Parental perceptions of the oral health-related quality of life of autistic children in Saudi Arabia

Perceptions of Parents/Caregivers About the Impact of Oral Conditions on the Quality of Life of Children and Adolescents with Autism Spectrum Disorder

PURPOSE

To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD.

METHODS

A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression.

RESULTS

Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721).

CONCLUSION

Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD.

Oral health status of children with autism spectrum disorder in KSA: A systematic review and meta-analysis

Background

Individuals with autism spectrum disorder (ASD) often face challenges in maintaining good oral health, because of factors including sensory sensitivities, communication difficulties, and microbial imbalances in the oral cavity. Despite growing awareness of ASD, both in Kingdom of Saudi Arabia (KSA) and globally, no systematic review has comprehensively assessed the effects of ASD on oral health status in KSA.

Objective

This study was aimed at assessing whether the oral health of individuals with ASD in KSA might differ from that of neurotypical individuals, on the basis of a systematic review framework.

Materials and methods

According to the Participants, Exposure, Comparison, and Outcome (PICO) framework, a systematic search of electronic databases was conducted, and screening was independently performed by two reviewers. Conflicts were resolved through discussion. Data on study characteristics and oral health findings were independently extracted by the two reviewers. The risk of bias was assessed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

Results

Of 763 initially identified articles, 14 met the inclusion criteria. These studies indicated that children with ASD have a higher prevalence of dental caries, greater gingival inflammation, and a greater risk of dental trauma than their neurotypical peers. Parents of children with ASD showed elevated concern regarding their children's oral health.

Conclusion

Training dental professionals to manage patients with ASD is essential. Further research with larger sample sizes and rigorous methods is necessary to enhance understanding of the relationship between ASD and oral health outcomes in KSA.

Oral habits, sociopsychological orthodontic needs, and sociodemographic factors perceived by caregivers impact oral health-related quality of life in children with and without autism?

BACKGROUND

Caregivers play a crucial role in assessing the oral health-related quality of life (OHRQoL) of young individuals with autism spectrum disorder (ASD).

AIM

This study assessed the impact of sociodemographic and oral conditions on OHRQoL and family dynamics in young individuals with and without autism, as perceived by guardians.

DESIGN

This comparative cross-sectional study included young individuals aged 6 to 14 years and their guardians. Data were collected at a specialized institution and dental schools. Guardians completed the Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS), and sociodemographic and oral habits questionnaires. The sociopsychological need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN).

RESULTS

The sample included 144 youths and caregivers. The ASD group had higher P-CPQ and FIS scores. Factors associated with poorer perceived OHRQoL included higher youth age, lower caregiver education, higher IOTN scores, teeth clenching (RR = 1.20; 95% CI: 1.01-1.41), and lip sucking. Lower parental education (RR = 1.75; 95% CI: 1.10-2.80) and higher IOTN scores from the caregiver's perspective impacted family dynamics.

CONCLUSION

Caregivers of young individuals with ASD perceived a lower OHRQoL, and families in this group were more affected by sociodemographic and oral conditions.

Parental perspectives on oral health-related quality of life in children and adolescents with autism spectrum disorder: A systematic review

BACKGROUND

Children with autism spectrum disorder (ASD) face unique challenges related to oral health, which can negatively impact their day-to-day lives, significantly compromising their overall quality of life. Primary caregivers of children with ASD have a critical role in delivering and seeking oral health care. Hence, it is vital to study their perspective towards their children's oral health and its impact on their quality of life.

AIM

To explore the parental perception of oral health-related quality of life in children with autism.

METHODS

A systematic electronic and manual search was conducted in Medline (via PubMed), Embase, Google Scholar, Scopus, and LILACS of articles published from January 2003 to May 2023 using appropriate MeSH terms, keywords, and other terms. A four-phase study selection process was followed according to PRISMA guidelines, and data extraction and synthesis were performed using an extraction form. The selected studies were critically appraised using the QATSDD and Crombie's assessment tool. The inter-reviewer agreement was assessed using the kappa with a linear weighting coefficient.

RESULTS

Out of the 885 results, 15 studies were included in the review after the two selection phases, and the study characteristics were summarized in tabular form. Study quality varied considerably, and out of a total possible QATSDD score of 42, scores for the individual studies ranged from 14 to 40. The risk of bias for the seven criteria was found to be low.

