Alterations in oral mucosa among preschool children: Prevalence and determinant factors

Pouco conhecimento est? dispon?vel em torno da preval?ncia e dos fatores associados ?s altera??es de mucosa bucal em crian?as pr?-escolares procedentes da zona urbana ou rural. O objetivo do presente estudo foi verificar a preval?ncia e os fatores associados com varia??es da normalidade e les?es de mucosa bucal em 541 pr?-escolares saud?veis da zona urbana e rural do munic?pio de Diamantina, Minas Gerais, Brasil. Atrav?s de question?rio aplicado aos pais/respons?veis investigaram-se informa??es sociodemogr?ficas como proced?ncia da crian?a (zona urbana ou rural), escolaridade da m?e e renda mensal do grupo familiar, al?m da presen?a de h?bitos nocivos como bruxismo, suc??o e mordiscagem de objetos. Em seguida, exames bucais foram realizados para verificar altera??es de mucosa e higiene bucal, al?m da presen?a de c?rie dent?ria. An?lise descritiva, testes Kruskal-Wallis, Mann-Whitney, qui-quadrado, Exato de Fisher e regress?o log?stica multivariada foram utilizados para an?lise dos dados (p<0,05). A preval?ncia de altera??es de mucosa bucal foi de 49,5%. As varia??es da normalidade mais frequentes foram: l?ngua saburrosa (23,4%), manchas mel?nicas (14,4%) e gr?nulos de Fordyce (8,1%). Por outro lado, as les?es mais prevalentes foram: les?es ulceradas (11,8%), queilite angular (3,0%) e f?stula (1,3%). Independentemente do g?nero, idade, escolaridade da m?e, renda familiar e proced?ncia da crian?a, pr?-escolares de 3 a 5 anos possu?ram maior chance de apresentar l?ngua saburrosa [OR:2,55; (IC95%: 1,6-4,1)], manchas mel?nicas [OR:4,07; (IC95%: 2,3-7,2)] e gr?nulos de Fordyce [OR:12,70; (IC95%: 7,2-28,6)]. L?ngua saburrosa foi mais prevalente em crian?as de baixa renda [OR:2,35; (IC95%: 1,3-4,3)] e higiene bucal insatisfat?ria [OR:4,65; (IC 95%: 2,9-7,4)]. Crian?as da zona rural [OR:3,86; (IC 95%: 2,1-7,1)] e do g?nero feminino [OR:2,23; (IC 95%: 1,3-3,8)] apresentaram maior ocorr?ncia de manchas mel?nicas. Pr?-escolares com c?rie possu?ram maior chance de apresentar linha alba [OR: 6,19; (IC95%: 1,1-26,1)], ulcera??es bucais [OR:2,15; (IC95%: 1,2-3,9)] e f?stula [OR:12,0; (IC95%: (1,4-11,3)]. Pr?-escolares com bruxismo apresentaram maior ocorr?ncia de queilite angular [OR:5,55; (IC95%: 1,9-16,3)]. Concluiu-se que a preval?ncia de altera??es de mucosa bucal em crian?as pr?-escolares foi alta. Os fatores mais frequentemente associados ?s varia??es da normalidade foram o g?nero feminino, idade entre 3 e 5 anos, higiene bucal insatisfat?ria, baixa renda familiar, proced?ncia rural e c?rie dent?ria. Por outro lado, os ?nicos fatores associados ?s les?es de mucosa bucal foram c?rie dent?ria e bruxismo.Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG)Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES)Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq)ABSTRACT Narrow knowledge is available about the prevalence of alterations in the oral mucosa and associated factors among preschool children coming from urban or rural area. The aim of the present study was to determine the prevalence of abnormalities and lesions in the oral mucosa and associated factors among 541 healthy preschool children in urban and rural areas of the city of Diamantina, Minas Gerais, Brazil. A questionnaire administered to parents/guardians investigated socio-demographic variables, such as child?s place of residence (urban or rural area), mother's schooling and monthly household income as well as harmful habits such as bruxism (teeth grinding/clenching), sucking habits and chewing on objects. Oral examinations were performed to determine mucosa alterations, oral hygiene and dental caries. Descriptive analysis, Fisher?s Exact test, the Kruskal-Wallis, Mann-Whitney and chi-square tests and multivariate logistic regression were used for data analysis (p < 0.05). The prevalence of alterations in the oral mucosa was 49.5%. The most prevalent abnormalities were coated tongue (23.4%), melanotic macules (14.4%) and Fordyce granules (8.1%). The most prevalent lesions were oral ulcers (11.8%), angular cheilitis (3.0%) and fistula (1.3%). Preschool children aged three to five years had a greater chance of exhibiting coated tongue (OR: 2.55; 95% CI: 1.6-4.1), melanotic macules (OR: 4.07; 95% CI: 2.3-7.2) and Fordyce granules (OR: 12.70; 95% CI: 7.2-28.6). Coated tongue (OR: 2.35; 95% CI: 1.3-4.3) and poor oral hygiene (OR: 4.65; 95% CI: 2.9-7.4) were more prevalent among low-income children. Children in rural areas (OR: 3.86; 95% CI: 2.1 to 7.1) and the female gender (OR: 2.23; 95% CI: 1.3-3.8) had a higher occurrence of melanotic macules. Preschool children with dental caries had a greater chance of exhibiting linea alba (OR: 6.19; 95% CI: 1.1-26.1), oral ulcers (OR: 2.15; 95% CI: 1.2-3.9) and fistula (OR: 12.0; 95% CI: 1.4-11.3). Children with bruxism had higher incidence of angular cheilitis (OR: 5.55; 95% CI: 1.9-16.3). The prevalence of alterations in the oral mucosa of preschool children was high. The factors most often associated with such abnormalities were the female gender, age between three and five years, poor oral hygiene, low income, residing in a rural area and dental caries. However, the only factors associated with oral mucosa lesions were dental caries and bruxism