Reliability and validity testing for the Child Oral Health Impact Profile-Reduced (COHIP-SF 19)

Patient-Reported Outcomes Following Systemic Antibiotic Adjunct to Nonsurgical Treatment of Periodontitis: A Randomized Controlled Clinical Trial

OBJECTIVES

Considering the importance of patient-centered care, we aimed to evaluate the impact of systemic antibiotics on oral health-related quality of life during nonsurgical periodontal treatment. This controlled trial addresses a gap in understanding how systemic antibiotics influence patient-reported outcomes, focusing on Stage III periodontitis.

MATERIALS AND METHODS

Sixty-one adults participated in a double-blind, randomized clinical trial, with participants divided into two groups: the test group, which received antibiotics, and the control group. All the participants received nonsurgical periodontal treatment. We conducted follow-up assessments at one and 3 months posttreatment, including recording clinical parameters and administering the Oral Health Impact Profile-14 (OHIP-14) questionnaire.

RESULTS

The results showed a notable improvement in the quality of life for patients in the test group compared to the control group at 1 month (p value = 0.012) and 3 months (p value = 0.014) after treatment. While there were improvements in pocket probing depth, gingival index, and clinical attachment loss in both groups, it is worth noting that only bleeding on probing exhibited a significant improvement in the test group after 3 months compared to the control group (p value = 0.008).

CONCLUSIONS

In summary, incorporating systemic antibiotics alongside nonsurgical periodontal treatments appears to bring about positive outcomes for individuals dealing with Stage III periodontitis during nonsurgical treatment, ultimately enhancing their oral health-related quality of life.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT Id): IRCT20201221049786N1.

The Development and Psychometric Properties of Malay Language Child Oral Health Impact Profile-Short Form 19 (ML COHIP-SF 19)

Background/Objectives: The Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) is widely used to measure the oral health-related quality of life (OHRQoL) of children and adolescents. The current study aimed to validate the Malay language version of the COHIP-SF19 (ML COHIP-SF 19) and to assess its psychometric properties among Malaysian children/adolescents. Methods: Children aged from 9 to 16 years attending the Faculty of Dentistry, Universiti Teknologi MARA (UiTM) participated in this study. The original English version of the COHIP-SF 19 was translated using forward- and back-translation. The psychometric properties of the final version were tested for reliability and validity using Cronbach's alpha, a non-parametric Spearman's correlation test, and confirmatory factor analysis (CFA). Results: A total of 252 children aged from 9 to 16 years (mean age = 11.33 ± 1.87 years) self-completed the ML-COHIP-SF 19. The total scores of the ML COHIP-SF 19 ranged from 20 to 75 (mean = 55.67 ± 10.45) with an internal consistency (α) of 0.81. Convergent validity showed a fair correlation between self-perceived oral health rating and total ML COHIP-SF 19 scores, as well as the socio-emotional well-being subscale scores (rs = 0.38-0.42, p < 0.01). Conclusions: The ML COHIP-SF 19 demonstrated reliable psychometric properties and acceptable four-factor model fits, indicating that it is a valid tool to measure the OHRQoL of Malaysian children aged from 9 to 16 years.

Evaluation of the effect of dental caries, oral hygiene, and treatment need on oral health-related quality of life among Turkish orphan children and adolescents

BACKGROUND

The oral and dental health and related quality of life of orphan children and adolescents-who are considered a vulnerable population-are critical for both individual and public health.

OBJECTIVES

This study aimed to investigate the status of the dental caries, oral hygiene, and dental treatment needs among a group of Turkish male orphan children and adolescents, as well as their impact on oral health-related quality of life.

METHODS

A total of 112 orphan children and adolescents aged between 9 and 17 years living in a residential care facility in Istanbul, Türkiye, were involved in this cross-sectional study. A comprehensive examination was conducted on each individual, encompassing the assessment of dental caries using the decayed, missing, and filled teeth (DMFT/dft) index, oral hygiene using the debris (DI-S), calculus (CI-S), and simplified oral hygiene (OHI-S) indices, and dental treatment need using the treatment need index (TNI). Oral health-related quality of life was evaluated using the validated Turkish version of the Child Oral Health Impact Profile-Short Form (COHIP-SF-19). The relationship between oral health-related quality of life and explanatory variables was evaluated using a multivariable linear regression model.

RESULTS

The mean age of the participants was 12 ± 1.79 years. The mean DMFT score was 4.57 ± 3.42, and the mean OHI-S score was 1.4 ± 0.52. Participants had a mean COHIP-SF-19 score of 57.79 ± 14.11, with 25% requiring at least one tooth to undergo radical treatment. Multivariable linear regression analysis indicated that the DMFT score (p = 0.009) and the need for radical treatment (TNI code 6) (p < 0.001) had a statistically significant impact on oral health-related quality of life among orphan children and adolescents aged 13-17.

CONCLUSIONS

This study underscores that dental caries and the need for radical treatment significantly impact the oral health-related quality of life of orphan children and adolescents.

Personality traits and their relationship with oral health related quality of life among adolescents in Saudi Arabia

BACKGROUND

Personality traits are linked with different oral health outcomes. However, personality traits and their associations among children are not fully understood. Therefore, this study aimed to investigate the relationship between personality traits and oral health-related quality of life (OHRQoL) among adolescents in Saudi Arabia.

METHODS

This cross-sectional study included male and female students aged 12-18 years from different schools in the Eastern Province of Saudi Arabia. The participants responded to a self-administered questionnaire after providing informed consent. The questionnaire included demographic information and Arabic versions of the Big Five Personality Inventory and the Child Oral Health Impact Profile-Short Form to evaluate personality traits and OHRQoL, respectively. Bivariate and multivariable analyses were performed.

RESULTS

This study included 231 (59.7%) males and 156 (40.3%) females. Regarding personality traits, conscientiousness had the highest mean score (15.31 ± 3.65), followed by agreeableness (14.94 ± 3.96) and openness (14.08 ± 3.98), whereas neuroticism had the lowest mean score (8.86 ± 3.34). Males had significantly higher mean scores for extraversion (14.28 ± 3.30) and conscientiousness (15.69 ± 3.62) compared to females, who had mean scores of 13.02 ± 3.35 and 14.75 ± 3.63, respectively (P < 0.05). Females, on the other hand, scored significantly higher in neuroticism (9.51 ± 3.71) and agreeableness (15.60 ± 3.75) compared to males, who had mean scores of 8.09 ± 2.94 and 14.49 ± 4.04, respectively (P < 0.05). Bivariate analyses showed that neuroticism was negatively correlated with OHRQoL (r = -0.455, P < 0.001), whereas extraversion (r = 0.182, P < 0.001) and conscientiousness (r = 0.110, P = 0.047) were positively correlated with OHRQoL. In multiple linear regression analyses, extraversion (B = 0.696, P = 0.012) and neuroticism (B=-2.229, P < 0.001) were statistically significant predictors of OHRQoL.

CONCLUSION

This study found that neuroticism was significantly and negatively correlated with OHRQoL, whereas extraversion was significantly and positively correlated with OHRQoL. In addition, there were statistically significant differences in personality traits between the male and female adolescents.

Oral health-related quality of life in Northland Māori children and adolescents with Polynesian amelogenesis imperfecta

Introduction

Amelogenesis Imperfecta (AI) is a hereditary developmental disorder of tooth enamel with few known variants with differing characteristics, depending on where in the amelogenesis process an error has occurred. Polynesian AI (or Poly AI) is prevalent among people of Polynesian descent and is prevalent among New Zealand Māori. While the impact of AI on the quality of life has been reported in some studies, however, the role of Poly AI on oral health-related quality of life (OHRQoL) is not known. This study explores OHRQoL among New Zealand Māori with and without AI.

Methods

A cross-sectional study was undertaken, with ethical approval obtained from the New Zealand Health and Disability Ethics Committee. 30 Māori children and adolescents with Poly AI and 60 Māori children and adolescents with no Poly AI as the comparison group matched by age and sex, were randomly selected and recruited participated in the study. OHRQoL was measured using the 19-item COHIP-SF.

Results

Statistically significant differences were observed in the OHRQoL between those with Poly AI and the comparison group. Linear regression analyses controlling for age and deprivation showed significantly poorer OHRQoL among those with Poly AI than in those with no Poly AI.

Discussion

The study findings highlight poorer OHRQoL among Māori children with Poly AI, emphasizing the need for early detection and management of the condition and the importance of providing appropriate training in diagnosing Poly AI and managing hypersensitivity. Further research among Polynesian populations is needed to understand the impact OHRQoL among those with Poly AI.

Child Oral Health Impact Profile Questionnaire: A Reliability Generalization Meta-analysis of Cronbach's Alpha

Background and aim

To evaluate the pooled estimates of Cronbach's alpha for the Child Oral Health Impact Profile (COHIP) questionnaire using reliability generalization meta-analysis.

Methods

We have conducted a systematic search of literature from PubMed, Scopus, Excerpta Medica Database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception till 31st May 2023. Studies in English and those that have reported Cronbach's alpha for the COHIP questionnaire were included. Screening was performed by two review authors independently. Information on authors, year, country, sample size, age, sex, target population, language and mode of administration, conditions studied for, study setting, and study design were recorded. The risk of bias was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for internal consistency. Meta-analysis was performed using the random effects model to derive a pooled estimate of Cronbach's alpha.

Results

A total of 626 studies were available for title and abstract screening after the removal of duplicates, and 106 studies were included for full text screening. A total of 25 estimates were obtained from 22 studies which yielded a total sample size of 10,639. The overall pooled Cronbach's alpha was 0.87 (95% CI = 0.85-8.88) with a high heterogeneity among the included publications (I 2 = 95.74%). Similarly, the parent or the caregiver reported COHIP also showed pooled Cronbach's alpha of 0.9 (95% CI: 0.87-0.93). Meta-regression showed no significant effect of sex (coefficient: -0.12), age (coefficient: -0.007), language (coefficient: 0.003), study setting (coefficient: -0.001), risk of bias (coefficient: -0.01), and continent (coefficient: -0.04) on the overall estimate.