CONCLUSION

The parental perception of the OHRQoL in children with ASD is poor, and the most significant perceived impact is on the child's functional and social well-being aspects. Parental-Caregiver Perception Questionnaire was the most commonly used. The most frequent symptoms include bad breath, food lodgment, mouth breathing and night grinding. The familial impact and influence on the OHRQoL of siblings were also studied.

A thematic review of autism spectrum disorder research in Saudi Arabia: Insights into diagnosis, assessment, and language considerations

This study reviews the crucial role of language in Autism Spectrum Disorder (ASD) diagnosis and assessment in Saudi Arabia. Using tailored search strings, 206 relevant documents were retrieved from the Web of Science and Scopus databases. An increasing trend in ASD research in Saudi Arabia was observed through temporal analysis. Keyword analysis identified key themes including "autism," "language," "assessment," "diagnosis," "Saudi Arabia," and "children." The focus of research has shifted over the years, from pure clinical and diagnostic aspects to a more comprehensive approach that includes language and cultural factors in ASD evaluation. The findings underscore the need for culturally and linguistically sensitive assessment tools, acknowledging the impact of bilingualism on language development, and the importance of language difficulties in diagnostic decision-making. The study highlights the necessity for further research, especially longitudinal studies examining the influence of language and cultural factors on ASD outcomes. The findings are significant for clinical practice, emphasizing the need for linguistically sensitive approaches in ASD diagnosis and assessment. This research serves as a guide for future studies by identifying the gaps in existing literature and areas of focus. The study identifies crucial gaps in existing literature, particularly the need for longitudinal studies examining the influence of language and cultural factors on ASD outcomes. The findings underscore the importance of culturally and linguistically sensitive approaches in ASD diagnosis and assessment, providing a novel insight for future research and clinical practice in Saudi Arabia.

Parental Perception of the Oral Health-Related Quality of Life of Children and Adolescents with Autism Spectrum Disorder (ASD)

This study evaluated the parental perception of the oral health-related quality of life (OHRQoL) of children and adolescents with autism spectrum disorder (ASD) and their family functioning. Moreover, sociodemographic factors associated with parental ratings of OHRQoL were assessed. A hundred parents/guardians of children and adolescents aged 6 to 14 years with ASD (ASD group) and 101 unaffected children and adolescents (UCA group) participated. Data collection was carried out using a Google form, containing three sections: (1st) Socioeconomic data and health history; (2nd) Oral health assessment by parental report; (3rd) The short forms of the Parental-Caregiver Perceptions Questionnaire (16-P-CPQ) and the Family Impact Scale (4-FIS). The scores of 16-P-CPQ total and subscales and 4-FIS were significantly higher for the ASD group (p < 0.02), except for the oral symptoms subscale (p > 0.05). Older ages (OR = 1.24), brushing 0/1x day (OR = 2.21), teeth grinding (OR = 2.20), gingival bleeding (OR = 3.34), parents with an elementary school degree (OR = 0.314) and family incomes less or equal to the minimum wage (OR = 3.049) were associated with a worse OHRQoL. Parents in the ASD group had a worse perception of QHRQoL when compared to the UCA group. ‘Frequency of tooth brushing’, ‘gingival bleeding’, and ‘teeth grinding’ were predictors of the worst parental perception of their children’s OHRQoL. Families with low socioeconomic conditions were more strongly affected by the oral conditions of their children.

Dental experiences related to oral care of children with autism spectrum disorders in Saudi Arabia: A literature review

The burden of autism spectrum disorder (ASD) in Saudi Arabia remains unclear with a dearth of literature, which focus on risk factors, prevalence, or interventions. This study is a review of the published literature related to dental experiences of children with ASD in Saudi Arabia. Twenty-two studies were included in this review, based on the predefined inclusion criteria which examined dental disease prevalence in children with ASD, identified the risk factors and the potential barriers to oral care. Results uncovered a lack of systematically published studies from Saudi Arabia which might have led to the limited development of effective oral health policies in the Kingdom. Identification of research gaps and potential intervention policies are needed to improve the oral health and quality of life of children with ASD in Saudi Arabia.

