Family Cohesion Is Associated with the Self-Perceived Need for Dental Treatment among Adolescents

Abstract

This study explored the association between family cohesion and self-perceived need for dental treatment among adolescents. A school-based representative cross-sectional study was conducted with 746 students aged 15 to 19 randomly selected from schools in Campina Grande, Brazil. Parents/guardians provided information on sociodemographic data, and students completed questionnaires about the self-perceived need for dental treatment, dental pain, and family cohesion and adaptability (FACES III). Two dentists were trained (kappa >0.80) to diagnosis dental caries using the Nyvad criteria and assess adolescents’ level of functional oral health literacy (BREALD-30). Descriptive analysis was performed, followed by nonadjusted and adjusted robust binary logistic regression for complex samples ( α = 5 % ). The prevalence of self-perceived need for dental treatment was 88.6%. The presence of dental caries ( OR = 2.10 ; IC 95%: 1.22–3.61), tooth loss ( OR = 15.81 ; IC 95%: 2.14–116.56), dental pain in the last six months ( OR = 1.87 ; IC 95%: 1.06–3.31), and enmeshed family cohesion type ( OR = 10.23 ; IC 95%: 3.96–26.4) remained associated with the self-perceived need for dental treatment in the final model. In conclusion, dental caries, dental pain, tooth loss, and family cohesion influenced the self-perceived need for dental treatment in adolescents.

Individual and Contextual Factors Associated with Adolescents’ Self-Perceived Need for Treatment

“…Symptomatic and functional parameters, such as toothache and the loss of the first permanent molars, also exerted an influence on the self-perceived treatment need, a result similar to that found in other studies [1,5]. This finding demonstrates that adolescents are more affected when the condition is more evident, affecting both esthetics and function.…”

“…In the adjusted analysis, active caries on anterior teeth were not associated with the self-perceived treatment need. On the other hand, previous studies analyzing clinical factors found an association between tooth decay in the anterior and posterior teeth and the self-perceived treatment need in adolescents in the same age group [1,5]. The prevalence of active caries on anterior teeth was 57.7%, and the mean number of caries on anterior teeth was low 1.62 (2.04).…”

“…Studies on factors associated with the self-perceived dental treatment need have been directed at clinical factors, such as dental caries in the anterior and posterior regions, tooth loss, pain, advanced periodontal disease, esthetic issues, dissatisfaction with one's teeth, dental appointments for the purpose of treatment, and oral health-related quality of life [1,[4][5][6]. The perception of caries in the anterior region is important as this location is more easily visible, and attention can be given early to avoid disease progression.…”

“…The family contributes to the formation of health-related habits in childhood that extend into adolescence and adulthood [7]. Thus, studies have focused on the influence of family type on oral health outcomes and indicators, demonstrating that family cohesion can exert an influence on the oral health status and treatment need among students [5,8]. Less cohesive families have worse oral health outcomes due to the greater difficulty in sharing healthy habits among their members [7].…”

“…Previous studies examining self-perception regarding the need for dental treatment primarily focused on assessing variables related to socioeconomic and clinical aspects [1,5]. This study aimed to expand this scope by integrating non-clinical factors into the analysis.…”