, including caries. In the original articles it was observed that children with less stimulation had 1.39 times greater odds of advancing a category of risk behaviors to oral health, compared to those without unhealthy behaviors (OR 1.39 95% CI 1.05-1.84). The prevalence of dental caries was 48.3% at 5 years of age and 41.2% of children in this follow-up had two or more decayed teeth. Regarding stimulation of the child and dental caries at 5 years of age, there was no association after adjustment for confounding factors, refuting the hypothesis of the review article. Finally, it was observed that the prevalence of dental caries at 12-13 years old was 39.6% and 26% had decayed teeth. The average IQ in this population at age six was 80.6. After adjusting for possible confounding variables, IQ remained associated with the experience of dental caries and the presence of decayed surfaces. Mediation analyzes showed that IQ mediated the association between maternal education and the occurrence of decayed teeth.