Conclusion

The COHIP questionnaire showed good internal consistency and can be used in research and practice among children.

How to cite this article

Pentapati KC, Chenna D, Kumar VS, et al. Child Oral Health Impact Profile Questionnaire: A Reliability Generalization Meta-analysis of Cronbach's Alpha. Int J Clin Pediatr Dent 2024;17(10):1193-1198.

Individuals with Cleft Lip and/or Palate Demonstrated Improved Self-Reported Psychosocial Functioning Following the Onset of the COVID-19 Pandemic

Objective

To evaluate the impact of the COVID-19 pandemic on the psychosocial functioning of individuals with cleft lip and/or palate (CL/P).

Methods

Patients with CL/P ≥ 6 years old were prospectively recruited from the Cleft and Craniofacial Clinic of a tertiary children's hospital. From July-October 2021, eligible patients (or their parent/guardian) were sent a survey regarding their psychosocial functioning before and after the start of the pandemic.

Main Outcome Measure

The difference between prepandemic and intrapandemic patient-reported outcome scores.

Results

Thirty-six patients (20 female, age: 15.9 ± 9.8 years) responded. Most had cleft lip and palate (77.8%), responded online (69.4%), interacted remotely via both voice- and video-conferencing (62.9%), and wore masks routinely (77.1%). Similar numbers of patients responded independently (27.8%), responded with the help of a parent/guardian (36.1%), or had a parent/guardian respond on their behalf (36.1%). General social-emotional well-being (p = 0.004, r rb = 0.659) and satisfaction with facial appearance (p = 0.044, r rb = 0.610) significantly improved after the start of the pandemic. Compared to their general intrapandemic social-emotional well-being scores, patients reported higher scores while wearing a mask (r rb = 0.827) and lower scores while interacting remotely (r rb = 0.605), although all were still significantly improved compared to their prepandemic scores (p ≤ 0.010). Patients also reported significant improvement in social functioning while wearing a mask (p = 0.036, r rb = 0.519), whereas they did not when considering their general intrapandemic feelings/experiences (p = 0.269, r rb = 0.211).

Conclusion

Patients with CL/P demonstrated significant improvement in overall social-emotional well-being, satisfaction with facial appearance, and social functioning after the start of the COVID-19 pandemic, particularly when wearing a mask.

Cross-cultural adaptation of the Arabic version of the oral health values scale

AIMS

The study aimed to adapt the original English-language oral health values scale (OHVS) to the Arabic culture and to test its psychometric properties.

METHODS

The original OHVS was translated into Arabic language and pre-tested using cognitive interviewing. The psychometric properties of Arabic OHVS were examined in a sample comprising 416 Libyan adults aged 18-70 years, recruited from the main public and private dental clinics in Benghazi. The participants' demographic information, oral health behaviour, perceived oral health, the Arabic version of the OHVS (A-OHVS), dental neglect scale, oral health-related quality of life, oral health literacy, simplified oral hygiene index (OHI-S), and decayed, missing, and filled teeth index (DMFT) were collected. Psychometric properties were tested using content validity, construct validity, discriminating validity, internal consistency, test-retest reliability, and floor as well as ceiling effects were examined.

RESULTS

The Arabic OHVS was successfully and smoothly developed. It showed an acceptable level of equivalence to the original version, The A-OHVS presented an overall Cronbach's Alpha of 0.74 and the average score was 40.02, ranging between 26 and 54. All hypotheses predefined to test construct validity were confirmed. The bivariate correlation between A-OHVS and other health indicators shows a significant positive correlation between A-OHVS and oral health literacy (p = 0.000). On the other hand, statistically significant negative correlations were observed between A-OHVS and dental neglect and quality of life (p ≤ 0.001) as well as DMFT and OHI-S (p ≤ 0.001). Floor or ceiling effects were not observed.

CONCLUSIONS

The A-OHVS was shown to be a valid and reliable tool for assessing oral health values in the Arabic-speaking population.

A standard set of outcome measures for the comprehensive assessment of oral health and occlusion in individuals with osteogenesis imperfecta

BACKGROUND

Osteogenesis imperfecta (OI) is a group of inherited connective tissue disorders of varying severity characterized by bone fragility. The primary objective of this international multidisciplinary collaboration initiative was to reach a consensus for a standardized set of clinician and patient-reported outcome measures, as well as associated measuring instruments for dental care of individuals with OI, based on the aspects considered important by both experts and patients. This project is a subsequent to the Key4OI project initiated by the Care4BrittleBones foundation which aims to develop a standard set of outcome measures covering a large domain of factors affecting quality of life for people with OI. An international team of experts comprising orthodontists, pediatric dentists, oral and maxillofacial surgeons, and prosthetic dentists used a modified Delphi consensus process to select clinician-reported outcome measures (CROMs) and patient-reported outcome measures (PROMs) to evaluate oral health in individuals with OI. Important domains were identified through a literature review and by professional expertise (both CROMs and PROMs). In three focus groups of individuals with OI, important and relevant issues regarding dental health were identified. The input from the focus groups was used as the basis for the final set of outcome measures: the selected issues were attributed to relevant CROMs and, when appropriate, matched with validated questionnaires to establish the final PROMs which represented best the specific oral health-related concerns of individuals with OI.

RESULTS

Consensus was reached on selected CROMs and PROMs for a standard set of outcome measures and measuring instruments of oral health in individuals with OI.

CONCLUSIONS

Our project resulted in consensus statements for standardization oral health PROMs and CROMs in individuals with OI. This outcome set can improve the standard of care by incorporating recommendations of professionals involved in dental care of individuals with OI. Further, it can facilitate research and international research co-operation. In addition, the significant contribution of the focus groups highlights the relevance of dental and oral health-related problems of individuals with OI.

The Child Oral Health Impact Profile-Short Form 19 Cross-Cultural Adaptation and Validity for the Portuguese Pediatric Population

Background/Objectives: To better understand the impact of different oral conditions on children, several instruments are available to measure oral health-related quality of life (OHRQoL). To adapt and validate cross-culturally the Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) questionnaire to the Portuguese language. Methods: The COHIP SF-19 was translated and back-translated, and tested for its reliability and for psychometric properties in children who were aged between 8 and 17 years old. The COHIP-19-PT was tested for its internal consistency, construct validity, content validity, and test-retest reliability. Results: The COHIP-19-PT revealed good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (interclass correlation = 0.78). The CFA analysis confirmed the structure of COHIP-19-PT. The first-order model showed an adequate fit: GFI = 0.878; CFI = 0.812; RMSEA = 0.083 (90% CI: 0.077-0.090). No invariance was found for the gender-based groups. The correlation between the sub-scales was also assessed, confirming significant correlations between all subdomains. Conclusions: The COHIP-19-PT is a valid and reliable scale for measuring children's oral health-related quality of life.

Randomized controlled clinical trial on the efficacy of a novel antimicrobial chewing gum in reducing plaque and gingivitis in adolescent orthodontic patients

OBJECTIVES

Chewing gums containing antiseptics or other antimicrobial substances may be effective in reducing plaque and gingivitis. Therefore, the aim of this randomized placebo-controlled clinical trial was to investigate the efficacy of a novel antimicrobial chewing gum containing essential oils (cinnamon, lemon, peppermint) and extracts on reduction of dental plaque and gingivitis as well as on oral health-related quality of life (OHRQoL) in adolescent orthodontic patients.

MATERIALS

52 patients (11-22 years of age) were randomly assigned to use a test chewing gum (COVIDGUM, Clevergum) or a commercially available control chewing gum over a period of 10 days. Approximal plaque index (API), papillary bleeding index (PBI) and an OHRQoL questionnaire for children (COHIP-G19) were assessed at baseline (BL), after 10 days (10d) and 30 days (30d). In addition, oral health and oral hygiene related questions of the COHIP-G19 questionnaire were evaluated separately in subscales at each timepoint. Data were analyzed using non-parametrical statistical procedures (α = 0.05).

RESULTS

API and PBI decreased significantly over time from BL to 10d and from BL to 30d in both groups, without significant differences between the groups. In both groups, the COHIP-G19 score, oral health subscale and oral hygiene subscale decreased significantly over time. Regarding the oral hygiene subscale, the test group showed significantly better scores at 30d (p = 0.011).

CONCLUSION

Both chewing gums performed similarly effective in terms of reducing plaque accumulation and gingival inflammation and improving OHRQoL.

CLINICAL RELEVANCE

Chewing gums without antimicrobial ingredients may be sufficient to decrease plaque accumulation and gingival inflammation.

Oral Health-Related Quality of Life in a Paediatric Population in the Dominican Republic

Introduction: During the summer of 2019 and within the framework of a social dentistry program carried out in the low-income town of San Francisco de Macorís (Dominican Republic), a descriptive study was carried out on oral health-related quality of life (OHRQoL), aiming to find out the oral health status of a population of children in the aforementioned Dominican city. Objective: The aim of this study was to describe the oral health status of a child population and its relationship with the quality of life perceived by these children in the aforementioned population of San Francisco de Macorís in order to develop an specific oral health program taking into account not only the existing oral health status but also the perceptions and feelings of the child population in this regard. Method: A descriptive cross-sectional study was carried out on a representative sample of children who were examined on their oral health status, following WHO guidelines, by professionals from the University of Seville (Spain) together with professionals from private practice (USA) and students from the Universidad Católica Nordestana (UCNE, Dominican Republic). Likewise, the children's parents voluntarily completed the Oral Quality of Life questionnaire COHIP-19 in its culturally adapted Spanish version. Results: For this purpose, 94 children with a mean age of 10.34 (SD 3.38) were observed in our study following WHO recommendations for oral health studies and evaluating OHQoL using the specific questionnaire validated in Spanish COHIP-19 in its short format (SF). The results show a state of oral health with a significant prevalence of caries (80.9%) and a DMFT of 1.70 (SD 1.90). The OHQoL perceived by these children shows that pain, bad breath or feeling sad because of the condition of their teeth were the factors with the worst evaluation score. Conclusions: The conclusion that mainly emerges from this study is that caries continues to be the main problem to be solved (more than other variables studied, such as malocclusion or fluorosis), and this ailment also causes pain, dysfunction, and bad breath and is therefore perceived as a problem to be solved in the children of this Dominican city.

