Impact of Caries Severity/Activity and Psychological Aspects of Caregivers on Oral Health-Related Quality of Life among 5-Year-Old Children

Self-reported oral health-related quality of life and caries experiences of 5-year-old children in Mandalay, Myanmar

BACKGROUND

This study aimed to examine the impact of dental caries and other potential socio-demographic factors on the oral health-related quality of life (OHRQoL) of preschool children from Myanmar. This was done using the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) as reported by both the children and their parents.

METHODS

A structured questionnaire was conducted to collect demographic information about the children and their caregivers, as well as socioeconomic data. The OHRQoL was assessed by interviewing the children and their parents using the Myanmar versions of SOHO-5c and SOHO-5p, respectively. Caries experience was assessed by two calibrated examiners and recorded using the dmft index. The Poisson regression model was adopted to investigate the association between OHRQoL and dental caries including socioeconomic factors.

RESULTS

A total of 454 pairs participated in the study. Among them, 64% of children and 70% of parents reported a negative impact on OHRQoL (with SOHO-5c and SOHO-5p scores exceeding 0). The mean score (SD) of the child self-report and parental version of the SOHO-5 was 1.86 (2.27) and 2.65 (3.13), respectively. Difficulties in eating and sleeping were the most commonly reported by both children and parents. The overall prevalence of dental caries was 87% (mean dmft score:5.59, SD:4.65). The final multivariate-adjusted model revealed that children with higher caries experiences were more likely to have lower OHRQoL for both child self-report (RR 4.38, 95% CI 3.16-6.14, p < 0.001) and parental report (RR 6.07, 95% CI 4.38-8.41, p < 0.001), respectively. A lower family income had a negative impact on the children's OHRQoL in child self-report (RR 1.59, 95% CI 1.26-2.04, p < 0.001) and parental report (RR 1.46, 95% CI 1.19-1.78, p < 0.001).

CONCLUSION

Two-thirds of the study children and their parents perceived the negative impact on children's OHRQoL. Higher caries experience and lower family income were associated with poorer OHRQoL of 5-year-old Myanmar children.

Mother's education and family relations protect children from dental caries experience: a salutogenic approach

The objective of this study was to identify dental caries-protective factors among 5-year-old children using the salutogenic theory. A cross-sectional study was conducted in a small-sized municipality in the Southeast region of Brazil, with a representative sample of 247 children registered in preschool and their respective mothers. The data were collected through questionnaires administered to the mothers about the socioeconomic, behavioral, and biological aspects of the mother and children. Additionally, the collections included validated instruments concerning psychosocial aspects, such as a sense of coherence, resilience, family cohesion and religiosity, and intraoral examinations of the children through the decayed-missing-filled primary teeth (dmft) index. All examinations were performed by a trained and calibrated examiner. The non-adjusted and adjusted odds ratios (OR) and their respective confidence intervals (CI) were estimated using multiple logistic regression with a hierarchical model. Among the examined children, 41.7% were caries-free. In the final model, the chances of the absence of dental caries experience (dmft = 0) were greater in children with mothers who had higher education levels (> 8 years of study) (OR = 2.55 [95%CIi:1.42-4.59]) and those who lived in an environment of high family cohesion (OR = 3.66 [95%CI: 1.19-11.29]). The results indicated that mothers' level of education and family relationships are protective factors against dental caries in 5-year-old children, which overlapped with behavioral and biological factors.

Internalizing problems are associated with oral health-related quality of life in early childhood: Outcomes from an Asian multi-ethnic prospective birth cohort

Oral health status ideally warrants for a holistic biopsychosocial approach to health and wellness. Little is known about the impact of behavioral problems on oral health-related quality of life (OHRQoL) in children due to the paucity of studies in early childhood, particularly in Asian multi-ethnic populations. This study evaluated the relationship between early child's socioemotional factors and OHRQoL, as well as its association with orofacial pain (OFP) and early childhood caries (ECC) in the Asian GUSTO birth cohort. Mother-child dyads were postnatally assessed at 3 time points. The Child Behavior Checklist (CBCL) was used to assess the child's socioemotional and behavioral problems at age 4-4.5 years together with other validated questionnaires to evaluate maternal anxiety and depression. ECC detection was performed at age 5, and OHRQoL (primary) and OFP (secondary) outcomes were assessed at age 6 from a total of 555 mother-child dyads. After a univariate regression analysis was performed to identify potential predictors and confounders, a multivariate regression model was run with predisposing factors (CBCL internalization and externalization problems, OFP, ECC) and adjusted for confounders (maternal psychosocial states, maternal education) to determine associations with OHRQoL. Results showed an association between CBCL internalization scores and poorer OHRQoL (RR = 1.03, p = 0.033, 95% CI 1.01 to 1.05), although the limited risk ratio may not have a practical applicability in psychosocially healthy children, alike the majority of those evaluated in this cohort. The average OHRQoL overall score among children with OFP was 2.39 times more than those without OFP (OR = 2.39, p < 0.001, 95% CI 2.00 to 2.86). Thus, in early childhood, OFP, and to lesser extent internalizing behaviors, may negatively impact OHRQoL. This study therefore highlights the complex relationship between OHRQoL and its predisposing socioemotional and somatic pain factors, and demands further investigations in clinically relevant populations.