Oral Health-Related Quality-of-Life According to Dental Caries Severity, Body Mass Index and Sociodemographic Indicators in Children with Special Health Care Needs

This study aimed to assess the impact of dental caries’ severity, body mass index (BMI), and sociodemographic factors on oral health-related quality of life (OHRQoL) for special health care needs (SHCN) children and the suitability of their caregivers as proxies to determine OHRQoL. This cross-sectional study recruited 107 pairs of SHCN children and their caregivers and asked them to complete a questionnaire on sociodemographic issues as well as the Arabic version of the early childhood oral health impact scale (A-ECOHIS). This was followed by a dental examination. Dental caries was measured using the dmft/DMFT index, while caries’ severity was also determined. The children’s height and weight were measured, and BMI (kg/m²) was recorded. Data were analyzed statistically using t-test, one-way ANOVA, and Poisson regression models. Our results revealed that the A-ECOHIS score was 10.93, while the OHRQoL was affected in 95.3% of children. The most-reported item was ‘pain in the teeth, mouth, or jaws’ (48.7%). By regression analysis, caries-free children (Odds Ratio (OR): 0.650) or those who had moderate caries (OR: 0.551) were less likely to have a negative impact on their OHRQoL than those with severe caries. Additionally, those whose caregivers had a maximum primary education (OR: 0.656) or whose occupation was in the health sector (OR: 0.721) were less likely to have a negative impact on their OHRQoL. Those who were ≤ 6 years old (OR: 1.188) were more likely to have a negative impact. BMI did not have a significant impact on the OHRQoL of the children. Further, we detected a significant positive correlation between children’s dmft/DMFT scores and the A-ECOHIS scores reported by the mothers. Given these variables, which included dental caries’ severity, but not BMI, and caregivers’ education level and occupation, plus the child’s age group, we found a significant impact on the OHRQoL. However, we found that mothers were better proxies for their children’s OHRQoL.

Parental perception of oral health related quality of life and barriers to access dental care among children with intellectual needs in Kottayam, central Kerala-A cross sectional study

AIM

To evaluate the parental perception of oral health related quality of life and barriers to access dental care among children with intellectual needs.

METHOD

This cross sectional study was conducted among randomly selected 300 parents of children aged 4-12 years with intellectual needs (mental retardation, cerebral palsy, epilepsy, autism). Data on oral health related quality of life (OHRQoL) were collected with parental-caregivers perceptions questionnaire (P-CPQ). DMFT/dmft index was used to express caries prevalence as per World Health Organisation. Chi-squared test, analysis of variance, t-test and correlation were performed.

RESULTS

Parents of children who fell in the high severity DMFT category reported higher score in all four domains of OHRQoL when compared to low severity and moderate severity. Parents of children suffering from autism had higher score in all four domain of OHRQoL (p = .000).Majority of the parents rated their children's oral health as either fair (47%) or poor (42%). Predominant barriers for access dental care were financial difficulties (35.3%), lack of knowledge about dental care (24%), transportation difficulties (15%).

CONCLUSION

The present study revealed that higher caries prevalence has negative impact on OHRQoL of children with intellectual needs and their parents faced certain barriers for accessing dental care.

Impact of dental treatment on the oral health-related quality of life of children and adolescents with Autism Spectrum Disorder

AIM

To evaluate the impact of dental treatment on the oral health-related quality of life (OHRQoL) of children and adolescents with Autism Spectrum Disorder (ASD), through the perception of caregivers.

METHODS AND RESULTS

A prospective longitudinal study was conducted on 115 individuals with ASD, 6-14 years of age, recruited from the referral centers for special needs individuals at Teresina, Brazil. A clinical examination was carried out and the OHRQoL was measured using the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) before and 3 months after dental treatment. Data were analyzed using Kolmogorov-Smirnov, Levene, Mann-Whitney, Kruskall-Wallis, and Wilcoxon tests, and the Poison regression with backward method (P < .05). Treatment needs of children with ASD consisted of dental restorations (81.7%), oral prophylaxis (66.1%), endodontic treatment (10.4%), and tooth extractions (10.4%). The baseline P-CPQ total score varied from 1 to 33 (mean score = 13.2 [±6.4]), and at 3 months after treatment it ranged from 0 to 10 (mean score 3.4 [±2.2] (P < .001). The effect magnitude varied between 0.55 and 0.56.

CONCLUSION

According to the perception of the caregivers, dental treatment had a positive impact on the OHRQoL of children and adolescents with ASD.

