Avaliação da saúde bucal de crianças com microcefalia atribuída à infecção congênita pelo Zika vírus

Abstract

The increase of number of children born with microcephaly in Brazil associated to the infection of pregnant by the Zika virus (ZIKV) this led the World Health Organization to declare an international public health state of emergency in 2015. The aim of this study was to evaluate the oral health condition and the quality of life associated with oral health (QoLOH) of children born in the state of Rio de Janeiro (RJ) with microcephaly attributed to congenital ZIKV infection, via the e longitudinal study of case series type, and to the oral and orofacial alterations in Brazilian children affected described in the scientific literature using a scoping review (SR). The study was approved by the Research Ethics Committee of HUPE-UERJ (82775617.2.0000.5259). After signing the informed consent term, the mothers were interviewed about their health history during pregnancy, type of delivery, characteristics of the child’s development, eating habits and oral hygiene; and clinical examination performed in dental equipment every six months by a single trained and calibrated examiner. The Brazilian version of the questionnaire “Early Childhood Oral Health Impact Scale” (ECOHIS-B) was applied in the consultation conducted after the child was 24 months old. The data were analyzed with the statistical program SPSS v.21 (IBM Corp, Armonk, NY, USA). The SR followed the methodology recommended by the “Joanna Briggs Institute Reviewer’s Manual” and following the guidelines “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews” (PRISMA-ScR). For the 34 children followed up to 30 months the main oral alterations identified were: delay in eruption of deciduous teeth, change in the sequence of tooth eruption (n=14; 41.1%), agenesis (n=5; 14.7%) and dental form changes (n=5; 14.7%); rash cysts (n=8; 23.5%), bruxism (n=22; 64.7%), gingival bleeding (n=19; 55.8%), anterior open bite (n=16; 47%), ogival palate (n=22; 64.7%). No child had dental caries. Regarding QolOH, 30 mothers answered the ECOHIS-B questionnaire; there were missing data in 21, all related to impacts experienced by children. ECOHIS-B values ranged from 0 to 24 (mean 8.2; SD=5.9; median=7.5). Impact on children presented higher frequency for: irritability (n=17; 56.7%) and pain in the mouth or teeth (n=16; 53.3%), and in families: feeling upset (n=12; 40%) and feeling guilty (n=6; 20%). There 20 studies met the inclusion criteria of SR the main orofacial alterations mentioned were: alteration in the chronology of eruption with delay and alteration in the sequence of eruption, defects of enamel development, tooth anomaly of number and form, bruxism, altered lingual frenulum, ogival palate and lip and lingual hypotonia. This study concluded that children with microcephaly attributed to congenital ZIKV infection born in RJ present oral and dental alterations and impairment of quality of life associated with oral health, and that Congenital Zika Virus Syndrome can affect the oral health of children.