Association among oral health and academic performance: a longitudinal study in a university in Southern Brazil

Abstract This longitudinal study aimed to investigate the association between self-perceived oral health, oral-health-related quality-of-life (OHRQoL), toothache, and university students’ academic performance or dropout. A cohort of 2,089 students from 64 different courses at a public university in southern Brazil was interviewed in 2016 regarding their self-perceived oral health (Locker instrument; dichotomized into good/poor), OHRQoL (Oral Impacts on Daily Performances instrument, OIDP) and having had any toothache over the last 6 months (yes/no). After three years (2020), the academic records of 1,870 of these students were assessed, their average grade over all courses evaluated, and their dropout status was determined. Multivariable linear or logistic regression adjusting for gender, skin color, age, family income and maternal education was used to associate oral health variables (self-perceived oral health, OIDP, toothache) and academic performance or dropout. In 2016, 28.6% reported negative self-perceived oral health through the Locker instrument and 31.4% had toothache in the last 6 months. Over the next three years, 36.2% had dropped out. In multivariable regression, toothache in the last 6 months had a decrease of 0.32 (β -0.32, CI95% -0.59; -0.04) points in the final grade and were 35% (OR 1.35 CI95% 1.08; 1.69) more likely to dropout than students without toothache. In conclusion, this study showed that worse oral health conditions may be associated with worse academic performance or dropping out.

摘要 本纵向研究旨在探讨自我感知口腔健康、口腔健康相关生活质量（oral-health-related quality-of-life, OHRQoL）、牙痛与大学生学业表现或辍学之间的关联。研究纳入巴西南部一所公立大学64个不同专业的2089名学生作为研究队列，于2016年对其开展访谈，内容涵盖自我感知口腔健康状况（采用Locker量表，二分类为良好/不佳）、口腔健康相关生活质量（采用日常表现口腔影响量表，Oral Impacts on Daily Performances, OIDP），以及过去6个月内是否曾出现牙痛（是/否）。三年后（2020年），对其中1870名学生的学业记录进行评估，统计其所有课程的平均成绩，并确定其辍学状态。本研究采用多变量线性回归与逻辑回归模型，校正性别、肤色、年龄、家庭收入及母亲受教育程度等混杂变量，以分析口腔健康相关变量（自我感知口腔健康、OIDP评分、牙痛史）与学业表现或辍学的关联。2016年调研结果显示，28.6%的学生通过Locker量表报告自我感知口腔健康不佳，31.4%的学生在过去6个月内曾出现牙痛。后续三年随访期间，36.2%的学生出现辍学情况。多变量回归分析结果表明，与无牙痛史的学生相比，过去6个月内曾牙痛的学生最终平均成绩降低0.32分（β=-0.32，95%置信区间[-0.59, -0.04]），辍学风险升高35%（优势比OR=1.35，95%置信区间[1.08, 1.69]）。综上，本研究表明，较差的口腔健康状况可能与较差的学业表现或辍学行为存在关联。