Dental caries and Oral Health-Related Quality of Life from childhood to adolescence: evidence from a 10-year cohort study

Author(s)

Bruna Brondani

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia (FO/SDO)
• Defense date: 2024-03-01

Examining board members

Daniela Prócida Raggio; Marcos Britto Correa; Bruno Emmanuelli; Tamara Kerber Tedesco

• Advisor: Fausto Medeiros Mendes

Abstract

Dental caries leads to various negative consequences in both dentitions, including the compromise of Oral Health-Related Quality of Life (OHRQoL). The assessment of risk factors, to predict both the occurrence of new lesions or the progression of existing lesions, is crucial for directing a more individualized approach. Furthermore, understanding the impact of social inequalities on oral health outcomes through the life course is valuable in comprehending how social structures and individual resources affect different trajectories of individuals. However, few studies have followed individuals from early childhood through adolescence, limiting a comprehensive understanding of the disease\'s behavior during this transitional period. Therefore, the present thesis aimed to evaluate, through a prospective cohort study with a 10-year follow-up, risk factors associated with the progression of caries lesions in deciduous teeth (i) and the occurrence of caries lesions in permanent dentition (ii), as well as to explore the direct and indirect pathways between dental caries and OHRQoL (iii) and the impact of socioeconomic inequalities on dental caries (iv) and OHRQoL (v) during the transition from childhood to adolescence. This research was initially conducted in 2010 in the city of Santa Maria (RS). In that year, 639 children aged 1 to 5 years were examined for dental caries using the International Caries Detection and Assessment System (ICDAS). These children were reexamined after 2, 7, and 10 years. Demographic, socioeconomic, and behavioral variables were collected at each of the four cohort waves through structured questionnaires administered to parents/guardians and participants. The OHRQoL of the schoolchildren was measured using the Early Childhood Oral Health Impact Scale (ECOHIS), Child Perceptions Questionnaire 8-10 (CPQ8-10), and CPQ11-14, according to age group. Poisson regression models with robust variance, Cox regression analysis with shared frailty, and structural equation modeling (SEM) were employed for statistical analysis. Key findings included: (i) The rate of progression of initial caries lesions in deciduous dentition remained low even after 7 years, but cavitated lesions in other teeth increased this risk; (ii) Children with dental caries in deciduous teeth had a higher risk of developing the disease in permanent dentition, but only when considering cavitated lesions; (iii) Dental caries negatively impacted OHRQoL, directly and indirectly, from childhood to adolescence; (iv) Individual-level socioeconomic inequalities played a significant role in the occurrence of dental caries after 10 years of follow-up; (v) Worsening or improvement in income over time do not influence OHRQoL. (AU)

• FAPESP's process: 19/27593-8 - Risk factors associated to the caries lesions progression in primary teeth and to caries incidence in permanent teeth in the childhood to adolescence transition: a 10-year cohort study
• Grantee: Bruna Brondani
• Support Opportunities: Scholarships in Brazil - Doctorate