Diagnostic Validity of Self-Perceived Dental Caries in Indonesian Young Adolescents Aged 12-15 Years

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Validation of self-reported oral health among Indonesian adolescents

Background and aim

With the recognition of health as a subjective state, self-reported oral health has been applied in many epidemiological studies. However, the validity of self-reports may vary across different age groups and socio-cultural backgrounds and by using different tools. This study aimed to assess the validity of self-reported oral health of 15-year-old Indonesian adolescents.

Materials and methods

This study used data from the Indonesian National Oral Health Survey, a part of the Indonesian Basic Health Survey 2018. The study included 572 15-year-old Indonesian adolescents. We compared the presence of clinically assessed dental caries, tooth loss, and fillings following the World Health Organization Basic Health Survey method and questionnaire-based self-reported oral conditions using McNemar test. The sensitivity (Sn), specificity (Sp), and likelihood ratios (LRs) of self-reports were calculated using clinical assessment as the reference standard. The overall accuracy of self-reports in identifying the clinical condition was assessed using the area under the curve (AUC) of a receiver operating characteristic curve.

Results

Self-reports significantly underestimated the clinical presence of caries (39.3% and 67.1%) and overestimated the clinical presence of tooth loss (9.3% and 4.2%) and filling (4.7% and 2.4%, p < 0.05). All self-reported conditions had higher Sp (at least 70.3%) than Sn (max 54.2%) and the AUC for all self-reported conditions were < 0.7. Self-reporting the presence of fillings had the highest LR+  = 11.

Conclusions

Self-reporting oral health in Indonesian adolescents had low accuracy. Further studies of other methods of self-reporting are needed before they can be used to assess adolescents’ oral health in epidemiological surveys.

Global and regional estimates of dental pain among children and adolescents-systematic review and meta-analysis

AIM

We aimed to evaluate the pooled prevalence of dental pain amongst children and adolescents.

METHODS

Studies conducted in children and adolescents up to18 years of age and where prevalence of dental is reported or calculated were included. Search was performed in four major databases from inception to June 1st, 2019. Prevalence estimate at the maximal recall for the dental pain for the individual study was used to calculate the overall pooled estimate.

RESULTS

The prevalence of dental pain ranged from 1.33 to 87.8% in the included publications for quantitative synthesis (n = 97). More than half of the publications reported the lifetime prevalence of dental pain (n = 51) while few studies reported the current prevalence of dental pain (n = 3) and only one study evaluated the dental pain in the past one week. Heterogeneity was high among the included publications (Q = 49,063.12; P < 0.001; df = 96 and I² = 99.8; P < 0.001). Overall pooled prevalence of dental pain was 32.7 (CI = 29.6-35.9). No difference was seen with respect to the trends in prevalence of dental pain (Coefficient: 0.005; 95% CI - 0.001-0.011; P-value: 0.101).

CONCLUSION

Two out of ten children below five years, four out of ten children between 6 and 12 years and three out of ten adolescents between 13 and 18 years would have experienced pain in the past. Overall, three out of ten children or adolescents might have experienced dental pain in the past. There was no difference in the pain prevalence between male and females. Studies from Africa reported highest pooled prevalence (50.1%) with least being from Australia (20.7%). Studies from India (40.4%), China (41.3%) and Iran (42.6%) reported high pooled prevalence estimates of dental pain.