Fluorose dentária em Araraquara-SP: prevalência, severidade e associação com fatores de risco
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Data
2016-03-24
Autores
Cavalheiro, Jéssica Patrícia [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O objetivo deste estudo transversal foi avaliar a fluorose dentária (FD) na dentição decídua e permanente em escolares de Araraquara/SP, considerando prevalência, severidade e possíveis fatores de risco. Foi realizado o exame clínico em 1193 crianças de 4 a 12 anos da rede pública e privada para o registro da fluorose dentária (Thylstrup e Fejerskov, 1978) (TF). Outras variáveis também foram avaliadas: cárie dentária (OMS, 1997), Hipomineralização de Molar e Incisivo (EAPD, 2003) e defeitos de desenvolvimento de esmalte não-fluoróticos (FDI, 1992). Dois questionários semi-estruturados foram enviados aos pais/responsáveis dos escolares, com intuito de identificar a condição socioeconômica, histórico médico da mãe e da criança e histórico de ingestão de fluoreto pela criança. Os dados foram tabulados e analisados por meio de estatística descritiva, pelo teste Qui-quadrado, ao nível de significância de 0,05, sendo as associações verificadas pelo Odds Ratio. A prevalência da FD em Araraquara foi de 4,4% na dentição decídua e 22,8% na dentição permanente. Os escores mais freqüentes foram TF 1 e TF 2. Na dentição decídua não houve associação entre a FD e as variáveis propostas: DDE, ceo-d. Na dentição permanente houve associação da FD com a variável CPO-D (p=0,006; OR: 0,59[0,40-0,86]), porém não houve associação para a HMI. Não foi observada associação entre maior idade e aumento da severidade da FD. Em linhas gerais, fatores de risco associados a FD foram: histórico de instrução de higiene oral e uso de medicamentos pela gestante, freqüência da escovação e responsabilidade pelo hábito, quantidade de dentifrício usada, hábito de engolir dentifrício e percepção da mãe de algum dente da criança manchado (p<0,05). Os fatores socioeconômicos não foram associados a FD. Conclui-se que a prevalência da FD na dentição permanente é consideravelmente superior a observada na dentição decídua. Além disso, diversos fatores se relacionam com a manifestação da FD, sendo que o conhecimento dos mesmos é fundamental para a prevenção do referido defeito.
The aim of this cross-sectional study was to evaluate dental fluorosis (DF) in primary and permanent dentition of Araraquara / SP schoolchildren. It was considered prevalence, severity and possible risk factors. The clinical examination was performed in 1193 children from 4 to 12 from public and private schools for the registration of dental fluorosis (Thylstrup and Fejerskov, 1978) (TF). Other variables were also evaluated: dental caries (WHO, 1997), MolarIncisor Hypomineralisation (MIH) (EAPD, 2003) and the presence of developmental defects of enamel (DDE) (FDI, 1992). Two semi-structured questionnaires were sent to parents / guardians of the children, in order to identify the socio-economic status, medical history of the mother and child and the child's fluoride intake history. Data were analyzed using descriptive statistics, by Chi-Square test, at a significance level of 0.05, and the associations verified the odds ratio. The DF prevalence in Araraquara was 4.4% in the primary dentition and 22.8% in the permanent dentition. The most frequent scores were TF 1 and TF 2. In the primary dentition, there was no association between the DF and the proposed variables: DDE, dmft. In the permanent dentition was found association with the DMFT variable (p=0,006; OR: 0,59[0,40-0,86]), but there was no association to the MIH. There was no association between older age and increased DF severity. In summary, the risk factors associated with DF were oral hygiene instructions and use of medicines by pregnant women, relative with stained teeth, frequency and who was brushing, amount of toothpaste used, swallowing toothpaste and mother`s perception about child with tooth stained (p<0,05). Socioeconomic factors were not associated with DF. It is concluded that the prevalence of fluorosis in permanent dentition is considerably higher than that observed in the primary dentition. Furthermore, several factors are related to the DF development, and their knowledge is essential to the enamel defects prevention.
The aim of this cross-sectional study was to evaluate dental fluorosis (DF) in primary and permanent dentition of Araraquara / SP schoolchildren. It was considered prevalence, severity and possible risk factors. The clinical examination was performed in 1193 children from 4 to 12 from public and private schools for the registration of dental fluorosis (Thylstrup and Fejerskov, 1978) (TF). Other variables were also evaluated: dental caries (WHO, 1997), MolarIncisor Hypomineralisation (MIH) (EAPD, 2003) and the presence of developmental defects of enamel (DDE) (FDI, 1992). Two semi-structured questionnaires were sent to parents / guardians of the children, in order to identify the socio-economic status, medical history of the mother and child and the child's fluoride intake history. Data were analyzed using descriptive statistics, by Chi-Square test, at a significance level of 0.05, and the associations verified the odds ratio. The DF prevalence in Araraquara was 4.4% in the primary dentition and 22.8% in the permanent dentition. The most frequent scores were TF 1 and TF 2. In the primary dentition, there was no association between the DF and the proposed variables: DDE, dmft. In the permanent dentition was found association with the DMFT variable (p=0,006; OR: 0,59[0,40-0,86]), but there was no association to the MIH. There was no association between older age and increased DF severity. In summary, the risk factors associated with DF were oral hygiene instructions and use of medicines by pregnant women, relative with stained teeth, frequency and who was brushing, amount of toothpaste used, swallowing toothpaste and mother`s perception about child with tooth stained (p<0,05). Socioeconomic factors were not associated with DF. It is concluded that the prevalence of fluorosis in permanent dentition is considerably higher than that observed in the primary dentition. Furthermore, several factors are related to the DF development, and their knowledge is essential to the enamel defects prevention.
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Palavras-chave
Fluorose dentária, Prevalência, Fatores de risco, Dental fluorosis, Prevalence, Risk factor