The factors that influence the oral health-related quality of life in 12-year-old children: baseline study of a longitudinal research

Evaluation of oral health-related quality of life in children with acute lymphocytic leukemia/acute myelocytic leukemia: A cross-sectional study

OBJECTIVE

Chemotherapy and radiotherapy, used to treat childhood hematological malignancies (acute lymphocytic leukemia [ALL] and acute myelocytic leukemia [AML]) can negatively affect oral tissues and organs. This study aimed to evaluate the oral health-related quality of life in children with ALL/AML.

MATERIALS AND METHODS

A total of 99 children, including 49 undergoing ALL/AML (41 with ALL and eight with AML) and 50 healthy volunteers, were included in this cross-sectional study. The mean age of the entire study group was 78.63 ± 34.41 months. The mean age of the ALL/AML and control groups was 87.12 ± 35.04 and 70.95 ± 34.85 months, respectively. The Simplified Oral Hygiene Index (SOHI), the Decayed, Missing, and Filled Teeth (DMFT/dmft) index, and the Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS-T) were administered to all children. The data were analyzed using SPSS software (version 22.0). The Pearson chi-square and Fisher's exact tests were used to compare demographic data.

RESULTS

The age and gender distributions of the two groups were similar. According to ECOHIS-T, the children in the ALL/AML group had significantly more loss of function (eating, drinking, sleeping, etc.) than those in the control group.

CONCLUSIONS

Oral health and self-care were negatively affected by childhood ALL/AML and its treatment.

Influence of malocclusion on OHRQoL in adolescents in initial orthodontic treatment phase

OBJECTIVES

Besides correcting malocclusions, another main objective of orthodontic treatment is to improve patients' oral health-related quality of life (OHRQoL). This study aimed to assess changes in OHRQoL of children within the first six months of orthodontic therapy with fixed orthodontic appliances.

METHODS

85 patients aged 11 to 14 years requiring fixed orthodontic appliance therapy were included. The children completed the German version of the Child Perceptions Questionnaire (CPQ-G-11-14) before (T0), 1 month (T1) and 6 months (T2) after the start of orthodontic treatment. The type of malocclusion was categorized according to the Index of Orthodontic Treatment Need (IOTN).

RESULTS

The initial type of malocclusion affected the children's OHRQoL, whereas gender and age did not. The IOTN dental health component (DHC) had a significant impact on the CPQ score (median CPQ of 15.00 for the group DHC 4 vs. 22.50 for DHC 5, p = 0.032). The onset of orthodontic treatment initially affected the CPQ domains "Oral symptoms" and "Functional limitations, with a change versus baseline of 2.00 (p = 0.001), but improved again after 6 months. Regression analysis demonstrated that children with an IOTN DHC 5 malocclusion experienced a greater impact on their ORHQoL, as indicated by a CPQ score 7.35 points higher than that of children with an IOTN DHC 4 malocclusion (p = 0.015).

CONCLUSIONS

At the beginning of orthodontic treatment, the OHRQoL slightly worsens, probably due to the discomfort and appearance of the appliances. However, 6 months after the start of orthodontic treatment, OHRQoL improved again in patients with severe malocclusion (IOTN 4 and 5), and approached baseline values.

CLINICAL RELEVANCE

The results help the clinician to better understand specific aspects of oral health that may be affected by different malocclusions, thereby improving the child's satisfaction and overall quality of life.

Malocclusions and quality of life among adolescents: a systematic review and meta-analysis

BACKGROUND

Malocclusions in adolescents might have a negative impact on oral health-related quality of life (OHRQoL). Potential confounding variables (confounders) such as age, gender, caries, and socioeconomic status may skew the real relationship between malocclusions and OHRQoL.

OBJECTIVES

To analyse the effect of malocclusions in adolescents on OHRQoL, when controlled for potential confounders.

SEARCH METHODS

Five databases (PubMed, Cochrane Library, Cinahl, Scopus, and Web of Science) were searched up to 15 June 2022.

SELECTION CRITERIA

Studies in which OHRQoL in 10-19-year olds with and without malocclusions were compared.

DATA COLLECTION AND ANALYSIS

Screening, data extraction, and quality assessments were performed by four investigators independently. Risk of bias was assessed according to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) guidelines. To be included, studies had to control for confounders. Certainty of evidence was assessed with GRADE.

