The Impact of Dental Pain on the Oral Health-Related Quality of Life (OHRQoL) of Preschool Children in Austria

Bibliometric Analysis of Cross-Sectional Studies on Early Childhood Caries

BACKGROUND/OBJECTIVES

Early childhood caries (ECC) is a significant global public health issue with economic and psychosocial consequences, impacting families and pediatric dentists. It affects children's quality of life, causing pain and infection. Despite increasing research on ECC cross-sectional studies worldwide, inconsistencies and gaps remain in terms of geographical disparities. This study aimed to conduct a bibliometric analysis of cross-sectional surveys on ECC by examining the co-authorship, citation analysis, co-citation networks, and keyword co-occurrence.

METHODS

An advanced search was performed using relevant terms in the Dimensions database from 2005 to 2024. Bibliometric parameters were retrieved through the database's analytical view tool and VOSviewer software.

RESULTS

A total of 571 documents were identified, with the highest output between 2019 and 2023 (355 records). Saul Martins Paiva authored the most articles (10), with 294 citations and a total link strength of 19. Brazil and the U.S. had the highest numbers of publications (56 and 52) and total link strengths, i.e., a measure of collaborative ties (21 and 50). The Universidade Federal de Minas Gerais in Brazil had the most published documents (15). BMC Oral Health led in terms of citations (44 articles, 899 citations, average 20.43%). The frequently co-occurring terms included ECC (1147 occurrences), oral health (417), and preschool child (301).

CONCLUSIONS

This bibliometric analysis highlights the global interest in cross-sectional ECC studies beyond pediatric dentistry, helping researchers understand the field's scope and progress.

Oral Health-Related Quality of Life in Children at a Pediatric Emergency Dental Service During the Start of COVID-19

Background/Objectives: Oral health-related quality of life (OHRQoL) has become increasingly significant in dentistry. By incorporating patient perspectives through questionnaires alongside objective diagnoses, the understanding of diseases is enhanced. This study examines OHRQoL during the early COVID-19 pandemic in children aged 0-10 who visited the Emergency unit of Pediatric Dentistry at the Medical University of Vienna from March to May 2020, focusing on the impact of COVID-19 restrictions on various social and health aspects. The study aimed to assess OHRQoL in children during the early weeks of the COVID-19 pandemic and correlate it with other health and social conditions. Materials and Methods: Children (up to 10 years) and their parents visiting the Emergency Unit of the department completed OHRQoL questionnaires. In children aged 0-6, their parents answered the Early Childhood Oral Health Impact Scale questionnaire (ECOHIS), while 7-10-year-olds completed the Child Perception Questionnaire (CPQ) by themselves. Summary scores and associations between oral and general health subdomains were analyzed. Results: Both the ECOHIS and CPQ groups showed high general summary scores, indicating decreased OHRQoL (ECOHIS 12.22 [±8.68] and CPQ 18.36 [±12.35]). The highest scores were in the "oral symptoms" domain, mainly due to "toothache". Significant correlations were observed between "general health" and "oral health" with the "family section" in the ECOHIS group and between "oral health" and "oral symptoms" with "emotional well-being" in the CPQ group. Conclusions: During the pandemic, both age groups experienced decreased OHRQoL. Family background influenced oral health (ECOHIS), while oral symptoms and emotional well-being correlated with oral health (CPQ). Further research is needed to understand pandemic-related factors affecting OHRQoL and develop preventive strategies.

