Associação entre sobrecarga familiar, letramento e condições de saúde bucal em crianças e adolescentes com deficiências.

Abstract

The concept of person with disability (PWD) in dentistry encompasses all individuals with one or more limitations, whether temporary or permanent, of a mental, physical, sensory, emotional, or other nature. Children and adolescents with disabilities may be totally or partially dependent on the knowledge, attitudes, and practices of their guardians. The objective of this cross-sectional study was to investigate the association between family burden, literacy, and oral health conditions in children and adolescents with disabilities treated at the Dental School Clinic of the Lagarto Department of Dentistry at the Federal University of Sergipe. Individuals of both sexes aged 3 to 18 years, with a medical diagnosis and accompanied by their guardians, were selected to form a convenience sample from September 2023 to November 2024. A questionnaire was administered to legal guardians to obtain socioeconomic and demographic data, as well as information on their previous medical and dental history. The Pediatric Quality of Life Inventory (PedsQL), Family Impact Module, version 2.0, and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) were used to assess caregivers' burden and oral health literacy (OHL), respectively. The intraoral clinical examination was performed by two previously trained and calibrated examiners, and the presence of gingival bleeding, caries experience, sequelae of dental trauma, malocclusions, and mucosal lesions in PWDs was assessed. Statistical analysis included descriptive, bivariate (Kruskal-Wallis and Mann-Whitney tests), and multivariate (Multinomial Logistic Regression and Negative Binomial) analyses. The final sample consisted of 61 individuals with disabilities and their caregivers. The majority (60.7%) had a diagnosis of autism spectrum disorder. The most prevalent oral health conditions were caries (77%) and gingival bleeding (57.4%). The mother was the primary caregiver (86.9%), most were unemployed (55.7%) and had completed elementary education (63.9%). The most negatively affected domains (lowest mean scores) were: worry (118.44 ± 107.23), daily activities (134.83 ± 92.79), and communication (158.60 ± 78.11). Worse WHL scores among caregivers were associated with gender (p = 0.010), family income (p = 0.031), and presence of malocclusion (p = 0.030). Families whose children had some mucosal lesion had worse family relationship scores (PR 1.47; 95% CI: 1.16–1.87). Single caregivers had a negative impact on the communication domain (PR 1.94; 95%CI 1.39-2.70), while those who did not have their own home had a negative impact on the emotional aspect (PR 1.61; 95%CI 1.26-2.06) and concern (PR 1.87; 95%CI 1.24-2.83). The socioeconomic conditions and quality of life of adults can be substantially affected by the presence of PWDs in the family environment, since the continuous demand for care can generate overload, also negatively reflecting on the oral health of these individuals.