The influence of protective psychosocial factors on the incidence of dental pain.

OBJECTIVE: To investigate the influence of protective psychosocial factors on the incidence of dental pain in the last six months among 12-year-old children living in Manaus (AM). METHODS: A prospective school-based cohort study was conducted with 210 12-year-old students enrolled in public schools in the eastern zone of Manaus (AM). Students were followed up for two years. Validated questionnaires were used to assess sociodemographic characteristics, protective psychosocial factors, including sense of coherence, social support, and self-esteem at baseline and after two years. Calibrated examiners clinically assessed dental caries and gingival bleeding. Multivariate multilevel Poisson regression was used to estimate the relative risk (RR) and 95% confidence interval (95%CI) between the changes on psychosocial factors scores and incidence of dental pain, adjusted for psychosocial factors scores at baseline, dental health insurance, frequency of tooth brushing, and dental caries. RESULTS: Mean scores for sense of coherence and social support reduced significantly from baseline to 2-year follow-up. The incidence of dental pain along the two-year follow-up was 28.6%. The risk of dental pain was 14% higher for every 10 points in the mean reduction of sense of coherence score (RR = 1.14; 95%CI: 1.02-1.20), and 6% higher for every 10 points of the mean reduction in social support score (RR = 1.06; 95%CI: 1.01-1.11). Change on self-esteem was not associated with risk of dental pain. CONCLUSION: Change on sense of coherence and social support over the two-year period influenced the incidence of dental pain among children, suggesting that protective psychosocial factors, health behaviours, dental health insurance, and clinical oral condition have an important role in the incidence of dental pain.

The influence of protective psychosocial factors on the incidence of dental pain / A influência de fatores psicossociais protetores sobre a incidência de dor dentária

ABSTRACT OBJECTIVE To investigate the influence of protective psychosocial factors on the incidence of dental pain in the last six months among 12-year-old children living in Manaus (AM). METHODS A prospective school-based cohort study was conducted with 210 12-year-old students enrolled in public schools in the eastern zone of Manaus (AM). Students were followed up for two years. Validated questionnaires were used to assess sociodemographic characteristics, protective psychosocial factors, including sense of coherence, social support, and self-esteem at baseline and after two years. Calibrated examiners clinically assessed dental caries and gingival bleeding. Multivariate multilevel Poisson regression was used to estimate the relative risk (RR) and 95% confidence interval (95%CI) between the changes on psychosocial factors scores and incidence of dental pain, adjusted for psychosocial factors scores at baseline, dental health insurance, frequency of tooth brushing, and dental caries. RESULTS Mean scores for sense of coherence and social support reduced significantly from baseline to 2-year follow-up. The incidence of dental pain along the two-year follow-up was 28.6%. The risk of dental pain was 14% higher for every 10 points in the mean reduction of sense of coherence score (RR = 1.14; 95%CI: 1.02-1.20), and 6% higher for every 10 points of the mean reduction in social support score (RR = 1.06; 95%CI: 1.01-1.11). Change on self-esteem was not associated with risk of dental pain. CONCLUSION Change on sense of coherence and social support over the two-year period influenced the incidence of dental pain among children, suggesting that protective psychosocial factors, health behaviours, dental health insurance, and clinical oral condition have an important role in the incidence of dental pain.

