Oral health-related quality of life and traumatic dental injuries in Brazilian adolescents

Abstract

Objectives: To evaluate the impact of traumatic dental injuries (TDI) on oral health-related quality of life (OHRQoL) among Brazilian adolescents.

Methods: A population-based case-control study was carried out, which was nested to a cross-sectional study with a sample of 1215 adolescents aged 11-14 years from Belo Horizonte, Brazil. OHRQoL was measured using the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14 )--Impact Short Form (ISF:16). Two-step cluster analysis was performed to define cases and controls based on CPQ11-14--ISF:16 scores. This method considers the pattern of responses for each item separately and how important each item is to the formation of clusters. The case group included those adolescents who presented higher negative impact on OHRQoL (n=405), while the control group included those with lower negative impact (n=810). Two controls for each case were individually matched from the same school and gender. The main independent variable was TDI, diagnosed by the Andreasen's classification. Untreated dental caries, malocclusion, and age were confounding variables. Conditional logistic regression analysis was performed with the significance level set at 5%.

Results: A multiple conditional logistic regression model demonstrates that adolescents diagnosed with fracture involving dentin and/or pulp had a 2.40-fold greater chance of presenting high negative impact on QHRQoL [95% CI=1.26-4.58; P=0.008] than those without evidence of fractures. Enamel fracture only [P=0.065] and restored fractures [P=0.072] were not statistically associated with OHRQoL.

Conclusions: Adolescents with more severe untreated TDI, such as fractures involving dentin and/or pulp, were more likely to self-report a higher negative impact on their OHRQoL than those without TDI.

Keywords: epidemiology; injuries; oral health; pediatric dentistry; quality of life.