Oral health-related quality of life in patients with cleft lip and/or palate or Robin sequence

PURPOSE

To compare the oral health-related quality of life (OHRQoL) in patients with cleft lip and/or palate or Robin sequence versus a healthy control group using the Child Oral Health Impact Profile (COHIP-G19). Factors such as age, gender, and cleft type were considered.

METHODS

Over an 8-month period, the OHRQoL was surveyed by using the COHIP-G19 questionnaire. Included were patients with a craniofacial disorder (n = 61; average age 11.24 years) and a healthy control group (n = 70, average age 12.63 years) for a total of 131 patients (average age 11.99 years) from the Department of Orthodontics University Hospital Tübingen, Germany. These were divided into two age groups (6-11 years; 12-18 years).

RESULTS

Statistically, patients with a craniofacial disorder presented a significantly lower OHRQoL than the control group (p = 0.0055). In the craniofacial disorder group, older patients revealed a significantly (p = 0.005) lower OHRQoL than the younger patients. Female patients showed in nearly all groups a better OHRQoL than male patients, but this difference was not statistically significant (p > 0.05). Males with a craniofacial disorder scored significantly lower than males without (p = 0.016); females showed no differences between the groups. Visibility, location, and severity of the craniofacial malformation did not have a significant influence on the OHRQoL.

CONCLUSION

The occurrence of a craniofacial malformation impacted the OHRQoL especially in older and male affected patients, unrelated to the expression level or localization. An early instruction about oral health, rehabilitation and functional training should be considered in therapy.

THE USE OF DENTAL PATIENT-REPORTED OUTCOMES AMONG COMPARATIVE OBSERVATIONAL STUDIES IN ORTHODONTICS: A METHODOLOGICAL STUDY

OBJECTIVE

To identify and summarize the presence and characteristics of dental patient-reported outcomes (dPROs) and dental patient-reported outcome measures (dPROMs) within comparative observational studies published in 5 leading orthodontic journals.

METHODS

Electronic searching was performed to identify intervention (therapeutic or preventive) related comparative observational studies published in selected journals between 2015 and 2021. Two authors extracted the characteristics of each included study independently and in duplicate and summarized the dPROs and dPROMs used in these studies. All dPROs were classified into 2 general types (oral health-related quality of life [OHRQoL] and others), while dPROMs were divided into 3 categories (single-item questionnaires, generic multiple-item questionnaires, and specific multiple-item questionnaires). In addition, dPROMs were examined, if they evaluated the 4 dimensions of OHRQoL (oral function, orofacial pain, orofacial appearance, and psychosocial impact).

RESULTS

A total of 683 observational studies were eligible and included of which 117 (17.1%) used dPROs and dPROMs. Seven different dPROs (OHRQoL, patients' satisfaction with treatment, preferences, concerns, compliance, duration, and unwanted events) and 33 different dPROMs (including 8 single-item questionnaires, 11 generic multiple-item questionnaires, and 14 specific multiple-item questionnaires) were identified in these studies. OHRQoL was the most commonly used dPRO (92/117, 78.6%), while Oral Health Impact Profile 14 (OHIP-14) was the most frequently used dPROM (20/92, 21.7%). In terms of study design, cross-sectional studies had the highest proportion of dPRO usage (62/148, 41.9%), followed by cohort studies (63/505, 12.5%) and case-control studies (1/30, 3.3%).

CONCLUSIONS

Only one-sixth of comparative observational studies published in leading orthodontic journals could reflect patients' perspectives. Observational studies in orthodontics need to provide more patient-important information through the use of dPROs and dPROMs.

Oral Health-Related Quality of Life in Persian-Speaking Elementary Schoolers in Iran: A Psychometric Study of Child Perception Questionnaire

Background and Purpose: The study aims to examine the validity and reliability of the impact of 16-item Short-Form Child Perception Questionnaire (CPQ11-14-ISF:16) in Persian-speaking elementary schoolers. Methods: From two main cities in Iran, 708 mother-child dyads were enrolled in 2018. Decayed, missing, and filled teeth (DMFT/dmft) indexes were examined for divergent validity. Two built-in indexes of overall oral health and overall impacted well-being were used for concurrent validity. Exploratory factor analysis (EFA) with Geomin rotation, Cronbach's α, and Spearman's correlation were executed. Results: The total Cronbach's α was 0.71. EFA indicated CPQ11-14-ISF:11 (α = 0.66) to compose three eligible factors (α = 0.66), including oral problems (α = 0.54), emotional problems (α = 0.66), and social problems (α = 0.41). The concurrent/divergent validity of CPQ11-14-ISF:11 and the subscales was partially confirmed. Conclusions: The use of CPQ11-14-ISF:11 to multidimensionally address dental care for children requires further investigations.

Validation of the Child-Oral-Health-Impact-Profile among adolescents in Johannesburg: A cross-sectional study

BACKGROUND

 Oral health-related quality of life (OHRQol) is described as the effect of oral conditions on the overall functioning and well-being of individuals.

AIM

 This study sought to determine the validity of a modified-child oral health impact profile (M-COHIP) among adolescents living with the human immunodeficiency virus (HIV) infection (ALHIV) and HIV-undiagnosed adolescents and establish the factors influencing OHRQoL among adolescents in central Johannesburg.

SETTING

 Schools and HIV wellness centre in central Johannesburg.

METHODS

 An interviewer-administered questionnaire was applied, followed by an oral examination.

RESULTS

 A total of 504 adolescents were included in the study. The overall mean decayed teeth for permanent dentition was 1.6 (standard deviation [s.d.]: 1.99) and caries prevalence was 62.2% (n = 309). The tool's Cronbach's alpha was 0.88. The item-rest correlations were from 0.6 to 0.85 for all items. The initial exploratory factor analysis explained 76% of the total variance. The overall M-COHIP score was 59.6 (18.2). The overall modified-COHIP scores for those not in care (schools) were higher [62.88] than those of ALHIV. The poor M-COHIP scores were associated with reporting toothache, having active decay, poor oral health-self-rating, and being selected from the school site (p  0.005).

CONCLUSION

 The validation study supports the use of the tool as a reliable and valid measure of OHRQoL. Future research can investigate the extent to which the tool is effective in measuring treatment outcomes and patient satisfaction.Contribution: The validated tool will be beneficial in the African context for programme assessments and overall measure of quality-of-life impacts from oral conditions.

[Effect of molar incisor hypomineralization on oral health-related quality of life in children and adolescents: a systematic review]

Introduction

Hypersensitivity, altered dental appearance and fractures are common problems in molar incisor hypomineralization that generate functional and socio-emotional problems.

Objective

to evaluate the effect of MIH on oral health-related quality of life in children and adolescents.

Materials and methods

A systematic bibliographic search was carried out in electronic databases (Pubmed, Epistemonikos, Dentistry & Oral Sciences Source and Virtual Health Library). Observational studies in English or Spanish conducted between 2016-2022 that evaluated the quality of life of children and adolescents with molar incisor hypomineralization were identified. Most studies were of good methodological quality.

Results

Of 96 identified studies, thirteen were included in the synthesis. The most frequent diagnostic criterion for hypomineralization of molar incisors was the index of the European Academy of Pediatric Dentistry and nine studies reported the severity of the disease. The most widely used scale to measure quality of life was the Child Perception Questionnaire (CPQ). According to the children's perception, the most affected dimensions were "Oral Symptoms" and "Emotional Well-Being", according to the parents they were "Oral Symptoms" and "Functional Limitations". Girls with molar incisor hypomineralization had worse oral health-related quality of life.

Conclusions

The negative effect of molar incisor hypomineralization on children's oral health-related quality of life seems to vary between the perception of parents and children.

Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis

BACKGROUND

Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications for an individual's life and well-being. The present systematic review and meta-analysis assessed whether the treatment of CLP impacts the oral health-related quality of life (OHRQoL) in children and adolescents in comparison to healthy controls.

METHODS

We searched MEDLINE/PubMed, EMBASE, and PsycINFO databases using terms related to CLP, and included articles until August 2023. Observational comparison studies that assessed OHRQoL in non-syndromic CLP patients aged 8-19 years with validated scales designed to such aim or scales capable to identify aspects related to oral health compared to healthy controls were included. We used the ROBINS-I tool for risk of bias assessment. A meta-analysis of continuous variables was performed using inverse variance for pooling estimates, Standardized Mean Difference (SMD) as a summary measure, with random effects model. Heterogeneity was estimated by the I2 statistics. Sensitivity analyses included subgrouping based on the scale, risk of bias and scale domains. Meta-regression was performed under a mixed-effects model considering the variables type of scale, scale domains and risk of bias.