Developing a Toothbrushing Visual Pedagogy (TBVP) for Preschool Children with Autism Spectrum Disorder

Visual pedagogy and social stories have been widely used to assist children with Autism Spectrum Disorder (ASD) in learning various skills. A toothbrushing visual pedagogy (TBVP) was developed adapting existing toothbrushing social stories for children with ASD. This TBVP consists of 13 toothbrushing steps with scripts describing the toothbrushing technique. To evaluate its feasibility, a review panel was formed to provide feedback on the TBVP and three other published toothbrushing social stories. Effectiveness of the TBVP was further evaluated among 119 preschool children with ASD with significant improvements in toothbrushing skills observed at 3-month and 6-month follow-ups. It is concluded that TBVP is a feasible and an effective educational means that assists children with ASD in learning toothbrushing skills.

Oral Health Status of Chinese Children With Autism Spectrum Disorders

OBJECTIVES

To assess and compare the oral health status of children with and without autism spectrum disorders (ASD) in China.

METHODS

This study recruited 144 children with ASD and 228 unrelated children with typical development (TD) aged 3-16 years from China. Data were collected using parent-reported questionnaires. Oral problems (oral symptoms and habits), oral health measures (oral hygiene practice and dental care experience), and the impact on the child's quality of life (based on a modified version of the Parental-Caregiver Perception Questionnaire) were assessed and compared between the two groups.

RESULTS

Children with ASD had worse oral health status than children with TD. Oral symptoms were more prevalent in the ASD group, especially halitosis (p < 0.001), food impaction (p < 0.001), and oral lesions (p < 0.001), than the TD group. The rate of damaging oral habits, including mouth breathing (p < 0.001) and object biting (p < 0.05), was also high in the ASD group. Compared with the TD group, more children with ASD did not brush their teeth independently and frequently (p < 0.001), had difficulty accessing dental care (p < 0.01), and reported unpleasant dental experiences (p < 0.001). The presence of ASD was associated with decreased oral health-related quality of life (p < 0.001) in these children and their families.

CONCLUSION

Oral problems such as halitosis and bad oral habits are more prevalent among children with ASD. These children also lack oral hygiene practice and dental visits. This situation negatively impacts their quality of life, and must be brought to the attention of their treating dentists.

Dental Caries Experience and Oral Health Related Quality of Life in Working Adults

Objective

To evaluate effect of dental caries experience and untreated dental decay on Oral Health-Related Quality of Life (OHRQoL) in working adults.

Methods

The clinical records of 160 patients were reviewed. Dental health indicators were derived from individual tooth- and surface-level data allowing for calculating the number of decayed surfaces (D), number of decayed missed filled surfaces (DMFS), and significant caries (SiC) indices. A questionnaire was administered to verify demographic factors and OHRQoL. The questionnaire was administered via face-to-face interview, for patients in the hospital; or via telephone interview, for those who could not complete it during their hospital visit. Models were developed using multivariable linear regression to predict total OHIP-14 scores and examine the simultaneous association of independent and outcome variables. The model was adjusted for age, gender, and nationality..

Results

Physical limitation and psychological discomfort were the most frequent impacted domains, affecting 17.1% and 7.5% of subjects, respectively. Painful aching was the most frequent item to have any impact, affecting 64.4% of the subjects. The results of multivariable analysis indicated that the SiC score could statistically significantly predict the Oral Health Impact Profile (OHIP) score, P=0.0003. In the linear regression model, for participants with DMFS equal to or higher than the SiC, on average, OHIP scores were almost 10 points higher than for participants with DMFS below the SiC.

Conclusion

The more the dental decay the higher the impact on OHRQoL. From a dental public health perspective, using OHRQoL as a need assessment tool, along with dental clinical indicator, can be helpful in planning and targeting public health programs for the most in-need adult populations.

Clinical Significance

This study identified that patients with severe dental caries report poorer OHRQoL. Clinicians should be aware of impacts that dental decay may have on OHRQoL, including physical, psychological concerns, and pain.

