Impact of oral clinical problems on oral health-related quality of life in brazilian children: a hierarchical approach

A Bibliometric Mapping Study of the Literature on Oral Health-related Quality of Life

BACKGROUND

Oral health is an indispensable component of overall health, and oral health status significantly influences people's physical, mental, and social well-being. Oral health-related quality of life (OHRQoL), an important and widely used dental patient-reported outcome (dPRO), is attracting more and more researchers' attention and interest. This study aimed to analyze and map the existing scientific literature regarding OHRQoL through a bibliometric approach, including a summary of the characteristics of OHRQoL-related publications, the identification of prolific entities, high-frequency keywords analysis, and research trend analysis via periodic high-impact keywords.

METHODS

A literature search was conducted in the Web of Science Core Collection to collect OHRQoL-related original research and review articles. After examination and deduplication, the following bibliometric information was extracted from each article: title, abstract, keywords, authors, affiliations, geographic origin (countries/regions), year of publication, journal name, and references. Various scientometric mapping tools including Microsoft Office spreadsheet, VOSviewer, Biblioshiny R-package software, and Scimago Graphica were used to analyze basic bibliometric parameters, leading producers, high-impact keywords, and research trends.

RESULTS

A total of 3324 OHRQoL-related articles (3119 original research articles and 205 review papers) were collected, which received 65,704 citations. A total of 9950 authors from 2429 organizations contributed to this body of research. Prolific authors from Europe, USA, Brazil, New Zealand, China, and Canada were identified, and they also centered collaboration clusters in the co-author network. Community Dentistry and Oral Epidemiology was the most prolific journal. Twenty-one keywords with more than 200 occurrences, and 23 keywords with more than 150 occurrences, were identified for publications of 1994-2021 and 2012-2021, respectively. Keyword analysis revealed hot topics such as instrument development and validation, studies targeting children and adolescents, as well as clinical studies in operative dentistry, implantology, orthodontics, and community dentistry. Oral Health Impact Profile is the most commonly used instrument in OHRQoL-related research.

CONCLUSIONS

OHRQoL is an impactful topic in dental health care as it is not only useful in dental research and patient-centered clinical outcome measures but also provides valuable guidance in dental public health administration and policy making. OHRQoL-related research presents a dynamic landscape and is expected to continue presenting high productivity and broad application in the future.

Unraveling the signs and symptoms of oral conditions that affect daily life activities and oral health-related quality of life

OBJECTIVES

Since oral conditions negatively affect oral health-related quality of life (OHRQoL), this study evaluated which oral clinical condition, signs, and symptoms are associated with the impact on OHRQoL, its domains, and specific daily life activities among adults.

MATERIALS AND METHODS

Data from a probabilistic sample of adults (35-44 years old) was used. The Oral Impacts on Daily Performance (OIDP) was used to evaluate OHRQoL, its domains (physical, psychological, and social), and nine daily life activities. Signs and symptoms of oral diseases (dental caries, periodontal disease, need for dental prothesis, and tooth loss) and oral self-perception were considered. Descriptive, bivariate, and multi-level analyses were conducted.

RESULTS

A total of 5,834 adults were included, of which 52.9% had some negative impact of oral conditions on OHRQoL. Difficulty in eating was the most affected daily life activity. For multiple models, dental caries lesions (cavities), filled teeth with caries, gingival bleeding, periodontal pocket, dental pain, need for upper or lower dental prosthesis, and oral health self-perception were associated (p < 0.05) with overall OHRQoL or at least one of its domains. The impact on daily life activities of each individual was associated with at least one oral condition. Dental caries lesions (cavity) and dental pain were associated (p < 0.05) with the impact on most daily life activities evaluated.

CONCLUSIONS

Different signs and symptoms of prevalent oral diseases are associated with the impact on specific daily life activities among adults, which may compromise the OHRQoL.

CLINICAL RELEVANCE

Knowledge of how signs, symptoms, and oral conditions affect OHRQoL and daily life activities can provide essential information for clinicians to establish proper disease management and preventive strategies focusing on improving patients' lives.

Parental perception of malocclusion, its severity and aesthetic concerns in children with mixed dentition: A cross-sectional study

OBJECTIVE

This study aimed to associate the parents' perception of the need for treatment and the children's aesthetic concern, considering the influence of malocclusion severity levels.

METHODS

A population-based cross-sectional study was conducted with 770 children aged 8 to 10 years in the mixed dentition stage. A closed question sent to parents assessed the subjective orthodontic treatment need (outcome). Orthodontic Aesthetic Subjective Impact Score (OASIS) evaluated children's aesthetic concerns, and the Dental Aesthetic Index (DAI) diagnosed the anterior characteristics and malocclusion severity levels. Individual analyses were performed relating the outcome as independent variables. The variables with P<0.20 in the individual analyses were tested in multiple logistic regression models, and those with P<0.10 remained in the model. The adjusted odds ratio was estimated with a 95% confidence interval.

