Influence of Depression and Use of Alcohol and / or Tobacco by Parents in the Oral Health of Children with Disabilities

Kriss Mélani Sanga  Gárate; Júlia de Medeiros  Cotrim; Marco Antônio Alves  Brasil; Glória Fernanda Barbosa de Araújo  Castro

Authors

Kriss Mélani Sanga Gárate
Júlia de Medeiros Cotrim
Marco Antônio Alves Brasil
Glória Fernanda Barbosa de Araújo Castro

Keywords:

Disabled Children, Oral Health, Tobacco, Depression, Caregivers

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.

References

American Academy of Pediatric Dentistry. Council on Clinical Affairs. Guideline on management of dental patients with special health care needs. Pediatr Dent 2012; 34(5):160-5.

The United Nations Children’s Fund. The State of the World's Children 2006: Excluded and Invisible. New York UNICEF; 2006. 143p.

Zhou N, Wong HM, Wen YF, Mcgrath C. Oral health status of children and adolescents with intellectual disabilities: a systematic review and meta-analysis. Dev Med Child Neurol 2017; 59(10):1019-26. https://doi.org/10.1111/dmcn.13486

Santos MT, Biancardi M, Guare RO, Jardim JR. Caries prevalence in patients with cerebral palsy and the burden of caring for them. Spec Care Dent 2010; 30(5):206-10. https://doi.org/10.1111/j.1754-4505.2010.00151.x

Tufail N, Batool S, Rehman A. A comparative research on disabled and non-disabled children’s mothers in terms of depression and anxiety prevalence. Indo Am J P Sci 2018; 5(6):5724-31. https://doi.org/10.5281/zenodo.1298687

Dang AT, Ho M, Kroenke K, Grupp-Phelan J. Maternal somatic symptoms, psychosocial correlates, and subsequent pediatric emergency department use. Pediatr Emerg Care 2013; 29(2):170-4. https://doi.org/10.1097/PEC.0b013e3182809a10

dos Santos Pinto G, de Ávila Quevedo L, Correa MB, Azevedo MS, Goettems ML, Pinheiro RT, et al. Maternal depression increases childhood dental caries: a cohort study in Brazil. Caries Res 2017; 51(1):17-25. https://doi.org/10.1159/000449040

Diéguez-Pérez M, de Nova-García M-J, Mourelle-Martínez MR, Bartolomé-Villar B. Oral health in children with physical (Cerebral Palsy) and intellectual (Down Syndrome) disabilities: systematic review I. J Clin Exp Dent 2016; 8(3):e337-343. https://doi.org/10.4317/jced.52922

Khan M, Monaghan M, Klein N, Ruiz G, John AS. Associations among depression symptoms with alcohol and smoking tobacco use in adult patients with congenital heart disease. Congenit Heart Dis 2015; 10(5):E243-E249. https://doi.org/10.1111/chd.12282

Salles PS, Tannure PN, Oliveira R, de Souza IPR, Portela MB, Castro GF. Dental needs and management of children with special health care needs according to type of disability. J Dent Child 2012; 79(3):165-9.

de Lima Osório F, Vilela Mendes A, Crippa JA, Loureiro SR. Study of the discriminative validity of the PHQ‐9 and PHQ‐2 in a sample of Brazilian women in the context of primary health care. Perspect Psychiatr Care 2009; 45(3):216-27. https://doi.org/10.1111/j.1744-6163.2009.00224.x

Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care. 2nd ed. Geneva: World Health Organization; 2001.

Meneses-Gaya IC, Zuardi AW, Loureiro SR, Crippa JA. Psychometric properties of the Fagerström test for nicotine dependence. J Bras Pneumol 2009; 35(1):73-82. https://doi.org/10.1590/s1806-37132009000100011

Ribeiro AA, Portela M, Souza IP. Relation between biofilm, caries activity and gingivitis in HIV+ children. Pesqui Odontol Bras 2002; 16(2):144-50. https://doi.org/10.1590/S1517-74912002000200009

Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975; 25(4):229-35.

World Health Organization. Oral Health Surveys: Basic Methods. 5th ed. Geneva: World Health Organization; 1997.

Mandić J, Jovanović S, Mandinić Z, Ivanović M, Kosanović D, Biljana M, et al. Oral health in children with special needs. Vojnosanit Pregl 2018; 75(00):675-81. https://doi.org/10.2298/VSP160707372M

Jabbarifar SE, Ahmady N, Sahafian SAR, Samei F, Soheillipour S. Association of parental stress and early childhood caries. Dent Res J 2009; 6(2):65-70.

D'Alessandro G, Cremonesi I, Alkhamis N, Piana G. Correlation between oral health in disabled children and depressive symptoms in their mothers. Eur J Paediatr Dent 2014; 15(3):303-8. https://doi.org/10.1037/11877-005

Ljubešić M. Roditelji djece s teškoćama u razvoju i usluge za podršku roditeljstvu. Zagreb: UNICEF; 2013. [In Croatian]

Beighton C, Wills J. Are parents identifying positive aspects to parenting their child with an intellectual disability or are they just coping? A qualitative exploration. J Intellect Disabil 2017; 21(4):325-45. https://doi.org/10.1177/1744629516656073

Phillips M, Masterson E, Sabbah W. Association between child caries and maternal health-related behaviours. Community Dent Health 2016; 33(2):133-7. https://doi.org/10.1922/CDH_3801Phillips05

Aligne CA, Moss ME, Auinger P, Weitzman M. Association of pediatric dental caries with passive smoking. JAMA 2003; 289(10):1258-64. https://doi.org/10.1001/jama.289.10.1258

Arora M, Weuve J, Schwartz J, Wright RO. Association of environmental cadmium exposure with pediatric dental caries. Environ Health Perspect 2008; 116(6):821-5. https://doi.org/10.1289/ehp.10947

Kum-Nji P, Meloy L, Herrod HG. Environmental tobacco smoke exposure: prevalence and mechanisms of causation of infections in children. Pediatrics 2006; 117(5):1745-54. https://doi.org/10.1542/peds.2005-1886

Tanaka K, Miyake Y, Arakawa M, Sasaki S, Ohya Y. Household smoking and dental caries in schoolchildren: the Ryukyus Child Health Study. BMC Public Health 2010; 10:335. https://doi.org/10.1186/1471-2458-10-335

De Menezes Oliveira MA, Torres CP, Gomes‐Silva JM, Chinelatti MA, De Menezes FC, Palma‐Dibb RG, et al. Microstructure and mineral composition of dental enamel of permanent and deciduous teeth. Microsc Res Tech 2010; 73(5):572-7. https://doi.org/10.1002/jemt.20796

Foster H, J Fitzgerald. Dental disease in children with chronic illness. Arch Dis Child 2005; 90(7):703-8. https://doi.org/10.1136/adc.2004.058065

Nirmala SV, Popuri VD, Chilamakuri S, Nuvvula S, Veluru S, Minor Babu MS. Oral health concerns with sweetened medicaments: Pediatricians' acuity. J Int Soc Prev Community Dent 2015; 5(1):35-9. https://doi.org/10.4103/2231-0762.151973