Condição socieconômica, fatores psicossociais, padrão de higiene bucal e gengivite em crianças de 12 anos

Abstract

Gingivitis is a fairly common condition in children and adolescents. The main risk factor for periodontal disease is the accumulation of biofilm at the level and below the gingival margin. However, other socioeconomic, psychosocial and behavioral factors may strongly influence oral clinical conditions. The objective of this study was to evaluate the mediating role of self-esteem, oral health beliefs and frequency of dental brushing in the relationship between socioeconomic characteristics and prevalence of gingival bleeding and oral hygiene effectiveness in 12-year-old students, guided by a theoretical-conceptual model. The study population consisted of 406 students from the municipal public network of the East Zone of the city of Manaus-AM. Participants answered a questionnaire with information related to socioeconomic status, self-esteem, oral health beliefs and frequency of toothbrushing. The clinical exams were performed with a WHO periodontal probe and clinical mirror to evaluate gingival bleeding and presence of dental calculus. The statistical analysis was conducted in three phases: descriptive data analysis, confirmatory factorial analysis (CFA) of the measurement model and structural equation model (SEM). The prevalence of gingival bleeding in children was 77.6% and dental calculus 57.4%. Most children (89.2%) reported that they brush their teeth three or more times a day. Worse socioeconomic condition was directly related to a lower frequency of dental brushing and greater gingival bleeding. More positive oral health beliefs and higher self-esteem were directly related to a higher frequency of dental brushing and indirectly associated with less gingival bleeding, tooth brushing frequency and oral hygiene effectiveness. The students with lower oral hygiene effectiveness showed greater gingival bleeding. There was no mediation of psychosocial factors in the relationship between socioeconomic status and gingival bleeding. However, dental brushing frequency was mediated in the indirect relation of both psychosocial factors (self-esteem and beliefs in oral health) and gingival bleeding.