Alterations of oral functions and dental malocclusions in adolescents: a cross-sectional population-based study

Freitas, Heloiza Viana; Alves, Cláudia Maria Coelho; Silva, Luciana Freitas Gomes e; Pereira, Alex Luiz Pozzobon; Hugo, Fernando Neves; Thomaz, Erika Barbara Abreu Fonseca

doi:10.1590/1413-812320212611.3.07992020

Tabla de contenido Anterior Actual Siguiente

Tabla de contenido

FREE THEMES • Ciênc. saúde coletiva 26 (suppl 3) • 2021 • https://doi.org/10.1590/1413-812320212611.3.07992020 linkcopy

Alterations of oral functions and dental malocclusions in adolescents: a cross-sectional population-based study

Alterações das funções orais e má oclusão em adolescentes: um estudo transversal de base populacional

Authorship SCIMAGO INSTITUTIONS RANKINGS

This article aims to assess whether alterations of oral functions (AOF) are associated with malocclusion (MO)’s type and severity. Cross-sectional study of a representative sample of 332 adolescents aged 12 years in São Luís-MA, Northeastern Brazil. MO criteria included Angle’s classification, Dental Aesthetic Index, and other morphological problems. The AOF were evaluated by breathing, phonation, chewing, and swallowing. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic and multinomial regression analyses (α=5%). Mouth breathing was associated with defined (OR=3.84; 95%CI=1.45-10.12), disabling (OR=4.34; 95%CI=1.99-9.49), and class III (OR=4.15; 95%CI=1.19-14.54) MO. Phonation problems were associated with defined (OR=2.01; 95%CI=1.02-4.39), disabling (OR=3.04; 95%CI=1.55-5.96), and Class II (OR=2.02; 95%CI=1.28-3.18) MO. Chewing disorders were associated with posterior crossbite (PCB) (OR=2.32; 95%CI=1.12-4.82). Swallowing disorders were associated with Class III MO (OR=5.66; 95%CI=1.35-23.71), PCB (OR=6.13; 95%CI=2.76-13.62), and posterior open bite (OR=4.53; 95%CI=1.72-8.92). Breathing and phonation alterations are associated with MO in anterior arch segments, while chewing and swallowing disorders, in the posterior segments.

Key words:
Malocclusion; Mouth Breathing; Phonation; Swallowing

Variables		Breathing alterations			P- value		Phonation alterations				P- value
		No		Yes			No		Yes
		n	%	n	%		n	%	n	%
Malocclusion (DAI)						0.002¹					0.048¹
	Normal/Mild	81	84.1	16	15.9	0.007²	69	70.0	28	30.0	0.029²
	Defined	51	55.1	31	44.9		47	51.9	35	48.1
	Severe	60	77.5	19	22.5		51	61.8	28	38.2
	Disabling	43	54.2	31	45.8		34	43.5	40	56.5
Malocclusion (Angle)						0.494³					0.003³
	Normal	10	85.3	2	14.7		11	96.5	1	3.5
	Class I	142	70.1	56	29.9		130	63.3	98	36.7
	Class II	72	72.5	31	27.5		51	53.1	52	46.9
	Class III	11	41.7	8	58.3		9	30.5	10	69.5
Posterior crossbite						0.085¹					0.280¹
	No	201	73.1	76	26.9		170	60.8	107	39.2
	Yes	34	53.4	21	46.6		31	47.9	24	52.1
Posterior open bite						0.384¹					0.298¹
	No	214	70.2	83	29.8		184	59.8	113	40.2
	Yes	21	65.0	14	35.0		17	48.0	18	52.0
Overbite						0.165¹					0.927¹
	No	142	72.9	51	27.1		118	58.7	75	41.3
	Yes	93	63.7	46	36.3		83	58.2	56	41.8
Sex						0.724¹					0.147¹
	Female	109	68.2	45	31.8		92	52.3	62	47.7
	Male	126	70.9	52	29.1		109	64.0	69	36.0
Race/color						0.166¹					0.082¹
	White	65	79.5	16	20.5		49	54.5	32	45.5
	Brown	147	66.6	70	33.4		126	57.1	91	42.9
	Black	23	67.7	11	32.3		26	73.8	8	26.2
Economic class (ABEP)						0.224¹					0.587¹
	A-B	102	74.9	35	25.1	0.132²	89	62.8	48	37.2	0.261²
	C	117	68.2	51	31.8		95	55.8	73	44.2
	D-E	16	60.9	11	39.1		17	61.7	10	38.3
School type						0.216¹					0.134¹
	Public	162	68.5	74	31.5		137	56.7	629	43.3
	Private	73	75.1	23	24.9		64	67.3	185	32.7
History of school failure						0.913¹					0.752¹
	No	165	69.3	67	30.7		144	59.5	88	40.5
	Yes	70	70.3	30	29.7		57	56.6	43	43.4
Pacifier sucking						0.986¹					0.351¹
	No	160	69.6	62	30.4		134	56.1	88	43.9
	Yes	75	69.7	35	30.3		67	63.3	43	36.7
Finger sucking						0.398¹					0.764¹
	No	210	68.5	87	31.5		181	58.0	116	42.0
	Yes	25	77.4	10	22.6		20	61.7	15	38.3
Biting lips/cheeks						0.476¹					0.425¹
	No	125	71.7	51	28.3		108	60.7	68	39.3
	Yes	110	67.3	46	32.7		93	56.1	63	43.9
Biting objects						0.077¹					0.510¹
	No	154	73.8	52	26.2		123	57.1	83	42.9
	Yes	81	64.7	45	35.3		78	60.1	48	39.9
Nail biting						0.978¹					0.380¹
	No	86	69.8	36	30.2		75	62.2	47	37.8
	Yes	149	69.6	61	30.4		126	56.3	84	43.7
Bruxism						0.094¹					0.121¹
	No	193	72.9	74	27.1		165	61.6	102	38.4
	Yes	42	55.8	23	44.2		36	45.2	29	54.8
Sleeping with hands under the face						0.252¹					0.596¹
	No	157	72.1	58	27.9		130	59.5	85	40.5
	Yes	78	64.9	39	35.1		71	56.6	46	43.4
Lingual interposition						0.913¹					0.249¹
	No	201	69.9	86	30.1		174	60.7	113	39.3
	Yes	34	68.2	11	21.8		27	46.7	18	53.3

