Associations between perceived needs for dental treatment, oral health-related quality of life and oral diseases in school-aged Thai children

Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Validity of mother-child self-perceived oral health for the assessment of 5 years old children's oral health in Indonesia

BACKGROUND

Early childhood caries (ECC) is a serious condition that has a negative impact on young children's quality of life. Mothers' perceived need for oral health care plays an important role in their children's oral health behavior. This study aimed to compare mother and child self-perceived and dentist-evaluated needs for oral health care.

METHODS

This cross-sectional study included 266 preschool children aged 5 years old and their mothers. A self-administered questionnaire to the mothers and interviews with the children were used to assess the perceived needs of oral health care. The mothers were asked to rate their children's oral health and determine if they needed dental treatment. The children were also asked how they felt about their oral health and whether they had any tooth decay. Agreement between mother and child regarding the child's oral health was assessed. The evaluated needs were assessed clinically using the dmft (decayed, missing, and filled teeth [primary dentition]) and pufa (pulpal involvement, ulceration, fistula, and abscess [primary dentition]) indices. The perceived and evaluated needs were compared using spearman analysis to determine their correlations and the validity of the perceived needs compared to the clinical examination was assessed using the area under the curve (AUC), sensitivity (Sn), specificity (Sp), and likelihood ratio (LR).

RESULTS

The prevalence rate of ECC was 89.4%, with 35% having at least one condition from untreated caries (pufa > 0). Mothers and children have a fair agreement regarding the child's oral health (ICC = 0.335). When comparisons were conducted between perceived and evaluated conditions, Mother's rating about their child's oral health showed the strongest correlation to dmft index (r = 0.372; p < 0.001). Several accuracy parameters done in this study (AUC, Sn, and Sp) did not meet the acceptable threshold. The sensitivity and specificity were the highest when comparing mothers' perceived need for their child's dental treatment to the dmft index (Sn = 96.7%) and pufa index (Sp = 88.1%), respectively.

CONCLUSION

Compared to the dentist's assessment, the mother and child self-reported oral health statuses showed lower accuracy in assessing the child's condition. But, the mothers in this study were better than their 5-year-old children at perceiving their child's oral health care needs. As a result, these subjective assessments can be used as a complement, but not as a substitute, to the actual clinical evaluation.

Family Cohesion Is Associated with the Self-Perceived Need for Dental Treatment among Adolescents

This study explored the association between family cohesion and self-perceived need for dental treatment among adolescents. A school-based representative cross-sectional study was conducted with 746 students aged 15 to 19 randomly selected from schools in Campina Grande, Brazil. Parents/guardians provided information on sociodemographic data, and students completed questionnaires about the self-perceived need for dental treatment, dental pain, and family cohesion and adaptability (FACES III). Two dentists were trained (kappa >0.80) to diagnosis dental caries using the Nyvad criteria and assess adolescents' level of functional oral health literacy (BREALD-30). Descriptive analysis was performed, followed by nonadjusted and adjusted robust binary logistic regression for complex samples (α = 5%). The prevalence of self-perceived need for dental treatment was 88.6%. The presence of dental caries (OR = 2.10; IC 95%: 1.22-3.61), tooth loss (OR = 15.81; IC 95%: 2.14-116.56), dental pain in the last six months (OR = 1.87; IC 95%: 1.06-3.31), and enmeshed family cohesion type (OR = 10.23; IC 95%: 3.96-26.4) remained associated with the self-perceived need for dental treatment in the final model. In conclusion, dental caries, dental pain, tooth loss, and family cohesion influenced the self-perceived need for dental treatment in adolescents.

Gingivitis influences oral health-related quality of life in adolescents: findings from a cohort study

INTRODUCTION

Oral health-related quality of life (OHRQoL) is affected by different clinical conditions. The aim of this study was to evaluate the impact of gingivitis on OHRQoL in adolescents.

METHODOLOGY

This cohort study consisted of a random sample of 1,134 schoolchildren enrolled during 2012, in Santa Maria, Brazil. After two years, 743 adolescents were follow-up (response rate: 65.5%). Clinical, socioeconomic and OHRQoL data were collected. OHRQoL was assessed by the short Brazilian version of the Child Perceptions Questionnaire 11-14 (CPQ11-14), and gingival bleeding through Community Periodontal Index. Gingivitis was considered with the presence of 15% or more bleeding sites. Poisson regression models were used to evaluate the association between gingivitis and overall and domain-specific CPQ11-14 scores. Prevalence of gingivitis at baseline was considered the main predictor for the OHRQoL at follow-up.