RESULTS

Parents of children with higher aesthetic concerns are 1.82 times more likely to believe that their child needs orthodontic treatment (P<0.05). Parents of children with very severe malocclusion are 1.91 times more likely to perceive their child's need for orthodontic treatment (P<0.05).

CONCLUSION

Parents of children with greater aesthetic concerns are more likely to perceive the need for orthodontic treatment, and very severe malocclusion also influences parents' perception of the need for orthodontic treatment.

Key factors associated with oral health-related quality of life in Sri Lankan adolescents: a cross sectional study

Background

Oral Health Related Quality of Life (OHRQoL) measures have emerged as an important oral health outcome that is able to reveal the subjective burden of illness due to oral diseases. The association between sociodemographic and socioeconomic factors, clinical dental conditions and OHRQoL indicators has been investigated in adolescent populations across the world. The purpose of this study was to investigate key factors associated with oral health-related quality of life of Sri Lankan adolescents.

Methods

A cross sectional study was conducted in a sample of 15–19 year-old secondary school students in the Gampaha district of Sri Lanka. The data was collected using two self-administered questionnaires. A modified Sinhalese version of the Oral Impact on Daily Performance (OIDP) questionnaire that has been validated for Sri Lankan adolescents was administered. A second questionnaire collected information on socioeconomic characteristics, oral health care seeking and oral health behaviours. A clinical oral examination was performed on each participant. Oral health related quality of life was measured using OIDP domains and total OIDP scores. Poisson regression was used to investigate the key factors associated with the OIDP additive score.

Results

A total of 1332 adolescents participated in the study. Negative quality of life impacts were more prevalent in the social and psychological domains of OIDP as compared with the functional domain. Total OIDP scores ranged from 0 to 36 with a mean of 3.16 (SD = 4.71). The multivariable analysis revealed that increasing age, low income, brushing teeth only once per day, and increased number of decayed teeth were found to be associated with poor overall OHRQoL, while male gender, frequent oral healthcare seeking patterns and absent dento-facial anomalies were associated with good OHRQoL.

Conclusion

This study identified modifiable behavioural and oral health related factors which are associated with OHRQoL in Sri Lankan adolescents. Oral health interventions should target these modifiable factors to improve the OHRQoL in these populations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01569-1.

Oral health-related quality of life among 12-year-olds

Aim: To assess oral health-related quality of life (OHRQoL) and associated factors among the 12-year-old population of the state of Minas Gerais, Brazil. Methods: Cross-sectional data from the SB-Minas Gerais 2012 study were used. The presence of poor OHRQoL was assessed using the Oral Impact on Daily Performance (OIDP) and its dimensions (physical, psychological and social domains). Independent variables included sociodemographic factors and variables related to the use of dental care and oral health conditions. The association between the outcomes and the independent variables were tested using logistic regression and the results reported as odds ratio with 95% confidence interval. Results: Prevalence of poor OHRQoL was 31.4%; the psychological domain was the most affected (22.6%). Pain and dissatisfaction with oral health were associated with poor OHRQoL on overall OIDP and all its domains. Non-whites had greater poor OHRQoL than whites on overall OIDP and physical domain. Conclusion: Self-perceived oral health and social inequalities were associated with poor OHRQoL.

Exploring the impact of oral health-related quality of life on the child’s family structure

Aim: The aim of this study was to explore the impact of oral health-related quality of life (OHRQoL) on the child’s family structure. Methods: A representative sample of 613 children from public preschools, in a city in southeastern Brazil, were enrolled in this cross-sectional study. The sample was determined through probabilistic sampling in two stages (preschools and children). The outcome variable (Early Childhood Oral Health Impact Scale [ECOHIS]) was multi-categorized in children and family. Independent individual variables were sex, race, family income, parents’/caregivers’ level of education, family income, dental caries, and malocclusion. Initially, individual analyses were performed, relating the study variables to the outcome variables, estimating the raw odds ratio with the respective confidence intervals of 95%. The variables with p < 0.20 in the individual analyses were tested in the multiple logistic regression models, and those with p < 0.10 remained in the model. Results: Impact on OHRQoL was reported by 40.9% of the children and 17% of their families. Children with low family income and caries experience had, respectively, 1.53 (95% CI: 1.00-2.32) (p = 0.0465) and 2.96 (95% CI: 1.81-4.84) (p < 0.0001) more chance of presenting negative impact on OHRQoL. Conclusions: The aspects that most affected the OHRQoL of child’s family structure were low income and dental caries experience.

