Prevalence of oral health-related shame and associated factors among Brazilian schoolchildren

Abstract The aim of the present study was to investigate the prevalence of oral health-related shame and the associated factors among 8-to-10-year-old Brazilian schoolchildren. A cross-sectional study was conducted with 388 children randomly selected from public and private schools of Diamantina, southeastern Brazil. In order to identify the feeling of shame, self-reports were collected through a single question, “In the last month, did you feel ashamed because of your teeth or mouth? Two calibrated examiners performed the clinical examination for dental caries (DMFT/dmft index), traumatic dental injuries (O’ Brien), and malocclusion (Dental Aesthetic Index). Sociodemographic indicators were obtained through a questionnaire answered by the children’s caregivers. Descriptive analysis, chi-square test, and hierarchical Poisson regression models were performed (95%CI; p < 0.05). The prevalence of shame was 38.1% (n = 148). The adjusted regression analysis demonstrated a significant association between shame and untreated dental caries (PR: 1.34; 95%CI: 1.04–1.74; p = 0.02), age of 10 years (PR: 1.36; 95%CI: 1.05–1.76; p = 0.01), and with parents with less than eight years of schooling (PR: 1.30; 95%CI: 1.00–1.68; p = 0.04). Older children with untreated dental caries and whose parents had lower education level presented a higher prevalence of oral health-related shame.

摘要 本研究旨在调查巴西8至10岁学龄儿童中与口腔健康相关的羞耻感患病率及其相关影响因素。本研究针对巴西东南部迪亚曼蒂纳市公立及私立学校中随机抽取的388名儿童开展横断面研究。为评估羞耻感，研究通过单一问题收集自我报告数据："过去一个月内，你是否曾因牙齿或口腔状况感到羞耻？" 两名经过校准的检查者完成了龋病（DMFT/dmft指数）、牙外伤（O’Brien分类法）及错颌畸形（牙齿美学指数，Dental Aesthetic Index）的临床检查。社会人口学指标通过儿童监护人填写的问卷获取。研究采用描述性分析、卡方检验及分层泊松回归模型进行统计分析（95%置信区间；p < 0.05）。结果显示，口腔相关羞耻感的患病率为38.1%（n=148）。校正后的回归分析显示，羞耻感与未治疗龋病（患病率比PR：1.34；95%CI：1.04–1.74；p=0.02）、10岁年龄组（PR：1.36；95%CI：1.05–1.76；p=0.01）以及父母受教育年限不足8年（PR：1.30；95%CI：1.00–1.68；p=0.04）存在显著关联。年龄较大、患有未治疗龋病且父母受教育水平较低的儿童，其口腔健康相关羞耻感的患病率更高。