RESULTS

Fourteen studies were included comprising 1,185 patients with CLP and 1,558 healthy controls. The direction of the effect of OHRQoL favoured the healthy group (-0.92; 95% CI:-1,55;-0,10) and I2 = 95%. After removing three studies, I2 dropped to 80%. Meta-regression showed no influence on risk of bias (p = 0.2240) but influence of scale type (p = 0.0375) and scale domains (p < 0.001). The subgroup analysis indicated that the CPQ and COHIP scales presented very discrepant SMD values, despite pointing to the same effect direction. In contrast, the OHIP scale showed a non-significant difference between cases and controls, with estimates much lower than the other two scales. Results also suggest that OHRQoL associated with oral functionality and social well-being is more influential on outcomes than emotional well-being.

CONCLUSION

The global OHRQoL is slightly worst in the CLP patients than control group. The difference between OHRQoL was mainly detected through OHIP. The most affected domains are functional, emotional and social.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022336956.

The use of the Hanks Herbst vs Twin-block in Class II malocclusion: A randomized controlled trial

INTRODUCTION

This 2-arm parallel study aimed to compare and evaluate the efficiency of Hanks Herbst (HH) and Twin-block (TB) functional appliances in treating adolescents with Class II malocclusion.

METHODS

A parallel-group randomized controlled trial was undertaken in a single United Kingdom hospital. Eighty participants were recruited and randomized in a 1:1 ratio to receive either the HH or TB appliance. Eligibility criteria included children aged 10-14 years with an overjet of ≥7 mm without dental anomalies. The primary outcome was the time (in months) required to reduce overjet to normal limits (<4 mm). Secondary outcomes included treatment failure rates, complications and their impact on oral health-related quality of life (OHRQOL). Randomization was accomplished using electronic software with allocation concealed using sequentially numbered, opaque, and sealed envelopes. Blinding was only applicable for outcome assessment. Data were analyzed using descriptive statistics and regression analyses to detect between-group differences, including Cox regression for time to treatment success.

RESULTS

HH was significantly faster than TB in reducing the overjet to within normal limits (95% confidence interval [CI], -3.00 to -0.03; P = 0.046). Mean overjet reduction was more efficient with the HH than the TB appliance (ß = 1.3; 95% CI, 0.04-2.40; P = 0.04). Fifteen (37.5%) of the participants in the TB group and 7 (17.5%) in the HH group failed to complete the treatment (hazard ratio = 0.54; 95% CI, 0.32-0.91, P = 0.02). However, TB was associated with fewer routine (incidence rate ratio = 0.81; 95% CI, 0.7-0.9; P = 0.004) and emergency (incidence rate ratio = 0.1; 95% CI, 0.1-0.3; P = 0.001) visits. Chairside time was greater with the HH (ß = 2.7; 95% CI, 1.8-3.6, P = 0.001). Participants in both groups experienced complications with similar frequency. A greater deterioration in OHRQOL was found during treatment with the TB.

CONCLUSIONS

Treatment with HH resulted in more efficient and predictable overjet reduction than TB. More treatment discontinuation and greater deterioration in OHRQOL were observed with the TB. However, HH was associated with more routine and emergency visits.

REGISTRATION

ISRCTN11717011.

PROTOCOL

The protocol was not published before trial commencement.

FUNDING

No specific external or internal funding was provided. Treatment for participants was provided as part of routine orthodontic treatment in the hospital.

Reflection on patients' experience with orthodontic appliances wear and its impact on oral health related quality of life: observational comparative study

BACKGROUND

The objective of this study was to explore and compare patient's experience with the use of a removable functional appliance or fixed orthodontic appliance and its influence on oral health-related quality of life.

MATERIAL AND METHODS

This clinical trial included 81 participants having Class II Division 1 and age ranging between 10 and 16 years. The participants were included in any of a three equal groups according to the set inclusion and exclusion criteria; Group 1: patients treated with a Twin-Block functional appliance; Group 2: patients treated with a fixed orthodontic appliance only; and Group 3 (control group): patients not in orthodontic treatment yet. The COHIP SF-19 was used. Patients were given the questionnaire as follows: Group 1: (1) after at least 8 months from starting treatment; (2) after completing phase 1 by 2-3 months without wearing the appliance; Group 2: (1) just before debonding; (2) after finishing the treatment by 2-3 months without any appliances; and Group 3: (1) at the patient's first visit to the orthodontic clinic; (2) after 2-3 months from the first visit to the orthodontic clinic and before starting any treatment.

RESULTS

The 81 participants were 31 males and 50 females with median age of 13 years. The total COHIP SF-19 scores at baseline were 57 (49-64), 67 (63-72), and 47 (42-53) for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively. Two-month mean scores adjusted to the baseline scores were 64.82 ± 1.15, 65.65 ± 1.47, and 54.45 ± 1.44 for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively.

CONCLUSIONS

Both at baseline and two-months (adjusted to the baseline scores), participants in the malocclusion group showed compromised socio-emotional quality of life and reported the poorest total OHRQoL. At the baseline, better socio-emotional and total OHRQoL was reported by the fixed appliance group compared to the Twin-Block group but, after two months both groups gave similar sores. Therefore; patients' perceptions about their experience with the orthodontic appliance might change.

One-Year Multicenter Randomised Controlled Trial Comparing OT Equator® and Locator Attachments to Retain an Early Loaded Implant Overdenture on Two Implants

This investigation aimed to compare the effectiveness of the OT Equator® (Rhein, Bologna, Italy) and the Locator attachment systems used to retain early loaded implant-retained overdentures. This study was designed as a multicenter randomised controlled trial of parallel groups. After implant placement, the patients were randomised to receive OT Equator® attachments in the test group or Locator attachments in the control group. The outcome measures were implant and prosthetic success and survival rates, any biological and technical complication, marginal bone loss, patients' satisfaction, and periodontal parameters. Overall, 42 patients were consecutively enrolled and treated. One implant was lost in the control group, while no implants were lost in the test group. No prostheses failed in both groups. Only a few complications were experienced in both groups. The main was represented by loss of retention of the attachments (retentive caps). The OT Equator® attachment showed statistically lower periodontal parameters. In conclusion, both attachment systems were suitable for overdenture implant retention.

Changes in oral health-related quality of life before and after dental treatment in 8-12-year-old Costa Rican schoolchildren

Aims

The aims of this study were to (1) evaluate oral health-related quality of life (OHRQoL) in 8-12-year-old Costa Rican schoolchildren before and after dental treatment and (2) collect clinical and sociodemographic characteristics.

Methods

Schoolchildren completed the Child Oral Health Impact Profile-Short Form (COHIP-SF-19) questionnaire before and after dental treatment. One of the parents was asked to complete a sociodemographic survey. Patients were treated for caries, hypomineralizations, and dental malocclusions. The prevalence of these conditions was assessed from the patient's electronic dental record.

Results

Eighty participants (39 male and 41 female, average age: 9.4 ± 1.0 years) were recruited. The prevalence of dental caries was 56.1% with a mean deft and DMFT score of 3.15 ± 0.96 and 2.22 ± 0.77, respectively. The prevalence of hypomineralization and dental malocclusions was 53.7% and 82.9%, respectively. The Simplified Oral Hygiene Index before treatment was 1.45 ± 0.45 and after was 1.42 ± 0.43. The mean COHIP-SF-19 total score decreased from 53.7 ± 7.8 before dental treatment to 31.4 ± 4.2 after treatment. Improvements in all subdomains were also observed. Regarding sociodemographic characteristics, 65% of the patients lived in San José, Costa Rica's capital city, and 56.3% of the studied population belonged to a low-income family. Most parents did not complete high school. Regarding the number of family members living in the same house as the patient, an average of four people was reported. In relation to family structure, 58.8% of the children's parents lived together, either married or free union. As for household ownership, 53.8% of parents reported owning their house, 36.3% lived in a rented house, and 10% lived in a borrowed home.

Conclusion

The prevalence of caries, hypomineralizations, and dental malocclusions were high before dental treatment. Reported sociodemographic characteristics unlikely changed after dental treatment, suggesting dental care played a pivotal role in improving self-perceptions of oral health and quality of life in our clinical setting.

Psychometric Validation of the CLEFT-Q Patient Reported Outcome Measure: A Prospective Study to Examine Cross-Sectional Construct Validity

OBJECTIVE

CLEFT-Q is a condition-specific patient-reported outcome measure (PROM) for patients with cleft lip and/or palate (CL/P). The aim of this study was to examine the cross-sectional construct validity of the CLEFT-Q scales.

DESIGN

Construct validity was assessed through a prospective study that tested hypotheses regarding correlations of scores with other PROMs that measure related constructs.

SETTING

Seven cleft centres in Canada, the USA, and UK were involved.

PATIENTS/PARTICIPANTS

Patients were aged eight to 29 years with CL/P.

INTERVENTIONS

Before undergoing rhinoplasty, orthognathic, cleft lip scar revision, and alveolar bone graft, participants were asked to complete the following PROMs: CLEFT-Q (9 scales), Child Oral Health Impact Profile (socio-emotional subscale) and Cleft Hearing Appearance and Speech Questionnaire (features 1 subscale).

MAIN OUTCOME MEASURE(S)

The correlation coefficients examining the relationship between the scales were the main outcome measures. Correlations (Spearman) were calculated and interpreted as follows: <0.3 weak, 0.30 to 0.50 moderate, ≥0.50 strong.

RESULTS

Participants (n = 177) were mostly male (61%) and aged between eight and 11 years (42%). Overall, 38 of 52 (73%) hypotheses tested were supported. More specifically, 20 of 26 (77%) hypotheses about correlations between the appearance scales were supported, two of three (67%) hypotheses about correlations between the health-related quality of life scales were supported, and 16 of 23 (70%) hypotheses about correlations between the appearance and health-related quality of life scales were supported.

CONCLUSIONS

Cross-sectional construct validity of the CLEFT-Q scales adds further evidence of the psychometric properties of this instrument.

Perceptions of Sports and Energy Drinks: Factors Associated with Adolescent Beliefs

PURPOSE

To understand what factors are associated with adolescents' perceived healthfulness of sports drinks (SD) and of energy drinks (ED), with a focus on health risk, athletics, and media-related variables.

