Relação entre condições bucais em dentes anteriores e vitimização por bullying em escolares de 12 anos de Manaus, Amazonas

Abstract

Bullying can be defined as intentional violence, carried out repeatedly and without apparent justification, in a context of power asymmetry between the parties. This aggression is highly prevalent in adolescence and can lead to psychological, emotional and social harm to the victim. Its occurrence may be related to a variety of factors, and physical characteristics such as weight, height and facial characteristics often stand out as the focus of the aggressors. The objective of this study was to identify the relationship between demographic and socioeconomic characteristics, psychosocial factors, oral condition in anterior teeth and tooth-related verbal bullying in 12-year-old schoolchildren living in Manaus, Amazonas. A cross-sectional study was conducted, including 12-year-old adolescents of both sexes enrolled in the public school system of Manaus, Amazonas. The bullying experience was assessed through questions adapted from the questionnaire used in the 2019 National School Survey. Dental caries, dental trauma, dental fluorosis in the anterior teeth and malocclusion were measured using the index of decayed, missing and filled teeth, O'Brien, Thylstrup and Fejerskov and the Orthodontic Treatment Need Index (aesthetic component), respectively. The psychosocial factors evaluated were social support (measured by the Social Support Appraisals), self-esteem (measured by the Rosenberg self-esteem scale) and sense of coherence (measured by the Sense of Coherence Scale - SOC -13). Socioeconomic status was assessed by parental education, family income and agglomeration. In the data analysis, initially, a descriptive analysis of the variables was performed. Then, the measurement model was tested using confirmatory factor analysis to assess the multidimensionality of the latent variables and the correspondence with the proposed indicators. Finally, the direct and indirect relationships between the observed and latent variables within the theoretical-hypothetical model of the study were tested through structural equation modeling. There was a prevalence of verbal bullying of 48.1%, indirect bullying of 39.8% and physical bullying of 25.7%, totaling 65.1% of students who reported some type of victimization. Among the students who suffered verbal bullying, 11.0% attributed the motivation to their teeth, corresponding to 5.1% of the total sample. Malocclusion was directly associated with tooth- related verbal bullying (β = 0.081), while better psychosocial factors reduced the occurrence of this outcome (β = -0.217). Female gender and better socioeconomic status had indirect effects mediated by psychosocial factors. The findings indicate that bullying was highly prevalent among public school students in Manaus and that malocclusion was associated with tooth-related verbal bullying. In contrast, the other oral conditions affecting anterior teeth were not associated with victimization. In addition, demographic and socioeconomic factors influenced this outcome, with psychosocial factors acting as mediators. These relationships highlight the multifactorial nature of bullying while underscoring the adverse effect of malocclusion on bullying victimization.