Universidade Federal de Minas Gerais . Departamento de Odontologia Social e Preventiva . Belo Horizonte , MG , Brasil.
Universidade Federal do Amazonas . Faculdade de Odontologia . Manaus , AM , Brasil.
Rev Saude Publica. 2022 Jul 8;56:67. doi: 10.11606/s1518-8787.2022056004061. eCollection 2022.
To investigate the influence of protective psychosocial factors on the incidence of dental pain in the last six months among 12-year-old children living in Manaus (AM).
A prospective school-based cohort study was conducted with 210 12-year-old students enrolled in public schools in the eastern zone of Manaus (AM). Students were followed up for two years. Validated questionnaires were used to assess sociodemographic characteristics, protective psychosocial factors, including sense of coherence, social support, and self-esteem at baseline and after two years. Calibrated examiners clinically assessed dental caries and gingival bleeding. Multivariate multilevel Poisson regression was used to estimate the relative risk (RR) and 95% confidence interval (95%CI) between the changes on psychosocial factors scores and incidence of dental pain, adjusted for psychosocial factors scores at baseline, dental health insurance, frequency of tooth brushing, and dental caries.
Mean scores for sense of coherence and social support reduced significantly from baseline to 2-year follow-up. The incidence of dental pain along the two-year follow-up was 28.6%. The risk of dental pain was 14% higher for every 10 points in the mean reduction of sense of coherence score (RR = 1.14; 95%CI: 1.02-1.20), and 6% higher for every 10 points of the mean reduction in social support score (RR = 1.06; 95%CI: 1.01-1.11). Change on self-esteem was not associated with risk of dental pain.
Change on sense of coherence and social support over the two-year period influenced the incidence of dental pain among children, suggesting that protective psychosocial factors, health behaviours, dental health insurance, and clinical oral condition have an important role in the incidence of dental pain.
调查保护心理社会因素对生活在马瑙斯（AM）的 12 岁儿童过去六个月牙痛发生率的影响。
对马瑙斯（AM）东区公立学校的 210 名 12 岁学生进行了一项前瞻性学校队列研究。对学生进行了两年的随访。使用经过验证的问卷评估了社会人口学特征、保护心理社会因素，包括在基线和两年后评估的总体感觉、社会支持和自尊。经过校准的检查者对龋齿和牙龈出血进行了临床评估。使用多变量多级泊松回归来估计心理社会因素评分变化与牙痛发生率之间的相对风险（RR）和 95%置信区间（95%CI），调整了基线心理社会因素评分、牙科健康保险、刷牙频率和龋齿。
从基线到两年随访，总体感觉和社会支持的平均得分显著降低。在两年的随访过程中，牙痛的发生率为 28.6%。总体感觉得分每降低 10 分，牙痛的风险增加 14%（RR = 1.14；95%CI：1.02-1.20），社会支持得分每降低 10 分，牙痛的风险增加 6%（RR = 1.06；95%CI：1.01-1.11）。自尊的变化与牙痛风险无关。
在两年期间，总体感觉和社会支持的变化影响了儿童牙痛的发生率，这表明保护心理社会因素、健康行为、牙科健康保险和临床口腔状况对牙痛的发生有重要作用。