Pediatric Dental Emergency Visits and Treatment During Lockdown in the COVID-19 Pandemic: A Retrospective Analysis at the Pediatric Emergency Unit of the University Clinic of Dentistry, Vienna, Austria

Background: In the beginning of the COVID-19 pandemic, the Department of Pediatric Dentistry at the University Dental Clinic Vienna switched from routine medical care to emergency operation mode. The study aims to retrospectively compare the characteristics of pediatric patients' emergency visits before, during, and after lockdown. Methods: All pediatric emergencies that presented at the Department of Pediatric Dentistry in the period from the 7 January 2020 to the 31 July 2020 were recorded. Patients were subclassified into three groups with regard to their time of presentation (group 1: before lockdown, group 2: during lockdown, group 3: after lockdown). Then, pediatric patients' purposes for emergency visit, diagnoses, and the treatments practiced were compared. Results: The number of patients was significantly lower during lockdown but increased again afterward. During lockdown, significantly more patients presented with dental pain, the diagnosis "Extraction: tooth not restorable" increased, and extractions were significantly more often the treatment of choice (p < 0.05). Conclusions: The presented study is the first research on pediatric dental emergency visits during the first lockdown of the COVID-19 pandemic in Austria. The results highlight the negative impact of the pandemic on pediatric dental care as the number of treatments decreased, elective treatments were postponed, and the diagnosis and prognosis of teeth deteriorated.

An investigator-blinded, 24-month, parallel-group, non-inferiority study to compare aesthetic restorations in primary anterior teeth in a paediatric dental clinic: study protocol for a randomised controlled trial

INTRODUCTION

Children who suffer from severe caries in childhood may have negative impacts on the growth, development, nutritional problems and quality-of-life problems related to the oral health of the child and their family. There are no studies that have compared rehabilitative techniques of primary anterior teeth regarding patient-centred outcomes and even longevity of the restoration. Thus, this project aims to evaluate the effectiveness of restorative treatment of anterior primary teeth with monochromatic composite resin in single insertion through polyvinyl crowns, after selective removal of carious tissue compared with the effectiveness of conventional restoration.

METHODS AND ANALYSIS

This study proposes to conduct a randomised clinical trial, composed of a sample of 194 deciduous central and lateral incisors with active cavitated lesions, simplified International Caries Detection and Assessment System (ICDAS) C+ score (active and extensive stage caries: ICDAS 5 and 6), with involvement of more than two surfaces. This sample will be divided into two experimental groups, both with selective removal of carious tissue: a group in which conventional restoration will be performed using opaque resins, and another group with monochrome resin with chameleon effect and polyvinyl crowns. The explanatory variables-gender, age, toothbrushing, use of fluoridated toothpaste and dental floss, and socioeconomic status-will be collected through a questionnaire with open questions. The progression of caries lesions after 24 months of follow-up will be considered as the primary outcome. Secondary outcomes will include tooth survival, longevity of restoration, quality of life, perception and satisfaction of the participants' parents/guardians.

ETHICS AND DISSEMINATION

This protocol has been approved by the Human Research Ethics Committee of Universidade Metropolitana de Santos (protocol number: 6.019.297. Approved 24 April 2023). Results will be submitted to international peer-reviewed journals and presented at international conferences.

TRIAL REGISTRATION NUMBER

NCT05875064.

Epidemiological and Oral Public Health Aspects of Dental Pain: A Narrative Review

The aim of this narrative review is to synthesize and discuss existing evidence on the epidemiological aspects of dental pain, addressing its prevalence, risk factors, population distribution, impact on the quality of life, and implications for public health. Dental pain is a common condition that involves complex mechanisms of pain transmission and perception. Dental pain can be due to various causes, such as caries, pulpitis, periodontitis, dental trauma, and soft tissue conditions (e.g., stomatitis). In addition, psychological and social factors influence pain perception and severity, such as anxiety and previous negative experiences. The global burden of dental pain is considerable, generating a significant impact on the quality of life of people at individual and collective levels. This impact manifests itself in a reduction in productivity, due to absenteeism from work and school, as well as difficulties in performing daily tasks. In addition, dental pain entails high costs for health systems, including expenses associated with diagnosis, treatment, and the care of complications arising from the lack of timely care. These costs also include indirect expenses associated with the loss of productivity and impacts on the general well-being of the population. The magnitude of these effects, both at individual and population levels, underlines the importance of prevention and access to timely and effective treatment of dental pain. The prevalence of dental pain varies by region and factors such as age, socioeconomic status, and access to services. Risk factors include sociodemographic (age, gender, and ethnicity), socioeconomic (income, education, and occupation), psychological (anxiety and depression), and behavioral (oral hygiene and diet) dimensions. People with lower socioeconomic and educational status are more likely to suffer from dental pain due to a lack of access to services and inadequate preventive practices. Dental pain negatively affects the quality of life, disrupting daily functions and causing emotional distress. Public health proposes improving access to preventive dental care, oral health education, and equitable policies to reduce disparities. Strategies aimed at reducing the burden of dental pain at the population level include expanding access to dental care, promoting healthy habits, and ameliorating the significance of care costs as a barrier. Future research should focus on innovative assessment methods, expanding the accessibility to various levels of care, and understanding the biopsychosocial determinants of dental pain to develop effective interventions.

