{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T01:24:58Z","timestamp":1794273898189,"version":"4.9.0"},"reference-count":43,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiologia"],"abstract":"<jats:p>This study aims to describe the prevalence of malocclusion and identify associated factors in preschool children. Completed in 2022\u20132023, this cross-sectional study included 523 children aged 26 to 80 months in municipal schools in Salvador. An oral examination was carried out on the children, and a questionnaire was self-administered by the parents. Descriptive analyses and multivariate logistic regression (the backward method, p-value \u2264 0.05, 95% CI) were conducted. The majority of children were female (51.82%), over 54 months old (52.2%), Black or mixed race (90.63%), and not affected by COVID-19 (92.35%). The prevalence of malocclusion was 43.21%, with open bite as the most common condition. There was a significant association between malocclusion and screen time (OR: 1.34; p: 0.116; CI: 1.0\u20131.94), physical\/psychological aggression (OR: 2.55; p: 0.031; CI: 1.0\u20135.98), consumption of ultra-processed foods (OR: 1.77; p: 0.003; CI: 1.22\u20132.57), digital suction (OR: 3.1; p: 0.001; CI: 1.56\u20136.16), and the habit of biting objects (OR: 1.56; p: 0.121; CI: 1.0\u20132.73). The promotion of comprehensive health in early childhood and psychosocial interventions are recommended, aiming to reduce screen time, aggression, consumption of ultra-processed foods, thumb sucking, and the habit of biting objects to prevent malocclusion.<\/jats:p>","DOI":"10.3390\/epidemiologia5020019","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T08:45:37Z","timestamp":1717663537000},"page":"275-288","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-Sectional Questionnaire Study"],"prefix":"10.3390","volume":"5","author":[{"given":"Amanda Ara\u00fajo de","family":"Carvalho","sequence":"first","affiliation":[{"name":"Departamento de Odontologia Social e Pedi\u00e1trica, Universidade Federal da Bahia (UFBA), Ara\u00fajo Pinho Street, 6\u00ba Floor, 62 Canela, Salvador 41110-150, BA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana Frederico de","family":"Almeida","sequence":"additional","affiliation":[{"name":"Departamento de Odontologia Social e Pedi\u00e1trica, Universidade Federal da Bahia (UFBA), Ara\u00fajo Pinho Street, 6\u00ba Floor, 62 Canela, Salvador 41110-150, BA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Beatriz Barreto de Sousa","family":"Cabral","sequence":"additional","affiliation":[{"name":"Departamento de Odontologia Social e Pedi\u00e1trica, Universidade Federal da Bahia (UFBA), Ara\u00fajo Pinho Street, 6\u00ba Floor, 62 Canela, Salvador 41110-150, BA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9295-9486","authenticated-orcid":false,"given":"Maria Cristina Teixeira","family":"Cangussu","sequence":"additional","affiliation":[{"name":"Departamento de Odontologia Social e Pedi\u00e1trica, Universidade Federal da Bahia (UFBA), Ara\u00fajo Pinho Street, 6\u00ba Floor, 62 Canela, Salvador 41110-150, BA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/cdoe.12035","article-title":"Exploring the impact of oral diseases and disorders on the quality of life of preschool children","volume":"41","author":"Kramer","year":"2013","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e2119244","DOI":"10.1590\/2177-6709.26.2.e2119244.oar","article-title":"Influence of malocclusion on oral health-related quality of life in children: A seven-year cohort study","volume":"26","author":"Knorst","year":"2021","journal-title":"Dent. Press. J. Orthod."},{"key":"ref_3","unstructured":"American Academy of Pediatric Dentistry (2024, April 10). Guideline on Management of the Developing Dentition and Occlusion in Pediatric Dentistry. Available online: http:\/\/www.aapd.org\/media\/Policies_Guidelines\/G_DevelopDentition.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Caruso, S., Nota, A., Darvizeh, A., Severino, M., Gatto, R., and Tecco, S. (2019). Poor oral habits and malocclusions after usage of orthodontic pacifiers: An observational study on 3-5\u2009years old children. BMC Pediatr., 19.","DOI":"10.1186\/s12887-019-1668-3"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1080\/00016357.2018.1472294","article-title":"Association between psychological factors, socio-demographic conditions, oral habits and anterior open bite in five-year-old children","volume":"76","author":"Gomes","year":"2018","journal-title":"Acta Odontol. Scand."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.ajodo.2019.06.014","article-title":"The influence of breastfeeding and pacifier use on the association between preterm birth and primary-dentition malocclusion: A population-based birth cohort study","volume":"157","author":"Bonow","year":"2020","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_7","first-page":"115","article-title":"Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis","volume":"21","author":"Lombardo","year":"2020","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_8","unstructured":"Minist\u00e9rio da Sa\u00fade (2011). SB BRASIL 2010: Pesquisa Nacional de Sa\u00fade Bucal: Resultados Principais."