RESULTS

Thirteen cross-sectional studies with low and moderate risk of bias were included in the qualitative synthesis. Four of these were also included in the quantitative synthesis (meta-analysis). The 13 studies in the qualitative synthesis displayed a large variation among the indices used for malocclusion ratings, as well as in instruments measuring OHRQoL. There was moderate quality of evidence that malocclusions have a negative effect on OHRQoL. The four articles included in the quantitative synthesis (meta-analysis) measured malocclusions with DAI and OHRQoL with CPQ 11-14 short form. There was moderate quality of evidence that malocclusions have a negative effect on OHRQoL (RR/PR 1.15, 95% CI 1.12-1.18, 3672 participants).

CONCLUSIONS

There is moderate quality of evidence that malocclusions in adolescents have a negative impact on OHRQoL, after taking relevant confounders into consideration. Future studies should ideally use standardized measures for malocclusion ratings and OHRQoL.

REGISTRATION

PROSPERO. CRD42020186152.

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.

Oral health-related quality of life in children with celiac disease

PURPOSE

There is limited knowledge about oral health-related quality of life (OHRQoL) in children with celiac disease (CD). This study aimed to assess OHRQoL in children with CD compared to healthy controls.

METHODS

This case-control study included children with CD and healthy controls. Three scales were used to assess OHRQoL in different age groups: 6-7 years, 8-10 years, and 11-14 years. The OHRQoL scores were compared between cases and controls to examine the possible associations between OHRQoL and demographics, socioeconomic status, and oral health.

RESULTS

Overall, 104 children with CD and 104 healthy children (controls) were included. The mean age was 10.67 ± 2.39 years in CD patients and 10.69 ± 2.36 in controls (P = 0.971). Male and female children constituted 50% of each group. Children with CD had significantly higher OHRQoL scores than controls (P = 0.003). Low education levels of parents of children with CD and a higher number of siblings in controls were associated with high OHRQoL scores (P = 0.002, P < 0.020, and P = 0.010, respectively). Recurrent aphthous stomatitis (RAS) increased the OHRQoL scores by 7.5 on average (P = 0.016).

CONCLUSION

Children with CD had poor OHRQoL compared with healthy controls. Poor OHRQoL in children with CD was associated with RAS and with lower parental income and education. RAS was an independent predictor of poor OHRQoL in children with CD.

Childhood Caries Management

Dental caries, also known as tooth decay or cavities, result from the breakdown of teeth due to bacterial acids [...]

The Efficacy of a Multi-Theory-Based Peer-Led Intervention on Oral Health Among Hong Kong Adolescents: A Cluster-Randomized Controlled Trial

PURPOSE

This study aimed to investigate the effects of a peer-led oral health intervention based on the Health Belief Model and the Social Cognitive Theory on improving oral health among Hong Kong adolescents.

METHODS

The study adopted a cluster-randomized controlled trial design, and 1184 students in 12 schools were randomized to intervention or control groups. After baseline assessment, the intervention group received a peer-led theory-based oral health intervention, while the control group received booklets for oral health promotion. Self-reported brushing and flossing, Health Belief Model/Social Cognitive Theory constructs, and oral health-related quality of life (OHRQoL) were measured at baseline, 6 months, and 12 months, and dental plaque accumulation and caries status were measured at baseline and 12 months. The trial was registered at https://www.clinicaltrials.gov (NCT03694496).

RESULTS

Brushing, flossing, and OHRQoL improved more in the experimental group than in the control group at the 6-month follow-up compared with baseline (p < .001). The mean gain score difference was .81 for brushing, .47 for flossing, and -2.51 for OHRQoL. At the 12-month follow-up, the mean gain score of brushing frequency, plaque index, caries status, and OHRQoL were .18, -.28, -.32, and -2.79, respectively, which all sustained the significant difference (p < .001).

CONCLUSIONS

Our findings suggested that the Health Belief Model combined with Social Cognitive Theory in a peer-led intervention is effective to increase self-reported brushing frequency and improve oral hygiene status and OHRQoL among adolescents.

Oral health-related quality of life among groups of foundling and delinquent children in comparison with mainstream children

AIM

This study envisages understanding about the Oral Health-Related Quality of Life (OHRQoL) among groups of foundling and delinquent children and compares them with mainstream children in Riyadh, Saudi Arabia.