RESULTS

Gingivitis at baseline was associated with higher overall CPQ 11-14 score (RR = 1.07; 95%CI 1.01 - 1.14), and emotional well-being (RR = 1.17; 95%CI 1.04 - 1.31), independently of other oral conditions and socioeconomic variables.

CONCLUSIONS

The findings indicate that gingivitis negatively impacts the adolescents' OHRQoL. Moreover, gender, maternal schooling and household income were also associated with OHRQoL.

The effectiveness of behavioral interventions to improve oral health in adolescents at different periods of follow-up: A systematic review and meta-analysis

BACKGROUND

The aim of this review was to examine the effectiveness of behavioral interventions at different follow-up periods to improve adolescents' oral health.

METHODS

CENTRAL, MEDLINE, EMBASE and other databases were systematically searched. Inclusion criteria were as follows: participants aged 10-19 years old, randomized controlled trials using behavioral interventions, outcome measurements including oral health knowledge, attitudes, practices, and oral health status. For each included study, behavior change techniques (BCT) were identified and the quality and risk of bias assessments obtained. PROSPERO reference: CRD42018090341.

RESULTS

After searching and screening, 17 clinical trials were included in the systematic review. The most commonly used BCTs were behavior health link, information on consequences, and social comparisons. A significant reduction of plaque index was detected (SMD:-0.46; 95 % CI:-0.82∼-0.10) for 3 months and (SMD:-0.71; 95 % CI:-1.08∼-0.33) for 6 months. The reduction of gingival index after 6 months was also significant (SMD:-0.90; 95 % CI:-1.33∼-0.47). Oral health knowledge and oral health-related behavior were also improved after behavioral interventions.

CONCLUSION

There is moderate evidence that behavioral interventions are effective in promoting oral health in adolescents. To establish more evidence-based conclusions, further research should focus on: quality control of interventions, full descriptions regarding the BCT, long-term follow-ups, and behavior change reinforcements.

PRACTICAL VALUE

Given the need of early prevention of oral diseases, well-designed oral health promotion programme are needed to improve behavior and outcome of adolescents' oral health.

Self-perceived dental treatment need among adolescents: A hierarchical analysis

OBJECTIVES

The aim of the present study was to analyse the factors associated with self-perceived need for dental treatment among adolescents.

METHODS

A representative sample in the state of São Paulo, Brazil, comprising 5558 adolescents, was evaluated in 2015. The adolescents were selected by probabilistic sampling by conglomerates in two stages. The outcome evaluated was self-perceived treatment need measured via a validated questionnaire. Independent variables included sociodemographic factors, type, frequency and reason for last dental visit, and examination of oral conditions. Statistical analysis was based on the multiple hierarchical logistic regression model.

RESULTS

Of the total sample, 3340 (62.6%) adolescents reported needing dental treatment. After fitting the model, the self-perceived need for treatment was associated with adolescents with family income of up to $1,500 BRL (OR 1.39; [95% CI = 1.20-1.60]; P < .001), who sought dental services solely for curative treatment (OR 1.58; [95% CI = 1.46-1.72]; P < .001), reported toothaches in the previous six months (OR 2.88; [95% CI = 2.53-3.28]; P < .001), were dissatisfied with the appearance of their teeth and mouth (OR 5.94; [95% CI = 5.03-7.01]; P < .001), had caries in the posterior teeth only (OR 3.04; [95% CI = 2.77-3.33]; P < .001) or had caries in the anterior teeth (OR 4.75; [95% CI = 4.05-5.56]; P < .001).

CONCLUSIONS

The self-perceived need for dental treatment among Brazilian adolescents was associated with normative and subjective needs, and sociodemographic context factors. This finding provides important evidence for collective health planning.

Negative effect of malocclusion on the emotional and social well-being of Brazilian adolescents: a population-based study

Background/objectives

The aesthetic impact of malocclusion can have negative repercussions on quality of life, social interaction, interpersonal relationships, and psychological well-being. The aim of this study was to evaluate the impact of malocclusion on the quality of life of Brazilian adolescents.

Methods

A representative cross-sectional study of 1612 adolescents from Belo Horizonte, Minas Gerais was conducted. The adolescents responded to the Brazilian version of the Child Perception Questionnaire (CPQ11-14-ISF:16) to assess the impact of the condition on quality of life. Cases of malocclusion were diagnosed using the Dental Aesthetic Index while clinical examination was performed by three calibrated examiners. Data regarding traumatic dental injuries, dental caries, gender, type of school, age and social vulnerability was collected. Data analysis was performed using bivariate and multivariate Poisson regression with robust variance (P < 0.05).