Variables		Chewing alterations				P- value	Swallowing alterations				P- value
		No		Yes			No		Yes
		n	%	n	%		n	%	n	%
Malocclusion (DAI)						0.554¹					0.453¹
	Normal/Mild	30	31.9	67	68.1	0.523²	74	80.0	23	20.0	0.160²
	Defined	16	21.6	66	78.4		64	68.7	18	31.3
	Severe	20	29.2	59	70.8		57	73.6	22	26.3
	Disabling	19	27.2	55	72.8		50	67.7	24	32.3
Malocclusion (Angle)						0.012³					0.027³
	Normal	6	64.9	6	35.1		12	100.0	0	0.0
	Class I	41	20.3	157	79.7		145	73.1	53	26.9
	Class II	35	37.4	68	62.6		78	77.6	25	22.4
	Class III	3	11.9	16	88.1		10	36.8	9	63.2
Posterior crossbite						0.031¹					<0.001¹
	No	74	30.7	203	69.3		220	80.5	57	19.5
	Yes	11	14.6	44	85.4		25	40.3	30	59.7
Posterior open bite						0.225¹					0.114¹
	No	75	27.0	222	73.0		228	75.6	69	24.4
	Yes	10	35.0	25	65.0		17	54.8	18	45.2
Overbite						0.078¹					0.420¹
	No	55	33.1	138	66.9		147	75.5	46	24.5
	Yes	30	18.2	109	81.8		98	69.3	41	30.7
Sex						0.352¹					0.712¹
	Female	42	30.2	112	69.8		117	74.9	37	25.1
	Male	43	25.8	135	74.2		128	72.0	50	28.0
Race/color						0.274¹					0.190¹
	White	25	32.8	56	67.2		65	78.0	16	20.0
	Brown	50	23.8	167	76.2		153	69.8	64	30.2
	Black	10	40.3	24	59.7		27	80.2	7	19.8
Economic class (ABEP)						0.870¹					0.231²
	A-B	40	29.6	97	70.4	0.218²	104	79.6	33	20.4	0.836²
	C	39	27.2	129	72.8		118	68.1	50	31.9
	D-E	6	25.9	21	74.1		23	86.8	4	13.2
School type						0.758¹					0.610¹
	Public	56	27.2	710	72.8		174	72.8	62	27.2
	Private	29	31.0	220	69.0		71	76.0	25	24.0
History of school failure						0.743¹					0.825¹
	No	61	27.1	171	72.9		171	74.1	61	25.9
	Yes	24	29.2	76	70.8		74	71.9	26	28.1
Pacifier sucking						0.612¹					0.816¹
	No	54	26.9	168	73.1		163	72.8	59	27.2
	Yes	31	29.8	79	70.2		82	74.5	28	25.5
Finger sucking						0.107¹					0.188¹
	No	70	25.8	227	74.2		218	71.8	79	28.2
	Yes	15	41.2	20	58.8		27	83.9	8	16.1
Biting lips/cheeks						0.104¹					0.821¹
	No	48	31.6	128	68.4		125	72.8	51	27.2
	Yes	37	23.7	119	76.3		120	74.0	36	26.0
Biting objects						0.251¹					0.240¹
	No	48	25.9	158	74.1		155	76.2	51	23.8
	Yes	37	30.1	89	69.9		90	70.0	36	30.0
Nail biting						0.153¹					0.789¹
	No	36	32.5	86	67.5		90	74.6	55	25.4
	Yes	49	25.1	161	74.9		155	72.6	87	27.4
Bruxism						0.022¹					0.284¹
	No	75	31.0	192	69.0		199	75.7	68	24.3
	Yes	10	14.2	55	85.8		46	63.1	19	36.9
Sleeping with hands under the face						0.442¹					0.226¹
	No	59	29.0	156	71.0		153	70.7	62	29.3
	Yes	26	25.5	91	74.5		92	78.4	25	21.6
Lingual interposition						0.323¹					0.699¹
	No	70	25.7	217	74.3		210	74.3	77	25.7
	Yes	15	39.2	30	60.2		35	68.4	10	31.6