METHOD

This is a cross-sectional, observational study of a group of foundling and delinquent children aged 11 to 14 years, in care houses in Riyadh, Saudi Arabia, and mainstream school children. Variables measured for each group were demographic data (age, gender), subjective oral health condition, and OHRQoL. An interview-based questionnaire was used for collecting the relevant data. The questionnaire was divided into four parts, oral symptoms, functional limitations, emotional well-being, and social well-being, with each response scored as per the following codes: (0) never, (1) once or twice, (2) sometimes, (3) often, and (4) every day. The top possible score for the total scale was 144, and the lowest was 0. A comparison group of mainstream school children was recruited from public schools. Data were analysed using SPSS version 25.0 statistical software, and one-way ANOVA was used for the analysis of data when three levels or more were categorical, and the response was numerical. A chi-square test was used to assess the correlation between any two categorical variables.

RESULTS

Out of the total 99 children, 33 were delinquents, 33 were foundling, and 33 were mainstream children included as a comparative group in the study. It was noted that the delinquents compared to the other children had significantly higher scores in accordance with the data collected, with a mean overall score of 30.61 compared to the score for foundling, which was 19.48, and mainstream children had a meager score of 9.18. Individual factorssuch as the oral symptoms, functional limitations, and emotional and social well-being were scored separately, with delinquents having the highest scores and mainstream children the least.

CONCLUSIONS

Health, including oral health, is a right everyone is equally subjected to, and while the concept of OHRQoL is relatively new, delinquents and foundling are definitely subjected to poorer standards in terms of their oral hygiene, on-time treatment, and diagnosis, which further deteriorates their quality of life.

The efficacy of peer-led oral health programs based on Social Cognitive Theory and Health Belief Model among Hong Kong adolescents: a cluster-randomized controlled trial

Oral diseases are preventable through the building of good oral health behaviors. Theory-based behavior change was key to the efficacy of oral health promotion since conventional promotion strategies achieved only short-lived and limited improvements. The objective of the study was to investigate the efficacy of a peer-led oral health intervention based on the health belief model (HBM) and the social cognitive theory (SCT) on oral self-care behaviors among Hong Kong adolescents. One thousand one hundred and eighty-four adolescents in 12 schools participated and were randomly assigned to either intervention or control group, utilizing a cluster-randomized controlled trial design. Brushing/flossing frequency, HBM/SCT constructs, oral health knowledge, and dental anxiety were measured at baseline and 6-month follow-up. Changes in behaviors were assessed using mixed-effects model and the mediators of behavioral change were identified with parallel multiple mediation analysis. At 6 months, the intervention group showed a significant increase in the frequency of brushing and flossing compared with the control group. Self-efficacy was identified as mediator between treatment condition and behavioral changes of brushing and flossing. Combining theories of HBM and SCT is a promising avenue for efficacy in oral health behaviors. The effects were mediated through cognitive variables, which provided guidance for both theory and health intervention development.

Dental visit experience and dental care barriers among Hong Kong preschool children with special education needs

BACKGROUND

Children with special education needs (SEN) require additional supports in education settings, as well as extra supports in healthcare services.

AIM

To investigate dental visit experience and dental care barriers among Hong Kong preschoolers with SEN.

DESIGN

This was designed as a cross-sectional study. A structured questionnaire was employed to investigate dental attendance and dental care barriers among Hong Kong preschoolers with SEN. Binary logistic regression and multi-factor ANOVA were performed to identify factors associated with children's dental visit experience.

RESULTS

A total of 383 children were included in the final analysis. The average age of the recruited children was 3.87 ± 0.95 years. 72.5% parents reported that dental visits were a challenging task for their children. Among children with caries, 70.7% had never visited a dentist. Regression models indicated that (a) children over 3 years or children whose parents received tertiary education were more likely to visit a dentist; (b) the existence of dental care barriers was associated with children's primary diagnosis, practical skills, conceptual skills, and parents' education attainment; and (c) children with low conceptual skills (95%CI:0.71 to 2.40, P < .001), or children from low-income families (95%CI:1.21 to -0.06, P = .031) had more dental care barriers than their counterparts.

CONCLUSION

Unmet dental treatment needs and dental care barriers existed among pre-schoolers with SEN. Dental care barriers were associated with children's developmental profile, parents' education attainment, and household income.

