title: Associations between oral health-related quality of life and emotional statuses in children and preadolescents.
abstract: OBJECTIVE
  To evaluate the associations between oral health-related quality of life (OHRQoL) and emotional statuses in children and preadolescents.
  
  
  METHODS
  One hundred and forty-five Brazilian students (8-14 years) were clinically examined for caries, gingivitis, fluorosis, malocclusions, and temporomandibular disorders (TMD). OHRQoL was measured using two global ratings of oral health (OH) and overall well-being (OWB). The Revised Children's Manifest Anxiety Scale (R-CMAS) and Children's Depression Inventory (CDI) were used to assess anxiety and depression, respectively. Saliva was collected 30 min after waking and at night to determine the diurnal decline in salivary cortisol (DDSC). The results were analyzed using non-paired t test/one-way ANOVA, Pearson's correlation test, and multiple linear regression analyses.
  
  
  RESULTS
  11-14-year-old participants had higher CDI scores (P < 0.01) and DDSC concentrations (P < 0.001). Participants with fewer caries and without gingivitis had higher DDSC concentrations (P < 0.05). TMD patients had higher DDSC concentrations and OWB ratings (P < 0.001). Girls had higher Revised Children's Manifest Anxiety Scale (RCMAS) scores (P < 0.01). There was positive correlation between RCMAS and CDI scores and OWB ratings (P < 0.05). The OH model retained age (β =0.312; P < 0.001) and the OWB model retained TMD (β = 0.271; P < 0.001) and CDI scores (β=0.175; P < 0.05).
  
  
  CONCLUSIONS
  Children and preadolescents with poor emotional well-being are more sensitive to the impacts of OH and its effects on OWB.
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba/SP, Brazil.
authors.forename: T S
authors.initials: TS
authors.lastname: Barbosa
authors.forename: P M
authors.initials: PM
authors.lastname: Castelo
authors.forename: M S
authors.initials: MS
authors.lastname: Leme
authors.forename: M B D
authors.initials: MB
authors.lastname: Gavião
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology*; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000523:psychology; D003863:Depression / Q000209:etiology*; D005260:Female; D009050:Fluorosis, Dental / Q000523:psychology; D005891:Gingivitis / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D016014:Linear Models; D008297:Male; D008310:Malocclusion / Q000523:psychology; D008347:Manifest Anxiety Scale; D009909:Oral Health; D011788:Quality of Life; D012463:Saliva / Q000737:chemistry; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000209:etiology*; D013705:Temporomandibular Joint Disorders / Q000523:psychology
chemical_list: D006854:Hydrocortisone