Do children's previous dental experience and fear affect their perceived oral health-related quality of life (OHRQoL)?

Analysis of factors influencing delayed treatment seeking for dental caries in preschool children: a cross-sectional study

OBJECTIVE

This study investigated the prevalence of treatment delays among preschoolers with dental caries, identified the associated influencing factors, and predicted the risk of delayed treatment. The findings of this study provide an evidence base for future interventions designed to reduce treatment delays in this population.

METHODS

A convenience sample of 264 preschool children with dental caries and their parents who visited the paediatric dental department between October 2023 and May 2024 was surveyed. Data were collected using a general information questionnaire, a medical status questionnaire, the Children's Fear Survey Schedule-Dental Subscale, the Modified Version Dental Anxiety Scale, the Short-Form Health Literacy Dental Scale, and the Illness Perception Questionnaire Revised for Dental. Influencing factors were analysed using univariate analysis and binary logistic regression, whereas the risk of occurrence was predicted using the receiver operating characteristic (ROC) curve.

RESULTS

The prevalence of delayed treatment among preschool children with dental caries was 71.21%, with an average delay of 117.5 days. Binary logistic regression analysis identified several independent factors significantly associated with delayed treatment (P < 0.05), including the primary caregiver, initial symptom recognition, children's dental fear, parental dental anxiety, and parental oral health literacy. Predictive analyses indicated that children's dental fear (AUC: 0.765, 95%CI: 0.707-0.823) and parental oral health literacy (AUC: 0.738, 95%CI: 0.673-0.802) demonstrated relatively high predictive values for delayed treatment.

CONCLUSION

Efforts to reduce delayed treatment should prioritise addressing children's dental fear and improving parental oral health literacy. Targeted and effective strategies in these areas may facilitate early prevention, diagnosis, and intervention, thereby minimising treatment delays, reducing disease burden, and promoting oral health among preschoolers.

Correlation Between Child's Dental Fear and Anxiety Symptoms and Evaluating Factors Associated With Dental Fear

Background and Aims

This study aimed to assess the correlation between dental fear and anxiety problems and evaluate factors associated with dental fear.

Methods

In this study, we utilized the standard Persian version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire and the Persian version of Spence Children's Anxiety Scale (SCAS) questionnaire to explore children's dental fear and anxiety problems, respectively. Questionnaires were completed by 290 children aged 8-12 years who visited Pediatrics Department of Babol Dental Clinic and private pediatric offices. Demographic characteristics were also recorded. The data were analyzed by the one-way ANOVA, independent t-test (α = 0.05), Pearson correlation, and logistic regression test using SPSS version 26.

Results

In this study, 151 boys and 139 girls were included. Based on the CFSS-DS questionnaire, 8.6% of children had dental fear (Scores > 38). Dental fear correlated with all aspects of anxiety symptoms (p < 0.05). There were significant correlations between children's age (p = 0.019) and location of dental treatment (p = 0.002) with their dental fear scores. Having a housewife mother is a protective factor in child's dental fear (OR = 0.380, CI = 0.989-0.047, and p = 0.047).

Conclusion

The findings of the present study suggest that dental fear and anxiety problems correlate with each other, and factors such as child's age, the location of dental treatment, and having a housewife mother serve as prominent factors contributing to dental fear of children.

Parental Perception of Oral Halitosis in Their Children and Its Effect on Oral Health-Related Quality of Life: A Cross-Sectional Study

Purpose

Halitosis, or oral malodor, is an oral condition characterized by unpleasant smells that exceed socially acceptable limits. Oral malodor is quite a frequent condition in the pediatric population. This study aimed to determine the prevalence and the impact of oral halitosis on oral health-related quality of life among children and adolescents based on parental perception in Saudi Arabia.

Patients and Methods

This study was conducted among parents or caregivers of children and adolescents aged 5-14 in Saudi Arabia. An online questionnaire link, provided in Arabic and English, was disseminated via different social media platforms targeting the eligible parents/caregivers of children visiting dental clinics. Subsequently, participants were recruited for this research using the snowball sampling approach. The questionnaire comprised of three sections: socio-economic information, parental perception of oral halitosis in their children, and oral health-related quality of life. The Child Oral Health Quality of Life Questionnaire (COHQoL) evaluated the children's oral health-related quality of life (OHRQoL). A Chi-square test, binary logistic regression analysis, and Spearman correlation tests were applied to determine the relationship between different variables and halitosis.

Results

A total of 1416 parents participated in this study. The prevalence of parental-perceived halitosis in their children was 74.1% (n=1049). A total of 563 (53.7%) male children and 486 (46.3%) female children were reported unpleasant breath odor without any significant difference (X2=0.200, df=1, p=0.654). A significant negative correlations were observed between halitosis and oral symptoms (r=- 0.214, P <0.001), emotions (r= -0.152, p<0.001), Family environment (r=-0.178, p<0.001), and overall OHRQoL of the children (r=-0.198, p<0.001).

Conclusion

The parent perceived prevalence of oral halitosis among children aged 8.04±3.5 years was very high in Saudi Arabia. The presence of oral halitosis among children and adolescents negatively impacted OHRQoL. Age, nationality, fathers' education and occupation were the significant predictors of OHRQoL among children.