A Novel Strategy for Caries Management: Constructing an Antibiofouling and Mineralizing Dual-Bioactive Tooth Surface

Existing single-functional agents against dental caries are inadequate in antibacterial performance or mineralization balance. This problem can be resolved through a novel strategy, namely, the construction of an antibiofouling and mineralizing dual-bioactive tooth surface by grafting a dentotropic moiety to an antimicrobial peptide. The constructed bioactive peptide can strongly adsorb onto the tooth surface and has beneficial functions in a myriad of ways. It inhibits cariogenic bacteria Streptococcus mutans adhesion, kills planktonic S. mutans, and destroys the S. mutans biofilm on the tooth surface. It also protects teeth from demineralization in acidic environments, and induces self-healing regeneration in the remineralization environment. Molecular dynamics simulations elucidate the main adsorption mechanism that the positively charged amino acid residues in the bioactive peptide bind to phosphate groups on the tooth surface, and the main mineralization mechanism that the negative charges on the outermost layer of the bioactive peptide repel acetic acid ions and attract calcium ions as nucleation sites for remineralization. This study suggests that this in-house synthesized dual-bioactive peptide is a promising functional agent to prevent dental caries, and is effective in inducing in situ self-healing remineralization for the treatment of decayed teeth.

Oral health and happiness in adolescents: A cohort study

OBJECTIVES

To investigate the influence of oral health conditions, socioeconomic status and dental care utilization on subjective happiness and identify the factors associated with changes in happiness among adolescents.

METHODS

Data were collected in 2012 and 2014. Oral health conditions were evaluated by performing clinical examinations; socioeconomic status and dental care utilization were assessed by using a questionnaire. The participants answered the Child Perceptions Questionnaire 11-14 for the evaluation of the impact of these variables on oral health-related quality of life (OHRQoL). Happiness was assessed using the Brazilian version of the Subjective Happiness Scale. For longitudinal data analysis, a mixed-effect model of linear regression was used to assess the factors related to happiness and multinomial logistic regression to appraise prospective changes in happiness.

RESULTS

A total of 1134 12-year-old adolescents were examined at baseline (response rate: 93%), and 770 were reevaluated after 2 years (retention rate: 68%). The adolescents who lived in households with lower equivalized income and greater overcrowding, had not visited the dentist in the later 6 months, had a higher number of cavitated carious lesions, and reported a higher impact on OHRQoL in 2012 presented lower happiness levels. Additionally, the adolescents with a higher number of decayed, missing or filled teeth and who reported a higher impact on OHRQoL were more likely to belong to the most unfavourable happiness trajectory categories.

CONCLUSIONS

The presence of dental caries, socioeconomic conditions, dental care utilization and OHRQoL influence happiness in adolescents. Having more teeth affected by dental caries and worse self-perception in early adolescence can lead to a decrease in happiness.

Do malocclusion and orthodontic treatment impact oral health? A systematic review and meta-analysis

INTRODUCTION

Currently, there is limited evidence on the effects of malocclusion on oral health and whether the correction of malocclusion results in an improvement in oral health. In this review, we examined the evidence from randomized controlled trials and prospective cohort studies to provide information on any association between malocclusion and oral health and the effects of orthodontic treatment.

METHODS

We conducted this review in 2 parts: (1) we looked at the impact of malocclusion on oral health, and (2) we reviewed the evidence on the effect of orthodontic treatment on oral health. We searched for randomized controlled trials and prospective cohort studies. The searches were completed for articles published between January 1, 1990 and October 8, 2018 and covered Medline via Ovid, Embase, and the Cochrane Database of Systematic Reviews. References of included articles and previous systematic reviews were hand-searched. No language restrictions were applied. Two members of the study team assessed the quality of the studies using the Appraisal Tool for Cross-Sectional Studies to appraise the quality of studies in part 1. The assessment was performed at the study level. Two authors assessed each study independently, with a third author consulted when a disagreement occurred. For studies in part 2, we used the Newcastle-Ottawa scale to assess the risk of bias. When studies were included in a Cochrane review, we incorporated the risk of bias assessment. We developed data extraction forms for each area of oral health under investigation (trauma, quality of life, caries, and periodontal disease). Each author piloted the form, and we held discussions to inform any necessary refinements. We extracted data from studies into 2 × 2 tables, which provided a binary analysis of malocclusion vs the outcome of interest. If these data were not available from the published paper, then studies were not included in the meta-analysis. The authors were contacted when possible to request data in this format.

RESULTS

For part 1 of the study, we identified 87 studies. The overall quality was low. We could not include any of the data into an analysis because of a large variation in the nature of the studies, data collected, and outcome measures that were selected. For part 2 of the study, we found 7 studies; however, there were similar deficiencies in the data as in part 1, and thus, we could not reach any strong conclusions.