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.ecresq.2021.12.004","article-title":"Heterogeneity in maternal and child mental health responses to the COVID-19 pandemic","volume":"59","author":"Saleem","year":"2022","journal-title":"Early Child. Res. Q."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jped.2020.08.008","article-title":"The potential impact of the COVID-19 pandemic on child growth and development: A systematic review","volume":"97","author":"Veloso","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e048430","DOI":"10.1136\/bmjopen-2020-048430","article-title":"Changes in pediatric dental clinic after reopening during COVID-19 pandemic in Wuhan: A retrospective study","volume":"12","author":"Yang","year":"2022","journal-title":"BMJ Open"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Koerber, M.I., Mack, J.T., Seefeld, L., Kopp, M., Weise, V., Starke, K.R., and Garthus-Niegel, S. (2023). Psychosocial work stress and parent-child bonding during the COVID-19 pandemic: Clarifying the role of parental symptoms of depression and aggressiveness. BMC Public. Health, 23.","DOI":"10.1186\/s12889-022-14759-5"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13034-022-00464-z","article-title":"A cross-sectional investigation of psychosocial stress factors in German families with children aged 0\u20133 years during the COVID-19 pandemic: Initial results of the CoronabaBY study","volume":"16","author":"Buechel","year":"2022","journal-title":"Child. Adolesc. Psychiatry Ment. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e210287","DOI":"10.1590\/s0104-12902022210287","article-title":"Implica\u00e7\u00f5es da COVID-19 no cotidiano das fam\u00edlias nordestinas e no cuidado infantil","volume":"31","author":"Silva","year":"2022","journal-title":"Saude Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1111\/fare.12702","article-title":"Reciprocal effects between young children\u2019s negative emotions and mothers\u2019 mental health during the COVID-19 pandemic","volume":"71","author":"Wei","year":"2022","journal-title":"Fam. Relat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s10643-022-01306-5","article-title":"I Felt Like I Was Going Crazy: Understanding Mother\u2019s and Young Children\u2019s Educational Experiences at Home During COVID-19","volume":"51","author":"Burns","year":"2023","journal-title":"Early Child. Educ. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"105457","DOI":"10.1016\/j.chiabu.2021.105457","article-title":"Mental health & maltreatment risk of children with special educational needs during COVID-19","volume":"130","author":"Tso","year":"2022","journal-title":"Child. Abus. Neglect."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Okely, A.D., Kariippanon, K.E., Guan, H., Taylor, E.K., Suesse, T., Cross, P.L., Chong, K.H., Suherman, A., Turab, A., and Staiano, A.E. (2021). The global effect of COVID-19 pandemic on physical activity, sedentary behavior and sleep among 3- to 5-year-old children: A longitudinal study of 14 countries. BMC Public. Health, 21.","DOI":"10.1186\/s12889-021-10852-3"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1542\/peds.2013-1632","article-title":"Interventions to improve cortisol regulation in children: A systematic review","volume":"133","author":"Slopen","year":"2014","journal-title":"Pediatrics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1590\/S1519-38292009000300003","article-title":"Condi\u00e7\u00f5es de sa\u00fade bucal de crian\u00e7as na faixa et\u00e1ria pr\u00e9-escolar, residentes em \u00e1reas de abrang\u00eancia do Programa Sa\u00fade da Fam\u00edlia em Salvador, Bahia, Brasil","volume":"9","author":"Almeida","year":"2009","journal-title":"Rev. Bras. Sa\u00fade Matern. Infant."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.33425\/2639-9490.1093","article-title":"Prevalence of malocclusion and associated factors in preschoolers from Salvador-BA in 2019","volume":"5","author":"Carvalho","year":"2021","journal-title":"Oral Health Dent. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e20210007","DOI":"10.1590\/2317-1782\/20212021007","article-title":"Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil","volume":"34","author":"Pegoraro","year":"2021","journal-title":"Codas"},{"key":"ref_23","first-page":"163","article-title":"Malocclusion in Brazilian Schoolchildren: High Prevalence and Low Impact","volume":"16","author":"Traebert","year":"2018","journal-title":"Oral Health Prev. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1111\/ipd.12417","article-title":"Association of breastfeeding and malocclusion in 5-year-old children: Multilevel approach","volume":"28","author":"Freire","year":"2018","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2021399","DOI":"10.1590\/1984-0462\/2023\/41\/2021399","article-title":"Toxic stress on a pediatric population during the COVID-19 pandemic","volume":"41","author":"Souza","year":"2023","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_26","unstructured":"World Health Organization (2024, April 10). Guidelines on Physical Activity, Sedentary Behavior, and Sleep for Children under 5 Years of Age. Available online: https:\/\/iris.who.int\/handle\/10665\/311664."