To investigate individual and contextual factors associated with orofacial dysfunction in schoolchildren. A cross-sectional study was conducted with 739 children eight to ten years of age. The children answered questionnaires addressing orofacial dysfunction and anxiety. Guardians provided information on sociodemographic characteristics, sleep disturbances, and family cohesion. Examiners investigated the presence of orofacial dysfunction, dental caries, malocclusion, and traumatic dental injuries (Andreasen criteria) (Kappa>0.80). The type of school and average monthly income of the school neighborhood were the contextual variables. Descriptive statistics were performed to characterize the sample. Unadjusted and adjusted (p <0.05) multilevel Poisson regression models were run. The prevalence of orofacial dysfunction was 33.3%. After adjustment by the contextual variables, a lower family income, a larger quantity of carious teeth, the presence of traumatic dental injury, severe/very severe malocclusion, the presence of sleep disturbances, and anxiety remained associated with orofacial dysfunction, whereas definite malocclusion was a protection factor. In terms of context, attending a public school was associated with orofacial dysfunction. Orofacial dysfunction was influenced by a lower family income, a larger quantity of carious teeth, and the presence of traumatic dental injury, sleep disturbances, and anxiety. Moreover, attending a public school was the contextual determinant that played a significant role in the outcome.
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