CONCLUSIONS

Overall, there is an absence of published evidence regarding the effects of malocclusion on oral health and the impact of orthodontic treatment on oral health.

The application of theory-guided oral health interventions in adolescents: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To explore theory-guided randomized controlled trials aimed at improving adolescents' oral health and evaluate their effectiveness.

DESIGN

Multiple library databases with search criteria for articles between 1990 and 2019.

MAIN OUTCOME MEASURES

Searched references were coded and screened for theory-guided interventions for adolescent oral health. Characteristics of each study (study sample, adopted theory, outcome measures, length of follow-up and main findings) were extracted and the quality of the eligible trials assessed. Effect sizes for theory-guided interventions for different follow-up periods were analysed and compared with traditional oral health education.

RESULTS

About 2135 results were uncovered, 64 were extracted for further screening, and 10 studies were eligible for inclusion. For plaque presence outcomes, no statistical difference was observed between theory-guided interventions and traditional interventions at 3 months (MD: -5.94, 95% CI: -16.39 to 4.51). When the duration of observation was extended to over one year, a significant reduction was found (SMD: -0.25, 95% CI: -0.46 to -0.04).

CONCLUSION

Theory-guided interventions for improving oral hygiene status appear to be more effective than traditional interventions for adolescents in the long term. However, more comprehensive studies are required for validation to support the implementation and adoption of these programs in the clinical setting.

Gender-specific associations of malocclusion traits with oral health-related quality of life in a Finnish adult population

AIM

The aim of this cross-sectional study was to investigate gender-specific associations of different malocclusion traits with oral health-related quality of life (OHRQoL) among Finnish adults.

MATERIAL AND METHODS

The study material comprised 1885 subjects from the Northern Finland Birth Cohort 1966. A clinical oral examination including registration of occlusion was carried out in connection with a 46-year follow-up examination. The 14-item Oral Health Impact Profile (OHIP-14) was used to measure OHRQoL. Subgroups with increased/decreased overjet, deep bite, open bite, lateral crossbite, and scissor bite were selected for further analysis. Subjects with normal occlusion were selected to form the normal occlusion group. Differences between subgroups and the normal occlusion group were evaluated for both genders separately. Education, number of teeth, caries, and orthodontic treatment history were chosen as confounding variables. Multivariate Poisson regression analyses were conducted to assess the effect of independent variables on OHRQoL.

RESULTS

After adjustments, decreased overjet, open bite, and scissor bite were associated with higher OHIP severity in women (P < 0.01). In men, deep bite was associated with higher OHIP severity (P = 0.007). Different malocclusion traits had associations with some OHIP dimension either in men or women. Orthodontic treatment history had a positive effect on OHRQoL in both genders.

CONCLUSION

The associations of malocclusion traits with OHRQoL differed between genders, with women reporting more impacts. Deviations from normal occlusion were generally found to have a negative impact on OHRQoL, but most of the adults with malocclusion seem to adapt to their condition.

Relationships of Dental Caries and Malocclusion with Oral Health-Related Quality of Life in Lithuanian Adolescents Aged 15 to 18 Years: A Cross-Sectional Study

There is a lack of evidence of the moderating effects of caries lesions and malocclusions on oral health-related quality of life (OHRQoL) among older adolescents. This study aimed to evaluate the relationship of dental caries and malocclusion with OHRQoL among Lithuanian adolescents aged 15 to 18 years. A survey in a representative sample of adolescents included a clinical examination to assess dental health status using the DMFT (Decayed, Missing, and Filled Permanent Teeth) index, and malocclusion using the Index of Complexity, Outcome, and Need (ICON). The Child Perceptions Questionnaire (CPQ) was used to evaluate respondents’ OHRQoL. Negative binomial regression was fitted to associate the clinical variables with the CPQ scores. A total of 600 adolescents were examined. The overall mean DMFT score was 2.7. A need for orthodontic treatment was detected among 27.7% of adolescents. Subjects with caries lesions (DMFT > 3) had higher CPQ scores in the domains of functional limitations and social wellbeing (relative risks were 1.35 (95% confidence interval: 1.09–1.67) and 1.30 (1.03–1.64), respectively), while subjects with a need for orthodontic treatment (ICON > 43) had higher CPQ scores in the domains of emotional wellbeing and social wellbeing (relative risks were 1.81 (1.40–2.22), and 1.69 (1.34–2.14), respectively). It was concluded that both dental caries and malocclusion have negative relationships with OHRQoL in adolescents above 15 years, but their effects occur differently in each OHRQoL domain.

