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.
Highlights
Patients with special health care needs (SHCN) can be defined as those with impaired cognitive, behavioral, neuromuscular, genetic, congenital, systemic, or limiting disorders that require healthcare intervention and specialized services or programs [1]
This could be due to the fact that, unlike the previous studies, our total sample was formed by regular patients at the pediatric dental clinic for children with special needs, who receive specialized dental care according to individual need
Our results indicate that patients with Medical Condition (MC) have greater dental treatment needs than those with Intellectual Disability (ID); this may be related to several factors, such as state of immunosuppression [28], medications [29] likewise, this could be due to the fact that parents of children with MC pay more attention to the main disease of their children, leaving oral health in a secondary plan
Summary
Patients with special health care needs (SHCN) can be defined as those with impaired cognitive, behavioral, neuromuscular, genetic, congenital, systemic, or limiting disorders that require healthcare intervention and specialized services or programs [1]. There is evidence for lower maternal capacity for self-care and care of their children when any form of mental health impairment is present [6]. This suggests that the presence of depressive symptoms can trigger secondary effects on the parents’ health, and on the child’s general and oral health and care. A previous study already suggests that maternal psychiatric disorders have a negative impact in the oral health of their children [7] This may be even more worrying for parents of children with disabilities because they require more support, supervision, and special care in their daily activities. There appears to be a positive association between depression and alcohol and tobacco use in the general population [9]
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