Variables		Breathing alterations						Phonation alterations
		Unadjusted analysis			Adjusted analysis			Unadjusted analysis			Adjusted analysis
		OR	95%CI	P- value	OR	95%CI	P- value	OR	95%CI	P- value	OR	95%CI	P- value
Malocclusion (DAI)
	Normal/Mild	1	-	-	1	-	-	1	-	-	1	-	-
	Defined	4.31	1.44-12.92	0.012	3.84¹	1.45-10.12	0.010	2.17	0.83-5.67	0.107	2.01¹	1.02-4.39	0.047
	Severe	1.53	0.69-3.41	0.273	1.44¹	0.69-3.01	0.303	1.44	0.65-3.21	0.341	1.43¹	0.62-3.28	0.372
	Disabling	4.47	2.17-9.18	<0.001	4.34¹	1.99-9.49	0.001	3.03	1.56-5.91	0.003	3.04¹	1.55-5.96	0.003
Malocclusion according to Angle
	Normal/Class I	1	-	-	1	-	-	1	-	-	1	-	-
	Class II	0.94	0.60-1.46	0.763	0.87²	0.56-1.36	0.528	1.69	1.01-2.85	0.049	2.02²	1.28-3.18	0.005
	Class III	3.45	0.67-17.72	0.127	4.15²	1.19-14.54	0.028	4.34	0.94-20.07	0.059	3.07²	0.95-9.92	0.059
Posterior crossbite
	No	1	-	-	1	-	-	1	-	-	1	-	-
	Yes	2.38	0.86-6.60	0.090	2.36³	0.87-6.39	0.085	1.23	0.62-4.57	0.283	1.68³	0.62-4.57	0.283
Posterior open bite
	No	1	-	-	1	-	-	1	-	-	1	-	-
	Yes	1.26	0.72-2.22	0.385	1.28⁴	0.70-2.31	0.396	1.61	0.62-4.17	0.302	1.59⁴	0.61-4.16	0.319
Overbite
	No	1	-	-	1	-	-	1	-	-	1	-	-
	Yes	1.53	0.82-2.85	0.166	1.64⁵	0.81-3.34	0.157	1.02	0.65-1.59	0.927	1.05⁵	0.66-1.68	0.821

Variables		Chewing alterations						Swallowing alterations
		Unadjusted analysis			Adjusted analysis			Unadjusted analysis			Adjusted analysis
		OR	95%CI	P- value	OR	95%CI	p- value	OR	95%CI	P- value	OR	95%CI	P- value
Malocclusion (DAI)
	Normal/Mild	1	-	-	1	-	-	1	-	-	1	-	-
	Defined	1.45	0.75-2.81	0.247	1.39¹	0.64-2.74	0.415	0.90	0.45-1.82	0.780	1.57¹	0.61-4.06	0.322
	Severe	1.16	0.46-2.92	0.731	1.09¹	0.43-2.74	0.851	1.24	0.63-2.45	0.532	1.38¹	0.71-2.69	0.322
	Disabling	1.38	0.49-3.87	0.511	1.28¹	0.51-3.21	0.579	1.54	0.79-3.03	0.207	1.94¹	0.90-4.17	0.087
Malocclusion according to Angle
	Normal/Class I	1	-	-	1	-	-	1	-	-	1	-	-
	Class II	0.77	0.31-1.96	0.574	0.73²	0.30-1.77	0.463	0.86	0.37-2.00	0.715	0.80²	0.33-1.96	0.612
	Class III	3.39	0.88-13.03	0.072	3.66²	0.88-15.23	0.072	5.13	1.11-18.78	0.046	5.66²	1.35-23.71	0.021
Posterior crossbite
	No	1	-	-	1	-	-	1	-	-	1	-	-
	Yes	2.30	1.08-4.90	0.032	2.32³	1.12-4.82	0.027	6.12	2.68-13.97	<0.001	6.13³	2.76-13.62	<0.001
Posterior open bite
	No	1	-	-	1	-	-	1	-	-	1	-	-
	Yes	0.60	0.24-1.49	0.250	0.60⁴	0.24-1.51	0.261	3.55	0.75-8.65	0.124	4.53⁴	1.72-8.92	0.037
Overbite
	No	1	-	-	1	-	-	1	-	-	1	-	-
	Yes	1.64	0.66-4.07	0.265	1.79⁵	0.78-4.10	0.157	1.36	0.61-3.04	0.421	1.42⁵	0.59-3.42	0.404

location_on

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

rss_feed Acompañe los números de esta revista en su lector de RSS

[TFN1] ¹Chi-square test; ²Trend chi-square test; ³Fisher’s exact test. Statistically significant P-values: P<0.05. DAI: Dental Aesthetic Index. ABEP: Economic class according to the Brazilian Association of Research Companies (Associação Brasileira de Empresas de Pesquisa - ABEP).

[TFN2] Source: Elaborated by the authors.