Advanced informatics understanding of clinician-patient communication: A mixed-method approach to oral health literacy talk in interpreter-mediated pediatric dentistry

Background

In the clinical dental consultation, multi-party configurations predominate with the presence of parents/ primary caregivers in pediatric dentistry adding another layer of complexity. In managing child oral healthcare, parents/ primary caregivers are critical, especially in dental caries prevention. This study aimed (1) to identify the structure of oral health literacy (OHL) talk in interpreter-mediated pediatric dentistry and (2) to analyze interpreter contributions to the communication strategies: patient-centered direct interpreting (PC-DI), patient-centered mediated interpreting (PC-MI), clinician-centered direct interpreting (CC-DI), and clinician-centered mediated interpreting (CC-MI).

Methods

Visual text analysis (VTA) of video recorded pediatric clinical consultations in Hong Kong utilized Discursis^™ software to illustrate temporal and topical structures and their distribution across turns-at-talk. Conversation analysis (CA) was applied to analyze turn-taking of the identified OHL talk qualitatively. The mixed-method approach of combining VTA and CA was applied to analyze the patterns and features of the recorded OHL talk.

Results

The conceptual recurrences of the 77 transcribed video recordings were plotted visually. CC- and PC-OHL talk were identified by the recurrence patterns of monochromatic and multi-colored triangular clusters formed by off-diagonal boxes, respectively. CA of interpreter-mediated turns supported earlier findings regarding patterns of MI in multilingual adult dental consultations; however, the role of the interpreter in parent/ primary caregiver education and patient management was more distinctive in the pediatric dentistry.

Conclusions

The mixed-method approach assisted in unpacking the complexities of the multi-party interactions, supported identification of effective communication strategies, and illustrated the roles of the dental professionals in initiating CC- and PC-OHL talk in pediatric dentistry. The intervention showed the implication of the professional education of evidence-based practices for clinicians in balancing agenda management and the communicative dimension of OHL with the help of VTA and CA in multilingual consultations.

A cohort study of factors that influence oral health-related quality of life from age 12 to 18 in Hong Kong

Background

There is a lack of cohort studies on the influence factors of oral health-related quality of life (OHRQoL). This study aimed to follow subjects from age 12 to 18 to analyse the sociodemographic and clinical factors that may influence OHRQoL.

Methods

This cohort study selected a representative sample from Hong Kong. Periodontal status and caries were examined according to WHO criteria. Four orthodontic indices were used to assess malocclusion. Child Perceptions Questionnaires (CPQ_11–14) with 8 items (CPQ_11–14-ISF: 8) and 37 items were used to assess OHRQoL at age 12 and age 15, respectively; Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL at age 18. Wilcoxon signed ranks test and Friedman’s test were used to analyse the age-related change of OHRQoL and malocclusion from age 12 to 18. Generalized estimating equations were used to analyse the influence factors of OHRQoL and to calculate adjusted risk ratio (RR).

Results

Subjects recruited in this study were 589 (305 females, 284 males), 364 (186 females, 178 males) and 300 (165 females, 135 males) at age 12, 15 and 18, respectively. Among them, 331 subjects (172 females, 159 males) were followed from age 12 to 15, and 118 subjects (106 females, 82 males) were followed from age 12 to 18. Subjects had less severe malocclusion at age 12 than at ages 15 and 18 (p = 0.000, measured by Dental Aesthetic Index). Age, periodontal status, and malocclusion had an effect on OHRQoL. When compared with OHRQoL at age 12, worse OHRQoL was observed at age 15 (adjusted RR = 1.06, 95%CI = 1.01–1.12, p = 0.032), but not at age 18 (adjusted RR = 1.01, 95%CI = 0.95–1.08, p = 0.759). Unhealthy periodontal conditions had a negative effect on OHRQoL (adjusted RR = 1.14, 95%CI = 1.04–1.25, p = 0.007). Only severe malocclusions had a negative effect on OHRQoL; a more severe malocclusion was associated with a higher effect on OHRQoL (adjusted RR = 1.09, 95%CI = 1.01–1.18, p = 0.032 for severe malocclusion, and adjusted RR = 1.17, 95%CI = 1.07–1.28, p = 0.001 for very severe malocclusion measured by Dental Aesthetic Index).