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"107572","DOI":"10.1016\/j.chb.2022.107572","article-title":"Screen media exposure and behavioral adjustment in early childhood during and after COVID-19 home lockdown periods","volume":"140","author":"Shalev","year":"2023","journal-title":"Comput. Hum. Behav."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/s12903-022-02303-1","article-title":"Occlusal features of 5-year-old Greek children: A cross-sectional national study","volume":"22","author":"Davidopoulou","year":"2022","journal-title":"BMC Oral Health"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Xu, J., Li, X., Liu, X., Li, S., Wang, X., and Liu, J. (2022). Investigation on the Prevalence of Malocclusion and Analysis of Oral Health-Related Quality of Life in Children Aged 6\u201312 Years in Jinzhou. Res. Sq.","DOI":"10.21203\/rs.3.rs-1544897\/v1"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/joor.13446","article-title":"Prevalence of temporomandibular disorders in children and adolescents evaluated with diagnostic criteria for temporomandibular disorders: A systematic review with meta-analysis","volume":"50","author":"Minervini","year":"2023","journal-title":"J. Oral Rehabil."},{"key":"ref_31","first-page":"1","article-title":"Temporomandibular joint disorders and associated factors in a Turkish pediatric population","volume":"19","author":"Torul","year":"2024","journal-title":"Oral Dis."},{"key":"ref_32","first-page":"138","article-title":"Relationship between Bruxism and Malocclusion among Preschool Children in Isfahan","volume":"6","author":"Ghafournia","year":"2012","journal-title":"J. Dent. Res. Dent. Clin. Dent. Prospect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000516414","article-title":"Oral Myofunctional and Articulation Disorders in Children with Malocclusions: A Systematic Review","volume":"74","author":"Thijs","year":"2022","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_34","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE) (2024, April 27). Ag\u00eancia IBGE. PNAD CONT\u00cdNUA. Seguran\u00e7a Alimentar Nos Domic\u00edlios Brasileiros Volta a Crescer em 2023, Available online: https:\/\/agenciadenoticias.ibge.gov.br\/agencia-noticias\/2012-agencia-de-noticias\/noticias\/39838-seguranca-alimentar-nos-domicilios-brasileiros-volta-a-crescer-em-2023."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S217","DOI":"10.1016\/S0929-693X(10)70930-1","article-title":"Diversifi cation alimentaire et d\u00e9veloppement dentaire: Importance des habitudes alimentaires des jeunes enfants pour la pr\u00e9vention de dysmorphoses orthodontiques","volume":"17","author":"Limme","year":"2010","journal-title":"Arch. P\u00e9diatrie"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/joor.12149","article-title":"Influence of maximum bite force on jaw movement during gummy jelly mastication","volume":"41","author":"Kuninori","year":"2014","journal-title":"J. Oral Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00784-016-1768-5","article-title":"Factors associated with masticatory performance among preschool children","volume":"21","author":"Marques","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s12903-024-03895-6","article-title":"Association between occlusal features and masticatory function in Hong Kong preschool children: A survey with one-year longitudinal follow-up","volume":"24","author":"Yeung","year":"2024","journal-title":"BMC Oral Health"},{"key":"ref_39","first-page":"56","article-title":"Masticatory evaluation of anterior open bite malocclusion using the colorimetric capsule method","volume":"66","author":"Maeda","year":"2018","journal-title":"Gen. Dent."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/joor.12227","article-title":"Assessment of masticatory function in patients with non-sagittal occlusal discrepancies","volume":"42","author":"Choi","year":"2015","journal-title":"J. Oral Rehabil."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"67","DOI":"10.46311\/2318-0579.56.eUJ2898","article-title":"Avalia\u00e7\u00e3o Da Influ\u00eancia Do Padr\u00e3o Alimentar Sobre O Desenvolvimento De Maloclus\u00f5es Dent\u00e1rias: Estudo Observacional Transversal Descritivo","volume":"56","author":"Lima","year":"2019","journal-title":"Rev. UNING\u00c1"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e2020267","DOI":"10.1590\/1984-0462\/2021\/39\/2020267","article-title":"Violence Against Children And Adolescents: Notification And Alert In Times Of Pandemic","volume":"39","author":"Platt","year":"2020","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1177\/1524838019835973","article-title":"Child Abuse in Natural Disasters and Conflicts: A Systematic Review","volume":"22","author":"Seddighi","year":"2021","journal-title":"Trauma Violence Abus."}],"container-title":["Epidemiologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-3986\/5\/2\/19\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:54:47Z","timestamp":1760108087000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-3986\/5\/2\/19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,6]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["epidemiologia5020019"],"URL":"https:\/\/doi.org\/10.3390\/epidemiologia5020019","relation":{},"ISSN":["2673-3986"],"issn-type":[{"value":"2673-3986","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,6]]}}}