Changes in the oral-health-related quality of life of Brazilian children after an educational preventive programme: an 1-month longitudinal evaluation

A scoping review of intervention components of school-based oral health-related behavioural interventions using the Theoretical Domains Framework

The aim of this study was to review the intervention components of school-based oral health-related behavioural interventions using the Theoretical Domains Framework (TDF). We identified relevant papers from the review of Cooper et al., and these papers came from both the original inclusion and exclusion article lists. We also modified and updated their search strategies (2013 - April 2019). The 53 included papers reported on 79 interventions (experimental groups = 57 interventions, control groups = 22 interventions). Most of the papers used three to nine domains (average = 5.6) in their experimental interventions, and the most commonly used domains were 'knowledge,' 'skills,' 'social influences,' and 'environmental context and resources.' Considering the complexity of intervention components in one programme, there is no one specific domain or domain set that can determine the success of behavioural interventions. The design of future programmes should be guided by a complex intervention methodology. However, the best combination set might not exist, and the choice of domains should depend on local context or resources. This study can be used as a resource for identifying previous papers, which have used the same domains.

The influence of the Brazilian school health program on the oral-health-related quality of life of adolescents

The aim of this study was to evaluate the influence of the Brazilian School Health Program (SHP) on dental clinical disorders such as caries, gingivitis, and dental trauma as well as on the oral-health-related quality of life (OHRQoL) of adolescents in Nova Friburgo, RJ, Brazil. The study consisted of a non-probabilistic (convenience) sample comprising 319 12-year-old adolescents, both participants and non-participants of the SHP, for at least two years. Socio-demographic and OHRQoL questionnaires (CPQ11-14, the Child Perceptions Questionnaire) were applied as well as clinical examinations for caries, periodontal disease, and dental trauma following the World Health Organization (WHO) criteria by calibrated researchers. Mann-Whitney, chi-square tests, and multiple logistic regression models were used for the data analysis. Statistically significant differences were observed between the groups covered and not covered by the SHP for gingivitis (p = 0.0373) and OHRQoL on the social welfare subscale (p = 0.0265) and total scale (p = 0.0449) of CPQ11-14. Multivariate analysis showed that female adolescents were 1.74 times more likely to present a lower OHRQoL (OR = 1.74, 95%IC = 1.10-2.77, p = 0.0183) than males. In addition, non-SHP subjects were 1.56 times more likely to have poor OHRQoL (OR = 1.56, 95%IC = 0.94-2.59, p = 0.0873) than program participants. In conclusion, SHP positively influenced the OHRQoL of adolescents. However, follow-up studies are needed to verify the continued effectiveness of this Brazilian SHP in improving the oral health levels and quality of life of adolescents.

Quality of life related to oral health and its impact in adults

Oral health is part of general health, and is recognized as an essential component of quality of life (QoL). For years, oral health was determined solely by the clinic, which did not allow an evaluation of the true impact of oral diseases on the patients' daily lives. The development of instruments for assessing QoL related to oral health has occurred due to the urgency of determining the effects of changes in the oral cavity of individuals. This study aims, through a bibliographical survey, to describe issues involving the relationship between QoL and oral health focusing on methodological and conceptual aspects as well as considering how oral health of adult individuals affects their QoL in a general way. Research in this area has developed the concept of "quality of life related to oral health", which comprises four categories: functional factors, psychological factors, social factors and existence of discomfort or pain. The negative impacts that poor oral health of the population have on their QoL makes this issue a relevant problem for public health. Although most oral problems do not represent an immediate risk of death, they are responsible for decreasing the QoL of individuals as they prolong states of pain and suffering, and cause functional, aesthetic, nutritional and psychological problems. Actions focused on health education with emphasis on self-perception, self-protection and self-care should be explored. Programs based on equity seeking to reduce inequalities and their negative effects on people's QoL should also be explored.

Development and evaluation of CARIES-QC: a caries-specific measure of quality of life for children

BACKGROUND

Existing paediatric oral health-related quality of life (OHRQoL) measures are generic instruments designed to evaluate a range of oral conditions. It has been found that disease-specific measures may be more adept at detecting subtle changes which occur following treatment of the condition in question. Furthermore, existing self-report OHRQoL measures have not involved children at all stages of development of the measure. The aim of this study was to develop a caries-specific measure of quality of life for children.

METHODS

The first stage of the study involved a qualitative enquiry with children, aged 5-16 years, to inform the development of the measure. Children generated the potential items, contributed to item reduction and questionnaire design and participated in the testing of face and content validity. The resulting measure was evaluated in a cross-sectional validation study. Ethical approval was granted for the study.

RESULTS

The qualitative study found that children discussed a number of caries-related impacts which affected their daily lives. These were incorporated into a draft measure which was further refined following testing of face and content validity. This resulted in the production of the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), comprising 16 items and one global question. Two hundred participants with a mean (range) age of 8.1 (5-16) years took part in the further evaluation of CARIES-QC. Four items, which did not fit the Rasch model, were removed from further analysis. The remaining 12 items demonstrated good internal consistency (alpha = 0.9) and the total score showed significant correlations with the number of decayed teeth, presence of pain, pulpal involvement, the Child Perceptions Questionnaire (16-item short form) and the global score (p < 0.01, Spearman's rho).

CONCLUSION

In conclusion, children's input allowed the development of a valid and reliable child-centred caries-specific quality of life measure. CARIES-QC can now be used to evaluate which interventions for dental caries are most effective in reducing impacts from the child's perspective.

Adjunctive dental therapy via tooth plaque reduction and gingivitis treatment by blue light-emitting diodes tooth brushing

The efficacy of blue light-emitting toothbrushes (B-LETBs) (405 to 420 nm, power density 2  mW/cm(2)) for reduction of dental plaques and gingival inflammation has been evaluated. Microbiological study has shown the multifactor therapeutic action of the B-LETBs on oral pathological microflora: in addition to partial mechanical removal of bacteria, photodynamic action suppresses them up to 97.5%. In the pilot clinical studies, subjects with mild to moderate gingivitis have been randomly divided into two groups: a treatment group that used the B-LETBs and a control group that used standard toothbrushes. Indices of plaque, gingival bleeding, and inflammation have been evaluated. A significant improvement of all dental indices in comparison with the baseline (by 59%, 66%, and 82% for plaque, gingival bleeding, and inflammation, respectively) has been found. The treatment group has demonstrated up to 50% improvement relative to the control group. We have proposed the B-LETBs to serve for prevention of gingivitis or as an alternative to conventional antibiotic treatment of this disease due to their effectiveness and the absence of drug side effects and bacterial resistance.