Determinants of pediatric dental anxiety after comprehensive dental treatments under general anesthesia

Providing dental treatment to young patients can pose challenges in certain circumstances, particularly when they experience anxiety about dental procedures. For this reason, general anesthesia (GA) is preferred as an alternative treatment for performing dental treatments on children. On the other hand, the use of general anesthesia could potentially increase the risk of developing dental anxiety complications. This study was aimed to explore determinants of pediatric dental anxiety after comprehensive dental treatments under general anesthesia (CDT-GA). In this prospective study, 80 healthy children aged 3 to 10 years who required CDT-GA were enrolled in 2023. Demographic information and treatment checklist (duration of GA, the number of fissure sealants, restorations, pulpectomies, pulpotomies, crowns, and extractions) were completed for each child. The standardized MCDAS-f (Modified Child Dental Anxiety Scale;- Faces Version) questionnaire was used to measure dental anxiety before GA, 7 days after GA, and 14 days after GA. Data were analyzed by SPSS 26 software, repeated measure analysis, and linear regression. The results of the study showed that dental anxiety significantly decreased 14 days after CDT-GA (P = 0.013) compared to before CDT-GA (P < 0.001). Additionally, anxiety before CDT-GA had a significant direct effect on anxiety levels on days 7 (P < 0.001) and 14 (P < 0.001). Other factors, such as the duration of GA, the number of treatments performed, age, and gender, did not have a significant effect on anxiety levels on days 7 and 14. Dental anxiety significantly decreases after CDT-GA, and this reduction is strongly influenced by the level of anxiety before CDT-GA. These findings highlight the importance of addressing preoperative anxiety to minimize postoperative anxiety and improve the overall dental experience for pediatric patients.

Association between Dental Fear and Children's Oral Health-Related Quality of Life

OBJECTIVES

This study aimed to examine the association between both parental dental fear and children's dental fear and its impact on the Oral Health-Related Quality of Life (OHRQoL) of Saudi children in the Eastern Province of Saudi Arabia.

METHODS

Data on 93 individuals aged 7-12 years were collected using clinical examination and Arabic-validated questionnaires: the Child Oral Health Impact Profile-Short Form (COHIP-SF19), and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Negative binomial regression analysis was performed to study the association between children's fear and parental dental fear as well as the OHRQoL, while adjusting for certain confounders.

RESULTS

Overall, our multivariate analyses showed that children with high dental fear (CFSS-DS ≥ 38, p = 0.027) and a higher percentage of dental caries (p = 0.013) had a significantly lower OHRQoL after adjusting for clinical and socio-demographic factors. Further, parental fear of dentists was significantly associated with children's fear of dentists (p < 0.001).

CONCLUSIONS

Our findings demonstrate that children's fear and dental caries are both associated with poorer OHRQoL. Further, parental dental fear about dentists was associated with children's fear of dentists.

Efficacy of kaleidoscope, virtual reality, and video games to alleviate dental anxiety during local anesthesia in children: a randomized clinical trial

Background

Distraction is a technique used to divert a patient's attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children.

Methods

Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong-Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal-Wallis and Wilcoxon signed-rank tests.

Results

In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores.

Conclusion

Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.

Is Dental Anxiety Associated with Oral Health-Related Quality of Life? Assessment of Statistical Significance and Clinical Meaningfulness in a Sample of Russian Medical and Dental Students

Information about oral health-related quality of life (OHRQoL) and dental anxiety (DA) in Russian young adults is scarce. We investigated how DA is associated with OHRQoL in a group of medical and dental students in North-West Russia. The study had a cross-sectional design and included 807 students aged 18-25 years who attended the Northern State Medical University in Arkhangelsk. OHRQoL and DA were measured by the Oral Health Impact Profile (OHIP-14) and Corah's Dental Anxiety Scale (DAS), respectively. A questionnaire collected information on socio-demographics and self-reported oral health (OH) characteristics. A dental examination was executed to assess dental caries and oral hygiene. We observed differences in the OHIP-14 scores between dentally anxious and non-anxious students: unadjusted incidence rate ratio [IRR] = 1.65, 95% confidence interval [CI]: 1.29-2.12; after adjustment for socio-demographics and clinically assessed OH: IRR = 1.58, 95% CI: 1.23-2.02; after adjustment for socio-demographics, clinically assessed OH, and self-reported OH characteristics: IRR = 1.27, 95% CI: 0.99-1.63. The differences between estimated marginal means for the DAS categories in the models were 2.92, 2.51, and 1.24, respectively. Minimal clinically important differences of OHIP-14 fell between 1.68 and 2.51. We found a negative statistical association between DA and OHRQoL in our study sample, but after adjustment for potential confounders, the association lost its clinical importance.

Changes in children's dental fear after restorative treatment under different sedation types: Associations with parents' experiences and dental health

BACKGROUND

Dentists often use sedative medications such as nitrous oxide inhaled sedation and general anesthesia (GA) to help decrease patient fear and manage paediatric patients' behavior during treatment.

AIM

The goal of this study was to examine factors associated with dental fear changes after restorative dental treatment under nitrous oxide or GA in children 4-12 years old.

DESIGN

A prospective cohort study of 124 children examined changes in dental fear, number of treatment visits, and parental factors among children receiving restorative dental treatment under nitrous oxide (n = 68) or GA (n = 56) sedation. Data were collected at pretreatment (T1), 16 weeks post-treatment (T2), and at 29-month follow-up (T3).

RESULTS

Dental fear increased slightly, but not significantly, under both forms of sedation between T1 and T3. Children's dental fear was associated with parents' poor dental experiences and oral health, but not with number of treatment visits.

CONCLUSIONS

Progression of children's dental fear seems not dependent solely on the type of sedation used but is likely predicted by factors including pretreatment dental fear and dental needs. Dentists recommending sedation for children's dental care may consider pretreatment dental need, fear levels, and parental factors when determining which type of sedation to use.

Impact of parental attributes on the oral health-related quality of life of Brazilian preschool children

PURPOSE

Considering the importance of parental attitudes and their influence on children's oral health, it is important to know which characteristics may impact it. The aim of this population study was to evaluate the impact of the parental sociodemographic characteristics on the oral health-related quality of life (OHRQoL) of preschool children from southeastern Brazil.

