title: Impact of malocclusion and dentofacial anomalies on the prevalence and severity of dental caries among adolescents.
abstract: OBJECTIVE
  To investigate the association between malocclusion/dentofacial anomalies and dental caries among adolescents.
  
  
  METHODS
  A cross-sectional study was conducted with 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório in southern Brazil. Parents/caregivers answered a structured questionnaire on demographic and socioeconomic variables. A trained examiner recorded the presence of malocclusion (Dental Aesthetic Index [DAI]), traumatic dental injury, and dental caries. Data analysis involved the chi-square, Mann-Whitney, and Kruskal-Wallis tests. Poisson regression with robust variance was used for the multivariable analysis.
  
  
  RESULTS
  A total of 44.8% of the adolescents had dental caries (mean DFMT  =  1.33 ± 1.84). The DAI index ranged from 15 to 77 (mean  =  29.0 ± 7.9); 43.6% of the sample had severe malocclusion and 11.6% had traumatic dental injury. The prevalence and severity of dental caries were significantly greater among adolescents with severe malocclusion. The multivariate analysis demonstrated that adolescents with severe or handicapping malocclusion had a 31% greater probability of having dental caries (prevalence ratio: 1.31; 95% CI: 1.02-1.67), independently of demographic, socioeconomic, or clinical aspects. The orthodontic characteristics associated with the occurrence and severity of caries were maxillary irregularity ≥3 mm (P  =  .021) and abnormal molar relationship (P  =  .021).
  
  
  CONCLUSIONS
  Handicapping malocclusion, maxillary irregularity, and abnormal molar relationship were associated with the occurrence and severity of dental caries. The findings suggest that the prevention and treatment of these conditions can contribute to a reduction in dental caries among adolescents.
authors.affiliation: a   Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Feldens
authors.affiliation: b   Lecturer, Department of Statistics, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil.
authors.forename: Angela Isabel
authors.initials: AI
authors.lastname: Dos Santos Dullius
authors.affiliation: a   Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Paulo Floriani
authors.initials: PF
authors.lastname: Kramer
authors.affiliation: c   Private Practice, Osório, Brazil.
authors.forename: Annarosa
authors.initials: A
authors.lastname: Scapini
authors.affiliation: d   Professor, Department of Restorative Dentistry, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Adair Luiz Stefanello
authors.initials: AL
authors.lastname: Busato
authors.affiliation: e   Research Assistant, Postgraduate Program in Dentistry, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Vargas-Ferreira
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology* / Q000473:pathology; D063169:Dentofacial Deformities / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000150:complications*; D015995:Prevalence; D012574:Schools; D013334:Students; D011795:Surveys and Questionnaires
keywords: Adolescent; Dental caries; Malocclusion