Do not know/do not recall 1.81 (0.90–3.66) 0.09 0.35 (0.15–0.81) 0.015 Consultation pattern Regular 1 1 Irregular 2.57 (1.84–3.61) <0.01 2.47 (1.71–3.57) <0.01 Do not go to dental consults 1.71 (1.13–2.59) 0.01 1.55 (0.97–2.48) 0.06 Sugar consumption High 1 1 Low 1.50 (1.18–1.91) <0.01 1.38 (1.07–1.78) 0.012

No 0.73 (0.58–0.91) <0.01 0.48 (0.20–1.11) 0.087

#### **Table 3.**

*Results of the multiple logistic regression, São Lourenço da Mata/PE, 2014.*

It was demonstrated in this research that the impact related to oral health in this group of adolescents was associated with sex, where the girls reported a greater impact than the boys. It was noticed, based on this findings, that girls are more attentive, perceiving, and enhancing oral health [1, 4, 34, 35] feel more comfortable in reporting their health-related concerns or emotional problems [36] and are more sensitive to the perception of his appearance [4].

Most of the interviewees had gone to the dentist at least once in their lifetime, and a considerable percentage consulted the dental services in less than a year. Similar data were found by other authors [37–39].

In the present study, the pattern of regular dental care was associated with the impact, which is in agreement with the findings of a study conducted in northern Tanzania [38] in which the frequency of having any oral impact had a directly proportional increase with the visit to the dentist. Likewise, another study verified an association of the impact with the recent use of dental services [39]. Studies have found that a greater proportion of participants who had never visited a dentist reported less impact [40, 41]. The possible explanation for this fact may be associated with the pattern of symptomatic dental care, since most adolescents visit the dentist only when they have toothache, have a mouth problem, or their oral health is poor, and statistically, these are more likely to have more regular dental care, according to the results of some studies [3, 4, 7, 37, 42, 43].

In the present study, adolescents with high sugar consumption showed a greater impact on quality of life related to oral health. Sugar consumption has long been

**155**

impact.

**Conflict of interest**

*Behavioral and Psychosocial Factors as Mediators of the Oral Health Impact on Adolescents…*

reported as one of the relevant factors in the etiology of caries [5, 44] also, lack of access to dental services is generally associated with low socioeconomic status [45, 46]. Untreated caries and its immediate consequence, the pain of dental origin, are the main causes of impacts related to the quality of life in adolescents [47, 48, 53]. Thus, improving behavior among dental visits of low socioeconomic groups would have a greater effect on improving oral health, reducing the impact on quality of life

A relevant finding was the fact that behavioral factors related to oral health, especially concerning a higher prevalence of dental caries, such as the pattern of irregular dental care and high sugar consumption were minimized when adjusted for psychosocial factors. This effect may be related to the fact that psychosocial factors seem to act at a level above the determinant chain [39, 41, 42, 49].

Another important finding of the present study was the association between the impact of oral health related to quality of life and the order of birth of school children. Previous studies have shown that younger children in families with more than two children report more pain [1]; they have more caries and more risk behaviors for oral health [50]. One possible explanation for this is the fact that, in socially disadvantaged families, parental care is hampered by the availability of time for the

These findings point to the strengthening of the theoretical models of the social

The present study demonstrated the independent association between behavioral and psychosocial factors in determining the impact on the quality of life related to oral health. This demonstrates that health promotion actions should be directed not only to specific actions such as tooth brushing and fluoride application but should include broader actions directed at contextual factors where the indi-

The study also found that oral diseases have an impact on the studied population, mainly in female adolescents, younger children of families with more than one child, an irregular pattern of dental care, and high consumption of sugar. Thus, these results indicate that the vulnerability of social conditions is represented by families with several children, in which oral health becomes more likely to report

determinants of the disease, in which the psychosocial factors point to a strong mediation of these factors with chronic diseases among them oral health [51, 52, 54]. The results of this study should be interpreted in light of its limitations; since it is a cross-sectional study, a cause-and-effect relationship cannot be established. However, the aspects related to its validity should be emphasized, since it is based on other studies, derived from a population sample, and used a universally accepted

*DOI: http://dx.doi.org/10.5772/intechopen.89567*

related to oral health [38].

care of the youngest children.

vidual lives and their family structure.

The authors declare no conflict of interest.

methodology.

**5. Conclusion**

*Behavioral and Psychosocial Factors as Mediators of the Oral Health Impact on Adolescents… DOI: http://dx.doi.org/10.5772/intechopen.89567*

reported as one of the relevant factors in the etiology of caries [5, 44] also, lack of access to dental services is generally associated with low socioeconomic status [45, 46]. Untreated caries and its immediate consequence, the pain of dental origin, are the main causes of impacts related to the quality of life in adolescents [47, 48, 53]. Thus, improving behavior among dental visits of low socioeconomic groups would have a greater effect on improving oral health, reducing the impact on quality of life related to oral health [38].

A relevant finding was the fact that behavioral factors related to oral health, especially concerning a higher prevalence of dental caries, such as the pattern of irregular dental care and high sugar consumption were minimized when adjusted for psychosocial factors. This effect may be related to the fact that psychosocial factors seem to act at a level above the determinant chain [39, 41, 42, 49].

Another important finding of the present study was the association between the impact of oral health related to quality of life and the order of birth of school children. Previous studies have shown that younger children in families with more than two children report more pain [1]; they have more caries and more risk behaviors for oral health [50]. One possible explanation for this is the fact that, in socially disadvantaged families, parental care is hampered by the availability of time for the care of the youngest children.

These findings point to the strengthening of the theoretical models of the social determinants of the disease, in which the psychosocial factors point to a strong mediation of these factors with chronic diseases among them oral health [51, 52, 54].

The results of this study should be interpreted in light of its limitations; since it is a cross-sectional study, a cause-and-effect relationship cannot be established. However, the aspects related to its validity should be emphasized, since it is based on other studies, derived from a population sample, and used a universally accepted methodology.
