Influence of Depression and Use of Alcohol and / or Tobacco by Parents in the Oral Health of Children with Disabilities

Gárate, Kriss Mélani Sanga; Cotrim, Júlia de Medeiros; Brasil, Marco Antônio Alves; Castro, Glória Fernanda Barbosa de Araújo

doi:10.1590/pboci.2021.024

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 21 • 2021 • https://doi.org/10.1590/pboci.2021.024 copy

Influence of Depression and Use of Alcohol and / or Tobacco by Parents in the Oral Health of Children with Disabilities

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To investigate the influence of parental depression and substance use in the oral health care of children with disabilities.

Material and Methods:

A cross-sectional study was conducted involving 151 children with disabilities and their parents/caregivers. To detect the presence of depression and alcohol or tobacco use, the parents/caregivers answered three questionnaires: two versions of the Patient Health Questionnaire (PHQ), AUDIT (Alcohol Use Disorders Identification Test), and the Fagerstrom Test for Nicotine Dependence (FTND). Then, the children with disabilities underwent oral examination to evaluate biofilm control, gingival condition and the dental carie index (decayed, missing, and filled teeth - dmft ̸ DMFT).

Results:

There was a statistically significant association between tobacco use and dental caries in deciduous teeth (p=0.046). The children of smokers had six times greater need for dental treatment than that of non-smokers (OR= 6.36; CI= 1.3-30.5). There was no statistically significant association between the oral health of the children with disabilities and parental alcohol consumption and depression (p>0.05). Children with medical condition had a higher need for dental treatment than children with intellectual disability (p=0.003).

Conclusion:

Parental smoking habits increase dental caries in the deciduous teeth of children with disabilities, but parental depression and alcohol use do not influence the oral health of children with disabilities. Children with medical condition have more treatment needs than children with intellectual disability.

Keywords:
Disabled Children; Oral Health; Tobacco; Depression; Caregivers

Variables	N	%
Patients
Sex
Male	99	65.6
Female	52	34.4
Age (Years)
<10	65	43.0
≥10	86	57.0
Classification
Intellectual Disability (ID)	90	59.6
Medical Condition (MC)	61	40.4
Caregivers
Age (Years)
<41	69	45.7
≥41	82	54.3
Type of Caregiver
Parent	139	92.1
Other	12	7.9
Education Level
Elementary School	64	42.4
High School	70	46.4
Higher Education	17	11.3
Lives in Risky Areas
Yes	86	57.0
No	65	43.0
Depression
Yes	47	31.1
Mild	18	11.9
Moderate	20	13.2
Severe	9	6.0
No	104	68.9
Alcohol Consumption
Low Risk or Abstemious	145	96.0
Risk of Consumption or Dependence	6	4.0
Tobacco Use
Yes	11	7.3
Very Low	1	0.7
Low	2	1.3
Medium	1	0.7
High	7	4.6
No	140	92.7

		Patients
Variables		Intellectual Disability	Medical Condition	p-value
		N (%)	N (%)
Need for Dental Treatment	Yes	31 (34.4)	36 (59.0)	0.003*
	No	59 (65.6)	25 (41.0)
Caries Experience in Deciduous Teeth	Yes	26 (42.6)	28 (65.1)	0.024*
	No	35 (57.4)	15 (34.9)
Caries Experience in Permanent Teeth	Yes	25 (30.5)	22 (40.0)	0.250
	No	57 (69.5)	33 (60.0)
Total Caries Experience	Yes	45 (50.0)	43 (70.5)	0.012*
	No	45 (50.0)	18 (29.5)

	Depression
Variables	Yes	No	p-value	OR (95%CI)
	N (%)	N (%)
Biofilm Control
Excellent/Satisfactory	37 (78.7)	72 (69.2)	0.228^† † chi-squared test and	1.64 (0.7-3.7)
Poor	10 (21.3)	32 (30.8)
Gingival Bleeding
Yes	13 (27.7)	33 (31.7)	0.615^† † chi-squared test and	0.82 (0.3-1.7)
No	34 (72.3)	71 (68.3)
Dmft - Mean (SD)	1.78 (2.55)	2.31 (3.32)	0.428^‡ ‡ T-test;	0.74 (0.3-1.7)
DMFT - Mean (SD)	1.15 (2.04)	0.80 (1.51)	0.276^‡ ‡ T-test;	1.15 (0.5-2.4)
Dental Treatment Needs
Yes	22 (46.8)	45 (43.3)	0.685^† † chi-squared test and	1.15 (0.5-2.3)
No	25 (53.2)	59 (56.7)
Total	47	104
	Alcohol Consumption
	Consumption of Risk or Dependence	Low Risk or Abstemious
Biofilm Control
Excellent/Satisfactory	4 (66.7)	105 (72.4)	0.758^† † chi-squared test and	0.76 (0.1-4.3)
Poor	2 (33.3)	40 (27.6)
Gingival Bleeding
Yes	3 (50.0)	43 (29.7)	0.289^† † chi-squared test and	2.37 (0.4-12.2)
No	3 (50.0)	102 (70.3)
Dmft - Mean (SD)	2.25 (2.22)	2.14 (3.14)	0.945^‡ ‡ T-test;	2.88 (0.2-28.6)
DMFT - Mean (SD)	0.80 (0.84)	0.91 (1.71)	0.888^‡ ‡ T-test;	3.00 (0.4-18.6)
Dental Treatment Needs
Yes	2 (33.3)	54 (44.8)	0.579^† † chi-squared test and	0.61 (0.1-3.4)
No	4 (66.7)	80 (55.2)
Total	6	145
	Tobacco Use
	Yes	No
Biofilm Control
Excellent/Satisfactory	8 (72.7)	101 (72.1)	0.967^† † chi-squared test and	1.03 (0.2-4.0)
Poor	3 (27.3)	39 (27.9)
Gingival Bleeding
Yes	2 (18.2)	44 (31.4)	0.358^† † chi-squared test and	0.48 (0.1-2.3)
No	9 (81.8)	96 (68.6)
Dmft - Mean (SD)	4.11 (4.05)	1.96 (2.95)	0.046^‡ ‡ T-test; ^* * Represent statistical significant p-values (p<0.05).	8.52 (1.03-70.8)
DMFT - Mean (SD)	0.55 (1.04)	0.94 (1.73)	0.463^‡ ‡ T-test;	0.69 (0.1-2.7)
Dental Treatment Needs
Yes	9 (81.8)	58 (41.4)	0.009^† † chi-squared test and ^* * Represent statistical significant p-values (p<0.05).	6.36 (1.3-30.5)
No	2 (18.2)	82 (58.6)
Total	11	140

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[1] Correspondence: Glória Fernanda Barbosa de Araújo Castro, Rua Rodolpho Paulo Rocco 325, Cidade Universitária, Rio de Janeiro-Brazil, 21941-913. E-mail:gfbacastro@yahoo.com.br