Factors Associated with Child Self-Perception of Oral Health

Objectives: Self-perception of oral health is a multidimensional measurement for assessing the health and quality of life interacting with multiple factors. This study aimed to evaluate the association of child perception of oral health with clinical, psychological and physiological variables. Methods: Forty-three children aged eight to ten years were recruited from public schools of Piracicaba city, São Paulo, Brazil. Self-perception of oral health was measured using the Child Perceptions Questionnaire (CPQ) 8-10. Clinical variables were evaluated by oral examinations of dental caries and malocclusion. The Revised-Children's Manifest Anxiety Scale (R-CMAS) and the Children's Depression Inventory (CDI) were used to assess the psychological variables, anxiety and depression, respectively. Saliva samples were collected 30 min after awakening and at bedtime, and cortisol levels measured by enzyme immunoassay analysis were considered to represent physiological variable. To identify the variables predicting the CPQ8-10 scores, correlation and multiple analyses were used. Results: CPQ8-10 scores ranged from 0 to 58 with a mean of 16.7 (SD=15.0). Positive significant correlations were observed between anxiety (r=0.47, p<0.01) and depression (r=0.34, p<0.05) ratings and CPQ8-10 scores. Salivary cortisol levels also significantly correlated with CPQ8-10 scores (r=0.38, p<0.05). In stepwise linear regression analysis, anxiety ratings (p<0.01) and salivary cortisol levels (p<0.05) remained significant predictors of CPQ8-10 scores after controlling for oral disease variables. Conclusion: Psychological (anxiety and depression symptoms) and physiological (salivary cortisol levels) variables were shown to influence child perceptions of oral health. Therefore, these factors should be considered in assessments involving this age group. (Financial support: FAPESP 08/00325-9)