Preschool oral health-related quality of life: A practical guide to measurement tools

Family functioning and preschool children's oral health-related quality of life

INTRODUCTION

Identifying which aspects of how a family functions are relevant to child oral health provides opportunities for interventions targeting the family context. The aim of this study was to investigate the associations of general and domain-specific family functioning with oral health-related quality of life (OHRQoL) of 3-4-year-old children.

METHODS

Cross-sectional data from 740 parent-child dyads from East London were analysed. Family functioning was assessed with the 60-item Family Assessment Device that yields scores for general functioning and six domains (roles, behaviour control, communication, affective involvement, affective responsiveness and problem solving). Children's OHRQoL was measured using the Early Childhood Oral Health Impact Scale (ECOHIS), which measures the lifetime impacts of children's oral conditions on the child (child impact section, CIS) and family (family impact section, FIS). The associations of family functioning with the ECOHIS total, CIS and FIS scores were assessed in negative binomial regression models (rate ratios [RR] and 95% confidence intervals [95% CI] were calculated), adjusting for parental sociodemographic factors and child demographic factors and caries experience.

RESULTS

Children in families with unhealthy general functioning had 1.45 (95% CI: 0.87-2.43), 1.24 (95% CI: 0.73-2.13) and 2.19 (95% CI: 1.20-3.99) times greater ECOHIS total, CIS and FIS scores, respectively, than those in families with healthy general functioning after adjustment for confounders. Unhealthy functioning in the roles domain was associated with greater ECOHIS total and FIS scores. Unhealthy functioning in the problem solving, roles and affective involvement domains were also associated with greater FIS scores.

CONCLUSIONS

Unhealthy family functioning was associated with worse child OHRQoL, especially in terms of disrupting family life. Effective assignment and undertaking of roles should be further explored as a target for intervention.

Oral-Health-Related Quality of Life as Measured with the Child-OIDP Index and Oral Health Status in Spanish Adolescents

BACKGROUND

Our aim was to analyze the relationship between OHRQoL (Oral-Health-Related Quality of Life) assessed by the C-OIDP (Child-Oral Impacts on Daily Performances) indexand oral health status in 13-15 years old Spanish population.

METHODS

A cross-sectional study was designed in a random sample of 337 adolescents. The C-OIDP and an oral health perception questionnaire were applied. ICDAS II (International Caries Detection and Assessment System) classification was used for assessing caries status, CPI (Community Periodontal Index) for periodontal status and discrepancy in the three planes for occlusal evaluation. Statistical analysis included Mann-Whitney, Kruskal-Wallis and Spearman correlation tests.

RESULTS

The prevalence of impact was 48.1%. The most frequently affected dimension was eating (21.4%). The overall mean C-OIDP index was 3.28. Higher DMFT (Decayed Missed Filled Tooth) was significantly associated with C-OIDP index (p = 0.03). Participants with CPI > 0 showed an impact index almost twice as high as those with CPI = 0 (p > 0.05). Significant association was found between quality of life and CPI for women (p < 0.01). Only the molar Angle's class was associated with the impact index (p = 0.04).

CONCLUSIONS

The OHRQoL in Spanish adolescents is good. The DMFT index had an impact on adolescents' quality of life, showing a greater impact in men than in women. Periodontal status had a greater impact in women. No association between the extent of the caries lesion and the impact index was found.

Does outpatient dental treatment have impact on the quality of life of children with early childhood caries?

AIM

To assess the impact of outpatient dental treatment on oral health-related quality of life (OHRQoL) of children and their families.

MATERIALS AND METHODS

This prospective observational study was conducted with children with untreated dental caries, recruited from a public university/the pediatric dentistry clinic of a public university in the northeastern Brazil. Sociodemographic data were collected, a clinical examination was carried out before and after dental treatment, and the Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was applied to those responsible for the children, before and after dental treatment. Descriptive and bivariate statistics were used, and the Wilcoxon and Student's t tests were applied (p < 0.05).