The Impact of Socio-Economic and Home Environmental Factors on Oral Health-Related Quality of Life Among Children Aged 11-14

Background and Objectives: Oral diseases are known to negatively impact physical, functional, and emotional well-being, and thus adversely affect quality of life. The aims of the study were (1) to assess the oral health-related quality of life (OHRQoL) and (2) to explore socio-demographic, -economic, and -environmental factors that are associated with OHRQoL among a sample of children aged 11–14 in Saudi Arabia. Materials and Methods: A cross-sectional design was used. The Child Perceptions Questionnaire (CPQ)—a self-administered, validated, and standardized questionnaire was used to collect data on OHRQoL in four domains: oral symptoms, functional limitations, and emotional and social well-being. In addition, data were collected on home environment, socioeconomic/demographic characteristics, and oral hygiene practices of participants and their parents or adult guardians. Univariate descriptive statistics, Spearman’s correlation, and Kruskal–Wallis H and Mann–Whitney tests were used. Data were analyzed using SPSS 23 Software. Significance was set at α = 0.05. Results: In total, 534 children participated in the study (91% response rate), of which 60% were females. Twenty percent of children described their oral health as “poor” and one in every four children reported that their oral health had at least some effect on their overall well-being. Children who were male, attending public schools, and living with both parents were more likely to report poor OHRQoL. Conclusions: A considerable proportion of children aged 11–14 could discern that their oral health had some effect on their overall well-being. The results identified potential predictors of OHRQoL. Disparities in OHRQoL exist among certain sub-populations. Active efforts and local interventions are necessary to improve OHRQoL.

Caregivers' perceptions of the oral-health-related quality of life of children with special needs in Johannesburg, South Africa

Background

The prevalence of dental caries and its effect on the oral-health-related quality of life (OHRQoL) of children with special needs (CSNs) have not been established in South Africa.

Aim

The study aimed to assess how caregivers of CSNs who attended Down Syndrome Association outreach sites in Johannesburg, South Africa, perceived the contribution of OHRQoL to the quality of life of these children.

Setting

The study was conducted at Down Syndrome Association (DSA) outreach sites in Johannesburg. These sites cater for children with several types of disabilities including cerebral palsy, hydrocephalus, autism, epilepsy and developmental delays. The association schedules and facilitates support group meetings for the caregivers of children with Down syndrome and other disabilities. These meetings are held at the outreach sites that are located at different district hospitals and community health centres in Johannesburg and are co-facilitated by the association’s outreach coordinator together with a team of physiotherapists, occupational therapists and speech therapists.

Methods

This cross-sectional study was composed of a convenient sample of 150 caregiver and child pairs from five outreach sites during January – June 2015. The short-form Parent-Caregiver Perception Questionnaire (P-CPQ) was used. The caries status of the children was assessed using the decayed, missing and filled teeth (dmft/DMFT) indices (whereby dmft or DMFT stands for decayed missing filled teeth in primary dentition [dmft] and in permanent dentition [DMFT]) based on World Health Organization guidelines.

Results

The mean age of the caregivers was 39.52 years (standard deviation [SD] 9.26) and 8.72 years (SD 6.07) for the children. The mean P-CPQ score was 12.88 (SD 12.14). All the caregivers stated that dental caries had a negative impact on the OHRQoL of the CSNs. However, 60% of caregivers stated that an oral condition had no impact on the child’s overall well-being. The majority (56.7%) of the caregivers rated their children’s overall oral health status as average and only 12% reported the oral health status to be poor. There was a high prevalence of untreated caries among the CSNs regardless of the type of disability.

Conclusion

All the caregivers stated that dental caries had a negative impact on the OHRQoL of the CSNs. However, they appeared to have contradictory perceptions of the oral health needs or status of their children.

Parents' Perceptions of the Oral Health-related Quality of Life of their Autistic Children in Iran

OBJECTIVES

The aim of this study was to evaluate parents' perception of the oral health-related quality of life (OHRQoL) of autistic children in Iran, and to determine the quality of life of their families in relation to child' oral health status.

STUDY DESIGN

70 families with at least one child with autism, and 70 families with normal children were enrolled. Parents' perceptions of the OHRQoL of children were assessed using pre-validated PedsQL oral health scale questionnaire. PedsQL Family Impact Module questionnaire was also used to evaluate the impact of having an autistic child on the quality of life of their families. Both of the questionnaires were filled by parents. Parents of children with autism spectrum filled a separate questionnaire for the sibling of the autistic child. In the control families, child-reported PedsQL oral health scale questionnaire was also filled by the child himself/herself. Mann-Whitney U-test, and chi-square were used for statistical analysis.

RESULTS

There was a significant difference in the mean total score of PedsQL oral health scale questionnaire between autistics and controls. Parents of normal children reported more oral problems (p<0.001). There was not a significant difference in the mean total score of PedsQL Family Impact Module questionnaire between the families of autistics and controls in the last 7 and 30 days.

