Autoestima e comportamentos de saúde bucal em adolescentes / Self-esteem and oral health behavior in adolescents

Resumo Este estudo investigou a mediação da autoestima nos comportamentos de saúde bucal dos adolescentes. Para avaliar a autoestima usou-se a escala de Rosenberg, já as características sociodemográficas e comportamentais foram analisadas por questões validadas em outros inquéritos. Com exceção da alimentação, a maior proporção dos adolescentes possuía bons comportamentos de saúde bucal. O número de adolescentes com alto nível de autoestima foi relevantemente menor que aqueles com baixa autoestima. A utilização dos serviços odontológicos, embora associado ao alto nível de autoestima, perdeu significância após ajustado pelo sexo, idade e escovação dos dentes. Porém, a análise de regressão logística múltipla, através das estimativas não-ajustadas e ajustadas com seus respectivos Intervalos de Confiança de 95%, evidenciou associação da autoestima com idade (p-valor=0,001) e frequência de escovação (p-valor=0,019). Independente do sexo, escolares maiores de 16 anos e com autoestima elevada, escovam seus dentes com maior frequência, adquirindo, possivelmente, melhor saúde bucal. Isto confirma a modulação da autoestima sobre os comportamentos de saúde bucal, e atesta a necessidade de implementar a análise e o exercício desse fator psicossocial na assistência à saúde bucal dos jovens.

Abstract This study investigated the mediation of self-esteem in adolescents' oral health behaviors. The Rosenberg self-esteem scale was used to assess self-esteem, whereas data from socio-demographic and behavior characteristics were analyzed by questions validated in previous surveys. The teenagers had good oral health behavior, except unhealthy diet. The number of adolescents with high self-esteem was a lot smaller than those with low self-esteem. The use of dental services, even when associated with high self-esteem, lost significance after being adjusted by sex, age and tooth brushing frequency. Nevertheless, multiple logistic regression analysis, using unadjusted estimates and adjusted with their respective Confidence Intervals of 95%, showed a relationship of self-esteem with age (p-value=0.001) and tooth brushing frequency (p-value=0.019). Regardless of the sex, students over 16 years old with high self-esteem brush their teeth more often, having probably better oral health. These results confirm the modulation of self-esteem in oral health, and then it is necessary the analysis and the use of these psychosocial factors in the young oral health care.

Self-esteem and oral health behavior in adolescents. / Autoestima e comportamentos de saúde bucal em adolescentes.

This study investigated the mediation of self-esteem in adolescents' oral health behaviors. The Rosenberg self-esteem scale was used to assess self-esteem, whereas data from socio-demographic and behavior characteristics were analyzed by questions validated in previous surveys. The teenagers had good oral health behavior, except unhealthy diet. The number of adolescents with high self-esteem was a lot smaller than those with low self-esteem. The use of dental services, even when associated with high self-esteem, lost significance after being adjusted by sex, age and tooth brushing frequency. Nevertheless, multiple logistic regression analysis, using unadjusted estimates and adjusted with their respective Confidence Intervals of 95%, showed a relationship of self-esteem with age (p-value=0.001) and tooth brushing frequency (p-value=0.019). Regardless of the sex, students over 16 years old with high self-esteem brush their teeth more often, having probably better oral health. These results confirm the modulation of self-esteem in oral health, and then it is necessary the analysis and the use of these psychosocial factors in the young oral health care.

Este estudo investigou a mediação da autoestima nos comportamentos de saúde bucal dos adolescentes. Para avaliar a autoestima usou-se a escala de Rosenberg, já as características sociodemográficas e comportamentais foram analisadas por questões validadas em outros inquéritos. Com exceção da alimentação, a maior proporção dos adolescentes possuía bons comportamentos de saúde bucal. O número de adolescentes com alto nível de autoestima foi relevantemente menor que aqueles com baixa autoestima. A utilização dos serviços odontológicos, embora associado ao alto nível de autoestima, perdeu significância após ajustado pelo sexo, idade e escovação dos dentes. Porém, a análise de regressão logística múltipla, através das estimativas não-ajustadas e ajustadas com seus respectivos Intervalos de Confiança de 95%, evidenciou associação da autoestima com idade (p-valor=0,001) e frequência de escovação (p-valor=0,019). Independente do sexo, escolares maiores de 16 anos e com autoestima elevada, escovam seus dentes com maior frequência, adquirindo, possivelmente, melhor saúde bucal. Isto confirma a modulação da autoestima sobre os comportamentos de saúde bucal, e atesta a necessidade de implementar a análise e o exercício desse fator psicossocial na assistência à saúde bucal dos jovens.

Impact of breathing patterns on the quality of life of 9- to 10-year-old schoolchildren.

BACKGROUND: Mouth breathing can cause a set of changes in craniofacial growth and development, with esthetic, functional, and psychological repercussions. OBJECTIVE: To determine the impact of mouth breathing on the quality of life of schoolchildren. METHODS: A school-based, cross-sectional study was conducted with 1911 children ages 9 and 10 years in the city of Recife, Brazil. The children answered the Mouth Breather Quality of Life questionnaire and a questionnaire that addressed sociodemographic data and health-related aspects. Clinical examinations were performed by an examiner who had undergone a training and calibration process for the diagnosis of mouth breathing (kappa = 0.90). Descriptive statistics were conducted to characterize the sample. Statistical analysis involved the Student's t-test and the F test (analysis of variance) (alpha = 5%). RESULTS: The prevalence of mouth breathing was 54.81%. Children with oral breathing demonstrated a poorer quality of life in comparison with children with nasal breathing (p < 0.001). The following variables were significantly associated with a poorer quality of life among the children with mouth breathing: a younger age (p < 0.001) and the use of medication (p = 0.002). CONCLUSION: Based on the present findings, children with the mouth-breathing pattern experience a greater negative impact on quality of life in comparison with those with the nose-breathing pattern. Thus, the early diagnosis and treatment of this clinical condition are fundamental to minimizing the consequences of mouth breathing on the quality of life of schoolchildren with respiration disorders.