METHODS

A population-based study was conducted with a sample of 321 children aged 2 to 5 years old who underwent a calibrated clinical oral examination to assess oral health status and their parents were asked to answer the two following questionnaires: (1) sociodemographic conditions and (2) Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Descriptive analysis, Mann-Whitney and Kruskal-Wallis tests and adjusted Poisson regression models were used.

RESULTS

Younger mothers (RP: 1.47; 95% CI: 1.11-1.95), lower household income (RP: 1.47; 95% CI: 1.11-1.96) and the presence of dental caries (RP: 2.28; 95% CI: 1.74-3.0) were more likely to have a negative impact on the OHRQoL B-ECOHIS total scores (P < 0.01).

CONCLUSION

The characteristics of mothers, such as age, schooling and salary, influenced the mean B-ECOHIS total score; however, paternal attributes were not associated with a negative impact on the children's quality of life. Also, dental caries and household income influenced the children's oral health-related quality of life.

The caries impacts and experiences questionnaire for Turkish children by age groups'

BACKGROUND

The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) assess children's effects of dental caries on their quality of life. This study aimed to determine the scale's Turkish version (CARIES-QC/T) validity and reliability according to age groups and to create the scale that is specific to selected age groups.

METHODS

Children were divided up into 3 age groups (5-7, 8-10 and 11-14 ages). Explanatory factor analysis (EFA) was used in the concept validation process. Confirmatory factor analysis (CFA) was used for cross-cultural validity. For each group, test-retest analyses were performed on 20 children. Inter-question correlation and Cronbach's alpha were used to examine internal consistency.

RESULTS

A total of 360 children (mean age; 9.04, 56.1% girls,) 120 children in each group, participated in the study. Questions 7 and 12 for the 5-7 age group, Questions 4 and 7 for the 8-10 and 11-14 age groups were excluded from the analysis (according to EFA results; factor loads < 0.30). Three modified CARIES-QC/T scales structures with a total of 10 questions were developed for the age groups of 5-7, 8-10, and 11-14.

CONCLUSIONS

Some questions on the Caries-QC/T scale should be eliminated, it was found when it was evaluated for age specificity. Although the results of the Caries-QC scale studies to be carried out in different societies and age groups vary, the high sample size in this study and the statistically strong results showed that the Caries-QC/T scale forms that we adapted could be used by the specified age groups.

Cross-Bite and Oral-Health-Related Quality of Life (OHRQoL) in Preadolescents Aged 11 to 14 Years Old: A Pilot Case-Control Study

INTRODUCTION

Malocclusions have a negative impact on oral-health-related quality of life (OHRQoL). Posterior cross-bite is one of the most prevalent malocclusions in the preadolescent population. This study investigated the influence of posterior cross-bites (unilateral or bilateral) on OHRQoL in an 11- to 14-year-old population.

MATERIALS AND METHODS

A pilot case-control study was carried out at the Dental Clinic of the University of Salamanca between 2021 and 2023. A consecutive sample of 120 preadolescent patients aged 11 to 14 years old was recruited. Three groups were analyzed: a control group (no posterior cross-bite) (n = 40), a group with unilateral posterior cross-bite (n = 40), and a group with bilateral posterior cross-bite (n = 40). To analyze the OHRQoL, the Spanish version of the Child Perception Questionnaire (CPQ-Esp11-14) was used.

RESULTS

The mean age of the sample was 12.2 years old (±0.96 years). The group of patients with a bilateral posterior cross-bite was shown to have higher scores in all dimensions of the CPQ-Esp11-14, as well as a higher total score. Sex only influenced the oral symptom dimension of the CPQ-Esp11-14 questionnaire; in this dimension, the girls described a greater impact. Age did not influence OHRQoL.

CONCLUSION

The presence of a posterior cross-bite had a negative impact on OHRQoL in the preadolescent population that was studied.

Social support, oral health knowledge, attitudes, practice, self-efficacy and oral health-related quality of life in Chinese college students

Oral health is crucial for health-related quality of life. However, the research on the factors affecting oral health status is not comprehensive enough. This investigation aimed to evaluate the multifaceted determinants of college students' oral health status and explore the impact of social support, oral health literacy, attitudes, behaviors, and self-efficacy on OHRQoL. By surveying 822 students from a university. Baseline data included sociodemographics (gender, age), social support (MSPSS scale), oral health self-efficacy (SESS scale), oral health knowledge, attitudes, and practices (KAP questionnaire), and OHRQoL (OHIP-14 scale). Based on social cognitive theory, partial least squares structural equation modeling (PLS-SEM) and fuzzy set qualitative comparative analysis (fsQCA) were used to examine the relationship between the study variables. PLS-SEM results showed that knowledge, attitude, and practice predicted OHRQoL through self-efficacy. FsQCA results showed that the combination of different variables was sufficient to explain OHRQoL. The conclusion was that self-efficacy plays an important role and the combination of high-level knowledge, positive attitudes, and strong self-efficacy was important in improving OHRQoL. The results of this study provided a reference for the oral health strategy planning of college students in China.

