Associação entre letramento em saúde bucal de pais/cuidadores e cárie dentária em crianças pré-escolares
DOI:
https://doi.org/10.35699/2178-1990.2025.61655Palavras-chave:
literacia para a saúde, saúde bucal, cárie dentária, criança, paisResumo
Introdução: O letramento em saúde bucal (LSB) refere-se à capacidade dos indivíduos de obter, processar e compreender informações e serviços básicos de saúde necessários para tomada de decisões adequadas. Pais e cuidadores formam um grupo crítico, pois influenciam tanto a própria saúde quanto a de seus filhos.
Objetivo: Avaliar a associação entre o LSB de pais/cuidadores e a experiência de cárie dentária de seus filhos.
Materiais e Métodos: Estudo transversal com pais/cuidadores e crianças de 2 a 6 anos, atendidas em uma Instituição de Ensino Superior (IES). Foram aplicados o BREALD-30 e um questionário socioeconômico aos pais/cuidadores e realizado um exame clínico bucal das crianças para avaliação da cárie dentária de acordo com o índice ceo-d. A análise estatística incluiu análise descritiva e testes Qui-quadrado, Exato de Fisher, tendência linear e regressão multivariada de Poisson, com um nível de significância de 5%.
Resultados: Participaram 27 pares pais/cuidadores-crianças. A média de idade das mães foi 32,65 anos (±6,61) e dos pais 36,67 anos (±12,37). A classe socioeconômica predominante foi C (48,10%) e 44,40% dos chefes de família tinham ensino médio completo ou superior incompleto. O LSB foi considerado ideal em 85,20% dos pais/cuidadores. As crianças tinham média de 4,33 anos (±0,87), 48,10% do sexo feminino e 51,90% masculino. A média do ceo-d foi 6,41 (±5,17). A prevalência de cárie foi de 74,10%, com igual percentual apresentando ao menos um dente com cárie sem tratamento; 59,30% não tinham dentes obturados. Não houve associação significativa entre LSB e experiência de cárie dentária. Entretanto, a idade da criança (RR: 1,988; IC 95% 1,461-2,702) e o baixo LSB de pais/cuidadores (RR: 1,655; IC 95% 1,162-2,358) associaram-se à maior severidade de cárie.
Conclusão: Não houve associação entre o LSB dos pais/cuidadores e a experiência de cárie dentária de seus filhos. O baixo LSB dos pais/cuidadores foi associado à maior severidade de cárie dentária das crianças.
Referências
Qiu RM, Tao Y, Zhou Y, Zhi QH, Lin HC. The relationship between children’s oral health-related behaviors and their caregiver’s social support. BMC Oral Health. 2016;16(1):86. doi: 10.1186/s12903-016-0270-4
Centers for Disease Control and Prevention (US). Promoting oral health: interventions for preventing dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries: a report on recommendations of the task force on community preventive services. MMWR Recomm Rep. 2001;50(RR-21):1-13.
Moriyama CM, Velasco SRM, Butini L, Abanto J, Antunes JLF, Bönecker M. How oral health literacy and parental behavior during the meals relate to dental caries in children. Braz Oral Res. 2022;36:e131. doi: 10.1590/1807-3107bor-2022.vol36.0131
Brega AG, Thomas JF, Henderson WG, Batliner TS, Quissell DO, Braun PA, et al. Association of parental health literacy with oral health of Navajo Nation preschoolers. Health Educ Res. 2016;31(1):70-81. doi: 10.1093/her/cyv055
Buhr E, Tannen A. Parental health literacy and health knowledge, behaviours and outcomes in children: a cross-sectional survey. BMC Public Health. 2020;20(1):1096. doi: 10.1186/s12889-020-08881-5
Sowmya KR, Puranik MP, Aparna KS. Association between mother’s behaviour, oral health literacy and children’s oral health outcomes: a cross-sectional study. Indian J Dent Res. 2021;32(2):147-52. doi: 10.4103/ijdr.IJDR_676_18
Bánfai-Csonka H, Betlehem J, Deutsch K, Derzsi-Horváth M, Bánfai B, Fináncz J, et al. Health literacy in early childhood: a systematic review of empirical studies. Children (Basel). 2022;9(8):1131. doi: 10.3390/children9081131
Dudovitz R, Teutsch C, Holt K, Herman A. Improving parent oral health literacy in Head Start programs. J Public Health Dent. 2020;80(2):150-8. doi: 10.1111/jphd.12361
Wang Y, Inglehart MR, Yuan C. Impact of parents’ oral health literacy on their own and their children’s oral health in Chinese population. Front Public Health. 2022;10:809568. doi: 10.3389/fpubh.2022.809568
Alzahrani AY, El Meligy O, Bahdila D, Aljawi R, Bamashmous NO, Almushayt A. The influence of parental oral health literacy on children’s oral health: a scoping review. J Clin Pediatr Dent. 2024;48(4):16-25. doi: 10.22514/jocpd.2024.074
Velasco SRM, Moriyama CM, Bonecker M, Butini L, Abanto J, Antunes JLF. Relationship between oral health literacy of caregivers and the oral health-related quality of life of children: a cross-sectional study. Health Qual Life Outcomes. 2022;20(1):117. doi: 10.1186/s12955-022-02019-4
Dieng S, Cisse D, Lombrail P, Azogui-Lévy S. Mothers’ oral health literacy and children’s oral health status in Pikine, Senegal: a pilot study. PLoS One. 2020;15(1):e0226876. doi: 10.1371/journal.pone.0226876
Khodadadi E, Niknahad A, Sistani MM, Motallebnejad M. Parents’ oral health literacy and its impact on their children’s dental health status. Electron Physician. 2016;8(12):3421-5. doi: 10.19082/3421
Yazdani R, Esfahani EN, Kharazifard MJ. Relationship of oral health literacy with dental caries and oral health behavior of children and their parents. J Dent (Tehran). 2018;15(5):275-82.
