Quality of life and socio-dental impact among underprivileged Brazilian adolescents
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To evaluate the influence of clinical variables, individual and contextual characteristics on the quality of life (QL) of underprivileged adolescents in a municipality in the interior of the State of São Paulo, Brazil.
An analytical cross-sectional study was conducted in Piracicaba, in 2012, with 1,172 adolescents aged 15–19 years, from 21 state schools and 34 Family Health Units. The dependent variables included the socio-dental impact (OIDP) and quality of life (WHOQOL-bref) indices. The dependent variables were classified as individual (DMFT index, CPI Index, age, sex, income, parents’ educational level) and contextual (Social Exclusion Index) variable. The multilevel regression model was estimated by the PROC GLIMMIX (“Generalized Linear Models-Mixed”) procedure, considering the individuals’ variables as being Level 1 and the contextual variables as being Level 2, and the statistical significance was evaluated at level of significance of 5 %.
Girls were found to have the worst QL (p < 0.000) and greatest OIDP (p = 0.000). There was an increase in OIDP (p < 0.001) and diminished QL (p < 0.052) with an increase in the periodontal index. This result is marginally significant since the significance probability is marginally greater than 0.05. In turn, there was an increase in QL (p = 0.000) and reduction in OIDP (p < 0.000) with an increase in the family income. Adolescents who resided in areas of greatest social exclusion (p = 0.031) and with greater OIDP (p < 0.000) presented the worst QL.
Individual and contextual variables were related to the OIDP and QL in underprivileged Brazilian adolescents.
KeywordsOral health Adolescent Quality of life Multilevel analysis
The authors thank the volunteers, the school principals and PHC units, for allowing the research carried out. This research was supported by FAPESP—São Paulo Research Foundation (Grants #2011/03657-5 and #2011/01768-4).
The study was approved by the Research Ethics Committee of the Piracicaba Dental School, University of Campinas (UNICAMP) (protocol number #027/2011) in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Consent was obtained from the parents before starting the study.
- 1.Brazil. (2004). Ministry of Health. Secretary of Health Attention. Department of Primary Care. National coordination of oral health. National oral health policy. Brasilia [in Portuguese].Google Scholar
- 2.Brasil. (2012). Ministry of Health. Oral health Brasil 2010 (SB Brasil 2010): National oral health research: Main results. http://184.108.40.206/dab/docs/geral/projeto_sb2010_relatorio_final.pdf. Accessed 03 Mar 2014.
- 10.Paula, J. S., Leite, I. C., Almeida, A. B., Ambrosano, G. M., Pereira, A. C., & Mialhe, F. L. (2012). The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren’s self-perception of quality of life. Health Qual Life Outcomes, 13(10), 6.CrossRefGoogle Scholar
- 16.Peres, K. G., Cascaes, A. M., Leão, A. T. T., Côrtes, M. I. S., & Vettore, M. V. (2013). Sociodemographic and clinical aspects of quality of life related to oral health in adolescents. Revista de saude publica, 47(Supl 3), 1–9.Google Scholar
- 17.Townsend, P., & Davidson, N. (1992). Inequalities in health: The black report. Harmondsworth: Penguin Books.Google Scholar
- 19.Hox, JJ.(1995). Applied multilevel analysis. Cap1, ( pp. 6–7). Amsterdam: TT-Publikaries.Google Scholar
- 21.IBGE. (2013). Brazilian Institute of Geography and Statistic. http://www.ibge.gov.br/home/Accessed 04 Dec 2013.
- 22.Brasil. (2005). Ministry of Health. Oral health Brasil 2003 (SB Brasil 2002–2003): National oral health research: Main results. http://dtr2001.saude.gov.br/editora/produtos/livros/pdf/05_0053_M.pdf. Accessed 03 Mar 2013.
- 23.WHO. (1997). World Health Organization. Oral Health Surveys. Basic Methods (4th ed.). Geneva: World Health Organization.Google Scholar
- 25.Meneghim, M. C., Kozlowski, F. C., Pereira, A. C., Ambrosano, G. M. V., & Meneghim, Z. M. A. P. (2007). A socioeconomic classification and the discussion related to prevalence of dental caries and dental fluorosis. Ciência e saúde coletiva, 12(2), 523–529. [In Portuguese].CrossRefPubMedGoogle Scholar
- 26.Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-Bref quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research, 13(2), 299–310.CrossRefPubMedGoogle Scholar
- 28.IPPLAP. (2011). Piracicaba Institute of Planning and Research. http://www.ipplap.com.br/docs/meis.pdf. Accessed 03 Dec 2011.
- 29.SAS Institute Inc. (2001). SAS/STAT guide for personal computers. version 9.2. Cary: North-Carolina/USA.Google Scholar
- 30.Turrell, G., Kavanagh, A., Draper, G., & Subramanian, S. V. (2007). Do places affect the probability of death in Australia? A multilevel study of area-level disadvantage, individual-level socioeconomic position and all-cause mortality, 1998–2000. Journal of Epidemiology and Community Health, 61(1), 13–19.CrossRefPubMedCentralPubMedGoogle Scholar
- 33.Tellez, M., Sohn, W., Burt, B. A., & Ismail, A. I. (2006). Assessment of the relationship between neighborhood characteristics and dental caries severity among low income African-Americans: A multilevel approach. Journal of Public Health Dentistry, 66(1), 30–36.CrossRefPubMedCentralPubMedGoogle Scholar
- 34.Skevington, S. M., Dehner, S., Gillison,F., McGrath, E.J., Lovell, C.R. (2014). How appropriate is the WHOQOL-BREF for assessing the quality of life of adolescents? Psychology and Health, 29(3), 204. doi: 10.1080/08870446.2013.845668.
- 35.Putnam, R. (2005). Community and democracy: The experience of modern Italy. Rio de Janeiro: FGV. [In Portuguese].Google Scholar
- 46.Andrade, F. B., Lebrão, M. L., Santos, J. L., da Cruz Teixeira, D. S., & de Oliveira Duarte, Y. A. (2012). Relationship between oral health-related quality of life, oral health, socioeconomic, and general health factors in elderly Brazilians. Journal of the American Geriatrics Society, 60(9), 1755–1760.CrossRefPubMedGoogle Scholar