Can oral health have an impact on academic performance and school absenteeism?: a systematic review and meta-analysis

Aim: The study aimed to evaluate the association between oral health and academic performance and/or school absenteeism. Methods: Electronic searches were performed of the PubMed, Web of Science, SCOPUS and LILACS/BVS databases. We included observational studies that evaluated the association between dental caries, tooth loss, dental pain or oral health status with school absenteeism or academic performance. The studies had to contain a representative sample of the population: schoolchildren, children or adolescents. After the removal of duplicates, the electronic searches produced 3,789 articles. Of these, 25 studies were included in the systematic review and 13 in the meta-analysis. Results: Considering all the studies evaluated in the meta-analysis, seven articles satisfied 100% of the Joanna Briggs Institute Critical Appraisal checklist, and six contained between 90% and 75% positive answers. The pooled effects showed that the chances of school absenteeism were 31% higher in subjects with dental caries (OR 1.31; 95%CI 1.12-1.54). Students with fair/poor dental health had a 50% higher chance of suffering poor academic performance (OR 1.50; 95%CI 1.22-1.84) and 34% higher chance of having problems at school (OR 1.34; 95%CI 1.06-1.70). Students with a history of toothache had a 3.7 higher chance of being absent from school (OR 6.65; 95%CI 1.60-8.32) and 71% higher chance of missing class due to toothache (OR 1.71; 95%CI 1.15-2.56). Subjects with a history of toothache had a 2.5 times higher chance of suffering poor academic performance (OR 2.58; 95% CI 2.04-3.27). Conclusion: Therefore, students with oral problems were more likely to take time off school and present inferior academic performance

Associação entre dor dentária, uso de serviços odontológicos e absenteísmo escolar: Pesquisa Nacional de Saúde do Escolar 2015 / Asociación entre dolor dental, uso de servicios dentales y absentismo escolar: Encuesta Nacional de Salud Estudiantil, Brasil, 2015 / Association between dental pain, use of dental services and school absenteeism: 2015 National School Health Survey, Brazil

Objetivo: Analisar a associação entre dor dentária, uso de serviços odontológicos e absenteísmo escolar em adolescentes brasileiros. Métodos: Estudo transversal, sobre dados da Pesquisa Nacional de Saúde do Escolar (PeNSE 2015). A variável dependente do estudo foi o absenteísmo escolar por motivo de saúde nos últimos 12 meses. Características socioeconômicas, dor dentária e utilização de serviços odontológicos foram as variáveis independentes avaliadas. Empregou-se regressão logística, para estimar odds ratio (OR) e respectivos intervalos de confiança de 95% (IC95%). Resultados: Foram incluídos 102.072 escolares. A prevalência de absenteísmo por motivo de saúde foi de 53,7% (IC95% 53,2;54,3). Pela análise ajustada, houve associação entre dor dentária e absenteísmo (OR=1,35 - IC95% 1,26;1,45), e aumento na ocorrência de absenteísmo conforme o maior número de consultas odontológicas. Conclusão: Os resultados sugerem que a dor dentária e a frequência de consultas odontológicas podem estar relacionadas ao absenteísmo escolar.

Objetivo: Analizar la asociación entre dolor dental, el uso de servicios dentales y el absentismo escolar en adolescentes brasileños. Métodos: Estudio transversal con datos de la Encuesta Nacional de Salud Escolar (PeNSE 2015). La variable dependiente del estudio fue el absentismo escolar por razones de salud en los últimos 12 meses. Características socioeconómicas, dolor dental y frecuencia del uso de los servicios dentales fueron las variables independientes evaluadas. La regresión logística se usó para estimar los odds ratio (OR) e intervalos de confianza del 95% (IC95%). Resultados: Se incluyeron datos de 102.072 estudiantes. La prevalencia de absentismo por razones de salud fue del 53,7% (IC95% 53,2; 54,3). En el análisis ajustado, hubo una asociación entre el dolor dental y el absentismo escolar (OR=1,35; - IC95% 1,26; 1,45), y un aumento del absentismo según el mayor número de consultas dentales. Conclusión: Los resultados sugieren que el dolor dental y la frecuencia de las visitas al dentista pueden estar relacionados con el absentismo escolar.

Objective: To analyze association between dental pain, use of dental services and school absenteeism in Brazilian adolescents. Methods: This was a cross-sectional study with data from the National School Health Survey (PeNSE 2015). The study's dependent variable was school absenteeism due to health reasons in the last 12 months. Socioeconomic characteristics, dental pain and use of dental services were the independent variables evaluated. Logistic regression was used to estimate odds ratios (OR) and respective 95% confidence intervals (95%CI). Results: Data on 102,072 schoolchildren were included. Absenteeism prevalence due to health reasons was 53.7% (95%CI 53.2;54.3). In the adjusted analysis, there was association between dental pain and school absenteeism (OR=1.35 - 95%CI 1.26;1.45), and an increase in absenteeism occurrence the greater the number of dental visits. Conclusion: The results suggest that dental pain and frequency of dental visits may be related to school absenteeism.

Contextual risk factors of depression and suicidal thoughts in Brazilian adults: a multilevel analysis

Objective: To evaluate the association between social and health contextual variables, and between major depressive episodes (MDE) and suicidal thoughts in Brazilian adults. Methods: This population-based cross-sectional study used data from the 2013 National Health Survey (Pesquisa Nacional de Saúde). The Patient Health Questionnaire was used to evaluate the presence of MDE and suicidal thoughts. We used number of Family Health Strategy teams (FHS) per 20,000 state population, number of Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) per 1,000 state population, gross domestic product (GDP), and Gini index for each Brazilian state as contextual variables. Multilevel logistic regression models were used to calculate OR and the intraclass correlation coefficient (ICC). Results: Prevalence of MDE and suicidal thoughts was 4.1% (95%CI 3.8-4.4) and 3.8% (95%CI 3.5-4.1), respectively. Multilevel regression models showed an ICC of 1.1% for MDE (95%CI 0.5-2.3) and 1.3% for suicidal thoughts (95%CI 0.6-2.6). Neither GDP, Gini, FHS, or CAPS showed evidence of association with the outcomes. Conclusions: In general, contextual variables, within each Brazilian state, do not seem to affect the prevalence of MDE and suicidal thoughts.