Impact of dental caries severity and activity on oral health-related quality of life among children aged 8-11 years

Comparing the effectiveness of an e-learning module at different levels of magnification for detecting occlusal caries in permanent teeth, utilizing the international caries detection and assessment system (ICDAS): an ex vivo study

OBJECTIVE

The purpose of this study was to compare the effectiveness of low and high magnifications in detecting occlusal caries in permanent posterior teeth using the International Caries Detection and Assessment System (ICDAS) II criteria through the ICDAS e-learning program.

MATERIALS AND METHODS

Forty extracted permanent posterior teeth were used. Two examiners received e-learning training on the ICDAS webpage for detecting occlusal caries before visual examinations. Visual inspections were performed under ×2.5 magnification with a magnifying loupe and ×25 magnification with a dental surgical microscope within a week. The ICDAS scores assigned by both examiners were validated by an ICDAS expert. The visual assessment results were compared with the histological analysis results using Downer's criteria as the gold standard.

RESULTS

Inter-examiner reliability for ICDAS-II scoring at low magnification (×2.5 loupe) and high magnification (×25 operating microscope) was moderate. However, the lenient (binary) criteria showed substantial agreement at both magnifications. Specificity was highest for both the low and high treatment thresholds (88.2% and 81.5%, respectively) at low magnification, whereas sensitivity peaked at high magnification for the high treatment threshold criterion (91.7%). Image-based ICDAS scoring by an expert also demonstrated good diagnostic accuracy (76.9%), though it was not superior to ICDAS scoring performed under ×2.5 magnification (82.1%).

CONCLUSION

The ICDAS-II score, particularly the lenient criterion, demonstrated a strong correlation with histological depth. The e-learning program effectively equips dentists with diagnostic skills. Extreme magnification resulted in the overestimation of dental caries, whereas low magnification (2.5x) resulted in greater diagnostic accuracy.

Association between oral health-related behaviors and quality of life of adolescents among three provinces in Northwest China

Objective

To assess the oral health-related quality of life (OHRQoL) of adolescents in Northwest China, and to explore the relationship between sociodemographic characteristics, oral health-related behaviors and OHRQoL.

Methods

A cross-sectional survey of adolescents aged 12-15 years in Shaanxi, Gansu province and Ningxia Hui Autonomous Region of Northwest China was conducted by stratified cluster random sampling. Oral examinations were performed with World Health Organization (WHO) standards, and the condition of crowns and periodontal was recorded. Adolescents' oral health-related behaviors and OHRQoL were collected by questionnaire. Chi-square test and binary logistic regression analysis were used to examine the relationship.

Results

A total of 7,648 subjects were included. The prevalence of low OHRQoL which defined as a score higher than 0, was 83.8%. A low OHRQoL was most prevalent in Gansu Province and least prevalent in Shaanxi Province. Younger (OR = 0.73, CI = 0.60-0.87), female (OR = 1.27, CI = 1.11-1.44), rural (OR = 1.44, CI = 1.21-1.72), and mother with less education (OR = 0.69, CI = 0.60-0.81) all showed statistically significant influence on teenagers' OHRQoL. From a behavior perspective, teens' OHRQoL was correlated with their frequency of sugar consumption (OR = 1.72, CI = 1.41-2.10), dental appointment rate (OR = 1.29, CI = 1.064-1.57), self-assessment of oral health (OR = 3.09, CI = 2.29-4.19), DMFT index (OR = 1.19, CI = 1.04-1.37), number of teeth calculus (OR = 1.20, CI = 1.01-1.43), and dental trauma (OR = 0.47, CI = 0.39-0.57) over the previous year; however, brushing their teeth was not statistically significant.

Conclusions

Generally speaking, oral health-related behaviors-such as eating more sugary foods and scheduling dental appointments within the last year-have a significant negative impact on the quality of life of adolescents in Northwest China. Female, and adolescents from families with low educational backgrounds are more likely to be affected by such behaviors in their daily lives.

Impact of Clinical Consequences of Pulp Involvement due to Caries on Oral Health-Related Quality of Life in Children and Adolescents: A Systematic Review and Meta-Analysis

INTRODUCTION

Dental caries with pulp involvement potentially impacts the oral health-related quality of life (OHRQoL). This meta-analysis aimed to evaluate whether clinical consequences of pulp involvement due to dental caries impacts OHRQoL of children and adolescents.