DESIGN

Cross-sectional survey.

SETTING

Online.

SUBJECTS

U.S. adolescents ages 14-18 years (n = 501) recruited from a combination of non-probability and probability-based panels.

MEASURES

Outcome variables were perceived healthfulness of SDs and of EDs. Independent variables included adolescents' health background (oral health, diabetes risk, self-reported weight); behaviors (SD and ED consumption, athletic identity, sports participation, physical activity), and media items (media literacy, exposure to advertisements on TV, YouTube, social media).

RESULTS

Regression results indicated that adolescents' increased perception that SDs are healthy was significantly associated (P<.05 level) with casual sports participation (b=.56, se=.27), athletic identification (b=.28, se= .11), exposure to SD advertisements on social media (b=.55, s =.25), and higher consumption (b=.28, se= .13). For adolescents' perceptions of EDs, significantly related correlates included athletic identification (b=.26, se=10), having an increased risk of diabetes (b= -.79, s =.26), poorer oral health (b=.33, se=.16), and consumption (b=.76, s =.16); increased media literacy was associated with more accurate perceptions (b=-.35, se=.14).

CONCLUSIONS

Adolescents' hold different perceptions about the healthfulness of sports and energy drink, and their beliefs about each drink are related to different types of factors that may have implications for public health interventions. Cross-sectional survey design and adolescent self-reports are limitations.

Association of oral health knowledge, self-efficacy and behaviours with oral health-related quality of life in Chinese primary school children: a cross-sectional study

OBJECTIVE

Achieving good oral health-related quality of life (OHRQOL) is of particular concern in children. The inter-relations among oral health knowledge, self-efficacy, behaviours and OHRQOL in children groups remain unclear. This study aimed to explore the inter-relations between these oral health behaviour-related factors and OHRQOL in primary school children.

METHODS

In this cross-sectional study, 651 children in grades 2 and 3 were recruited in October 2020 from two primary schools in Minhang District, Shanghai, China. Data were collected through self-reported questionnaires, consisting of demographic characteristics, oral health knowledge, self-efficacy, oral health behaviours and OHRQOL. Pearson's correlation analyses were used to analyse the relationship between study variables. Structural equation models were used to test the inter-relations between OHRQOL and oral health behaviour-related factors.

RESULTS

Four hypothetical structural equation models were tested and one of them was selected as the most appropriate model, which explained 15.0% of the variance in OHRQOL. This selected model showed that oral health behaviours were directly related to OHRQOL. Oral health knowledge was indirectly associated with OHRQOL through both self-efficacy and oral health behaviours. Self-efficacy was directly associated with OHRQOL or was indirectly associated with OHRQOL through oral health behaviours.

CONCLUSION

This study revealed a pathway of association between children's oral health knowledge and their OHRQOL, in which children's oral health self-efficacy and behaviours had indirect effects. This provides a basis for understanding the mechanism of oral health promotion interventions to improve children's OHRQOL and helps to identify direct or indirect intervention targets.

Impact of oral hygiene habits on oral health-related quality of life of in-school adolescents in Ibadan, Nigeria

Background

Recent evidence has shown that the prevalence of periodontal diseases is still high among adolescents and, thus, there is an impetus to promote good oral hygiene habits among them through schools. There is a need to provide baseline data on the oral hygiene habits of adolescents and how it impacts their oral health-related quality of life for appropriate intervention to be instituted. Moreover, oral health-related quality of life describes how oral health affects the daily activities of individuals; thus, it provides a holistic means of involving individuals in making decisions about their oral health including uptake of oral hygiene habits.

Aim

To assess the impact of oral hygiene habits on adolescents' oral health-related quality of life.

Methods

A cross-sectional study was conducted among 1,800 adolescents aged 14–18 years attending 36 Senior Secondary Schools in the metropolis of Ibadan, Nigeria. Data were collected using a self-administered questionnaire, which assessed students' sociodemographic characteristics, oral hygiene habits, and oral health-related quality of life with COHIP-SF19. Data obtained was analyzed with SPSS version 25 and the p-value was set at <5%.

Results

The mean age of the adolescents was 15.16 (±1.16) years. Many 1,094 (60.3%) cleaned their teeth twice or more often daily with 126 (7.0%) cleaning after meals and 1,519 (84.4%) changing their tooth cleaning agent at three months intervals or less. About 1,215 (67.5%) spent three minutes or longer in cleaning their teeth. Only a few 238 (13.2%) cleaned interdentally and 137 (7.6%) used dental floss. The OHRQoL scores of the adolescents ranged from 9–76. A total of 1,612 (93.5%) had at least an impact on their OHRQoL. Those who cleaned their teeth more frequently (twice or more) were more likely to have better OHRQoL (OR = 1.6, 95% CI = 1.1–2.4, p = 0.025) and those who did not clean interdentally were more likely to have better OHRQoL (OR = 2.8, 95% CI = 1.2–6.5, p = 0.014) than others.

Conclusion

The oral hygiene habits of the adolescents were suboptimal and those who cleaned their teeth twice or more often each day had fewer impacts on their OHRQoL, whereas those who engaged in interdental cleaning had higher impacts on their OHRQoL than others.

Validation of the French version of COHIP-SF-19 among 12-years children in New Caledonia

BACKGROUND

Assessment of oral health-related quality of life is now associated to clinical indicators in epidemiological studies. This study aimed at validating the French Short Form of the Child Oral Health Impact Profile (COHIP-SF-19) and assessing the impacts of oral diseases among schoolchildren in New Caledonia (NC).

METHODS

A sample of 12-years-old children (n = 971) was selected in 2019 in NC using a random, stratified, and clustered sampling technique. Children filled the French COHIP-SF-19 questionnaire. Information on sociodemographic characteristics, oral hygiene habits, perception of oral health problems were also collected through self-administered questionnaires or from the schools' database. Dental status (dental caries, gingival status, and dental functional units) was clinically recorded at school by four calibrated examiners. Cronbach's alpha and intraclass correlation coefficients (ICC) were calculated. Kruskal-Wallis tests and spearman correlations were used along with multilevel mixed models taking into account the cluster and examiner effects. A confirmatory factor analysis was conducted and sensitivity analyses were performed.

RESULTS

Among the 693 children examined, 557 children were included. Oral diseases were frequent in the study population 40% had dental caries and 55% presented gingivitis. The COHIP scores ranged from 7 to 76 (57.9 ± 9.96) with 96.4% of the children having experienced oral health problems, 81.7% reporting functional impacts and 90.5% socio-emotional impacts. Overall, the French COHIP-SF-19 showed satisfactory psychometric characteristics. Internal consistency was high (Cronbach's alpha = 0.80) and reproducibility excellent (ICC = 0.9). Discriminant and concurrent validity were adequate. Indeed, children with less optimal social situation, impaired dental status, declaring severe dental problems or difficulties in accessing oral health care showed lower COHIP-SF-19 scores. Factor analyses suggested a four-component structure with identification of a new domain (self -image) and changes in the repartition of the items within the original domains. Sensitivity analyses showed similar results for children with partial or complete answers in the COHIP questionnaire.

CONCLUSIONS

The French COHIP-SF-19 showed satisfactory psychometric characteristics and allowed to identify the high impacts of oral diseases in New Caledonian children, namely for socially deprived children.

Oral Health-related Quality of Life and Oral Hygiene of Children and Adolescents with Hearing Impairment

Background

Hearing impairment affects communication and oral hygiene practices.

Aim

To determine the effect of dental education and motivation on oral health-related quality of life (OHRQoL) and oral hygiene in children and adolescents with hearing impairment.

Materials and methods

Ninety children aged 8–16 years were selected from a special school of hearing impaired. Their OHRQoL was assessed using child oral health impact profile short form (COHIP–SF) at baseline and at 12 months. Oral hygiene was assessed using Silness and Loe plaque index and Loe and Silness gingival index. Oral health education followed by motivational sessions once a month was carried out for 12 months. Data was statistically analyzed using student paired t-test and Karl Pearson correlation test. Level of significance was considered as 5%.

Results

COHIP score showed a significant improvement from 39.7 at baseline to 48.0 at 12 months (p < 0.05). A significant reduction was seen in plaque (p = 0.002) and gingival inflammation (p < 0.05) at 6 and 12 months. An inverse relation was seen between the COHIP score and gingival health.

Conclusion

OHRQoL of children and adolescents with hearing impairment significantly improved from baseline to 12 months.

How to cite this article

Manohar PS, Subramaniam P. Oral Health-related Quality of Life and Oral Hygiene of Children and Adolescents with Hearing Impairment. Int J Clin Pediatr Dent 2022;15(3):311-315.

Body Image in Preschool Children Following Premature Loss of Primary Teeth: A Cross-sectional Study

INTRODUCTION

Pediatric dentists often see a good number of children under 6 years of age and are likely to encounter a child with missing anterior teeth. Here the parents are more concerned about the facial esthetics of the child and also about the timing of permanent teeth to erupt.

AIM

To know the impact on self-esteem or body image of preschool children following the premature loss of primary anterior teeth.

MATERIALS AND METHODS

The present cross-sectional study was conducted among 780 children in the age group of 4-6 years. The COHIP-SF 19 was utilized to know the social well-being of the child following the premature loss of anterior teeth. The descriptive and inferential analysis of the data was done by using IBM SPSS software.