Effectiveness of buccal infiltration anaesthesia compared to inferior alveolar nerve block anaesthesia in primary mandibular molar extractions: a randomised controlled study

Aim The current study assessed the efficiency of buccal infiltration (BI) and inferior alveolar nerve block (IANB) during the extraction of deciduous mandibular molars.Subjects and method A total of 112 children aged between 5-8 years with mandibular molar indicated for extraction were divided into two groups at random. The BI group was injected with 4% articaine using BI, while the IANB group was injected with 2% lidocaine using IANB. The effectiveness of both techniques was examined using the Wong-Baker FACES Pain Rating Scale (W-BFPRS); Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and pulse oximetry.Results Using the W-BFPRS scale, success rates were 83.9% and 75.0% for the BI group and 82.1% and 71.4% for the IANB group during the injection and extraction, respectively, while using the FLACC scale, success rates were 83.9% and 92.9% for the BI group and 78.6% and 89.3% for the IANB group. In terms of pulse rate and oxygen saturation, there was no significant difference between the two groups.Conclusions BI with articaine is as efficient as IANB with lidocaine in the extraction of deciduous mandibular molars.

Dental Fear and Anxiety of Chinese Preschool Children in a School-Based Outreach Service Using Silver Diamine Fluoride for Caries Control: A Cross-Sectional Study

Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA) of preschool children after participating in a school-based outreach service using SDF to arrest early childhood caries (ECC). The study recruited 3- to 5-year-old children with untreated ECC. A trained dentist performed a dental examination and applied SDF therapy to the carious lesions. ECC experience was measured using the dmft index. Questionnaires for parents were used to collect the children's demographic information and their dental treatment experiences. The children's DFA before and immediately after SDF therapy was assessed using the self-reported Facial Image Scale (FIS) on a Likert scale of 1 (very happy) to 5 (very distressed). The association between the children's DFA after SDF therapy and the potentially related factors, including demographic background, caries experience, and DFA before SDF therapy, were analysed using bivariate analysis. Three hundred and forty children (187 boys, 55%) joined this study. Their mean (SD) age and dmft scores were 4.8 (0.9) and 4.6 (3.6), respectively. Most of them (269/340, 79%) never had a dental visit. After SDF therapy, 86% (294/340) of the children exhibited no or low DFA (FIS ≤ 3), whereas 14% (46/340) reported high DFA (FIS > 3). No factor was associated with children's DFA after SDF therapy (p > 0.05). This study showed most preschool children with ECC exhibited no or low DFA after SDF therapy in a school setting.

Relationship between Children's Lifestyle and Fear during Dental Visits: A Cross-Sectional Study

The purpose was to analyze the relationship between new family and social patterns and child emotions in the dental clinic. The sample consisted of 174 children between the ages of four and nine. Parents completed 20 questions that referred to social, family, cultural, and economic factors. The Wong−Baker scale was completed by the children after the end of the treatment. A total of 129 of the children were found to be extremely happy (45.4%) or happy (28.7%) with the dental care received. There were statistically significant differences (p < 0.05) between younger children and sad and incredibly sad faces on the Wong−Baker test with a strong association (V > 0.3). Regarding children who practiced team sports, the chi-square test revealed a very significant association with happy and incredibly happy faces (p < 0.001) and the Cramer statistic evidenced a strong relationship between team sports and less dental fear (V > 0.3). Considering the limitations, small children (4−6 years) would be more fearful. In addition, stable environments in the family life of children (appropriate routines, adequate time spent with videogames, sport activities) could be interesting factors for improved control of fear and emotions in children. Further research is needed in this field.

Associations between oral habits, dental anxiety, dental service utilization, and maternal mental health status among 6- to 12-year-old children in Ile-Ife, Nigeria

PURPOSE

The current study sought to determine the associations between maternal mental health and oral habits, dental anxiety, and dental service utilization of 6- to 12-year-old children in Ile-Ife, Nigeria.

METHODS

Data were obtained from a household survey involving 1411 mothers and their 6- to 12-year-old children. Data collected were the confounding (maternal age, child's age at last birthday, sex at birth and socioeconomic status), independent (maternal psychological distress, and depression status) and dependent (child's non-nutritive oral habits, dental anxiety level, and most recent dental visit) variables. Bivariate analyses were conducted to test the associations between the dependent and independent variables. After controlling for confounding variables, the associations between the dependent and independent variables were determined using multivariable linear and logistic regression analyses.

RESULTS

Overall, 479 (33.9%) reported one oral habit, 189 (13.4%) reported two and 99 (7.0%) children reported three or more oral habits. Only 25 (1.7%) children reported a dental visit in the year preceding the study. Higher maternal psychological distress was associated with higher dental anxiety in children (AOR: 0.094; 95% CI - 0.080 to - 0.293; p < 0.001). There was no significant association between maternal psychological distress, child's non-nutritive oral habits, and the child's most recent dental visit. There was also no association between maternal depression and the child's non-nutritive oral habits, dental anxiety level, and most recent dental visit.

CONCLUSION

Maternal psychological distress was a significant risk indicator for dental anxiety, but not for dental service utilization or non-nutritive oral habits among children in Ile-Ife, Nigeria. Maternal educational status was also associated with dental anxiety. Further research is needed to elucidate the study's findings.

Impact of a Dental Storybook on Parents' Knowledge of Children's Oral Health: A Randomized Controlled Trial

Purpose

To evaluate the effectiveness of a dental storybook on parents' knowledge about oral health of their children and to assess their perception of its effect in reducing dental anxiety levels among their children, as well as improving their oral health knowledge.

Patients and Methods

This was a two-arm parallel, single-blind, randomized controlled trial (RCT) which was performed at the pediatric dental clinics in the Dental University Hospital, King Saud University, Riyadh, Saudi Arabia. Parents of 88 children (6-8 years old) were included in the present study. Parents and their children were randomly divided into two groups as follows: the intervention group (received the storybook and verbal oral hygiene instructions) and the control group (only received verbal oral hygiene instructions; same information included in the book). Three dental visits, including screening, examination/cleaning and treatment, were provided for each child. In the screening visit, baseline parental oral health knowledge was evaluated for all parents. Afterward, parental oral health knowledge was re-evaluated in the examination visit. In the treatment visit, a parental perception questionnaire was administered to parents following treatment to evaluate their satisfaction regarding the use of the storybook in reducing anxiety levels among their children.