Sun Y, Li C, Zhao Y, Sun J. Trends and developments in oral health literacy: a scientometric research study (1991-2020). BDJ Open. 2021;7(1):13. doi: 10.1038/s41405-021-00066-5
World Health Organization. Oral health surveys: basic methods. 5th ed. Geneva: WHO; 2013.
Montes GR, Bonotto DV, Ferreira FM, Menezes JV, Fraiz FC. Caregiver’s oral health literacy is associated with prevalence of untreated dental caries in preschool children. Cien Saude Colet. 2019;24(7):2737-44. doi: 10.1590/1413-81232018247.18752017
Junkes MC, Fraiz FC, Sardenberg F, Lee JY, Paiva SM, Ferreira FM. Validity and reliability of the Brazilian version of the rapid estimate of adult literacy in dentistry-BREALD-30. PLoS One. 2015;10(7):e0131600. doi: 10.1371/journal.pone.0131600
Associação Brasileira de Empresas de Pesquisa. Critério de Classificação Econômica Brasil 2018. São Paulo: ABEP; 2018.
Lisboa SO, Assunção CM, Drumond CL, Serrra-Negra JMC, Machado MGP, Paiva SM, et al. Association between level of parental oral health literacy and the rational use of fluoride for children from 0 to 4 years of age after instruction: an intervention trial. Caries Res. 2022;56(5-6):535-45. doi: 10.1159/000527419
Baskaradoss JK, AlThunayan MF, Alessa JA, Alobaidy SS, Alwakeel RS, Alshubaiki AH, et al. Relationship between caregivers’ oral health literacy and their child’s caries experience. Community Dent Health. 2019;36(2):111-7. doi: 10.1922/CDH_4444Baskarados
Yousaf M, Aslam T, Saeed S, Sarfraz A, Sarfraz Z, Cherrez-Ojeda I. Individual, family, and socioeconomic contributors to dental caries in children from low- and middle-income countries. Int J Environ Res Public Health. 2022;19(12):7114. doi: 10.3390/ijerph19127114
Gomes MC, Clementino MA, Pinto-Sarmento TCA, Costa EMM, Martins CC, Granville-Garcia AF, et al. Brazilian parental perceptions of oral health status in preschool children and associated factors. Braz Dent J. 2015;26(4):428-34. doi: 10.1590/0103-6440201300245
Divaris K, Lee JY, Baker AD, Gizlice Z, Rozier RG, DeWalt DA, et al. Influence of caregivers and children’s entry into the dental care system. Pediatrics. 2014;133(5):e1268-76. doi: 10.1542/peds.2013-2932
Toh JR, Wooi N, Tan SN, Wong K, Lopez-Silva C, Zafar S. Association between lack of dental service utilisation and caregiver-reported caries in Australian Indigenous children: a national survey. J Paediatr Child Health. 2022;58(12):2218-24. doi: 10.1111/jpc.16192
Hegde D, Suprabha BS, Shenoy R, Rao A. Association of parental oral health literacy and child temperament with dental attendance in children with early childhood caries: a cross-sectional study. Eur Arch Paediatr Dent. 2025. doi: 10.1007/s40368-025-01083-w
Al-Halabi M, Salami A, Alnuaimi E, Kowash M, Hussein I. Assessment of paediatric dental guidelines and caries management alternatives in the post-COVID-19 period. A critical review and clinical recommendations. Eur Arch Paediatr Dent. 2020;21(5):543-56. doi: 10.1007/s40368-020-00547-5
Matsuyama Y, Isumi A, Doi S, Fujiwara T. Impacts of the COVID-19 pandemic exposure on child dental caries: difference-in-differences analysis. Caries Res. 2022;56(5-6):546-54. doi: 10.1159/000528006
Ruiz-Roso MB, Padilha PC, Mantilla-Escalante DC, Ulloa N, Brun P, Acevedo-Correa D, et al. Covid-19 confinement and changes of adolescent’s dietary trends in Italy, Spain, Chile, Colombia and Brazil. Nutrients. 2020;12(6):1807. doi: 10.3390/nu12061807
Galván M, Hernández-Cabrera J, López-Rodríguez G, Bustos N, García-Cruz R, Guzmán-Saldaña, et al. Perceptions of food environments in the school and at home during Covid-19: an online cross-sectional study of parents, teachers and experts from Latin America. PLoS One. 2023;18(6):e0287747. doi: 10.1371/journal.pone.0287747