Conclusion

Age, periodontal status, and malocclusion had an influence on OHRQoL from age 12 to 18. When clinicians attempt to improve subjects’ OHRQoL, it is necessary to consider these factors.

Socioeconomic inequalities in oral health-related quality of life in adolescents: a cohort study

PURPOSE

Socioeconomic inequalities are recognized as a major problem with people in low socioeconomic groups having worse subjective oral health outcomes, including oral health-related quality of life (OHRQoL). However, only a few longitudinal studies assessed the impact of contextual and individual socioeconomic determinants in adolescents' OHRQoL. We estimate the impact of socioeconomic inequalities on adolescents' OHRQoL over a 2-year period.

METHODS

This study followed up a random sample of 1134 12-year-old schoolchildren for 2 years in Brazil. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-year-old Children (CPQ11-14) at baseline and follow-up. Participants were clinically examined for dental caries, gingival bleeding, and malocclusion. The schoolchildren's parents answered a questionnaire regarding socioeconomic status, social capital, and adolescents' use of dental service. Socioeconomic contextual variables were collected from official city publications. Multilevel linear regression models fitted the associations between socioeconomic factors and overall CPQ11-14 scores over time.

RESULTS

A total of 747, 14-year-old adolescents were reassessed for OHRQoL (follow-up rate of 66%). Adolescents with lower mean income school's neighborhood (P < 0.05), household income (P < 0.05), and maternal schooling (P < 0.05) had higher overall CPQ11-14 scores. Female sex, attending a dentist by toothache, dental caries, and malocclusion were also associated with higher overall CPQ11-14 scores.

CONCLUSIONS

Adolescents from low socioeconomic background reported worse OHRQoL at 2-year follow-up compared to those from high socioeconomic background. Actions toward health inequalities need to address socioeconomic factors in adolescence.

Family Affluence Based Inequality in Oral Health-Related Quality of Life in a Population of Lithuanian Adolescents

Background: The social inequalities in oral health have had increasing attention in recent years. The present study aimed to explore the impact of family affluence on Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 years. Methods: The cross-sectional, population-based study included a representative sample of 881 adolescents aged 11–18 years (mean = 15.55; SD = 1.51) randomly selected from 20 schools in Lithuania. The schoolchildren completed questionnaires to evaluate their OHRQoL using a Lithuanian version of the Child Perceptions Questionnaire (CPQ). The adolescents’ family affluence was indirectly assessed by inquiring whether they possessed various modern life items. In dental examination, the severity of malocclusion was predetermined by the Index of Complexity, Outcome, and Need (ICON). The relationship among variables was examined employing the negative binomial regression and the path analysis. Results: The sum score of CPQ as a whole and the sum scores of all four domains were significantly associated with family affluence, indicating higher OHRQoL among adolescents from more affluent families. The severity of malocclusion had a significant association with emotional and social well-being domains of OHRQoL only. Conclusion: This study evidences the family affluence based inequality in OHRQoL among Lithuanian adolescents.

Oral health-related quality of life in children using the child perception questionnaire CPQ11-14: a review

OBJECTIVES

The Child Perceptions Questionnaire 11-14 (CPQ11-14) is the most common and effective indicator of paediatric oral health-related quality of life. The aim of this review was to verify if CPQ11-14 can be considered a valid instrument for assessing the impact of oral health on the quality of life of adolescents for the paediatric population aged between 11 and 14 years old and which dental conditions mainly affect it.

STUDY DESIGN

A literature research from Pubmed Medline database was adopted to identify the eligible studies among the published articles related to CPQ 11-14 using keyword search strategy. From 170 initial articles, a total of 128 articles were included for the full text reading.

RESULTS

Conditions that mainly interest the oral health-related quality of life are untreated dental caries, dental trauma, increased dental protrusion, wearing orthodontic appliances, and severe periodontal disease.

CONCLUSION

CPQ 11-14 seems to be a solid and valid indicator to measure oral health-related quality of life, because it has been widely tested and validated in several states including developed, developing and underdeveloped countries.