RESULTS

The study included 64 children, of both sexes, aged between 3 and 5 years old. The majority had a dmft index higher than or equal to 6 (60.9%), with a mean value of 7.11 (± 4.11). Sociodemographic conditions such as sex, age, and socioeconomic status had no impact on their OHRQoL (p > 0.05). The mean total ECOHIS questionnaire scores and those of its domains decreased after completion of the treatments (p < 0.05), except for scores in the self-image and distress domains of the parents (p > 0.05). This study reinforces the relevance of adopting oral health policies aimed at the prevention and treatment of ECC.

CONCLUSION

Outpatient dental treatment had a positive impact on the OHRQoL of children and their families.

CLINICAL RELEVANCE

The possibility of evaluating the services provided by the pediatric dentistry clinic.

Cross-cultural adaptation and psychometric properties of the Mexican version of the Early Childhood Oral Health Impact Scale (ECOHIS)

BACKGROUND

Instruments adapted for the Mexican population to assess oral health-related quality of life (OHRQoL) in preschoolers remain lacking. This study aimed to cross-culturally adapt and evaluate the psychometric properties of the Mexican version of the Early Childhood Oral Health Impact Scale (M-ECOHIS).

METHODS

This cross-sectional study was conducted with preschool children from southern Mexico. The investigation was divided into a transcultural adaptation phase and a validation phase. The M-ECOHIS was completed by the children's guardians, and clinical data were also evaluated. Reliability was evaluated using tests of internal consistency and test-retest measures, while construct validity was assessed through Spearman's correlation coefficient between M-ECOHIS scores and self-reported oral health, and through confirmatory factor analysis (CFA). Construct validity was also evaluated through discriminant validity of the M-ECOHIS, which was determined according to questionnaire scores on oral health measures (e.g., dental caries).

RESULTS

A total of 303 preschool children participated in this study. Regarding internal consistency, Cronbach's alpha was > 0.78 for the child section, family section, and general M-ECOHIS. The general intraclass correlation coefficient (ICC) for test-retest reliability was 0.95. The correlation between the scores obtained on the child and family impact sections was significant with the self-reported oral health status rating. In relation to CFA, all items of the M-ECOHIS confirmed the latent variables. Further, M-ECOHIS scores were associated with the presence of untreated dental caries, indicating that the questionnaire has good discriminant validity.

CONCLUSION

Our findings suggest that the M-ECOHIS is a valid and reliable instrument for assessing the impact of oral health on quality of life in Mexican preschool children.

Validating a short form of the Parental-Caregivers Perceptions Questionnaire (P-CPQ) and the Family Impact Scale (FIS) in Finnish language

Aim

This study aimed to adapt the short-form versions of the Parental-Caregivers Perceptions Questionnaire (P-CPQ), and the Family Impact Scale (FIS) in the Finnish language and to test its validity and reliability. Another aim was to compare the background factors of parents with respect to P-CPQ and FIS outcomes.

Methods

This study was conducted among a convenient sample of parents who visited the public dental clinic in Sievi, Finland, from May to October 2016. A total of 54 parents of 2–8-year-old children completed the short-form of the P-CPQ questionnaire and 50 parents of 2–8-year-olds completed the FIS questionnaire while visiting for their children’s routine dental check-up. Parents completed the self-administered P-CPQ and FIS questionnaires. Reliability and validity of the short-form of the P-CPQ and FIS were assessed. Differences between gender, and family size were evaluated using the Mann–Whitney U test and the differences between age groups were evaluated using the Kruskal–Wallis one-way ANOVA test.

Result

The Finnish versions of both the short forms of the P-CPQ and FIS had alpha values within the acceptable range. The scales also showed good construct validity. Toddlers (2–4-year olds) had the highest scores for both the P-CPQ and FIS-8 subscales. Likewise, families with 5 or more children had high FIS scores.

Conclusion

The short form of the P-CPQ and FIS in Finnish language are valid and reliable. The oral health of the child seems to have the greatest family impact among parents with five or more children and in families with 2–4-year olds.