Avaliação da influência das crenças sobre comportamentos relacionados à saúde bucal na cárie dentária em adolescentes: um estudo longitudinal

Abstract

The objective of the present study was to evaluate the influence of oral health beliefs on behaviors related to oral health on the incidence of dental caries in adolescents. A study was carried out with a sample of 312 12-year-old adolescents, from public schools located in an urban area characterized by low social indicators, in Manaus, Amazonas, Brazil. Baseline data included sociodemographic characteristics (sex, parent’s education, family income, number of goods, and house overcrowding), psychosocial factors (social support and oral health beliefs) and behaviors related to oral health (daily frequency of sugar consumption, frequency of toothbrushing and self-reported use of fluoride toothpaste). Clinical data on dental caries were collected by five calibrated examiners at baseline and at 1-year follow-up, using the DMFT index. Follow-up measurements were recorded at 13 years according to the number of new decayed teeth. Data collection was carried out through self-administered questionnaires for adolescents and their guardians. The relationships between the variables were tested through structural equation modeling using a theoretical Health Belief Model (HBM). Female gender represented 56.4% of the sample and most of them had a low monthly family income. The majority (70.5%) of those responsible reported having 8 to 11 years of education, living predominantly in households with less than two residents per room. The mean number of decayed teeth at baseline and at one-year follow-up was 0.60 and 0.91, respectively. The incidence of dental caries at one-year follow-up was 25.6%. Having a higher socioeconomic status was associated with a lower daily frequency of sugars consumption (β= -0.213). Greater social support was a direct predictor of favorable oral health beliefs (β= -0.378). Female gender was associated with a greater frequency of toothbrushing (β= 0.120) and a lower incidence of dental caries via a higher frequency of toothbrushing (β= -0.017). Adolescents who reported a lower frequency of toothbrushing were associated with a higher incidence of dental caries (β= -0.140). Greater social support was an indirect predictor of lower daily frequency of sugars consumption (β= -0.056), higher frequency of toothbrushing (β= 0.082) and non-use of fluoride toothpaste (β= -0.098) and lower incidence of dental caries ( β=-0.016). Unfavorable oral health beliefs were direct predictors of higher daily frequency of sugars consumption (β=0.148), lower frequency of toothbrushing (β= -0.218) and non-use of fluoride toothpaste (β = 0.258) and were indirect predictors of a higher incidence of dental caries (β=0.041) via a higher daily frequency of sugars consumption and lower frequency of toothbrushing. Thus, unfavorable oral health beliefs were important predictors of behaviors related to oral health and, through these, influenced the occurrence of new dental caries among adolescents.