Trauma in primary teeth and its effect on the development of permanent successors: a controlled study

Objective: This controlled study investigated the occurrence of sequelae to permanent successors (SPS) following traumatic dental injury in primary teeth (TDIp). Additionally, this study evaluated whether TDIp is a risk factor for SPS, with a focus on an association between SPS and the child's age and type of trauma. Materials and methods: The trauma group (TG) consisted of permanent teeth, whose antecessors had suffered TDIp, in a population of children with complete eruption of permanent teeth. The control group (CG) consisted of permanent teeth from the same individuals, whose antecessors had not suffered TDIp. There were 214 cases of TDIp with their respective permanent teeth. In the CG 247 permanent teeth, whose antecessor had not suffered TDIp, were included. Data concerning such teeth and when TDIp occurred (in terms of the child's age) and types of SPS were collected. The chi-square test, regression logistic with generalized estimating equations (GEE) test, and risk analyses were applied to investigate the associations. Results: Overall, 29% of the permanent teeth in the TG presented SPS. This was compared to the development disturbances in the CG, which was 7%. The TG demonstrated the highest risk for SPS (OR, 5.388; p = .0001). The discolouration of enamel (37%) was the most common type of SPS found. SPS was more prone to occur in permanent teeth whose antecessors had been intruded (39%; p < .001). TDIp when the child was 1-year old was associated with SPS (p < .001). Moreover, children who had TDIp had a 4.1 times higher risk of presenting SPS. Conclusions: TDIp is a risk factor for the development of SPS. All types of TDIp caused SPS in this research. Additionally, the younger ages at the time of the injury and intrusions were related to SPS.

Socioeconomic inequalities in the use of dental care services during early childhood: an epidemiological survey

BACKGROUND

The use of dental care services contributes to the improvement of children's healthy behaviors, reducing the prevalence of future dental problems. In this way, the purpose of this study was to describe the use of dental care service during early childhood and the possible socioeconomic inequalities in this use.

DESIGN

Data from the Brazilian Oral Health Survey (SB Brasil, 2010) were used. Interviews with the children's parents and clinical examinations with the children were conducted in a 5-year-old representative sample. Descriptive, bivariate and multiple hierarchical statistical analyses were applied.

RESULTS

Of the 7241 children included, 3812 (53.2%) had used dental care services at least once in their lifetimes, and 1872 (48.8%) had used services for check-up/prevention. The use of dental services was greater among children with a higher family income (P < 0.05). The use of check-ups was lower among children with non-White skin color (Black and Browns) and among those who did not live in state capitals (P < 0.05). Clinical conditions and self-perception were also associated with the use (P < 0.05).

CONCLUSION

Socioeconomic differences in the general use of dental care and in its use for check-ups were identified during early childhood, indicating the presence of inequalities.

Contextual and Individual Determinants of Root Caries in Older People

The aim of this study was to identify the association of the presence of root caries in older people with contextual and individual determinants using a multilevel model. Data from the National Survey of Oral Health collected in Brazil were used. A sample of older Brazilians (aged 65-74 years) was included and selected through multistage probability cluster sampling, using probability proportional to size. Contextual variables of municipalities and individual variables of older people were included. Descriptive, bivariate, and multilevel analyses were conducted. Of the 3,926 older people included in the study, 934 (21.8%) had at least 1 tooth with root caries. There seemed to be no pattern of involvement between the anterior and posterior teeth in the dental arches. Multilevel analysis showed a higher presence of root caries among older people resident in municipalities that were noncapital cities (OR = 1.50), who were over 70 years of age (odds ratio, OR = 1.22), had nonwhite skin color (OR 1.35), had coronal caries (OR = 5.58), were dissatisfied with their teeth and mouth (OR = 1.47), and had self-perceived dental treatment needs (OR = 1.33). Contextual and individual determinants were associated with the occurrence of root caries in older people. Lesion presence demonstrated a profile of social inequality.

Impact of untreated dental caries on the daily activities of children

OBJECTIVES

Untreated dental caries can compromise oral health-related quality of life (OHRQoL). However, it is not clear which specific daily activities related to OHRQoL are compromised by the presence of this problem. Therefore, the purpose of this study was to identify which specific daily activities are affected by the presence of untreated dental caries using a representative sample of Brazilian children.

METHODS

A cross-sectional study using a representative sample of Brazilian children (12 years of age) was conducted. The presence of untreated dental caries was assessed using the "decayed - D" component of the DMFT (decayed, missing, and filled teeth) index. Clinical exams were conducted by trained and calibrated dentists. The daily activities were evaluated using the survey Oral Impacts on Daily Performance (OIDP), considering items and domains. Descriptive, bivariate, and multiple analyses were conducted (α = 0.05).

RESULTS

A total of 7,247 children were included, and 39.9 percent had at least one tooth with untreated dental caries, with 33.5 percent experiencing an impact on at least one of the OIDP activities. This study identified a greater chance of the presence of untreated dental caries in children having an impact on the psychological domain (P = 0.006), as well as on the "difficulty eating" (P = 0.007), and "difficulty sleeping" (P = 0.023) items.

CONCLUSION

The presence of untreated dental caries among Brazilian children was associated with an impact on specific daily activities (difficulty eating and sleeping) and the psychological domain of OHRQoL.