Traumatismos dentários na dentição decídua: prevalência, influência da atividade física e papel dos problemas comportamentais em crianças de quatro anos, coorte de nascimentos de Pelotas 2015

Abstract

Traumatic Dental Injuries (TDI) represent a significant concern for oral health and the quality of life of children across various age groups. Although these injuries are not recognised in the lists of the most prevalent diseases, their inclusion would highlight their magnitude, as they could be considered among the most common types of injuries in childhood. The worldwide prevalence of TDI is high and has shown a pronounced increase in Brazil. Studying the relationship between physical activity and child behavior is crucial, as these factors may contribute to the development and prevention of dentoalveolar trauma, impacting children's oral health and well-being. This study aimed to investigate the prevalence of dental trauma in 4-year-old children and identify associated factors, with a focus on the influence of physical activity and child behavior as primary exposures. Data from 3,650 four-year-old children, collected in a longitudinal study in Pelotas, were analysed. The data were examined using Stata 15.1 software. Descriptive analysis was conducted to ascertain the prevalence of the variable of interest. Subsequently, the association between trauma and independent variables was tested using bivariate analysis. To investigate the independent association of the exposures on the occurrence of TDI, regression analysis was performed, estimating relative risk (RR) and their corresponding confidence intervals (CI95%). The prevalence of traumatic dental injures was 20.2% (CI 95% 18.9%–21.5%), comprising complicated (14.5%) and uncomplicated trauma (85.5%). Boys exhibited a higher likelihood of TDI and presented more complicated injuries compared to girls (RR 0.80; CI 95% 0.79 0.91). Additionally, height-for-age increased the risk of TDI (RR 1.55; CI 95% 1.14–2.09), as did pronounced overjet (RR 1.45; CI 95% 1.20–1.74) and anterior open bite (RR 1.26; CI 95% 1.01–1.56). Regarding physical activity, no direct association was observed; however, a trend was noted in children in the upper tertile of PA exhibited more complicated injuries (RR=2.38; CI 95%: 1.04-5.45) compared to those in the lower tertile. Trajectories of PA at 12, 24, and 48 months were also investigated but did not show significant associations. Additionally, children whose mothers perceived them as more active than others also had complicated TDI (RR=1.56; CI 95%: 1.09-2.23). Finally, conduct (RR=1.21; 95% CI: 1.06-1.4) and peer relationship problems (RR=1.23; 95%CI:1.03-1.46) were associated with an increased prevalence of TDI. In conclusion, the prevalence and severity of TDI are associated with factors such as sex, height-for-age, occlusal characteristics, high levels of physical activity, and disruptive behaviours and peer relationship problems. To prevent the occurrence of dental trauma (TD), it is essential to promote safe environments for physical activities and implement interventions targeting children with vulnerable behaviors, particularly by providing safer settings in daycare centers and family contexts, as well as guiding parents and caregivers on attentive supervision.