RESULTS

There was a statistically significant association between gender and social well-being. More number of boys were concerned about their looks (p = 0.054). However, girls were found to be significantly more (p = 0.003) shy or withdrawn as compared to boys. There was a statistically significant association between a child's age and social well-being. More number of children between the ages of 4 years (23.1%) and 6 years (25.8%) were worried or anxious due to premature loss of an anterior tooth. Significantly more no of children of age 5 years (48.6%) was uncomfortable when asked about the missing tooth as compared to 4- and 6-year-old children. No statistically significant (p > 0.05) difference in the mean social well-being scores between boys and girls. No statistically significant difference in the mean social well-being scores between children of ages 4, 5, and 6 years (p > 0.05).

CONCLUSION

There is an association between the self-image of younger children and missing anterior teeth.

HOW TO CITE THIS ARTICLE

Acharya S, Biswas R. Body Image in Preschool Children Following Premature Loss of Primary Teeth: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(3):293-298.

Silver diamine fluoride, atraumatic restorations, and oral health-related quality of life in children aged 5-13 years: results from the CariedAway school-based cluster randomized trial

Objective

Silver diamine fluoride (SDF) is a non-surgical treatment for the arrest and prevention of dental caries that results in irreversible black staining of dental decay. The objective of this study was to evaluate the short-term impact of SDF treatment on oral health-related quality of life (OHRQoL) relative to a standard package of glass ionomer sealants and atraumatic restorative treatment (ART) in children aged 5–13 years.

Methods

CariedAway is a pragmatic, longitudinal, cluster-randomized non-inferiority trial of non-surgical interventions for caries. Secondary study outcomes included OHRQoL and academic performance. Oral health-related quality of life was measured at each study visit using the Child Oral Health Impact Profile. Change in OHRQoL was assessed using linear regression and non-inferiority was determined using t tests.

Results

160 children with an average age of 8.7 years completed quality of life assessments. Untreated decay at baseline (approximately 25%) was associated with significantly worse OHRQoL and treatment in both groups resulted in incremental improvement: children receiving SDF improved their OHRQoL scores from 16.44 (SD = 11.12) to 14.62 (SD = 11.90), and those receiving traditional sealants and atraumatic restorations slightly improved from 16.65 (SD = 10.56) to 16.47 (SD = 11.09). Quality of life in children receiving silver diamine fluoride was non-inferior to those receiving sealants and ART at least 6 months post-treatment (mean difference = 1.85, 95% CI = − 2.10, 5.80), and change in OHRQoL did not depend on the severity of baseline decay.

Conclusions

OHRQoL is related to untreated dental caries, and observed changes following SDF treatment were non-inferior relative to standard preventive therapies.

Velopharyngeal Inadequacy-Related Quality of Life Assessment: The Instrument Development and Application Review

Objective

For the patient-reported outcome (PRO) measures related to patients with velopharyngeal inadequacy (VPI), different quality of life (QOL) instruments have been developed. The present systematic review was designated to identify current VPI-related QOL instrument development, validation, and applicability.

Methods

Pubmed, Cochrane, Embase, Web of Science, and EBSCO databases were searched in January 2022. “Velopharyngeal” or “palatopharyngeal” and “quality of life” or “life quality” were searched in title, abstract, and keywords. This study followed Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Two investigators independently reviewed abstracts and full texts of the identified literature. An established checklist was used to evaluate the measurement properties of each identified instrument.

Results

A total of 375 articles and 13 instruments were identified, which can be divided into nine types of families according to their development procedures. Developmental and measurement characteristics, evidence of conceptual model, content validity, reliability, construct validity, scoring, interpretation, respondent burden, and presentation for all instruments were shown.

Conclusion

The patient's self-report assessment and parent-proxy assessment are both valuable. The conclusion that any QOL instrument is absolutely the best for patients with velopharyngeal inadequacy could not be drawn. Understanding the development and characteristics of different QOL instruments, including their reliability, validity, aim, target, language, and resource, should be important before application in clinic or research.

The association between molar incisor hypomineralization and oral health-related quality of life: a cross-sectional study

Objectives

We aimed to assess the association between molar incisor hypomineralization (MIH) and the oral health-related quality of life (OHRQoL) in a group of 7- to 14-year-old children in Berlin, Germany.

Materials and methods

The cross-sectional study consisted of a consecutive sample of 317 children, aged 7–14 years (49% girls, 51% boys; mean age, 8.71). Data were collected between June 2018 and December 2019. MIH was diagnosed using the criteria of the European Academy of Paediatric Dentistry. OHRQoL was assessed using the German 19-item version of the Child Oral Health Impact Profile (COHIP-G19). Differences in COHIP-19 summary scores between controls without MIH and MIH patients and with regards to MIH severity were tested for statistical significance using t test and analysis of variance (ANOVA), respectively.

Results

Data were obtained for 217 untreated MIH patients and 100 controls. OHRQoL of MIH patients was significantly more impaired than of controls indicated by COHIP-19 mean scores (60.9 ± 10.7 vs. 67.9 ± 7.8; p < 0.001). Patients with severe MIH (59.6 ± 11.0) reported significantly worse OHRQoL than patients with mild MIH (63.6 ± 9.1; p = 0.013).

Conclusions

MIH has a significant negative impact on the children’s OHRQoL. Patients with severe MIH experience a greater negative impact on OHRQoL than those diagnosed with mild MIH.

Clinical significance

MIH is one of the major dental problems of our time; pediatric dentists should be aware of its impact on the OHRQoL of the patient.

Cross-cultural adaptation of the Arabic version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15)

OBJECTIVES

Many patients who suffer from Dentine Hypersensitivity (DH) often go undiagnosed because they do not consider DH as serious problem that requires treatment. The use of patient reported outcome measures can help in diagnosis and management of DH problems. The aim of the present study was to adapt cross-culturally the original English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Arabic speaking countries.

METHODS

An Arabic version of DHEQ-15 was first developed by forward-backward translation and piloted among a group of dental patients. A cross-sectional study design was then used to test the psychometric properties of the Arabic DHEQ-15 in a wider convenience sample of Libyan dental patients diagnosed with DH. Confirmatory factor analysis was used to test the 3-dimensional distribution of the subscales. The significance level of all statistical tests was set at p≤0.05.

RESULTS

The Arabic DHEQ-15 demonstrated good face and content validity. A total of 462 participants aged on average 39.2 ± 12.9 years took part in the psychometric testing of the Arabic DHEQ-15. The overall Cronbach alpha of the questionnaire was 0.91, and overall Interclass correlation coefficient (ICC) for test-retest repeatability was 0.914. Participants with more severe DH had a significantly higher DHEQ-15 score than those with less severe DH (p<0.001). Those who reported better global rating of their oral health had lower scores on the Arabic DHEQ-15 (p<0.001). Confirmatory factor analysis confirmed 3 subscales of the Arabic DHEQ-15.

CONCLUSIONS

The Arabic DHEQ-15 has been developed and further testing has demonstrated acceptable levels of psychometric properties in an Arabic population. The Arabic DHEQ-15 is a reliable measure of the quality of life impact of DH for use with Arabic speaking populations.

APPROVAL OF THE USE OF THE SHORT FORM 19 OF THE CHILD'S ORAL HEALTH IMPACT PROFILE (COHIP-SF 19) FOR DENTAL PUBLIC HEALTH NEEDS

OBJECTIVE

The aim: Is an adaptation, determination of psychometric properties, and approbation of the use of COHIP-SF 19 for the needs of dental public health in the Ukrainian sample of children and teenagers.

PATIENTS AND METHODS

Materials and methods: A cross-sectional validation study was conducted on a sample of 236 Ukrainian children aged 6 to 18. The psychometric indicators of the questionnaire were evaluated; analysis of the reliability and internal structure of the methodology based on correlation and factor analysis, calculation of Chronbach's alpha; reliability of re-testing (Intraclass Correlation Coefficient); assessment of convergent and discriminant validity (Mann-Whitney U test, ROC analysis, and correlation analysis). STATISTICA 6.1 (StatSoftInc., № AGAR909E415822FA) was used to analyze the results. The ethics of the study was confirmed by the conclusion of the relevant commission.

RESULTS

Results: After cultural direct and reverse translation of the original version, the Ukrainian version of COHIP-SF 19 UK was obtained. The internal consistency of the subscales and COHIP-SF 19 UK was generally sufficient (Cronbach's alpha is greater than 0.7). Sufficient reliability of retesting, convergent and discriminant validity of the methodology was proved. The presence of a correlation between COHIP-SF 19 UK indicators and self-assessment of children's health and quality of life was determined.

CONCLUSION

Conclusions: The study proved that COHIP-SF 19 UK is a reliable valid method for assessing the quality of life-related to oral health among Ukrainian children and adolescents, and its good psychometric properties are sufficient for research in the field of dental public health.

Development of a classification (descriptive) system for a preference-based quality of life measure for dental caries (dental caries utility index) among adolescents

OBJECTIVES

Preference-based quality-of-life measures (PBMs) have been developed in many clinical areas to aid estimation of more accurate utility values for economic evaluations. Existing oral health-related quality-of-life (OHRQoL) instruments are non-PBM and hence, cannot be used to generate utility values. The objective of this study was to develop a classification system for a new PBM (dental caries utility index-DCUI) for the most prevalent childhood oral health condition: dental caries.

METHODS

Possible domains and items to be included in the classification system were identified based on the reviewing available pediatric non-PBM OHRQoL instruments, studies eliciting utility values for oral health outcomes and clinical dentistry textbooks and based on the findings, a draft classification system was developed. To refine the draft classification system, semi-structured interviews were conducted among a convenience sample of 15 12-17-year-old adolescents who had experience with dental caries. The classification system was further refined and validated by a group of dental experts, using a modified Delphi technique.

RESULTS

The classification system comprised five items (pain/discomfort, difficulty in eating food/drinking, worried, ability to participate in activities, and appearance) and each item had a four-level response scale.

CONCLUSION

The classification system developed herein is considered an amenable tool for the subsequent development of a new PBM for dental caries. Once the scoring algorithm is completed, the classification system can be used to incorporate economic evaluations of dental caries health interventions.

