Prevalência e severidade da cárie dentária e seu impacto na qualidade de vida de pré-escolares: uma análise de acordo com a avaliação da atenção primária à saúde

Abstract

Introduction. Dental caries in childhood, due to increases of this condition in pre-school children, is a disease of high prevalence and a problem that affects the quality of life. Objective. To evaluate the prevalence and severity of dental caries in pre-school children, its relationship with the perception of the service offered in primary health care (PHC), and the impact of oral health on the quality of life of children. Methods. This is a cross-sectional study, with a representative sample of pre-school children from 3 to 5 years of the public school in Presidente Prudente 2019, and parents or guardians of children who gave their consent to participate in the research and completed the information about their child and socioeconomic condition of their family. Questionnaires were applied to parents / guardians, which addressed the impact of quality of life associated with the child's oral health (B-ECOHIS), socioeconomic status of the families (family income, family size, occupation, educational level, situation and condition of housing, and social benefit), and the questionnaire on the perception of the quality of primary care services (PCATool) used by children (Family Health Strategy-FHS, Conventional Health Care-CHC and private services). In addition, the modalities of dental coverage in schools (FHS, prevention groups-PG and full-time dentist in school-DIS) was evaluated based on the child's oral condition. The child's oral examination was performed using the ICDAS index and the prevalence and severity of dental caries was evaluated. Poisson regression test was used to determinate models of the prevalence and severity of dental caries. The data were analyzed by Chi-square, Wilcoxon, Kruskal-Wallis and Spearman correlation tests (significance level 5%). Results. The prevalence of dental caries (dmft= 0.83±2.00) had correlation with quality of life (ρ=0.42; p<0.05), predominantly in the decayed component (92.97%), severity conditions were associated with quality of life, age and family income (p<0.05). The best quality of care was provided by FHS (p<0.05), the type of PHC was associated with socioeconomic class (p<0.05). The quality of PHC had correlation with the prevalence of dental caries (ρ = -0.19; p <0.05) and the severity was represented predominately by initial lesions and dentin lesions. Conclusions. Dental caries is related to quality of life and to the type and quality of PHC service. Therefore, it is necessary to strengthen the PHC of health systems in order to obtain a better quality of life for children, where models based on family care suppose an effective solution, fundamentally in unfavourable socioeconomic situations.