Results

There was a significant improvement in the total knowledge score at the follow-up visit in the intervention group compared to the control group (P<0.0001). Overall, the majority of parents perceived the storybook as a useful source of information, and they found it to be effective in reducing dental anxiety levels among their children.

Conclusion

The dental storybook is an effective educational tool that can help parents become more knowledgeable about their children's oral health. Moreover, parents perceived the storybook as an effective tool for enhancing their oral health knowledge and lowering their children's dental anxiety.

Oral health-related quality of life in children with celiac disease

PURPOSE

There is limited knowledge about oral health-related quality of life (OHRQoL) in children with celiac disease (CD). This study aimed to assess OHRQoL in children with CD compared to healthy controls.

METHODS

This case-control study included children with CD and healthy controls. Three scales were used to assess OHRQoL in different age groups: 6-7 years, 8-10 years, and 11-14 years. The OHRQoL scores were compared between cases and controls to examine the possible associations between OHRQoL and demographics, socioeconomic status, and oral health.

RESULTS

Overall, 104 children with CD and 104 healthy children (controls) were included. The mean age was 10.67 ± 2.39 years in CD patients and 10.69 ± 2.36 in controls (P = 0.971). Male and female children constituted 50% of each group. Children with CD had significantly higher OHRQoL scores than controls (P = 0.003). Low education levels of parents of children with CD and a higher number of siblings in controls were associated with high OHRQoL scores (P = 0.002, P < 0.020, and P = 0.010, respectively). Recurrent aphthous stomatitis (RAS) increased the OHRQoL scores by 7.5 on average (P = 0.016).

CONCLUSION

Children with CD had poor OHRQoL compared with healthy controls. Poor OHRQoL in children with CD was associated with RAS and with lower parental income and education. RAS was an independent predictor of poor OHRQoL in children with CD.

Estimating the Need for Sedation in Patients with Dental Anxiety and Medical Complexities Reporting to Tertiary Care Dental Hospital Using the IOSN Tool

Objectives

To provide consistent method for assessment of sedation need among patients undergoing dental treatment based on specific risk factors that is dental anxiety, medical status, and treatment complexity of needed dental treatment using IOSN (indication of sedation need) tool for assisting the clinician in decision making process.

Methods

A total of 237 patients aged ≥12, ASA I and II were enrolled in the study. A structured questionnaire comprising of three sections was distributed among the participants. Section 1 comprises details about age, gender, literacy level, occupation, monthly income, and previous dental treatment history. Section 2 is based on Modified Dental Anxiety Scale which is a questionnaire comprising of five questions ranging from “not anxious” to “extremely anxious.” The third section was based on using the IOSN tool comprising three components: MDAS (Modified Dental Anxiety Scale) rank score, Systemic Health (ASA status) rank score, and treatment complexity rank scores. The total of three scores was then computed to determine the total rank score which suggested the sedation need. History of past traumatic dental experiences was also inquired from each patient.

Results

A total of 237 patients aged ≥12, ASA I and II were enrolled in the study, out of which 56.1% were female. Statistical analysis was conducted by using the IBM SPSS Statistics 23 software. Based on the MDAS score, 47/237 (19.8%) participants were found to be highly anxious related to dental procedures. 34.6% of the participants showed to have a high sedation need while performing a dental procedure. The sedation need was found to be significantly associated with the female gender with a significant p value of (p=0.016), higher education status (p=0.016), and history of previous traumatic dental experience (p < 0.001).

Conclusion

A simple assessment tool can enable clinicians in their decision making to identify patients in need for dental treatment under sedation based on patient-specific risk factors such as past traumatic dental experiences. Need for sedation can be assessed by information on patient anxiety level towards dental treatment, medical history, and complexity of planned dental treatment. The IOSN tool is a simple and quick assessment tool that can be applied for preprocedural assessment of sedation need for dental treatment.

Impact of dental caries on oral health-related quality of life in children with dental behavior management problems

The aim of this cross-sectional study was to evaluate the impact of dental caries and sociodemographic factors on the oral health-related quality of life (OHRQoL) of children with dental behavior management problems (DBMP) and their families. One hundred and thirty-four dyads of caregivers and children participated. The impact of OHRQoL was assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). Socioeconomic variables were obtained from an interview. Dental caries was assessed using the dmft index. The total B-ECOHIS score was categorized as low, medium, or high impact, and its association with the independent variables was determined based on bivariate tests and a multivariate model. The median score for B-ECOHIS was 13 (range: 1-40). The negative impact was reflected mainly by complaints of oral/dental pain, difficulty in eating and parental guilt. The number of teeth with caries was significantly higher among children who experienced a high negative impact on OHRQoL (mean 9.2 [standard deviation 3.5]; p = 0.003) than those who had a low negative impact (7.0 [3.3]). The final adjusted model showed that dental caries remained independently associated with poor OHRQoL (b = 0.100; x2 Wald 4.205; p = 0.040). A greater impact on OHRQoL was experienced by children with DBMP and greater caries experience.

Intranasal versus sublingual route of dexmedetomidine sedation in paediatric dentistry: A randomized controlled clinical trial

BACKGROUND

Many children experience dental anxiety during dental treatment. Conscious sedation is used to alleviate anxiety and enhance a child's cooperation.

AIM

This study aimed to compare the efficacy of intranasal versus sublingual dexmedetomidine.

