Impact of a dental care program on the quality of life of children with and without caries

Effect of educational strategy combined with ART on oral health-related quality of life: a controlled clinical trial

This study aimed to assess whether complementing atraumatic restorative treatment (ART) with oral health educational strategies (OHES) improves the perception of oral health-related quality of life (OHRQoL) and clinical oral outcomes. A controlled clinical trial included 93 six- to eight-year-old students from five public schools of Piracicaba, Saltinho, and Charqueada municipalities (State of São Paulo, Brazil) divided into 3 groups (31 children each) which received: OHES (caries-free), ART (dental caries), and ART plus OHES (dental caries). OHRQoL (CPQ8-10-ISF:16), dental caries, biofilm control, and gingivitis were assessed before and 1 month after interventions by one calibrated examiner. OHES consisted of an educational interactive activity performed once a week for four weeks. Data were analyzed using mixed model ANOVA, Chi-square, and Sign tests. After 1 month of follow-up, improvement in gingivitis status, OHRQoL total score, and Functional Limitations, Emotional Well-Being and Social Well-Being domains scores were found in all groups (p < 0.05). The improvement in biofilm control was observed only in the OHES group (p < 0.001; power = 0.98), while a decrease in Oral Symptoms scores was observed only in ART+OHES group (p <0.001; power = 0.99) and a significant change in the perception of oral health was observed in the two groups that received ART (p < 0.05). In conclusion, improvement in overall OHRQoL and oral status was observed in all children, although the effect of including health educational strategies in the treatment plan was determinant for the perception of an improved oral health after restorative treatment.

Association of dental caries morbidity stages with oral health-related quality of life in children and adolescents

BACKGROUND

Dental caries morbidity stages and their impact on oral health-related quality of life (OHRQoL) have not yet been established.

AIM

To compare the association of dental caries morbidity stages with OHRQoL in children and adolescents from public schools of Patos-PB, Brazil.

DESIGN

A cross-sectional study was performed on 461 students at 8-10 years and 454 at 11-14 years. Caries was evaluated by Caries Assessment Spectrum and Treatment (CAST) instrument. The maximum CAST code per individual was registered. OHRQoL was assessed using the Child Perceptions Questionnaires for children (CPQ_8-10 ) and adolescents (CPQ_11-14 ).

RESULTS

Morbidity stage was the most prevalent caries condition in children (40.8%) and adolescents (38.1%). Factors associated with higher CPQ_8-10 scores in the multivariate regression analysis after adjustments were age [9 years, prevalence ratio (PR): 1.24; 95% confidence interval (CI): 1.06-1.45; and 10 years, PR: 1.32, CI: 1.13-1.55] and dental caries status [morbidity, PR: 1.23, CI: 1.03-1.48; and severe morbidity, PR: 1.30, CI: 1.04-1.61]. The factor associated with higher CPQ_11-14 scores was dental caries status [morbidity, PR: 1.20, CI: 1.00-1.44].

CONCLUSIONS

The OHRQoL of children was negatively associated with morbidity and severe morbidity stages of dental caries, while for adolescents, only morbidity had a negative association with their OHRQoL.

Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Mexican Schoolchildren

Objective: To evaluate the impact of Molar Incisor Hypomineralization (MIH) in the OHRQoL in a group of 8 to 10 year-old Mexican schoolchildren. Study design: A cross-sectional study of 411 8 to 10 year-old schoolchildren selected from public schools in Naucalpan, in the State of Mexico. The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. The OHRQoL was evaluated using the Child Perceptions Questionnaire (CPQ). Poisson regression models were performed for the analysis. Results: The prevalence of MIH in the permanent dentition was 40.4%. High scores were found in the four domains of the CPQ for children with MIH compared to children without MIH (p<0.001). In the Poisson model, a greater negative impact in the four CPQ domains was found for schoolchildren with MIH: oral symptoms [RR=1.75 (CI95% 1.63-1.78)]; functional limitations [RR=2.17 (CI95% 2.01-2.35)]; emotional wellbeing [RR=1.94 (CI95% 1.80-2.08)]; and, social well-being [RR=2.62 (CI95% 2.49-2.77)]. A greater impact on the four CPQ domains were found for children with moderate/severe MIH compared to children without MIH (p<0.001). Conclusion: Children with moderate/severe MIH experienced a greater negative impact on their OHRQoL compared to children without MIH.

Responsiveness of Oral Health-Related Quality of Life Questionnaires to Dental Caries Interventions: Systematic Review and Meta-Analysis

This systematic review and meta-analysis were undertaken to assess the responsiveness of validated oral health-related quality of life (OHRQoL) questionnaires to dental caries interventions in children, adolescents, and young adults. Studies eligible were randomized clinical trials (RCTs), controlled clinical trials (CCTs), and prospective case series (PCS), which had OHRQoL questionnaires answered before and after caries intervention(s). The main outcome was improvement in OHRQoL mean scores following caries intervention. Twenty-six studies were selected for the quality assessment and 14 were selected for the meta-analysis. Most of the studies were PCS with a single group pretest and posttest study design (n = 19). Five studies were CCT and only 2 were RCT. The numbers of participants were 3,522 in the control group (baseline = 2,002; final = 1,520) and 5,917 in the test group (baseline = 3,102; final = 2,815). The age of the subjects ranged from 3 to 19 years. All studies showed significant improvement in OHRQoL following caries intervention. Most of nonrandomized studies (n = 15) had low or moderate risk of bias. The meta-analysis showed the effect of caries interventions (standardized weighted mean differences = -1.24; 95% CI: -1.68 to -0.81; p < 0.001). However, high heterogeneity between the studies was found. The Grading of Recommendations Assessment, Development and Evaluation approach classified the quality of evidence as very low and its strength weak. In conclusion, there is evidence that the OHRQoL of children and adolescents improved following caries intervention procedures, but the quality of the evidence was very low. In spite of that, caries interventions are highly recommended as abstaining from treatment is likely to result in a deterioration of OHRQoL.

Trends over Time in Dental Caries status in Urban and Rural Thai Children

Background

Historically, the prevalence of dental caries was higher in urban areas than rural areas of Thailand. This study aim to examine the time trends in caries status in children in Thailand.

Material and Methods

Linear regression was used to examine trend of dental caries prevalence and mean number of teeth with caries, filled and missing due to caries (dmft/DMFT) in urban and rural, of 3-, 5-6 and 12-year olds from seven Thailand National Oral Health Surveys conducted approximately every 5 years from 1977 to 2012.

Results

There were declines in the caries prevalence and mean dmft/DMFT in every age group. Significant results were observed in the mean dmft of 3 year-olds and the mean DMFT of 12 year-olds (p= 0.03 and p=0.05, respectively). A significant trend of declining prevalence of dental caries was observed in urban children ages 5-6 (p=0.002), along with urban 12 year-olds (p<0.001). A declining trend of mean dmft for 3 and 5-6 year-olds, and mean DMFT for 12 year-olds was observed in both rural and urban areas, but significant results were shown in urban 3 and 5-6 year-olds (P=0.04, and p<0.001, respectively), and urban 12 year-olds (p=0.001). For restoration outcome, both urban and rural of all age groups have an increasing trend of mean ft/FT index.

Conclusions

There have been differences over time in the prevalence and quantity of dental caries between urban and rural school children. A significant reduction was observed in urban areas. More effort needs to be given to supply rural areas in order to have fair and equal access of all citizens to oral health care. Key words:Dental caries, prevalence, children, Thailand, rural, urban, time trend, national survey.