Self-Perceptions of the Impact of Oral Problems on the Social Behavior of Preschoolers

Introduction: Investigating preschool children's social behaviors and the association with oral health variables helps to understand child development. Besides that, different perceptions need to be explored regarding the impact of oral problems on the social behavior between the child's self-report and parent's/caregiver's proxy report.

Objective: To determine which socioeconomic and oral factors are associated with difficulty sleeping and playing and the avoidance of smiling in preschoolers.

Methods: A cross-sectional study was conducted with a representative random sample of 769 pairs of parents/caregivers and 5-y-old preschoolers. The preschoolers answered a questionnaire on difficulty sleeping, difficulty playing, and the avoidance of smiling for reasons related to oral problems. The parents/caregivers answered a questionnaire addressing socioeconomic characteristics as well as the use of dental services. Two calibrated dentists examined the children for the determination of dental caries, traumatic dental injury (TDI), malocclusion, and bruxism. Descriptive and Poisson regression analysis for complex samples with robust variance was used to test the associations (α = 5%).

Results: The variables associated with difficulty sleeping were low household income (confidence interval [CI]: 1.40-3.01), number of untreated dental caries (CI, 1.02-1.04), dental pain (CI, 1.76-3.59), TDI (CI, 1.08-2.11), and anterior open bite (CI, 1.11-2.20). Difficulty playing also was associated with the low household income (CI, 1.34-3.15), number of untreated dental caries (CI, 1.01-1.04), dental pain (CI,1.42-3.61), and TDI (CI, 1.13-2.33). The number of untreated dental caries (CI, 1.02-1.05), dental pain (CI, 1.03-2.88), anterior open bite (CI, 1.30-3.26), and not using dental services (CI, 1.13-2.73) were determinant factors for the avoidance of smiling.

Conclusion: Socioeconomic, symptomatic, and/or oral esthetic problems exerted an impact on the social behavior of the preschoolers analyzed, such as playing, sleeping, and smiling.

Knowledge transfer statement: The results of the present study may help parents and clinicians to understand better the association of oral problems with the social behavior of preschool children. Moreover, this study shows the importance of listening to children in clinical decisions. These results also can help in the elaboration of oral health policies.