Oral health-related quality of life in children with osteogenesis imperfecta

Purpose

Osteogenesis imperfecta (OI) results from mutations in the genes involved in the modification or biosynthesis of collagen. This study aimed to assess the oral health-related quality of life (OHRQoL) in children with OI.

Methodology

Participants were recruited from a highly specialised OI centre for children. The Child Oral-Health Impact Profile—Short Form (COHIP-SF) was used, adding demographic and qualitative questions. Children aged 8–16 years participated between January and October 2019. Statistical analysis was carried out. A higher COHIP-SF score indicates better OHRQoL (maximum score, 76).

Results

One hundred and six (106) children participated (44 female, mean age 11.93 years). COHIP-SF median score was 59. Children reporting mild OI (n = 55) had higher median scores (62) compared to severe OI (n = 7) with median scores of 55 (P = 0.087). When comparing mixed (< 12 years, n = 46) and permanent dentition (≥ 12, n = 60), no significant difference in OHRQoL was seen (P = 0.977). There was no significant difference between severities for each COHIP-SF domain. Limited data on the presence of dentinogenesis imperfecta did not impact overall score (P = 0.109), but was significant in the oral-health domain (P = 0.033).

Qualitative

Common themes were the need for braces, discolouration, pain and function.

Conclusion

This study confirmed that children with OI have dental concerns in areas including oral health, functional well-being and socio-emotional well-being. This was related to severity of OI.

Quality of life and phonatory and morphological outcomes in cognitively unimpaired adolescents with Pierre Robin sequence: a cross-sectional study of 72 patients

Background

Pierre Robin sequence (PRS) is a heterogeneous condition involving retro(micro)gnathia, glossoptosis and upper airway obstruction, very often with posterior cleft palate. Patients with PRS, either isolated or associated with Stickler syndrome have good intellectual prognosis. Nevertheless, the quality of life in adolescence and the phonatory and morphological outcomes are rarely analysed. We assessed the phonatory and morphological outcomes of 72 cognitively unimpaired adolescents with PRS, studied their oral (COHIP-SF19), vocal (VHI-9i) and generic quality of life (QoL; KIDSCREEN-52), and searched for determinants of these outcomes.

Results

Two-thirds of our adolescents retained low or moderate phonation difficulties, but risk factors were not identified. For 14%, morphological results were considered disharmonious, with no link to neonatal retrognathia severity. Only one vs two-stage surgery seemed to affect final aesthetic results. The oral QoL of these adolescents was comparable to that of control patients and was significantly better than that of children with other craniofacial malformations (COHIP-SF19 = 17.5, 15.4 and 25.7, respectively). The oral QoL of the adolescents with non-isolated PRS was significantly worse (COHIP-SF19 = 24.2) than that of control patients and close to that of children with other craniofacial malformations. The vocal QoL of the adolescents (mean [SD] VHI-9i = 7.5 [5.4]) was better than that of patients with other voice pathologies and better when phonation was good. The generic QoL of the adolescents was satisfactory but slightly lower than that of controls, especially in dimensions concerning physical well-being, relationships and autonomy. QoL results were lower for adolescents with non-isolated than isolated PRS. Only non-isolated PRS and low oral QoL affected generic QoL.

Conclusion

Morphological or phonatory impairments remain non-rare in adolescents with PRS but do not seem to be directly responsible for altered QoL. These adolescents, especially those with non-isolated PRS, show self-confidence and social-relation fragility. We must focus on long-term functional and psychological results for PRS patients and improve therapy protocols and follow-up, notably those affecting the oral aspects of the disease.

Comparison of two survey instruments measuring quality of life in pediatric dentofacial patients

OBJECTIVES

(1) To assess the effectiveness of the Orthognathic Quality of Life Questionnaire (OQLQ) and the Child Oral Health Impact Profile (COHIP) to detect differences in Oral Health-Related Quality of Life (OHRQoL) between pediatric patients with dentofacial deformities and controls. (2) To assess for correlations between scores from the OQLQ and COHIP domains with the type and severity of the skeletal mal-relationship. (3) To assess if the COHIP and OQLQ were identifying unique or overlapping OHRQoL concerns.

MATERIALS AND METHODS

Subjects were under age 18, presented with a dentofacial deformity, and completed both surveys. Matched controls completed the same. Severity for conditions was recorded via overjet, overbite, and ANB values and subjects were classified as skeletal Class I, II, or III.

RESULTS

Enrollment yielded 30 subjects and 31 controls. For the OQLQ, significant differences between subjects and controls were found for the Facial Esthetics domain, Oral Function domain, and total score. For the COHIP, significant differences were found for the Social/Emotional Well-Being and Self-Image domains plus total score. There were no significant correlations between the severity of the condition as measured by overjet and reported OHRQoL for any domains.

CONCLUSIONS

The OQLQ and COHIP are effective at detecting significant OHRQoL differences between pediatric patients with dentofacial deformities and controls. Although there is some overlap in the results, the instruments appear to identify different OHRQoL concerns.

A comparative assessment of oral health-related quality of life of children born with orofacial clefts in Sudan and their caregivers'

BACKGROUND

Cleft lip and palate(CL/P)is the most common orofacial malformation affecting one in every 700-1000 newborns worldwide. The aim of the study wasto evaluate the impact of CL/P on health- related quality of life (OHRQoL) in Sudanese children and the level of concordance between caregivers' and children and to investigate correlates of the caregivers' perceptions of OHRQoL with that of their children.

METHODS

The sample consisted of 75 children with clefts (age range 8-16 years), (46 male, 29 female) and their caregivers' attending University of Science and Technology Dental Teaching Hospital. The children and their caregivers' were interviewed separately. The interview consisted of 38 questions adopted from the COHIP (Arabic version).The level of concordance between caregivers' and children was compared using paired t-tests and intraclass correlations. Predictive validity was assessed using Pearson correlations and linear regression analyses.

RESULTS

The translated COHIP and its subscales, had Cronbach' alphas score ranged between (0.65 and 0.75) for caregivers' and children with cleft. COHIP scores for children and caregivers' were (89.41 ± 19.97) and (94.34 ± 19.52) respectively. Caregivers' and children differed significantly in the overall COHIP and oral symptoms subscale. There were high correlations between caregivers' and children ranged from (0.63 to 0.87). The correlation between all subscales was statistically significant (p = 0.05).

CONCLUSIONS

Caregivers' had higher perceptions of oral symptoms and overall COHIP compared to their children using the Arabic version of the COHIP. Caregiver's reports have to be considered complementary to the reports of their children themselves.

Rasch Analysis of Patient- and Parent-Reported Outcome Measures in the International Consortium for Health Outcomes Measurement Standard Set for Cleft Lip and Palate

OBJECTIVES

The aim of this study was to evaluate the psychometric performance of the patient- and parent-reported measures in the International Consortium for Health Outcomes Measurement (ICHOM) Standard Set for Cleft Care, and to identify ways of improving concept coverage.

METHODS

Data from 714 patients with cleft lip and/or palate, aged 8 to 9, 10 to 12.5, and 22 years were collected between November 2015 and April 2019 at Erasmus University Medical Center, Boston Children's Hospital, Duke Children's Hospital, and from participating sites in the CLEFT-Q Phase 3 study. The Standard Set includes 9 CLEFT-Q scales, the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, the Child Oral Health Impact Profile-Oral Symptoms Scale (COHIP-OSS), and the Intelligibility in Context Scale (ICS). Targeting, item-fit statistics, thresholds for item responses, and measurement precision (PSI) were analyzed using Rasch measurement theory.

RESULTS

The proportion of the sample to score within each instruments range of measurement varied from 69% (ICS) to 92% (CLEFT-Q teeth and COHIP-OSS). Specific problems with individual items within the NOSE and COHIP-OSS questionnaires were noted, such as poor item fit to the Rasch model and disordered thresholds (6 of 10). Reliability measured with PSI was above 0.82 for the ICS and all but one CLEFT-Q scale (speech distress). PSIs were lowest for the COHIP-OSS (0.43) and NOSE questionnaire (0.35).

CONCLUSION

The patient- and parent-reported components within the facial appearance, psychosocial function, and speech domains are valid measures; however, the facial function and oral health domains are not sufficiently covered by the CLEFT-Q eating and drinking, NOSE, and COHIP-OSS, and these questionnaires may not be accurate enough to stratify cleft-related outcomes.

Patients With a History of Oronasal Fistula Repair Exhibit Lower Oral Health Measured With Patient-Centric Outcomes Measures

INTRODUCTION

Oronasal fistulae following palatoplasty may affect patients' quality of life by impacting their ability to eat, speak, and maintain oral hygiene. We aimed to quantify the impact of previous oronasal fistula repair on patients' quality of life using patient-reported outcome psychometric tools.

METHODS

A cross-sectional study of 8- to 9-year-old patients with cleft palate and/or lip was completed. Patients who had a cleft team clinic between September 2018 and August 2019 were recruited. Participants were divided into 2 groups (no fistula, prior fistula repair). Differences in the individual CLEFT-Q and Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) Oral Health scores between the 2 groups were evaluated using a multivariate analysis controlling for Veau classification and syndromic diagnosis.

RESULTS

Sixty patients with a history of cleft palate were included. Forty-two (70%) patients had an associated cleft lip. Thirty-two (53.3%) patients had no history of fistula and 28 (46.7%) patients had undergone a fistula repair. CLEFT-Q Dental, Jaw, and Speech Function were all higher in patients without a history of a fistula repair; however, none of these differences were statistically significant. The COHIP-SF 19 Oral Health score demonstrated a significantly lower score in the fistula group, indicating poorer oral health (P = .05).

