Oral Health-Related Quality of Life and Traumatic Dental Injuries in Young Permanent Incisors in Brazilian Schoolchildren: A Multilevel Approach.
BACKGROUND
Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children.


OBJECTIVE
To describe the association of oral health-related quality of life (OHRQoL) and domains (oral symptons, functional limitation, emotional- and social-well-being) of children with individual and contextual variables.


METHODS
A cross-sectional study was performed using a representative sample of 1,201 schoolchildren, 8-10 years-old, from public and private schools of Belo Horizonte, Brazil. The CPQ8-10 was used to assess OHRQoL, dichotomized in low and high impact. Sociodemographic information was collected through questionnaires to parents. Children were examined at schools, using the Andreasen criteria. Individual variables were gender, age, number of residents in home, parents/caregivers' level of education, family income, and TDI (dichotomized into without trauma/mild trauma and severe trauma). Dental caries and malocclusion were considered co-variables. Contextual variables were the Social Vulnerability Index and type of school. Ethical approval and consent forms were obtained. Data were analyzed using SPSS for Windows 19.0 and HLM 6.06, including frequency distribution, chi-squared test and multilevel approach (p < 0.05).


RESULTS
The prevalence of a negative impact on OHRQoL in children with severe trauma was 55.9%. The TDI negatively impacted emotional and social domains of OHRQoL. A multilevel analysis revealed a significant difference in OHRQoL according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; ICC = 0.16). The negative impact on OHRQoL was higher in girls (p = 0.009), younger children (p = 0.023), with severe TDI (p = 0.014), those from public schools (p = 0.017) and whose parents had a lower education level (p = 0.001).


CONCLUSIONS
Severe trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.
Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Fernanda Bartolomeo
FB
Freire-Maia
Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Sheyla Márcia
SM
Auad
Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Mauro Henrique Nogueira Guimarães de
MH
Abreu
Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Fernanda
F
Sardenberg
Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Milene Torres
MT
Martins
Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Saul Martins
SM
Paiva
Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Isabela Almeida
IA
Pordeus
Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Míriam Pimenta
MP
Vale
D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007180:Incisor / Q000293:injuries*; D007182:Income; D008297:Male; D008310:Malocclusion / Q000150:complications / Q000453:epidemiology; D009909:Oral Health / Q000706:statistics & numerical data*; D010290:Parents; D015995:Prevalence; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D018677:Tooth Injuries / Q000150:complications* / Q000453:epidemiology*; D014947:Wounds and Injuries / Q000150:complications* / Q000453:epidemiology*