DESIGN

Forty-two healthy, uncooperative children participated in the study. They were divided randomly into two groups: In the first visit, Group I received intranasal dexmedetomidine and group II received sublingual dexmedetomidine, whereas at the second visit, the alternate route was implemented in a crossover design. The child's acceptance of drug administration method was assessed using a 4-point rating scale. Time until optimum sedation was measured. Anxiety during local anesthesia administration was scored using Venham's rating scale. Postoperative response was recorded through Vernon et al's questionnaire.

RESULTS

The sublingual dexmedetomidine route was better accepted than the intranasal route (P=0.01), while the latter acted faster (P>0.001). No significant difference in anxiety scores was found between groups at baseline (P=0.84) or during local anesthetic administration (P=0.44). No negative effect was recorded by the parents who answered the Modified Vernon et al questionnaire 24 hour after the dental visit compared to before the dental visit (P=1.00).

CONCLUSIONS

Both routes prevented the increase in anxiety scores equally during local anesthesia and do not have negative effect on postoperative behavior of children. However, the sublingual route showed better acceptance with longer onset time of action than the intranasal route.

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model

Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.

Dental Fear and Associated Factors among Children and Adolescents: A School-Based Study in Lithuania

Dental fear is a challenging problem in dentistry and many contributing factors have been identified. Although this problem among children and adolescents has been studied in the literature for a long time, few such studies have been conducted in Lithuania. This study aimed to evaluate the prevalence of dental fear and examine its association with gender, age and several psychological and social factors among children and adolescents in Lithuania. The cross-sectional survey included a randomly selected sample (n = 1590) of children aged 11-14 and adolescents aged 15-18. The data were supplemented by interviewing the parents of these subjects (n = 1399). Dental fear was measured with a single five-score question. The data collection also included questions on oral health, socioeconomic status, oral health-related quality of life and self-esteem. Poisson regression analysis was used to assess the association between perception of dental fear and potential predictor variables. It was found that 32.2% (95% CI: 29.9-34.4%) of children and adolescents reported no fear of dental treatment, 12.5% (10.8-14.2%) of their peers were highly afraid of dental treatment, and other subjects assessed their dental fear gradually. Girls reported greater dental fear scores than boys, but the level of dental fear did not depend on the age. We identified the groups of subjects by gender and age, and a higher level of dental fear was significantly associated with untreated caries experience, a delay in the age of the subject's first visit to the dentist, low self-esteem, low oral health-related quality of life, low overall life satisfaction and low family affluence. The results also suggested that dental fear could originate from previous toothache, dentists' actions, high sensitivity in the child and poor psychological readiness for treatment. It was concluded that dental fear among Lithuanian children and adolescents is a common problem that is associated with gender and several dental, psychological and social factors. The findings indicate that school-based health policies, paediatric dentists and parents should be encouraged to focus on the psychosocial factors associated with dental fear because most of them can be prevented.

Does Dental Fear in Children Predict Untreated Dental Caries? An Analytical Cross-Sectional Study

Despite free health care services in Saudi Arabia, the prevalence of caries in children is substantially greater in comparison to other high-income countries. Dental fear in children may be an important issue that needs attention. Therefore, the aim was to investigate the role of dental fear in predicting untreated dental caries in schoolchildren. This analytical cross-sectional study included children aged 8–10 years residing in Saudi Arabia. Dental status via oral examinations was surveyed with the WHO standardized chart and the Children Fear Survey Schedule—Dental Subscale was used to score dental fear. Descriptive, binary, and multivariable logistic regression analyses were performed to report the findings at 5% statistical significance. Overall, there were 798 schoolchildren with an average fear score of 36. Nearly 70.4% reported fear of someone examining their mouth. About 76.9% had at least one carious tooth in their oral cavity. Children with dental fear were 1.8 times (OR = 1.80; 95% CI = 1.26, 2.56) more likely to have at least one untreated carious tooth in their oral cavity than those who did not express fear during oral examinations and dental procedures. Thus, the current study concludes that fear of dentists and dental treatment procedures successfully predicts untreated carious teeth in schoolchildren.

Association of siblings' presence and oral health-related quality of life among children: a cross-sectional study

Background

The quantity–quality trade-off theory indicates that an increase in siblings might decrease a child’s well-being, but little is known about the impacts of sibling number on children’s oral health-related quality of life (OHRQoL). This study aims to investigate the effects of presence of siblings on children’s OHRQoL, and to further test whether there is an interaction effect between siblings’ presence and locations on children’s OHRQoL.

Methods

Data were obtained from an oral-health survey of 12-year-old children in Beijing, China, which was a part of the 4th National Oral Health Survey in the Mainland of China (2015–2016). This study included 2158 children data for analysis. OHRQoL was assessed by the child’s Oral Impacts on Daily Performance (OIDP). OIDP prevalence served as an indicator of OHRQoL. Children with and without siblings were recorded as non-single and single children, respectively. Dental variables, including active caries, gingival bleeding, and calculus, were reported. A logistic regression model was applied to investigate the association of siblings’ presence and OIDP prevalence. A synergy index was used to assess the possible interaction effect between siblings’ presence and location on OIDP prevalence.

Results

Sixty percent of Chinese children reported suffering OIDP in the previous six months. OIDP prevalence for non-single and single children were 68.3% and 56.9%, respectively. The adjusted odds ratio (OR) of OIDP for non-single children was 1.31 (95% CI: 1.05, 1.63), and the adjusted OR of OIDP for non-single and rural children was 2.03 (95% CI: 1.47, 2.81). The synergy index between siblings’ presence and location on OIDP was 2.18 (85% CI: 1.30, 3.67), which indicates that an excessive risk increase for OIDP was observed among non-single and rural children.

