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182 rev port estomatol med dent cir maxilofac. 2018;59(4):181-190

Auto-avaliação de saúde e saúde oral em pacientes diabéticos tipo 2
– estudo caso-controle

r e s u m o

Palavras-chave: Objetivos: Verificar existência de diferenças entre a autoavaliação da saúde geral (SRS) e da
Estudo caso-controlo saúde oral (SROH) entre pacientes com diabetes melittus tipo 2 (DM2) e sem (nDM2) e explo-
Cuidados de saúde primários rar as condições de maior impacto na saúde geral (GH) e oral (OH) associadas à autoperceção.
Autoavaliação da saúde Métodos: Após aprovação ética e consentimento informado, obteve-se 343 adultos DM2 e
Autoavaliação da saúde oral 323 controlos. Os dados clínicos e de OH foram coletados usando critérios da OMS e pergun-
Diabetes tipo 2 tas para autoclassificação de GH e OH numa escala de Likert (5 pontos). A análise inferencial
utilizou testes não-paramétricos e regressão logística multivariada (MLR) (α=0,05).
Resultados: Os pacientes DM2 autoavaliam significativamente pior a sua GH do que nDM2
(p<0,001). Nos nDM2, a MLR mostrou que cálculo e higiene oral à noite são fatores de risco
para uma perceção de pior GH; entre os DM2 é a HTA, dislipidemia, ≥1 dente ausente. Para
os DM2, a SRH e SROH, mostra significativamente (p<0,001) mais frequente as perceções de
“má” ou “muito má”. O cálculo e bolsas ≥4mm foram identificadas como fatores de risco
(OR=3,55, p=0,049; OR=4,32, p=0,025, respetivamente) e CPOD>0, presença de cálculo e re-
cessões estão associadas (p<0,001) a mais frequente perceção como “má” ou “muito má” SRH
e SROH.
Conclusões: Indivíduos com diabetes melittus tipo 2 mostraram uma pior autoperceção de
saúde geral e oral do que os indivíduos sem esta patologia e a saúde oral foi pior autoava-
liada que a saúde geral. (Rev Port Estomatol Med Dent Cir Maxilofac. 2018;59(4):181-190)
© 2018 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
Publicado por SPEMD. Este é um artigo Open Access sob uma licença CC BY-NC-ND
(http://creativecommons.org/licenses/by-nc-nd/4.0/).

12
OH is an integral part of GH. Some studies have identified
Introduction
associations between oral pathology and DM2, 1,8,13,14 and both
15
Oral health (OH) is one of the domains of general health (GH). are associated with a worse perceived GH and worse oral-
Both are related to personal well-being, which includes func- health quality of life due to OH manifestations. 16-18
tional capacity, physical wellness, emotional stability, and so- The self-perception of health (SPH) is a subjective indicator
1
cial-familial interactions. Personal well-being also depends on that complements the clinical health status, independently of
the perception of disease and the way individuals understand medical interpretations of signs and symptoms, and has been
several aspects related to health and disease, considering their identified as an important predictor of mortality or health
individual and social experiences, including their knowledge care. The SPH is a valid assessment of the individual’s GH and
about their pathology, symptoms, potential causes, probable OH perception 19-22 and can be used as a predictor of future
2
3
duration, evolution in time and potential consequences. OH is health outcomes 23,24 or related to OH in diabetic patients. 25-29
multi-faceted and includes the abilities to speak, smile, smell, The self-perception of impacts on both GH and OH is not al-
taste, touch, chew, swallow and convey a range of emotions ways significantly valued in literature, 1,30-32 and it can be the-
through facial expressions with confidence and without pain, orized that the association between the individuals’ percep-
discomfort and any disease of the craniofacial complex. 4 tion of OH and GH is not always clear. 33
Diabetes mellitus is associated with significant multi-mor- This study aims to analyze whether there are differences
bidity and affects about 422 million individuals worldwide, a between self-rated general health (SRH) and self-rated oral
number that is increasing. Because diabetes mellitus type 2 health (SROH) between individuals with DM2 and without DM2
5,6
(DM2) is a chronic disease, the health status of the affected and to characterize the general and oral conditions associated
individuals tends to degrade over time, with the arising of clin- with general-health and oral-health self-perception.
ical complications mostly due to an increasingly difficult gly-
caemic control. The development of comorbidities leads to a
7
depreciation of the perceived quality of life. Oral pathology is Material and methods
one of the major complications in DM2 patients and, therefore,
it is important to intervene early in order to reduce the risk of A case-control study was conducted among adult volunteers
a future interaction between these pathologies. 8-11 with DM2 and without DM2 attending a primary healthcare
The emphasis on similarities between determinants of OH centre – the Family Health Unit (FHC) of Espinho, Portugal. Eth-
and GH is broadly consistent and leads to the conclusion that ical clearance (Parecer CES/ARSN n.8/2013) was obtained from