Malocclusion and dental appearance in underprivileged Brazilian adolescents

Abstract Satisfaction with dental aesthetics is a subjective indicator used in epidemiological studies and is related to health behaviours. Little is known about the factors that influence this indicator, particularly among adolescents who live in a situation of social vulnerability. The aim of this study was to investigate the relationship between malocclusion and dental appearance in underprivileged Brazilian adolescents. This analytical cross-sectional study was conducted in Piracicaba, Brazil, and evaluated 884 adolescents from 13 to 19 years of age. The dependent variable was satisfaction with dental appearance, and the independent variables were classified as individual (components of the Dental Aesthetic Index - DAI, sex and age) and contextual (social exclusion index). For statistical analysis, multilevel regression models were estimated. The individual variables were considered Level 1, and the contextual variable was considered Level 2, with a level of significance of 5%. The mean age of the adolescents was 15.3 years. Female adolescents more frequently affirmed that they were satisfied with their dental appearance than did male individuals. There was an increase in dissatisfaction with oral health with the increase in anterior maxillary overjet, midline diastema, larger anterior irregularity in the maxilla, larger anterior irregularity in the mandible, anterior open bite and antero-posterior molar relation. Satisfaction with dental appearance was associated with individual factors such as sex and DAI components.

摘要 对牙齿美学的满意度是流行病学研究中常用的主观指标，且与健康行为密切相关。目前学界对影响该指标的相关因素仍缺乏深入了解，尤其针对处于社会弱势处境的青少年群体。本研究旨在探究巴西弱势青少年的错颌畸形与牙齿外观之间的关联。本研究为分析性横断面研究，在巴西皮拉西卡巴开展，共纳入884名13至19岁的青少年作为研究对象。本研究的因变量为牙齿外观满意度，自变量分为个体层面（牙齿美学指数（Dental Aesthetic Index, DAI）的组成要素、性别与年龄）与情境层面（社会排斥指数）。统计分析采用多层回归模型，将个体变量设为Level 1，情境变量设为Level 2，显著性水平设定为5%。研究对象的平均年龄为15.3岁。女性青少年对自身牙齿外观表示满意的比例显著高于男性。随着上颌前牙覆盖增大、上颌正中间隙、上颌前牙区不规则程度加重、下颌前牙区不规则程度加重、前牙开（牙合）以及磨牙近远中关系异常，口腔健康满意度呈显著下降趋势。牙齿外观满意度与性别、牙齿美学指数组成要素等个体因素显著相关。