What do children's global ratings of oral health and well-being measure?

A Pilot Study of the Use of Oral Health-Related Quality of Life Measures as an Outcome for Analysing the Impact of Caries Disease among Swedish 19-Year-Olds

OBJECTIVES

To be useful as a supplement for health economic evaluations in caries preventive care, the oral health-related quality of life (OHRQOL) measures must be able to discriminate for caries disease. The aim of this study was therefore to explore whether any differences existed in perceived OHRQOL among adolescents with either high or no caries experience.

METHODS

Eighty-two individuals (all 19-year-olds) agreed to participate in a pilot exploratory case-control study. Thirty individuals with high caries experience formed the test group. The control group consisted of 52 individuals with no caries experience, selected randomly from a caries-free population. OHRQOL scores were collected for analysis through personal interviews using two OHRQOL measures, the Child Perceptions Questionnaire (CPQ(11-14)) and Oral Health Impact Profile-14 (OHIP-14).

RESULTS

The OHRQOL measures used were not able to discriminate between young adults with high and no caries risk experience with respect to perceived OHRQOL. Despite a consistently higher impact score for the test group throughout the overall and subscale scores, the differences were not statistically significant except for one of the subscale scores, oral symptoms.

CONCLUSIONS

This study indicates that the prevalence and incidence of caries must be seen as too low in Sweden to have major influence on young adults' perceived OHRQOL and well-being. Therefore, the usefulness of OHRQOL measures in supplementing outcome measurement in health economic evaluations, particularly those that focus on caries preventive strategies, must be questioned.

Exploring factors that influence child use of dental services and toothbrushing in New Zealand

OBJECTIVES

To explore factors contributing to dental service use and toothbrushing among Mäori, Pacific and New Zealand European or Other (NZEO) children in New Zealand.

METHODS

Data were obtained from the 2002 National Child Nutrition Survey. Models representing demographic, socio-economic status (SES), lifestyle, dietary, food security and oral health paradigms were tested using logistic regression.

RESULTS

Mäori and Pacific children were more likely to not attend for dental care (OR: 1.99 and 2.05 respectively) than NZEO children when age, sex and time lived in New Zealand were accounted for. The addition of household (OR: 1.93 and 2.05 respectively) or lifestyle (OR: 1.95 and 1.81 respectively) factors resulted in minimal OR changes for Mäori or Pacific child dental attendance, whereas addition of dietary (OR: 1.44 and 1.23 respectively) and food security (OR: 1.43 and 1.32 respectively) items reduced the ORs of Mäori and Pacific child dental attendance so they no longer differed significantly to NZEO children. Addition of dental factors increased the ORs of Mäori and Pacific children not utilizing dental services compared with NZEO children (OR: 2.30 and 2.13 respectively). Mäori and Pacific children were more likely to not brush teeth (OR: 3.86 and 1.49 respectively) than NZEO children when age, sex and time lived in New Zealand were accounted for. Addition of dietary factors resulted in a 36% OR reduction of Mäori children not brushing (OR: 2.57), while addition of household SES (OR: 1.06), lifestyle (OR: 1.14), dietary (OR: 0.71) or food security factors (OR: 1.19) reduced the ORs of Pacific children so they were no longer significantly different to NZEO children.

CONCLUSIONS

Mäori and Pacific children were more likely to have not received dental care (variance largely explained by dietary and food security factors) and Mäori children were more likely to not brush their teeth (variance largely explained by dietary items) than NZEO children.