Access to oral health care services for individuals with rare genetic diseases affecting skeletal development

OBJECTIVE

To identify factors associated with oral health care services for individuals with and without rare genetic diseases.

MATERIALS AND METHOD

A cross-sectional study was undertaken, with 140 individuals paired by sex and age (70 with rare genetic diseases and 70 without), aged between 3 and 27 years, and their parents. The sample was selected from two reference hospitals for patients with rare genetic diseases in southeastern Brazil. The parents completed a questionnaire on individual aspects and their child's medical/dental history. Participants who did and did not suffer from rare genetic diseases were examined for dental caries, malocclusion, dental anomalies, and oral hygiene. The theoretical model Directed Acyclic Graphs (DAG) was used to identify possible confounding variables in the association between rare diseases and access to dental care. Descriptive analyses and non-matched and matched logistic regression models (p < 0.05) were carried out.

RESULTS

The chance of individuals without rare genetic disease having access to oral health care service was 5.32 times higher (95% CI 2.35-12.01) than those with such conditions. Individuals who had not suffered upper respiratory tract infections had a 3.16 times greater chance of being in the group with access to oral health care service (95% CI 1.45-6.90).

CONCLUSION

Individuals with no rare genetic diseases and no history of upper respiratory tract infections had a greater chance of belonging to the group of individuals with access to a dental service. Individuals with rare genetic diseases have less access to oral health care.

Dental caries experience and its impact on quality of life in Latin American and Caribbean countries

Robust epidemiological data allow for logical interventions taken in the interest of public health. Dental caries is a major public health problem driven by increased sugar consumption and various biological, behavioral, and psychosocial factors, and is known to strongly affect an individual's quality of life. This study aims to critically review epidemiological data on the prevalence of dental caries in Latin American and Caribbean countries (LACC) and its impact on the oral health-related quality of life (OHRQoL) of the population. Although the majority of national surveys did not include all age groups and several countries reported a reduction in the prevalence of cavitated carious lesions, most nations still exhibited a high burden of decayed teeth. OHRQoL evaluation was limited to children and older adults only, and was not included in any national survey. Study heterogeneity and methodological issues hindered comparison of evidence between studies and over time, and updating national level data on caries prevalence and its impact on OHRQoL should be prioritized in LACCs.

Salutogenesis in oral health research in preschool children: A scoping review

BACKGROUND

Oral health research in children has focused both on identifying the risk factors for dental caries and on the impact the disease has on children's life.

AIM

Identifying studies that used the salutogenic theory to investigate positive aspects to promote a healthy condition in preschool children.

DESIGN

A literature scoping review was conducted to answer the question: 'What has been produced in scientific literature about children's oral health with a salutogenic theoretical reference?' The checklist preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) was applied. The research was conducted on the databases PubMed, Scopus, and Web of Science with no language, design, country or date restrictions. Three independent reviewers selected the studies to be included in the research, extracted data, and assessed the studies' contribution to the review.

RESULTS

Among the 38 studies retained, 10 were included, those were published between 2009 and 2018: five in Brazil, two in the United States of America, and one in Canada, China and India, respectively. All articles were published in English language. Nine studies investigated the relation between the parents'/caretakers' sense of coherence and aspects related to the children's oral health condition. One study investigated health factors among the parents of caries-free children.

CONCLUSION

Salutogenic orientation must be included in oral health research, so that salutary and risk factors may coexist, contributing to a new perspective for oral health promotion among children.

Impact of early childhood caries on oral health-related quality of life: A systematic review and meta-analysis

OBJECTIVES

The aim of this study was to conduct a systematic review in order to assess the impact of early childhood caries (ECC) and its severity on Oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

An electronic search was conducted in MEDLINE, EMBASE, Cochrane, SciELO and Lilacs databases. The study eligibility criteria were primary studies published in English, Spanish or Portuguese that assessed OHRQoL in preschool children with dental caries using validated instruments. Two researchers independently performed the selection process and data extraction. The Effective Public Health Practice Project's Quality Assessment Tool was used for the quality assessment. Random effects models were used to estimate the pooled effect for continuous and categorical data.