Change in Oral Health-Related Quality of Life Following Minimally Invasive Aesthetic Treatment for Children with Molar Incisor Hypomineralisation: A Prospective Study

Molar incisor hypomineralisation (MIH) is a common enamel condition, presenting with incisor opacities, which may be of psychosocial concern to children. This clinical study sought to determine whether minimally invasive treatment, aiming to improve incisor aesthetics, would also improve children's oral health-related quality of life (OHRQoL). 111 MIH patients, aged 7⁻16 years, referred to a UK Dental Hospital, were invited to complete the Child Oral Health Impact Profile (C-OHIP-SF19) prior to any intervention (T₀) and again at one-month following the intervention (T₁) for MIH. Treatment regimens included one or more of the following: Microabrasion; resin infiltration; tooth whitening; resin composite restoration. Data were obtained for 93 children with a mean age of 11 years. Mean total C-OHIP-SF19 score at T₀ was 47.00 (SD = 9.29; range = 0⁻76) and this increased significantly at T₁ to 58.24 (SD = 9.42; range = 0⁻76; p < 0.001, paired t-test), indicating a marked improvement in self-reported OHRQoL. There were no statistically significant differences according to gender. This is the first study to show that simple, minimally invasive dental treatment, to reduce the visibility of enamel opacities, in MIH, can have a positive impact on children's wellbeing.

The factors that influence oral health-related quality of life in young adults

Background

Young adulthood is a time when subjects transform their role from a dependent child to an independent social identity. This cross-sectional study aimed to analyze the sociodemographic and clinical factors that may influence the OHRQoL of 18-year-old young adults.

Methods

A representative sample was selected from Hong Kong. Periodontal status and caries were examined according to WHO criteria. Four orthodontic indices were used to assess malocclusion. The oral health impact profile (OHIP-14) was used to measure OHRQoL. Adjusted OR was calculated by ordinal logistic regression.

Results

A total of 300 eligible subjects (165 females, 135 males) were recruited. Females had more severe caries than males; however, gender was not a significant factor of OHRQoL. Household income affected OHRQoL more than parents’ education did: household income had effects on physical pain, psychological discomfort, psychological disability, and the total OHIP; while parents’ education had some effects on functional limitation, physical pain and psychological discomfort. As for clinical factors, unhealthy periodontal conditions were more prevalent than caries (94.67% vs. 59.00%); however, both of them showed no effect on OHRQoL. Malocclusion had a negative effect on OHRQoL; the most affected subscales were psychological discomfort and psychological disability.

Conclusion

In this study, family ecosocial factors and malocclusion had an effect on OHRQoL. Among the family ecosocial factors, it was household income that had the most effect on OHRQoL. Malocclusion mainly affected the subscales of psychological discomfort and psychological disability. Gender, periodontal status and caries had no effect on young adults’ OHRQoL.

The factors that influence oral health-related quality of life in 15-year-old children

Background

Several hypotheses on factors that influence oral health-related quality of life (OHRQoL) have been proposed but a consensus has not been reached. This cross-sectional study aimed to analyse the sociodemographic and clinical factors that may influence the OHRQoL of 15-year-old children.

Methods

A representative sample was selected from Hong Kong. Periodontal status and caries were examined according to WHO criteria. Four orthodontic indices were used to assess malocclusion. Child Perception Questionnaire (CPQ_11–14, 37 items) including four domains, namely oral symptoms (OS), functional limitations (FL), emotional well-being (EWB), and social well-being (SWB), was used to measure OHRQoL. Adjusted OR was calculated by ordinal logistic regression.

Results

A total of 364 eligible subjects (186 girls, 178 boys) were recruited. The prevalence of caries was higher in girls than in boys (P = 0.013). Compared with girls, boys tended to have a better experience in the domains of EWB, SWB and the total CPQ (adjusted OR = 0.46, 0.59 and 0.61, respectively). Unhealthy periodontal conditions were more prevalent than caries (92.6% vs. 52.7%); moreover, periodontal conditions with CPI scores of 2 had a negative effect on the domain of SWB and the total CPQ (adjusted OR = 1.76 and 1.71, respectively). Only the most severe malocclusion showed an effect on the domain of FL and the total CPQ (adjusted OR = 1.55 and 2.10, respectively). Little effect of family ecosocial factors and caries was found on CPQ scores.

Conclusion

In this study, gender, periodontal status, and malocclusion showed an effect on OHRQoL after adjusting for potential confounders. Boys had less caries and better OHRQoL than girls did. Unhealthy periodontal conditions led to worse social welfares and OHRQoL. The most severe level of malocclusion caused oral functional limitations, hence worse OHRQoL.