Sangramento gengival autorreportado em adultos e idosos brasileiros: fatores associados e a relação com qualidade de vida relacionada à saúde bucal

Abstract

This cross-sectional study aimed to assess the association between self-reported gingival bleeding, social determinants of health and oral health-related quality of life in a population of Brazilian adults and elderly. For this purpose, the ELSI-Brasil database – Longitudinal Study of the Health of the Elderly in Brazil – was used. Self-reported gengival bleeding was measured using the question "Do your gum currently bleed?" with options of answers dichotomized in “yes” or “no”. The quality of life variable was verified by the Oral Impacts on Daily Performance as a categorical variable, dichotomized into “no impact”, for those who answered no to all questions and “has an impact on their oral health-related quality of life”, for those who answered yes to at least one question. The analysis of the social determinants of health was based on the model suggested by Peres and contributors in 2019, formed by three large blocks of determinants. Sex, education, skin color, age, wealth index, depression, life satisfaction, trust in the neighborhood, use of toothbrush and dental floss, smoking, dental services, diabetes and number of teeth were analyzed. At first, the association between self-reported gingival bleeding as an outcome and associated factors was evaluated. Next, the relationship between oral healthrelated quality of life as an outcome and self-reported gingival bleeding exposure was sought. Of the 6,114 individuals included in this study, the prevalence of self-reported gingival bleeding was 10,4%. There was an independent association with self-reported gingival bleeding and psychosocial variables such as depression, dissatisfaction with life, lack of trust in neighbors and smoking. It is also observed that there was a lower perception of gingival bleeding in the olders. Individuals aged 60-69 years, 70-79 years and over 80 years had, respectively, 27%, 55% and 71% lower prevalence of reporting gingival bleeding than those between 50-59 years old. Regarding oral health-related quality of life, the prevalence was 46.3%. Those who reported experiencing gingival bleeding had a higher prevalence of poor oral health-related quality of life (Reason for Prevalence: 1.10; 95% Confidence Interval: 1.02-1.18) than their peers, even after adjustment for all variables in the model. Therefore, psychosocial characteristics were strong associated with self-reported gingival bleeding. And individuals who report gingival bleeding had a poor quality of life than those who do not report gengival bleeding. The importance of public health actions that address the community, seeking to modify health inequities, is highlighted here.