Oral health and subjective happiness in adolescents of a Southern Brazilian town: longitudinal analysis

Author(s)

Simone Tuchtenhagen

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
• Defense date: 2018-03-09

Examining board members

Jose Leopoldo Ferreira Antunes; Jenny Haydeé Abanto Alvarez; Fausto Medeiros Mendes; Saul Martins de Paiva; Tatiana Natasha Toporcov

• Advisor: Jose Leopoldo Ferreira Antunes; Thiago Machado Ardenghi

Abstract

Happiness is a multidimensional construct and can be defined as the degree to which a person evaluates the quality of his life as a whole as favorably; It has been associated with several health outcomes and measures. The transition from childhood to adolescence involves a number of physical and especially psychological changes, and the impact of oral diseases can be perceived as an obstacle to the social development of individuals. The objectives of this paper were to investigate the influence of oral health conditions, socioeconomic status and use of dental services on subjective happiness during the transition from childhood to adolescence; to identify the factors associated with the change in the perception of happiness and to evaluate the incidence of oral health problems in the sample after 2 years of follow-up. Data collection was performed at two periods, in 2012 and 2014. Clinical examinations were performed to evaluate oral health conditions (dental caries, malocclusion, dental trauma and gingival condition), interviews were conducted to evaluate the subjective happiness (using the Subjective Happiness Scale -SHS ) and the impact of oral health conditions on quality of life (using the Child Perception Questionnaire -CPQ11-14), questionnaires were sent to the parents to assess socioeconomic family characteristics, demographic variables and the use of dental services. To analyse the factors associated with the subjective happiness, data were fitted into a linear multilevel model for repeated measures and hierarchical selection of variables; to analyze the factors associated with changes in happiness, data were fitted into a multinomial logistic model. From 1134 children examined in the baseline, 770 were reevaluated after 2 years (response rate of 67.9 per cent), and it was observed an increase in the prevalence of oral health conditions (experience of dental caries, prevalence of malocclusion, gingival bleeding and dental plaque). In the multilevel model, following adjustment, there was an association between the mean score of SHS and socioeconomic variables, the use of dental services, clinical conditions and self-perception. Adolescents from lower income families (p = 0.030), who lived in households with worse overcrowding (p<0.001), whose mothers had lower levels of education (p = 0.014), who used dental services due to pain or to seek dental treatment (p= 0.039), which had a higher number of cavitated caries lesions (p = 0.010) and who reported higher impact of oral health conditions on quality of life (p <0.001) presented to a worse degree of happiness. The multinomial final model indicated an association between dental caries experience and self-perception and the changes in happiness over time: adolescents with a greater number of teeth decayed, missng orfilled (OR = 1.16-1.19, p = 0.018-0.037), and with higher CPQ11-14 scores (OR = 1.04-1.07, p = 0.000-0.014) had a higher chance of being in the most unfavorable categories of happiness trajectory. These results highlight the importance of inclusive publicpolicies and oral health promotion for the psychosocial development of adolescents (AU)

• FAPESP's process: 14/01924-4 - Oral health and subjective happiness in adolescents of a Southern Brazilian town - longitudinal analysis
• Grantee: Simone Tuchtenhagen
• Support Opportunities: Scholarships in Brazil - Doctorate