METHODS

Observational studies evaluating whether children/adolescents (population) with pulp involvement due to caries (exposition) compared with those without it (comparison) have more negative impact on their OHRQoL (outcome) were included. A systematic search was undertaken in August 2022 in seven databases. Alerts were set until August 2023. JBI Critical Appraisal tool for cross-sectional studies was used for methodological quality assessment. Random-effects meta-analyses were performed to calculate mean differences (MD) or standardized mean differences (SMD) of impact on OHRQoL. For studies with dichotomous outcome, meta-analysis calculated the odds ratio (OR). Robustness, heterogeneity, certainty of evidence, and publication bias were evaluated.

RESULTS

From 29 included studies, 14 assessed preschoolers, nine assessed schoolchildren, four assessed adolescents, and two assessed children/adolescents. PUFA was the main index used to assess the exposure. ECOHIS (preschoolers) and CPQ (children/adolescents) were the main tools used to assess the outcome. Only five articles fully adhered to the quality criteria. The meta-analyses found the following main results: (a) preschoolers: MD -10.79 (-16.50; -5.09); (b) schoolchildren: MD -5.12 (-7.51; -2.72); (c) adolescents: MD -1.86 (-4.59; 0.87); (d) overall impact: SMD -2.18; (CI: -3.21;-1.15) and OR 0.52 (CI: 0.30; 0.90).

CONCLUSION

Pulp involvement impacted OHRQoL of children negatively. In adolescents, this impact was not observed. Results must be interpreted with caution due to very low certainty of evidence.

Effectiveness of theory-based educational interventions of promoting oral health among elementary school students

BACKGROUND

The aim of the present study was to determine the effect of oral health education programs on the oral health of primary school students.

METHODS

In this randomized controlled trial study, 190 elementary fifth-grade female students were chosen using the multistage cluster sampling method. In this study, the Plaque Index (PI), Simplified Oral Hygiene Index (OHI-S), Community Periodontal Index (CPI), tooth brushing using fluoride toothpaste, dental flossing frequency and factors affecting them were determined according to social cognitive theory (SCT). Interventions were implemented using the play method and with the help of three pamphlets, five posters, a celebration of oral health, and the creation of a Telegram group. Data were analyzed using descriptive statistics indexes, t tests, paired sample t tests, chi-square tests, and Pearson correlation tests.

RESULTS

The results showed that 3 months after the intervention, compared to before the intervention, the percentage of participants in the intervention group who brushed their teeth twice or more per day increased by 48.5%, and the percentage of participants who used dental floss at least once per day increased by 64.2%. The rate of gum bleeding decreased by 6.3%. The good OHI-S rate increased by 44.4%. Dental plaque decreased by 38.1%.

CONCLUSION

The results demonstrated that a gamification design can be effective and useful in promoting the oral health of students.

TRIAL REGISTRATION

registration timing: retrospective, registration date: 18/10/2022, registration number: IRCT20141128020129N2.

Reliability and validity of the Child Perception Questionnaire 8 ~ 10 (CPQ8~10) in China: an instrument for measuring oral health-related quality of life among 8-10-year-old children

OBJECTIVES

Children aged 8-10 are in a critical stage of growth and development, facing complex and specific oral health problems. In China, there is no specific assessment questionnaire for this age group. The Child Perception Questionnare 8 ~ 10 (CPQ8~10) has been widely used in many countries, with good reliability and validity. This study aimed to translate the CPQ8~10 into Chinese and assess its reliability and validity, and ascertain its applicability for 8-10-year-old children in China.

MATERIALS AND METHODS

Brislin's translation model was used in developing the Chinese version of CPQ8~10. Internal consistency, retest reliability, criterion validity, and confirmatory factor analysis were performed to evaluate the reliability and validity of the Chinese version of the CPQ8~10 among 494 8 ~ 10-year-old children in China.

RESULTS

A Chinese version of the CPQ8~10, aligned with Chinese culture and social features, was developed. The criterion validity was 0.719 (P < 0.001). The item-level content validity index (I-CVI) and scale-level content validity index (S-CVI) for the Chinese version of the CPQ8~10 were 0.80 ~ 1.00 and 0.968, respectively. Factor analysis revealed a logical relationship among the items in the Chinese version of the CPQ8~10. The Cronbach's α coefficient, retest reliability, and Guttman split-half reliability coefficient for the Chinese version of the CPQ8~10 were 0.819, 0.830, and 0.849, respectively.

CONCLUSIONS

The Chinese version of the CPQ8~10 exhibited a structure consistent with the original questionnaire, displaying good reliability and validity. This study facilitates the application of CPQ8~10 in China.

CLINICAL RELEVANCE

The Chinese version of the CPQ8~10 is a brief and suitable tool to evaluate oral health-related quality of life of 8 ~ 10-year-old children.