CONCLUSION

According to parents' point of view, oral health-related quality of life of autistic children was better than normal children. However, parents of autistic children had more problems in the social and communication issues.

Parental Perception of Children Affected by Amelogenesis Imperfecta (AI) and Dentinogenesis Imperfecta (DI): A Qualitative Study

This qualitative study was conducted to explore parental attitudes and values regarding aesthetics and treatment needs of children in primary dentition affected by AI and DI. A purposive sample of parents of young children attended two focus groups: mothers (n = 7) and fathers (n = 6). A topic guide with open-ended questions was formulated and standardised photographs showing primary teeth affected by varying severity of AI/DI and photographs of different aesthetic treatments were utilised to stimulate discussion. Data was audio-recorded and transcribed verbatim. A cross-sectional thematic analysis was performed which identified six main themes; the impact on affected children, the impact on parents, the life course of the disease, coping mechanisms, treatment need, and experience of treatment. Parents believed that young children were aware of their altered dental appearance. A feeling of guilt was evident among fathers affected by the same condition. Most parents sought dental treatment before starting school due to worries of bullying at school. Parents appeared to rely solely on the professional advice of the paediatric dentist in making all treatment related decisions. The personal experience of parents affected by AI/DI played a pivotal role in parent's judgements of their children's teeth and perceived need for treatment.

Effects of dental treatment and systemic disease on oral health-related quality of life in Korean pediatric patients

Background

The findings that not only dental caries but also systemic disease can exert a negative effect on oral health-related quality of life (OHRQoL), and that dental treatment can improve OHRQoL have been confirmed in multiple studies. The purpose of this study is to investigate the impact of dental treatment on OHRQoL of Korean pediatric patients and the differences in OHRQoL between patients with and without systemic disease.

Methods

All the primary caregivers of pediatric patients who underwent dental treatments under either general anesthesia or intravenous deep sedation at Seoul National University Dental Hospital completed abbreviated versions of the Child Oral Health Impact Profile (COHIP-14) and Family Impact Scale (FIS-12) surveys on OHRQOL pre- and post-treatment (average: 2.4 ± 1.7 months after dental treatment). This is a case control study with patients divided into two groups according to the presence or absence of systemic disease.

Results

Data from 93 pediatric patients (46 male and 47 female, average patient age: 5.0 ± 3.4 years) were analyzed to compare OHRQoL before and after treatment with the Wilcoxon signed-rank test and to calculate the effect size using Cohen’s d. All of the patients exhibited an improvement in OHRQoL (COHIP-14: p <  0.001, effect size = 1.0; FIS-12: p <  0.001, effect size = 0.7). Patients with systemic diseases demonstrated lower OHRQoL in both pre- and post-treatment surveys than patients without systemic diseases (Wilcoxon Rank-sum test, both COHIP-14 and FIS-12: p <  0.05). The COHIP-14 appears to have a greater impact on the FIS-12 in patients with systemic disease than those without (explanatory power of 65.3 and 44.6%, respectively).

Conclusions

Based on the primary caregivers’ perceptions, dental treatment can improve the OHRQoL in Korean pediatric patients. Systemic disease results in a reduced OHRQoL, and the awareness of patients’ oral health appeared to have a greater impact on OHRQoL for family members of patients with a systemic disease.

Trial registration

KCT0002473 (Clinical Research Information Service, Republic of Korea) and 22 Sep 2017, retrospectively registered.

Occurrence of oral habits among preschool children with Autism Spectrum Disorder

Objective:

To determine occurrence of oral habits among Saudi preschool children with autism spectrum disorder (ASD) and compare it with healthy preschool children.

Methods:

This study was conducted over a 14-months period in Riyadh, Saudi Arabia. The sample consisted of two groups; a study group (SG) of 150 ASD children, and a control group (CG) of age- and gender-matched 150 healthy children. The parents of the children in both the groups were administered a questionnaire that included questions about the children’s demographic information and previous or persistent oral habits.

Results:

The prevalence of oral habits was higher (87.3%) among the SG children as compared to CG children (49.3%). The most prevalent oral habit among the SG was bruxism (n = 82; 54.7%), followed by object biting (n = 67; 44.7%) and mouth breathing (n = 40; 26.7 %). Among the CG; the most prevalent oral habit was mouth breathing (n = 40; 26.7%) followed by nail biting (n=18; 12%) and object biting (n = 7; 4.7%). The prevalence of bruxism, object biting, thumb sucking and tongue biting was significantly (p<0.05) higher in the SG than the CG.