Conclusions

Children with siblings are more likely to report OIDP and have lower OHRQoL, especially those from rural areas. These findings indicate that oral-health interventions should be given priority for non-single and rural children.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01526-y.

Evaluation of a new paediatric dentistry intravenous sedation service

Introduction Intravenous sedation (IVS) with propofol offers an alternative to inhalation sedation or general anaesthesia (GA) for dentally anxious young people who require treatment. It offers a greater level of anxiolysis than inhalation sedation and reduced morbidity when compared with GA.Methods Data were collected prospectively from a convenience sample of children requiring IVS. Participants completed the Children's Experiences of Dental Anxiety Measure (CEDAM) at the start of every visit. Patient demographics, treatment completed, surgery and recovery time were recorded. Feedback was obtained following their first visit.Results Treatment was successful for 91.5% (43/47) of patients. The average surgery and discharge time was 32.9 (8-105 minutes) and 33.1 (5-84 minutes), respectively. The CEDAM scores were between 14 and 30 (mean score 20.8). Thematic content analysis of the feedback was carried out and themes relating to communication, environment, appointment times, service satisfaction and advice to other patients emerged.Discussion CEDAM scores may have been lower than expected due to under-reporting by patients or clinicians' perception of higher anxiety levels. Feedback was reviewed regularly and improvements made where possible.Conclusion The majority of patients successfully received dental treatment under IVS. Changes have been made to the service to improve patient experience and maximise productivity.

Prevalence of dental anxiety in children and adolescents globally: A systematic review with meta-analyses

BACKGROUND

Dental anxiety (DA) negatively impacts oral health-related quality of life, and patients with DA usually require more dental treatment time.

AIM

To describe the global prevalence of DA in children and adolescents and to examine the influence of individual factors (age, sex, and caries experience) and variables related to DA measurement on pooled prevalence.

DESIGN

Systematic review with meta-analyses of observational studies published between 1985 and 2020 (PROSPERO CRD42014013879).

RESULTS

Searches yielded 1207 unique records; 224 full-text articles were screened, and 50 studies were used in the qualitative and quantitative synthesis. No study was considered as having high methodological quality according to 'The Joanna Briggs Institute assessment tool'. Overall pooled DA prevalence was 23.9% (95% CI 20.4, 27.3). Pooled prevalence in preschoolers, schoolchildren, and adolescents was as follows: 36.5% (95% CI 23.8, 49.2), 25.8% (95% CI 19.5, 32.1), and 13.3% (95% CI 9.5, 17.0), respectively. DA was significantly more prevalent in preschool children (one study) and schoolchildren (two studies) with caries experience and in female adolescents (one study). The scale used for DA assessment was shown to influence pooled prevalence in preschoolers and adolescents.

CONCLUSION

DA is a frequent problem in 3- to 18-year-olds worldwide, more prevalent in schoolchildren and preschool children than in adolescents.

Impact of Lifestyle Variables on Oral Diseases and Oral Health-Related Quality of Life in Children of Milan (Italy)

A large part of the Italian population doesn’t receive adequate information and support on how to maintain oral health. In this observational, cross-sectional, pilot study, we investigated how some lifestyle-related variables affect oral diseases and oral health-related quality of life (OHRQoL) of children attending public-school summer services in Milan. A survey that included questions on children’s oral disease, OHRQoL and lifestyle-related factors (feeding habits, oral hygiene protective behaviors, dental coaching and socio-economic and educational status), was administered to the children’s caregivers. Data from 296 surveys were analyzed to assess the protective/negative effect of each variable on oral disease and OHRQoL. With respect to disease, the “never” consumption of fruit juice, the use of fluoride toothpaste, higher educational qualification and ISEE (equivalent family income) of those who filled out the form, resulted protective factors. Regarding OHRQoL, the “never” assumption/use of tea bottle, sugared pacifier and fruit juice as well as the use of fluoride toothpaste, a higher educational qualification and ISEE of those who filled out the form, resulted to have protective effects. In conclusion, protective behaviors and socio-economic status affect oral disease and OHRQoL in children of Milan.

Molar-incisor hypomineralization: parent's and children's impact perceptions on the oral health-related quality of life

PURPOSE

To evaluate the perception of parents and children and the impact of molar and incisor hypomineralization (MIH) on the oral health-related quality of life (OHRQoL).

METHODS

A cross-sectional study was conducted with a group of 253 children aged 6-12 years presenting MIH and their parents or guardians who initially answered an interview containing socioeconomic and demographic questions as well as the Parental-Caregiver's Perceptions Questionnaire (P-CPQ). The children answered the Child Perceptions Questionnaire (CPQ8-10) and Child Perceptions Questionnaire (CPQ11-14) and the clinical evaluation of MIH was performed. Poisson regression with robust variance was used in the data analysis.

RESULTS

The parent's perception showed that the impact felt by the children regarding caries leads to a higher oral symptom impact, functional limitation, emotional well-being and total PCPQ score domains, as well. For children with severe MIH, a higher prevalence of impact was felt regarding the functional limitation and emotional well-being. For CPQ8-10, the oral symptoms domain presented the highest mean score, while CPQ11-14 showed the functional limitations domain and P-CPQ the emotional well-being domain.

CONCLUSION

Considering the perception of parents or guardians, it was concluded that MIH promotes a negative impact on the OHRQoL. MIH had no significant impact on OHRQoL according to children's perceptions.

Effect of routine dental attendance on child oral health-related quality of life: A cohort study

BACKGROUND

There is an improvement in oral health status among people who receive preventive dental care during their lifetime, highlighting the possible effect in resolving oral health problems and consequently oral health-related quality of life (OHRQoL).

AIM

Assessed the effect of routine dental attendance on child OHRQoL.

