Early-life socioeconomic status and malocclusion in adolescents and young adults in Uruguay.

Marília Leão Goettems,Ramon Álvarez-Vaz,Mariana Ourens,Laura Cosetti,Susana Lorenzo,Roger Keller Celeste

doi:10.1590/0102-311x00051017

Abstract

This study aims to estimate orthodontic treatment need among 15-24 year-old individuals in Montevideo, Uruguay, and the association of occlusal traits with demographic, clinical and socioeconomic factors, considering a life course approach. A cross-sectional study using data from the First National Oral Health Survey in Uruguay was conducted. A two-stage cluster procedure was used to select a sample of 278 individuals in Montevideo. Household interviews and oral examinations were performed by six dentists. Dental Aesthetic (DAI) and Decayed Missing and Filled Teeth Indices (DMFT) were used to assess orthodontic treatment need and dental caries, respectively. Early life and current socioeconomic factors were obtained from the interview. Ordinal logistic regression was used to model the DAI index. Prevalence of definite malocclusion was 20.6%, followed by severe (8.2%) and very severe (7.6%). In the adjusted analysis, individuals with untreated dental caries (OR = 1.11; 95%CI: 1.03-1.20) and those who reported a lower socioeconomic level at 6 years of age (OR = 5.52; 95%CI: 1.06-28.62) had a higher chance of being a worse case of malocclusion. Current socioeconomic position was not associated with orthodontic treatment need. Individuals aged 22-24 years (OR = 1.59; 95%CI: 1.05-2.41) had a lower chance than those aged 14-17. This study shows that orthodontic treatment need is relatively high in Uruguayan adolescents and young adults. There is a potential relationship between early life socioeconomic status and the occurrence of malocclusion in adolescents and young adults under a life course approach.

Highlights

Malocclusion is associated with functional and/or aesthetic consequences, and with psychosocial consequences, especially in adolescents 1,2
A total of 76.9% (95%CI: 71.2-81.8) had at least one teeth affected by dental caries and mean Decayed Missing and Filled Teeth Indices (DMFT) was 3.60 (DT = 1.36; MT = 0.78; FT = 1.46)
One study has investigated the effects of early life socioeconomic factors on malocclusion, but results showed no association with open bite, in a sample of 6 year-old children 30

Summary

Introduction

Malocclusion is associated with functional and/or aesthetic consequences, and with psychosocial consequences, especially in adolescents 1,2. There is evidence that children from lower socioeconomic background may adopt more often deleterious oral habits associated with malocclusion, including thumb sucking and pacifier use 9, nursing bottle, mouth breathing and onicophagia 10. Children from less educated mothers may have earlier exclusive breastfeeding abandonment 11, which is associated with malocclusion in primary dentition 12. The occurrence of malocclusion in primary dentition is predictive for malocclusion in the permanent dentition 13, especially when there is late discontinuing of deleterious habits 14. A study with adolescents in Brazil showed that severe or very severe malocclusion was more prevalent among socially disadvantaged adolescents, with reported harmful habits 15

Objectives

Methods

Results

Conclusion