Prevalence of Dental Pain in Schoolchildren Aged 6 to 12 Years and Clinical, Sociodemographic, and Socioeconomic Risk Indicators: A Multicenter Study of Four Mexican Cities

Background: Dental pain is a significant public health issue globally and in Mexico, with substantial negative impacts on affected individuals. Objective: The objective of this study was to evaluate the prevalence of dental pain and its association with clinical, sociodemographic, and socioeconomic risk indicators in schoolchildren aged 6 to 12 years in four cities in Mexico. Material and Methods: A cross-sectional study was conducted on 500 children attending public schools in the cities of Pachuca, Tepatitlán, Toluca, and San Luis Potosí. A questionnaire was applied, and a clinical examination was performed on the schoolchildren. Self-reported dental pain within the 12 months preceding the study, categorized as 0 (no pain) and 1 (pain), was used as the dependent variable. For the statistical analysis, the Stata program was used, where a multivariate binary logistic regression model was applied. Results: The mean age was 8.92 ± 1.99 years; 50% were girls. The prevalence of dental pain was 34.0%. Independent variables associated (p < 0.05) with the experience of dental pain were as follows: age (OR = 0.81), having a car at home (OR = 0.77), a lower socioeconomic position (OR = 2.03), curative or specialized dental care (OR = 8.40), and self-reported dental and/or gingival disease (OR = 5.39). Conclusions: Dental pain is a significant health problem in schoolchildren aged 6 to 12 years in Mexico, with a prevalence of 34% in this study. Sociodemographic and socioeconomic factors, as well as clinical indicators, play an important role in the experience of dental pain. Inequalities in oral health were observed. There is a need for public health interventions to reduce this problem in vulnerable populations.

Early Childhood Oral Health Impact Scale: Psychometric Evaluation in Portuguese Preschoolers

Objective

to contribute to the validation of the Early Childhood Oral Impact Scale (ECOHIS) by studying its psychometric properties when applied to a Portuguese preschool population.

Methods

Cross-sectional study conducted with children aged between three and five-years-old. The non-probabilistic sample included two preschools in the municipality of Lisbon. Children who agreed to participate and whose guardians signed the informed consent were included. Data collection included a questionnaire, administered to the parents, and an intraoral examination of the children. The questionnaire included the Portuguese version of ECOHIS. The intraoral examination included the caries diagnosis according to the World Health Organization criteria. Discriminant validity compared the ECOHIS score between children with and without caries experience (Mann-Whitney U-test). Cohen's d was calculated to estimate the magnitude of the difference. Reliability analysis included Cronbach's α and test-retest. Construct validity was analyzed by the correlation between the ECOHIS score and dmft (Spearman's correlation). A significance level of 5% was used.

Results

The sample included 104 children (mean age 4.1 years). ECOHIS values were significantly different between children with and without caries (p=0.004). The Cohen's d was 0.84. The Cronbach's was 0.78, with no significant increase in value when eliminating any of the items. The test-retest showed significant correlation (r=0.76; p=0.01). There was a significant correlation between the ECOHIS score and caries experience (r=0.28; p=0.004).

Conclusion

The Portuguese version of the ECOHIS showed good psychometric properties, indicating that it is a reliable and valid tool to measure the impact of oral health in preschool children.