RESULTS

Of 2,037 identified articles, thirty-five studies (37 articles) met the inclusion criteria. The methodological quality was judged mainly as moderate. Children with ECC were more likely to report any impact on OHRQoL than children without caries (OR: 1.99; 95% CI: 1.51-2.62; 6 studies). Severe ECC (dmft > 5) presented a higher effect (OR: 5.00; 95% CI: 3.70-6.74; 8 studies). Sensitivity analysis including only population studies showed uncertain results on the impact of ECC on OHRQoL (OR: 1.67; 95% CI: 0.99-2.82; I²  = 95%). The symptom and psychological domains were the most affected (SMD: 0.60, 95% CI: 0.38-0.81 and SMD: 0.61, 95% CI: 0.37-0.85 respectively).

CONCLUSIONS

ECC has a negative impact on the OHRQoL of both preschoolers and their families. However, its impact on OHRQoL is diluted when it is evaluated at population level.

Impact of Oral Health on the Quality of Life of Preschoolers and Their Families

The aim of this study was to evaluate how the oral hygiene condition can influence the Oral Health-Related Quality of Life (OHRQoL) of preschoolers and their families. A cross-sectional study was conducted involving 446 children aged 2 to 6 years from public schools located in Rio de Janeiro, Brazil. The groups were dichotomized: regular/poor oral hygiene condition (RPOH) or good oral hygiene condition (GOH). The caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The average score in the RPOH group was 6.36 (6.35 DP) and GOH was 4.43 (5.35 SD) (P < .01). In the child subscale, the average of the RPOH and GOH group were, respectively, 4.12 (4.14 DP) and 3.13 (3.66 DP) (P = .01). In the family subscale, RPOH and GOH group were, respectively, 2.24 (3.12 DP) and 1.29 (2.52 DP) (P = .01). RPOH group had the greatest impact on OHRQoL.

THE PERCEPTION OF CAREGIVERS OF POOR ORAL HEALTH OF THEIR CHILDREN AND ITS RELATED CLINICAL CONDITIONS

Objective:

To determine the association between the perception of caregivers regarding the oral health of their children and socio-demographic characteristics, report of dental pain, and clinical oral conditions.

Methods:

A cross-sectional study was conducted with 570 children aged two to five years old, enrolled at public preschools, and with their caregivers. Data regarding perceptions of oral health status in children, socio-demographic characteristics, and dental pain were collected from a questionnaire. Three examiners (Kappa>0.7) evaluated children’s oral health status using the dmft index, pufa index, and the Andreasen classification for traumatic dental injury (TDI). The occurrence of open bite and overjet was also investigated. Descriptive analyses, and unadjusted and adjusted logistic regression were used, considering a 5% significance level.

Results:

A total of 24.7% of children had poor oral health status, which increased 4.92-fold (95% confidence interval [95%CI] 3.05-7.93) when children had dental caries, and 3.78-fold (95%CI 1.63-8.76) when there were consequences from dental caries. The perception of poor oral health was also associated to open bite (Odds Ratio [OR] 1.98; 95%CI 1.16-3.38) and TDI (OR 1.68; 95%CI 1.06-2.68). No associations were found between the perception of caregivers and socio-demographic variables or overjet.

Conclusions:

The perception of caregivers of poor oral health in their children was associated to dental caries, its consequences, TDI, and open bite.

The Prevalence of Dental Caries in Primary Dentition in 3- to 5-Year-Old Preschool Children in Northern China

Objectives

To investigate the prevalence and factors promoting caries in primary dentition of 3-5-year-old children in Northeast China.

Materials and Methods

Data of 1,229 children aged 3 to 5 years were randomly selected. The caries prevalence and other indicators were assessed, and the results analyzed by SPSS. A questionnaire was also given to the children's guardians to ascertain the potential risk factors associated with caries.

Results

The decayed, missing, and filled teeth (dmft) index in children aged 3, 4, and 5 years old was 3.17, 5.13, and 6.07, respectively, while the caries prevalence rate was 62.16%, 75.89%, and 87.28% accordingly. The incidence of caries among rural children was higher than that in urban areas. Regarding oral health awareness, it was found that parents in urban areas had more accurate perceptions of oral health problems. It was also noted that the children's brushing habits were worrying. Family economic and medical resources are not the main causes of serious dental caries in rural areas.

Conclusions

The oral health status of children aged 3-5 years is not optimistic. Many parents have a low awareness of oral health. Strengthening the promotion of oral health knowledge is an effective way to change the situation.