Results

The prevalence of malocclusion was 31.3%. The presence of definite malocclusion (PR = 1.28; CI = 1.13-1.45), severe malocclusion (PR = 1.24; CI = 1.04-1.47) and handicapping malocclusion (PR = 1.55; CI = 1.31-1.84) was associated with a greater negative impact on Emotional Well-Being. The presence of definite malocclusion (PR = 1.18; CI = 1.02-1.36), severe malocclusion (PR = 1.46; CI = 1.21-1.76) and handicapping malocclusion (PR = 1.61; CI = 1.35-1.94) was also associated with a greater negative impact on Social Well-Being.

Conclusions

Adolescents with handicapping malocclusion, where the need for treatment was mandatory, suffered from a greater negative impact on quality of life, with emotional and social aspects most affected.

Ability of two single-step restorative materials to avoid crown darkening caused by intracanal minocycline paste

OBJECTIVES

This study aimed to quantitatively assess the ability of two single-step restorative materials to avoid crown darkening caused by the use of minocycline as an intracanal medicament.

MATERIALS AND METHODS

After coronal access and instrumentation, 120 maxillary incisors were divided into four groups (n = 30). Two experimental groups according to the restorative material applied to the inner walls of the access cavity: OB, OptiBond All-In-One + minocycline intracanal paste; U200, RelyX U200 + minocycline intracanal paste. Two control groups without restorative materials: MIN, minocycline intracanal paste and SL, saline intracanal. Color determination was performed using a spectrophotometer at five time points, immediately after materials were applied (baseline), and at 7, 14, 21, and 28 days from the baseline.

RESULTS

Decrease in the mean values of L* (luminosity) was observed after insertion of minocycline paste in all groups at all time points. Statistically significant differences were absent between the time points (P > .05). After 28 days, MIN showed significantly more darkening (ΔL*) (- 10.6 ± 7.3) than OB (- 5.4 ± 6.2), U200 (- 5.8 ± 3.9) and SL (- 2.3 ± 1.2) (P < .05).

CONCLUSIONS

Crown darkening can be minimized by the previous application of RelyX U200 or OptiBond All-In-One to the inner walls of the access cavity before a minocycline-containing paste is applied as an intracanal medication.

CLINICAL RELEVANCE

The American Association of Endodontists Clinical Considerations for Regenerative Procedures in necrotic immature teeth suggests the triple antibiotic paste as an intracanal medication (2018). However, discoloration and crown darkening are common unfavorable outcomes. The clinical protocol suggested in this paper has shown to be able to minimize crown darkening, predictably leading to a better patient-centered clinical success.

Relationship Between Orthodontic Treatment Need and Oral Health-Related Quality of Life among 11⁻18-Year-Old Adolescents in Lithuania

The aim was to examine the relationship between orthodontic treatment need and Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 across gender and age groups. A representative cross-sectional study of 911 adolescents aged 11–18 (mean (M) = 15.53; Standard Deviation (SD) = 1.52) was conducted in 26 public schools. The schoolchildren completed the Child Perceptions Questionnaire to evaluate their OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to evaluate the severity of malocclusion. The strength of association between variables was evaluated via negative binomial regression estimating the ratio of sum score means (RSSM). A worse OHRQoL score was associated with a higher grade of IOTN; however, only the Emotional and Social wellbeing domains were significantly affected by malocclusion (RSSM = 1.158; 95% Confidence Interval (CI): 1.083–1.237 and RSSM = 1.205; 95% CI: 1.114–1.304, respectively). The significant association was identified only among females (RSSM = 1.264; 95% CI: 1.176–1.359). A significant association was observed in all age groups for Emotional and Social well-being domains but only in the oldest age group for Oral Symptoms and Functional Limitations domains. Conclusions: Malocclusion has a negative impact on the OHRQoL of young people with emotional and social aspects being the most affected. Girls and older adolescents suffered from malocclusion more than boys and their younger counterparts.

Social vulnerability and factors associated with oral impact on daily performance among adolescents

Background

Oral disorders may negatively affect the quality of life (QoL) of adolescents.

To investigate how social vulnerability and oral-health status factors affect QoL in 15–19 years olds who participated in the “SB São Paulo 2015” state survey.

