Screen Time, Dental Caries, and Oral Health-Related Quality of Life in Adolescents Living in Deprived Neighbourhoods in Manaus, Brazil: A Two-Year Follow-Up Study.

OBJECTIVES: To examine the influence of screen time and behavioural pathways on the incidence of dental caries and oral health-related quality of life (OHRQoL) among adolescents living in deprived neighbourhoods. METHODS: A 2-year prospective cohort study involving 323 12-year-old adolescents enrolled in public schools was conducted in the East region of Manaus, Brazil. Baseline data encompassing sex, socioeconomic status (family income, parents' education and household crowding), social support (SSA questionnaire), screen time (number of hours spent on screen-based activities), behaviours (sugar consumption and frequency of toothbrushing) and dental caries (DMFT index) was collected through self-administered questionnaires and clinical examinations. OHRQoL (Child Perceptions Questionnaire-CPQ11-14) and dental caries incidence were measured at baseline and 2-year follow-up. Structural equation modelling, guided by the Wilson and Cleary conceptual framework, was employed to examine both direct and indirect associations among the study variables. RESULTS: Increased screen time directly predicted higher dental caries incidence and poor OHRQoL after 2 years. Sugar consumption mediated the association between screen time and dental caries incidence. Incidence of dental caries mediated the association between screen time and OHRQoL. Poor OHRQoL was also directly predicted by dental caries incidence and female sex. Screen time and sugar consumption mediated the association of socioeconomic status and social support with dental caries incidence and OHRQoL. CONCLUSIONS: The findings of this study indicate that spending more time on screen-based activities is significantly associated with a greater consumption of sugar, higher incidence of dental caries and negative impact on OHRQoL among adolescents. These findings underscore the need for targeted strategies aimed at reducing screen time and sugar consumption to mitigate its detrimental effects on oral health and overall quality of life.