RESUMO OBJETIVO Investigar a influência de fatores psicossociais protetores sobre a incidência de dor dentária nos últimos seis meses em crianças de 12 anos residentes em Manaus (AM). MÉTODOS Um estudo de coorte prospectivo de base escolar foi realizado com 210 alunos de 12 anos, matriculados em escolas públicas da zona leste de Manaus (AM) que foram acompanhados por dois anos. Questionários validados foram usados para avaliar características sociodemográficas, fatores psicossociais protetores, incluindo senso de coerência, apoio social e autoestima na linha de base e após dois anos. Examinadores calibrados avaliaram clinicamente cárie dentária e sangramento gengival. Regressão de Poisson multinível multivariada foi usada para estimar o risco relativo (RR) e o intervalo de confiança de 95% (IC95%) entre a variação dos escores dos fatores psicossociais e a incidência de dor dentária, ajustada para os escores dos fatores psicossociais na linha de base, plano de saúde odontológico, frequência de escovação dentária e cárie dentária. RESULTADOS As médias dos escores do senso de coerência e do apoio social reduziram significativamente entre linha de base e seguimento de dois anos. A incidência de dor dentária no seguimento de dois anos foi 28,6%. O risco de dor dentária foi 14% maior para cada 10 pontos na redução média do escore do senso de coerência (RR = 1,14; IC95% 1,02-1,20), e 6% maior para cada 10 pontos na redução média do escore do apoio social (RR = 1,06; IC95% 1,01-1,11). A mudança na autoestima não foi associada ao risco de dor dentária. CONCLUSÃO A variação do senso de coerência e do apoio social no período de dois anos influenciou a incidência de dor dentária em crianças, sugerindo que fatores psicossociais protetores, comportamentos em saúde, plano odontológico e a condição clínica bucal desempenham um papel importante na incidência da dor dentária.

A influência de fatores psicossociais protetores na incidência de dor dentária em crianças: um estudo longitudinal / The relationship of protective psychosocial factors in the incidence of dental pain in children: a longitudinal study

A percepção da dor dentária resulta de uma complexa relação entre fatores biológicos, comportamentais e psicossociais. O presente estudo investigou a associação entre fatores psicossociais protetores e a incidência de dor dentária nos últimos seis meses em crianças de 12 anos residentes em Manaus (AM). Um estudo de coorte prospectivo de base escolar foi realizado com 210 alunos de 12 anos matriculados em escolas públicas da zona leste de Manaus (AM) que foram acompanhados por 2 anos. Questionários validados foram usados para avaliar os fatores psicossociais protetores, incluindo senso de coerência (SOC), apoio social e autoestima na linha de base e após 2 anos. Regressão de Poisson multinível multivariada foi usada para estimar o risco relativo (RR) e o intervalo de confiança de 95% (IC 95%) entre a variação dos escores dos fatores psicossociais e incidência de dor dentária, ajustada para os escores dos fatores psicossociais na linha de base, plano de saúde odontológico, frequência de escovação dentária e cárie dentária. As médias dos escores do SOC e do apoio social reduziram significativamente entre linha de base e seguimento de 2 anos. A incidência de dor dentária no seguimento de 2 anos foi 28,6%. O risco de dor dentária foi 14% maior para cada 10 pontos na mudança do escore do SOC (RR = 1,14, IC95% = 1,02 ­ 1,20), e 6% maior para cada 10 pontos na mudança do escore do apoio social (RR = 1,06, IC95% = 1,01 ­ 1,11). A mudança na autoestima não foi associada com o risco de dor dentária. A variação do SOC e do apoio social no período de 2 anos, influenciou a incidência de dor dentária em crianças.

The perception of dental pain results from a complex relationship among biological, behavioural and psychosocial factors. The present study investigated the association between protective psychosocial factors and the incidence of dental pain in the last six months in 12-year-old children living in Manaus (AM). A prospective school-based cohort study was conducted with 210 12-year-old students enrolled in public schools in the eastern zone of Manaus (AM) who were followed up for 2 years. Validated questionnaires were used to assess protective psychosocial factors, including sense of coherence (SOC), social support, and self-esteem at baseline and after 2 years. Multivariate multilevel Poisson regression was used to estimate the relative risk (RR) and 95% confidence interval (95% CI) between the change in psychosocial factor scores and dental pain incidence, adjusted for psychosocial factor scores at baseline, dental health plan, frequency of tooth brushing, and dental caries. Mean SOC and social support scores reduced significantly between baseline and 2-year follow-up. The incidence of dental pain at the 2-year follow-up was 28.6%. The risk of dental pain was 14% higher for every 10 points in change in SOC score (RR = 1.14, 95%CI = 1.02 - 1.20), and 6% higher for every 10 points in change in social support score (RR = 1.06, 95%CI = 1.01 - 1.11). Change in self-esteem was not associated with risk of dental pain. The change in SOC and social support over the 2-year period influenced the incidence of dental pain in children.