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The association between bullying and toothache in Brazilian students

An analysis of the Brazilian National Student Health Survey

Bibliographic Data

ID19595016
AuthorsCaroline Segatto Girardon (0009-0000-3563-5469, Universidade Federal de Santa Maria), Orlando Luiz Do Amaral Júnior (0000-0002-6611-3871, Universidade Federal de Santa Maria), Fernando Neves Hugo (0000-0003-2222-7719, York University, corresponding author), Jessye Melgarejo Do Amaral Giordani (0000-0002-3825-9734, Universidade Federal de Santa Maria), Luana Severo Alves (0000-0003-0110-7929, Universidade Federal de Santa Maria)
EditorsPengpeng Ye (0000-0002-2924-1436)
Year2026
Volume6
Issue4
Pagese0005167
Publication date2026-04-20
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0005167
PMID42008472
OpenAlexW7154956842
LanguageEN
References cited14

This study analyzed the association between self-perceived bullying and self-reported toothache among Brazilian students and evaluated the moderating role of school-based health actions, including participation in the School Health Program, oral health promotion, and bullying prevention. A cross-sectional study was conducted using data from the 2019 National School-based Health Survey, including 53,711 students aged 13–17 years. The outcome was self-reported toothache and the main exposure was self-perceived bullying. Moderating variables included school participation in the School Health Program, oral health promotion actions, and bullying prevention actions. Poisson regression models with robust variance were fitted, with standard errors adjusted for clustering by school. Overall, 23.6% of students reported toothache and 13.7% reported bullying. Moderation analyses showed no evidence that school health actions influenced the association between bullying and toothache. For bullying once or ≥2 times, prevalence ratios were: School Health Program participation (PR_once = 0.92, 95%CI 0.77–1.09; PR_ ≥ 2 = 1.07, 95%CI 0.81–1.41), bullying prevention (PR_once = 0.98, 95%CI 0.76–1.25; PR_ ≥ 2 = 0.82, 95%CI 0.72–1.09), and oral health promotion (PR_once = 1.13, 95%CI 0.96–1.33; PR_ ≥ 2 = 1.19, 95%CI 0.94–1.52). These findings indicate that school-based health actions alone may be insufficient to mitigate the impact of bullying on adolescents’ oral health

Adolescent health · Association (psychology) · Health promotion · Moderation · Occupational safety and health · Poison control · Poisson regression · Toothache · Bullying, Victimization, and Aggression · Pediatric health and respiratory diseases · Smoking Behavior and Cessation

  • Statistical Analysis of Correlated Data Using Generalized Estimating Equations

    James A Hanley•American Journal of Epidemiology•2003

  • Lesões no complexo maxilofacial em vítimas de violência no ambiente escolar

    Open Access•Alessandro Leite Cavalcanti•Ciência & Saúde Coletiva•2009

  • School environment and oral health promotion

    Open Access•Newillames Gonçalves Nery, Lidia Moraes Ribeiro Jordão et al.•Revista de Saúde Pública•2019

  • Implementation of the School Health Program

    Open Access•Rafael Da Silveira Moreira, Herika De Arruda Mauricio et al.•Saúde em Debate•2022

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Highly citedNo

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