Conclusions:

The prevalence of oral habits was higher in the ASD group children than the healthy children.

Dental knowledge of educators and healthcare providers working with children with autism spectrum disorders

OBJECTIVES

To evaluate dental knowledge and attitudes toward oral health care among healthcare providers and educators working with children with autism spectrum disorders (ASD) in central Saudi Arabia.  

METHODS

 There were 305 questionnaires distributed to 7 special-needs centers between September and November 2014. A total of 217 questionnaires were collected with a response rate of 71.1%. The study took place in the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. 

RESULTS

Approximately 50.2% of the participants did not offer any toothbrushing advice, and 73.3% never recommended dental checkup visits to parents, and 75.6% never performed dental examinations to children under their care. Ten percent thought that children should have their first dental visit after 6 years of age. Almost all participants agreed that children should practice oral hygiene, and 60.4% think they should brush twice per day. In general, the participants choose toothbrushes and toothpaste as the main tools to perform oral hygiene. There were 35% of participants who believed that parents should be responsible for the children's oral hygiene, and a few participants mentioned teachers and therapists to be responsible. Most of the participants (71.4%) did not receive any dental information from dental professional resources, only 14.3% of participants believed bacteria to be the cause of dental cavities.  

CONCLUSION

There is a clear lack of dental knowledge and attitudes, and its practical application among the participating group of healthcare providers working with children with ASD in Riyadh.

Effects of Dental Rehabilitation under General Anesthesia on Children's Oral-Health-Related Quality of Life: Saudi Arabian Parents' Perspectives

Aim: To determine whether dental treatment under general anesthesia (GA) would improve quality of life for children as reported by Saudi Arabian parents using a Parental-Caregivers Perceptions Questionnaire (P-CPQ) and a Family Impact Scale (FIS). Methods: Sixty-six parents completed P-CPQ and FIS scales four to eight weeks after their children (ages three to ten years) underwent comprehensive dental treatment under GA. Postoperative data were compared with baseline data gathered before GA using paired t-test at the 0.05 level of significance. The responsiveness of the P-CPQ and the FIS and the magnitude of changes in children’s quality of life as a result of dental treatment were determined by calculating the effect size (ES). Cross-sectional construct validity and internal consistency were also examined using the pretreatment scores of the P-CPQ and the FIS scores. Results: The overall P-CPQ and FIS scores showed a significant decrease following treatment, concomitant with large ES in both scales and all their subscales with the exception of social wellbeing, which showed moderate ES (ES 0.59). The greatest relative changes were seen in the oral symptoms (ES 1.81) and the family activity (ES 1.57) subscales. Conclusion: Dental treatment under GA is associated with considerable improvement in children’s quality of life as perceived by Saudi parents. The P-CPQ and the FIS scales are valid and responsive to changes resulting from dental treatment of young children affected by severe childhood caries.

A systematic review of the impact of parental socio-economic status and home environment characteristics on children's oral health related quality of life

Childhood circumstances such as socio-economic status and family structure have been found to influence psychological, psychosocial attributes and Oral Health Related Quality of Life (OHRQoL) in children. Therefore, the aim of this study was to conduct a systematic review of the published literature to assess the influence of parental Socio-Economic Status (SES) and home environment on children's OHRQoL. A systematic search was conducted in August 2013 using PubMed, Medline via OVID, CINAHL Plus via EBSCO, and Cochrane databases. Studies that have analysed the effect of parental characteristics (SES, family environment, family structure, number of siblings, household crowding, parents' age, and parents' oral health literacy) on children's OHRQoL were included. Quality assessment of the articles was done by the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative studies. Database search retrieved a total of 2,849 titles after removing the duplicates, 36 articles were found to be relevant. Most of the studies were conducted on Brazilian children and were published in recent two years. Early Childhood Oral Health Impact Scale and Children's Perception Questionnaire were the instruments of choice in preschool and school aged children respectively. Findings from majority of the studies suggest that the children from families with high income, parental education and family economy had better OHRQoL. Mothers' age, family structure, household crowding and presence of siblings were significant predictors of children's OHRQoL. However, definitive conclusions from the studies reviewed are not possible due to the differences in the study population, parental characteristics considered, methods used and statistical tests performed.