Shame from Smiling and Speaking Due to Oral Health Problems in Brazilian Adolescents: A Nationwide Population-Based Study


  • Ramon Targino Firmino
  • Ana Flávia Granville-Garcia
  • Saul Martins Paiva
  • Priscila Hernandez de Campos
  • Alba Valeska Oliveira
  • Michele Baffi Diniz


Dental Caries, Fluorosis, Dental, Quality of Life, Tooth Injuries, Oral Health


Objective: To investigate the association between oral health problems and being ashamed of smiling or speaking among Brazilian adolescents. Material and Methods: This was a population-based cross-sectional study carried out with secondary data from 7,328 12-year-old Brazilian adolescents from the latest Brazilian national oral health survey (SB Brasil 2010). The question “In the previous 6 months, have you been ashamed of smiling or speaking due to your teeth?” was the outcome variable. Calibrated examiners performed clinical examinations on adolescents for the diagnosis of dental caries (DMF-T), dental trauma, dental fluorosis and occlusal alterations. Data were analyzed descriptively and by Poisson unadjusted and adjusted Poisson regression analysis (p<0.05). The final model was controlled by family income. Results: The prevalence of being ashamed of smiling or speaking was 13.6%. The following variables were associated with the outcome: female sex (PR=1.33; 95% CI: 1.17-1.53), cavitated dental caries on upper incisors (PR=1.81; 95% CI: 1.51-2.15), dental trauma (PR=1.36; 95% CI:1.16-1.60), increased maxillary overjet (PR=1.36; 95% CI:1.18-1.57), dental crowding (PR=1.60; 95% CI:1.40-1.83), midline diastema (PR=1.30; 95% CI:1.11-1.44), tooth loss (PR=1.45; 95% CI:1.16-1.80), mild/questionable dental fluorosis (PR=1.23; 95% CI:1.06-1.44) and moderate/severe dental fluorosis (PR=1.67; 95% CI:1.15-2.44). Conclusion: Oral health problems that impact dental aesthetics were predisposing factors for being ashamed of smiling or speaking in Brazilian adolescents.


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How to Cite

Firmino, R. T., Granville-Garcia, A. F., Paiva, S. M., de Campos, P. H., Oliveira, A. V., & Diniz, M. B. (2022). Shame from Smiling and Speaking Due to Oral Health Problems in Brazilian Adolescents: A Nationwide Population-Based Study. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 22, e210188. Retrieved from



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