Methods

The relationship of several independent variables, namely Paulista Social Vulnerability Index (PSVI) score, gender, skin color, family income, age, untreated caries, tooth loss [determined by the Decayed, Missing, Filled-Teeth (DMF-T) index], toothache, periodontal condition [determined by the Community Periodontal Index (CPI)], and malocclusion (maxillary overjet, cross bite, or open bite) affect daily life, measured by the Oral Impacts on Daily Performance (OIDP) instrument. Logistic regression analyses were carried out based on a hierarchical model.

Results

The final sample consisted of 5402 adolescents. The prevalence of at least one negative impact of oral health on QoL was 37.3%. After adjustment, demographic factors that were found to influence this impact significantly (p < 0.01) were female gender [odds ratio (OR) 1.78, 95% confidence interval (CI) = 1.59–2.0], non-white skin color (OR 1.66, 95% CI = 1.47–1.88), and a low family income (OR 1.28, 95% CI = 1.28–1.29). Additionally, oral conditions associated with oral health impact on QoL included the presence of at least one untreated tooth decay lesion (OR 1.42, 95% CI = 1.25–1.61), loss of at least one tooth (OR 1.49; 95% CI = 1.25–1.78), toothache (OR 4.87, 95% CI = 4.25–5.59), bleeding on probing (OR 1.45, 95% CI = 1.25–1.68), and severe maxillary overjet (OR 1.68, 95% CI = 1.15–2.45).

Conclusion

Social vulnerability (PSVI score) was not associated with the OIDP score, but oral health conditions and socio-demographic variables, including gender, skin color, and income, were found to affect adolescents’ daily activities. Strategies that consider the perceptions of this segment of the population should be implemented to strengthen their autonomy and totality of care.

Oral health-related quality-of-life scores differ by socioeconomic status and caries experience

OBJECTIVES

(i) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience.

METHODS

This study was a cross-sectional analysis of children in southern Brazil (n=456, mean age: 38 months) participating in an existing health centre-based intervention study. OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1-4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modelling, overall and within socioeconomic strata defined by maternal education, social class and household income.

RESULTS

Caries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 vs dmft=0, a pattern that persisted regardless of family socioeconomic status (P for interaction: all >0.3). However, adjusted for dental status and sociodemographic characteristics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0) or in lower income households (ratio: 0.8; 95% CI: 0.6, 1.3).

CONCLUSION

Dental caries was associated with negative child and family experiences and lower OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality-of-life impact at the same level of disease experience. Thus, subjective quality-of-life measures may differ under varying social contexts, with possible implications for service utilization, evaluating oral health interventions, or quantifying disease morbidity in low-SES groups.

The child and adolescent with HIV in resource poor countries

Although sub-Saharan Africa caries the burden of paediatric and adult HIV/AIDS infections, the epidemic is spreading most rapidly in the Middle East and North Africa Region where between 2005 and 2013, AIDS-related deaths increased by 66% in comparison with a worldwide fall of 35%. For the first time, in 2011, more than half of people in need of antiretroviral drugs were receiving them, with coverage reaching 54%; yet only 28% of children have access to HIV treatment. This review sought to provide an update of paediatric and adolescent oral HIV/AIDS issues in resource poor countries.

OBJECTIVES

To review the literature on paediatric & adolescent HIV with a focus on oral lesions as predictors of HIV infection; as markers of the efficacy of HAART and quality of life; caries risk; management of oral lesions; and epidemiological tests for clinical significance of oral lesions.

METHODS

A search strategy was developed for PubMed to identify papers on paediatric oral HIV. Publications in English were selected on the basis that their titles and abstracts were relevant to the review objectives. The reference lists of included papers were screened for additional articles. The time-search for publications was limited from 2009 to 15 October 2014.

RESULTS

Papers on the prevalence of oral lesions lacked standardization in diagnostic criteria and the introduction of HAART had significantly reduced prevalence; oral lesions remain useful predictors for HIV infection and as markers for the efficacy of HAART. Evidence suggest that caries risk is increased with HIV infection; management of oral lesions is inconsistent with available resources and surprisingly little recent information has been published in the past 5 years. Revised case definitions are proposed for large-scale epidemiologic studies with the development of an oral lesion index showing promise. Oral health quality of life indicators for children and adolescents are becoming important as more of these indicators are being developed and their negative oral impacts in individuals with oral lesions are now well established.

CONCLUSIONS

Paediatric and adolescent oral HIV research needs to be prioritized as current studies are few and are characterized by poor quality study designs, small study samples and a lack of multicentre collaborations. There is a lack of high quality evidence for a number of interventions available for management of oral lesions.