Basir L, Khanehmasjedi M, Khanehmasjedi S. Knowledge, attitudes, and practices regarding the oral health of children: a cross-sectional study among iranian parents. Braz J Oral Sci. 2022;21:e228274. Doi: 10.20396/bjos.v21i00.8668274
Miller E, Lee JY, DeWalt DA, Vann WF Jr. Impact of caregiver literacy on children’s oral health outcomes. Pediatrics. 2010;126(1):107-14. doi: 10.1542/peds.2009-2887
Sanzone LA, Lee JY, Divaris K, DeWalt DA, Baker AD, Vann WF Jr. A cross-sectional study examining social desirability bias in caregiver reporting of children’s oral health behaviors. BMC Oral Health. 2013;13(1):24. doi: 10.1186/1472-6831-13-24
Menoncin BLV, Crema AFA, Ferreira FM, Zandoná AF, Menezes JV, Fraiz FC. Parental oral health literacy influences preschool children’s utilization of dental services. Braz Oral Res. 2023;37:e090. doi: 10.1590/1807-3107BOR-2023.vol37.0090
Barasuol JC, Daros BCI, Fraiz FC, Menezes JV. Caregiver oral health literacy: relationship with socioeconomic factors, oral health behaviors and perceived child dental status. Community Dent Health. 2020;37(2):110-4. doi: 10.1922/CDH_4550Barasuol05
Zamry NNN, Mahmood Z, Saddki N. Influence of oral health literacy on knowledge and attitude towards children’s oral health among pregnant women in Malaysia. Med J Malaysia. 2022;77(5):534-41.
Corrêa-Faria P, Martins-Júnior PA, Vieira-Andrade RG, Marques LS, Ramos-Jorge ML. Factors associated with the development of early childhood caries among Brazilian preschoolers. Braz Oral Res. 2013;27(4):356-62. doi: 10.1590/S1806-83242013005000021
Mialhe FL, Santos BL, Bado FMR, Oliveira AJ Jr, Soares GH. Association between oral health literacy and dental outcomes among users of primary healthcare services. Braz Oral Res. 2022;36:e004. doi: 10.1590/1807-3107bor-2022.vol36.0004
Domingos PSA, Rossato EM, Bellini A. Levantamento do perfil social, demográfico e econômico de pacientes atendidos na Clínica de Odontologia do Centro Universitário de Araraquara – Uniara. Revista Uniara. 2014;17(1):37-50. doi: 10.25061/2527-2675/ReBraM/2014.v17i1.3
Adil AH, Eusufzai SZ, Kamruddin A, Ahmad WMA, Jamayet NB, Karobari MI, et al. Assessment of parents’ oral health literacy and its association with caries experience of their preschool children. Children (Basel). 2020;7(8):101. doi: 10.3390/children7080101
Chawłowska E, Karasiewicz M, Lipiak A, Cofta M, Fechner B, Lewicka-Rabska A, et al. Exploring the relationships between children’s oral health and parents’ oral health knowledge, literacy, behaviours and adherence to recommendations: a cross-sectional survey. Int J Environ Res Public Health. 2022;19(18):11288. doi: 10.3390/ijerph191811288
Assunção LRS, Vilella KD, Rocha DP, Menezes SL, Pinheiro RPS, Nascimento LS, et al. Epidemiologia da cárie dentária em crianças da primeira infância no município de Belém, PA. Rev APCD. 2015;69(1):74-9.
Hu J, Jiang W, Lin X, Zhu H, Zhou N, Chen Y, et al. Dental caries status and caries risk factors in students ages 12-14 years in Zhejiang, China. Med Sci Monit. 2018;24:3670-8.
Maciel SS V, Oliveira RLC, Fernandes ACA, Steinnhauser HC, Torres MJS, Freire MNB, et al. Prevalência da cárie precoce na infância em crianças de 6 a 36 meses em creches públicas de Caruaru/PE. Pesq Bras Odontoped Clin Integr. 2007;7(1):59-65.
Ministério da Saúde (BR), Secretaria de Atenção à Saúde, Secretaria de Vigilância em Saúde. SB Brasil 2010: pesquisa nacional de saúde bucal: resultados principais. Brasília, DF: Ministério da Saúde (BR); 2010.
Brega AG, Jiang L, Johnson RL, Wilson AR, Schmiege SJ, Albino J. Health literacy and parental oral health knowledge, beliefs, behavior, and status among parents of American Indian newborns. J Racial Ethn Health Disparities. 2020;7(4):598-608. doi: 10.1007/s40615-019-00688-4