Qualidade de vida em saúde bucal e hábitos deletérios em crianças e adolescentes com asma e rinite alérgica

Abstract

Introduction: Asthma is a global health problem with 2.5 million deaths annually. Most patients with asthma have associated rhinitis. Both pathologies can influence the stomatognathic system. The presence of deleterious oral habits (DOH) can cause structural and functional changes in the components of this system and influence the quality of life in oral health of individuals. Objective: (1) To evaluate the association between deleterious oral habits (DOH) and asthma in children; (2) To investigate the oral health-related quality of life index (OHRQL) and DOH in children and adolescents with asthma and allergic rhinitis according to disease control. Method: The study included two complementary designs: i) systematic review and meta-analysis to verify the association between DOH and asthma in children and; ii) cross-sectional study including children and adolescents aged 6 to 17 years, diagnosed with asthma and rhinitis, seen between 2020 and 2021 in the Pediatric Allergy Outpatient Clinic of the University Hospital of the Universidade Federal de Sergipe. A structured interview was carried out, applying questionnaires for asthma/rhinitis control, a socioeconomic and demographic questionnaire, and the Oral Health Impact Profile (OHIP-14) to check the HRQL. A clinical oral examination was performed to observe the occlusal condition, dental abnormalities, and caries index. Results: Five studies were included in the systematic review and meta-analysis. Information was collected on presence of HOD in children with and without asthma. The meta-analysis showed an association between bottle feeding and asthma (OR = 1.25; 95% CI 1.13 to 1.38; p < 0.001) and between pacifier use and asthma (OR = 1.11; 95% CI 1.00 to 1.24; p = 0.05). There was no association for nail biting habit, thumb sucking, and asthma. The cross-sectional study included 73 individuals. The median (interquartile range [IIQ]) age was 10 (8-13) years. Fifty (68.5%) participants were considered to have satisfactory control of asthma and rhinitis diseases. Forty-nine (67.1%) had some non-nutritive sucking habit. Class I occlusion predominated (n = 60, 82.1%). The mean DTM presented a median (IIQ) of 1 (0-3), with no statistical difference between the control and non-control groups. Among the developmental and eruption disorders observed, the most frequent were diastema (48%), dental stains (31.5%) and rotations (23.3%). There was no difference in overall OHIP-14 scores between the 'controlled' and 'uncontrolled' groups (4.5 [2.0-8.0] vs 3.0 [2.0-10.0], p = 0.976), as well as for six of the seven OHIP-14 domains. Children with controlled disease had lower HRQL scores in the physical pain domain when compared to children without disease control (1.0 [0.0-2.0] vs 2.0 [1.0-4.0], p = 0.018). Conclusions: Bottle feeding and pacifier use were associated with asthma in children. Although most children had a non-nutritive sucking habit, oral health did not negatively impact quality of life regardless of disease control, except for the physical pain domain.