Development of a questionnaire for measuring health-related quality of life among children and adolescents with mouth breathing.

BACKGROUND: Mouth breathing can exert an influence on quality of life and should be evaluated within a multidimensional context. However, there is no specific questionnaire to measure the impact of mouth breathing on quality of life. OBJECTIVE: To develop and validate a questionnaire for measuring the impact of mouth breathing on quality of life among children and adolescents. METHODS: Thirty-six items were evaluated by six health care professionals, one parent and one child with mouth breathing. After a qualitative evaluation, a modified set of 32 items was developed. The modified Mouth Breather Quality of Life (MBQoL) questionnaire was submitted to a pretest with a sample of 30 children and adolescents diagnosed with mouth breathing to evaluate comprehension, the order of the items, and the form of administration. The MBQoL questionnaire was then administered to 60 children and adolescents (30 mouth breathers and 30 nose breathers) for the evaluation of construct validity, internal consistency, and reproducibility. All the participants answered the questionnaire, and 50% of each group answered the questionnaire a second time after a 1-week interval (test-retest). RESULTS: Higher MBQoL scores (which indicated poorer quality of life) were significantly associated with mouth breathing. The Cronbach α coefficient for the items of the questionnaire was 0.88, and the Spearman correlation coefficient for test-retest reliability demonstrated that the questionnaire was reproducible (r = 0.993; p < 0.01). CONCLUSION: Through this validation study, the MBQoL questionnaire demonstrated a good performance in the evaluation of the quality of life of children and adolescents with mouth breathing and may be a useful tool in clinical studies as well as public health programs. However, further studies are needed to establish its applicability in other populations with respiration disorders.

Targeted assessment of the temporomandibular joint in patients with rheumatoid arthritis.

PURPOSE: This observational study was done to identify the signs and symptoms of temporomandibular joint (TMJ) involvement in patients with rheumatoid arthritis (RA) and to assess the association between these and quantitative measurements for the evaluation of rheumatologic disease. PATIENTS AND METHODS: The sample comprised 61 patients suffering from RA whose signs and symptoms of TMJ were recorded by means of a questionnaire (scale of limited mandibular function) and clinical measurements (pain during jaw movement, limitation of maximal mouth opening, joint sounds, tenderness on TMJ palpation, tenderness on masticatory muscle palpation). These findings were correlated with the quantitative measurements for evaluating RA: duration of the disease, positivity for rheumatoid factor, Health Assessment Questionnaire (HAQ) score, number of edematous and painful joints, and overall assessment of functional status. RESULTS: In terms of overall figures, 70.5% of the patients presented with at least 1 sign or symptom, 49.2% had at least 1 symptom, and 54.1% had at least 1 sign. The variable pain on movement was associated with the number of painful joints and the overall assessment findings (P < .05). Sound on movement was positively associated with the number of edematous joints (P = .0291). The scale of limited mandibular function was statistically significantly correlated with 4 quantitative measurements (P = .0283 to .0448). The variable pain on palpation of the masticatory muscles was associated with the number of painful joints (P = .0023). Pain on palpation of the TMJ was statistically significantly associated with the HAQ score (P = .0344) and with the number of painful joints (P = .0006). CONCLUSION: A significant percentage of the patients with RA have signs and symptoms of TMJ involvement, and the scale of limited mandibular function proved to be an important measurement tool.

Impacts of dental pain on daily activities of adolescents aged 14-15 years and their families.

OBJECTIVE: To assess the prevalence and severity of dental pain on the daily lives of adolescents and their families in Brazil, and, in terms of socio-economic status, whether there are differences in the prevalence of impacts. MATERIAL AND METHODS: In a cross-sectional survey of a random sample of 14 to 15-year-olds in Brazil, the prevalence and severity of dental pain, and how dental pain affects daily functioning, were assessed using a child-related questionnaire. A family-related questionnaire included questions on a child pain inventory and the pain-related impacts on the daily lives of the child's family members. RESULTS: 14.5% of children reported high impact levels on their daily lives related to dental pain, the more so among girls than among boys, i.e. 16.7% compared to 11.6%. Significantly more impacts occurred in lower socio-economic class children than in higher, i.e. 19.7% versus 7.8%. The prevalence of impacts among children who reported dental pain (n=354) was high; 64.7% reporting that concentration at school was affected, 55.6% that home activities were affected, and 51.4% that leisure activities were affected. There was a significant relationship between impacts of dental pain on children and families. Overall prevalence of impacts on children's families was 15.2%. The most frequent family dimensions affected were: in carrying out normal household activities (19.7%) and in visiting friends and relatives (17.7%). Emotional stability was the most frequent psychological activity dimension affected (14.1%); 9.6% of parents were woken up as a result of their child's dental pain on an average of 3.7 nights per week. CONCLUSIONS: Dental pain has considerable impact on the daily lives of adolescents and their families in Brazil. There are many more dental pain-related impacts in girls and in lower social class children.