CONCLUSIONS

One would expect that successful repair of a fistula would result in improved function and patient satisfaction, but the consistent trend toward lower CLEFT-Q scores and significantly increased COHIP-SF 19 Oral Health scores in our study group suggests that residual effects linger and that the morbidity of a fistula may not be completely treated with a secondary correction.

Development of patient-reported outcome measures of children's oral health aesthetics

OBJECTIVES

To develop and evaluate the psychometric properties of child- and parent-proxy measures of oral health aesthetics.

METHODS

Items that describe children's perceptions of their oral attractiveness and its impact on social, emotional, and behavioural functioning were developed based on a systematic review of existing measures, clinician feedback (n = 13) and child semi-structured interviews (n = 27). The tools' content validity was assessed in cognitive interviews with 21 children. Items were administered to socio-demographically diverse samples of 998 children aged 8-17 years and 626 parents of children aged 5-17 years. Psychometric methods were used to finalize and calibrate item banks, generate short questionnaire forms, and evaluate the tools' reliability, precision and validity.

RESULTS

The item banks and their short forms provide precise measurement across a wide range of oral health aesthetic states. They measure relevant and meaningful positive and negative experiences using terminology that most children as young as 8 years of age can understand. Known-group comparisons and convergence with existing measures of oral health-related quality of life, global health and body image provide evidence of construct validity. The scores are interpretable relative to the US general population.

CONCLUSIONS

The oral health aesthetic item banks and short forms provide precise and valid assessments of children's satisfaction with their oral appearance. They may be useful for targeting and evaluating paediatric dental and orthodontic care in clinical practice and research settings.

The development, validation, and psychometric properties of the Japanese version of the Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) for school-age children

Background

This study was performed to develop and validate a Japanese version of Child Oral Health Impact Profile-Short Form (COHIP-SF) 19 and to assess its psychometric properties in Japanese school-age children.

Methods

The original English COHIP-SF 19 was translated into Japanese (COHIP-SF 19 JP) using a standard forward and backward translation procedure. The psychometric properties of the COHIP-SF 19 JP were assessed in 379 public school students between 7 and 18 years of age in Fukuoka, Japan. Internal consistency (Cronbach’s alpha) and test-retest reliability (intraclass correlation coefficient, ICC) were the metrics used for evaluation of this questionnaire. The discriminant validly was examined using the Wilcoxon rank sum test to identify significant differences in COHIP-SF 19 JP scores according to the results of dental examinations. The convergent validity was examined using the Spearman correlations to determine the relationships between COHIP-SF 19 JP scores and the self-perceived oral health ratings. Confirmatory factor analyses (CFA) were performed to verify the factor structure of the questionnaire.

Results

The COHIP-SF 19 JP revealed good internal consistency (Cronbach’s alpha, 0.77) and test-retest reliability (ICC, 0.81). Discriminant validity indicated that children with dental caries or malocclusion had significantly lower COHIP-SF 19 JP scores (P <  0.05); convergent validity indicated that the self-perceived oral health rating was significantly correlated with the COHIP-SF 19 JP total score and subscores (rs = 0.352–0.567, P <  0.0001), indicating that the questionnaire had a sufficient construct validity. CFA suggested that the modified four-factor model had better model fit indices than the original three-factor model.

Conclusion

The collected data showed that the COHIP-SF 19 JP possesses sufficient psychometric properties for use in Japanese school-age children.

Family Impact of Child Oro-Facial Cleft

OBJECTIVE

To describe the association between children's orofacial cleft (OFC) and families' quality of life (QoL), using the short-form Family Impact Scale questionnaire (FIS-SF). Also assessed were the psychometric properties of the FIS-SF, as well as whether certain demographic and clinical variables impacted the family.

DESIGN

Observational cross-sectional study.

SETTING

Tertiary care public children's hospital in New South Wales, Australia.

PARTICIPANTS

Parents/caregivers of children with OFC.

MAIN OUTCOME MEASURE(S)

The short-form Family Impact Scale questionnaire.

RESULTS

Two hundred and fourteen parents completed the FIS-SF. Excellent convergent validity was evident, but discriminant validity was weaker. Those children with velopharyngeal insufficiency/submucous cleft reported lower scores on the family/parental activity, and lower overall family impact scores than those with cleft lip (CL) or cleft palate (CP). Those with cleft lip and palate (CL/P) had poorer family/parental activity scores than those with CP. There were no systematic differences in FIS-SF scores by the child's age, gender, private health insurance, living location, the number of cleft-related operations, or whether a child had commenced orthodontic treatment.

CONCLUSIONS

The FIS-SF is a valid and reliable measure for determining the impact that OFC has on family QoL. The impact of OFC on children's families differs according to cleft type.

Determinants of children's oral health-related quality of life following aesthetic treatment of enamel opacities

OBJECTIVES

To identify clinical and psychosocial predictors of oral health-related quality of life (OHRQoL) in children with molar incisor hypomineralisation (MIH) following aesthetic treatment of incisor opacities.

METHODS

Participants were 7- to 16-year-old children referred to a UK Dental Hospital for management of incisor opacities. Prior to treatment (T_o), participants completed validated questionnaires to assess OHRQoL and overall health status (C-OHIP-SF19), and self-concept (Harter's Self-Perception Profile for Children [SPPC]). Interventions for MIH included microabrasion, resin infiltration, tooth whitening or composite resin restoration. Children were reviewed after six months (T₁) when they re-completed the C-OHIP-SF19 and SPPC questionnaires. The relationships of predictors with improvement of children's OHRQoL (T₁-T_o) and children's overall health status at T₁ were assessed using linear and ordinal logistic regression respectively, guided by the Wilson and Cleary's theoretical model.

RESULTS

Of 103 participants, 86 were reviewed at T₁ (83.5 % completion rate). Their mean age was 11-years (range = 7-16) and 60 % were female. Total and domain OHRQoL scores significantly increased (improved OHRQoL) following MIH treatment. There was a significant positive change in SPPC physical appearance subscale score between T_o and T₁. A higher number of anterior teeth requiring aesthetic treatment were associated with poor improvement of socio-emotional wellbeing at T₁ (Coef =-0.43). Higher self-concept at T_o was associated with greater improvement of socio-emotional wellbeing at T₁ (ß = 3.44). Greater orthodontic treatment need (i.e. higher IOTN-AC score) at T₀ was linked to worse overall oral health at T₁ (OR = 0.43).

CONCLUSIONS

Psychosocial factors and dental clinical characteristics were associated with change in children's OHRQoL following minimal interventions for incisor opacities.

CLINICAL SIGNIFICANCE

MIH is a common condition and clinicians should be aware of the negative impacts some children experience, particularly those with multiple anterior opacities, poor tooth alignment and low self-concept. However, simple, minimally invasive treatments can provide good clinical and psychosocial outcomes and should be offered to children reporting negative effects.

Quality Appraisal of Child Oral Health-Related Quality of Life Measures: A Scoping Review

BACKGROUND

Children's oral health-related quality of life (COHQoL) measures are well known and widely used. However, rigorous systematic reviews of these measures and analyses of their quality are in absence.

OBJECTIVES

To systematically review and quantitatively assess the quality of COHQoL measures through a scoping review.

DATA SOURCES

Systematic literature search of PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE (Excerpta Medica database), HaPI (Health and Psychosocial Instruments), and DOSS (Dentistry and Oral Sciences Source).

STUDY ELIGIBILITY

The measure's focus was COHQoL; the child age ranged from 5 to 14 years; the publication was either a research article or a systematic review and related to caries; and it was written in English or had an English abstract. Two authors independently selected the studies. Disagreements were reconciled by group discussions with a third author.

APPRAISAL

The International Society for Quality of Life Research minimum standards for patient-reported outcome measures were used for quality appraisal.

SYNTHESIS

Descriptive analysis.

RESULTS

We identified 18 measures. Their quality scores ranged from 9.5 to 15.0 on a scale of 16. The quality appeared to bear no relationship to the citation and use of these measures. However, elements of these measures might be more useful than others, depending on the age-specific use and primary quality concerns.

LIMITATIONS

Some of the information on the minimum standards of the 18 measures cannot be found in the existing literature. Measures published without English abstract were not searched.

CONCLUSIONS

The quality of these measures is suboptimal. Researchers and practitioners in this field should exercise caution when choosing and using these measures. Efforts at improving the quality of the COHQoL measures, such as refining existing ones or developing new measures, are warranted.

KNOWLEDGE TRANSFER STATEMENT

Researchers, clinician scientists, and clinicians can use the results of this study when deciding which oral health-related quality of life measure they wish to use in children.

Malocclusion, Dental Caries and Oral Health-Related Quality of Life: A Comparison between Adolescent School Children in Urban and Rural Regions in Peru

Rural, isolated areas benefit less from caries prevention programs and access to treatment than urban areas, and, hence, differences in oral health can be expected. This study aims to assess the prevalence of caries and malocclusion in urban and rural areas of Peru and to compare them with patients’ oral health perception. A total of 1062 adolescents were examined in five schools of rural (Titicaca) and urban (Lima and Cuzco) areas in Peru. Decay Missing Filled Teeth’s Surfaces, the Index of Complexity, Outcome and Need and the Child Oral Health Impact Profile short form-19 (COHIP-SF 19) were used to assess caries, severity of malocclusion and Oral Health Quality of Life, respectively. Significant differences in the prevalence (p = 0.001) and degree of caries (p = 0.001) were found between regions. The prevalence of caries was the highest in Cuzco (97.65%), followed by Titicaca (88.81%) and Lima (76.42%). The severity of malocclusion was the lowest in Titicaca. There was a negative relation between malocclusion, caries and COHIP-SF 19, with no evidence of a difference between the regions. This suggests that the higher the prevalence of caries and the more severe the malocclusion, the poorer the perception of oral health. In our study, rural areas presented a lower severity of malocclusion than urban areas.