DESIGN

This cohort study used baseline data from 639 preschoolers from 2010. After 7 years, 449 children were re-examined (70.3%). Mothers of the children completed a questionnaire collecting data on the pattern of use of dental services. Children were classified as adhering to long-term routine dental attendance according to their pattern of use (routine vs curative) in the baseline and in follow-up. The child OHRQoL was assessed through the Child Perception Questionnaire (CPQ8-10). The association between routine dental attendance and child OHRQoL was assessed using multilevel Poisson regression models.

RESULTS

The proportion of participants who reported the worst CPQ8-10 scores were higher among those who, at some point in their life, experienced a curative dental attendance. Also, the mean CPQ8-10 was two times higher for non-routine dental attendance.

CONCLUSION

The findings showed that there is an impact of long-term routine attendance on child OHRQoL. This is important for tackling oral health iniquities.

Untreated dental caries prevalence and impact on the quality of life among 11 to14-year-old Egyptian schoolchildren: a cross-sectional study

Background

This study aimed to assess caries prevalence and experience among 11 to 14 years, school children, analyze demographic, socioeconomic, personal and professional dental care in relation to untreated carious lesions, and evaluates the effect of decayed teeth on early adolescents’ oral health-related quality of life (OHRQoL).

Methods

A cross-sectional analytical investigation was conducted on 1020 preparatory schoolchildren selected on the basis of a multistage sampling technique. Caries status of the participants detected via recording their caries experience and untreated cavities using DMFT and DT indices. OHRQoL was determined using a validated Arabic CPQ_11–14 short-form questionnaire. Statistical methods for descriptive analysis, chi-square test, Independent-Samples t test and one-way analysis of variance (ANOVA) were used. Multivariate Poisson regression analysis through a hierarchical approach was used to detect the influence of independent variables on DT scores. To declare the association between independent variables and QoL, a step-by-step, multivariate regression analysis was conducted.

Results

The average scores of DMFT and DT in this study were 2.97 ± 1.29 and 1.66 ± 1.24. Poisson regression analysis demonstrated that early adolescents whom their mothers with a lower level of education and of low socioeconomic status were 1.41 and 1.27 times respectively had higher DT scores when compared with their peers. Untreated cavities affected mainly by mother education, school type, family income, and regular dental appointments. Children with DMFT≤3) or DT = 0 recorded a statistically significant lower CPQ_11–14 average score (p<0.01) and (p<0.0001) respectively.

Conclusions

Untreated carious cavities and caries experience were associated with lower socioeconomic, maternal education andl ess frequent tooth brushing. Untreated carious cavities have a significant negative impact on schoolchildren’s QoL.

Conceptual modelling of the factors affecting oral health-related quality of life in children: A path analysis

BACKGROUND

It is important to understand the interaction of various predictors with oral health-related quality of life (OHRQoL) to better design effective interventions to improve OHRQoL.

AIM

The aim of this study was to develop and validate a conceptual model evaluating the factors affecting the OHRQoL in children.

DESIGN

The study group consisted of 754 parent-child dyads. The data collection tools were a socio-demographic data form, the Early Childhood Oral Health Impact Scale (ECOHIS), Corah Dental Anxiety Scale (C-DAS), Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and an oral and dental health examination form. A conceptual model was developed to examine the factors affecting OHRQoL in children consisting of four endogenous and four exogenous variables. Path analysis was used to test the compatibility of the conceptual model.

RESULTS

OHRQoL was associated with parental socio-economic status (β = -0.12; P < .001), dental anxiety (β = -0.15; P < .001), and oral health behaviours (β = -0.13; P < .001). Although parental dental anxiety had the strongest direct effect on OHRQoL, children's oral health behaviours had the strongest indirect effect.

CONCLUSIONS

This study revealed a valid demonstrable path of association between parental socio-economic status, dental anxiety, childhood dental anxiety, oral health behaviours, and OHRQoL.

Comparison of the effectiveness of Bach flower therapy and music therapy on dental anxiety in pediatric patients: A randomized controlled study

BACKGROUND

Dental anxiety is a primary cause of missed dental appointments, delayed treatment, and untreated dental caries in children. Alternative techniques such as music therapy (MT) and Bach flower therapy (BFT) have potential to reduce anxiety. Lack of randomized controlled studies evaluating effectiveness of these methods in reducing dental anxiety led us to this study.

AIM

To compare the effectiveness of BFT and MT on reduction of dental anxiety in pediatric patients.

MATERIALS AND METHODS

A total of 120 children (aged 4-6 years) were selected and randomly allocated to three groups: BFT, MT, and control. All children received oral prophylaxis and fluoride treatment. Dental anxiety was evaluated using North Carolina Behavior Rating Scale, Facial Image Scale (FIS), and physiological parameters.

RESULTS

Significantly better behavior was seen in children from the BFT group as compared to the control group (P = 0.014). FIS scores measured postoperatively did not show significant differences among the groups. Children from the BFT and MT groups showed a significant decrease in the pulse rates intraoperatively from the preoperative period. Intraoperative systolic blood pressure in children from the MT group was significantly lower than both the BFT and the control groups. Diastolic blood pressure significantly increased in the control group intraoperatively, whereas other groups showed a decrease.

CONCLUSION

The results of this study demonstrate significant effects of both single dose of BFT and exposure to MT, on reduction of dental anxiety in children aged between 4 and 6 years.

The effect of enamel fractures on oral health-related quality of life in adolescents

BACKGROUND/AIM

Enamel fractures are the most common type of traumatic dental injury (TDI) in children and adolescents. Recognizing the impact of these fractures on oral health-related quality of life (OHRQoL) could contribute to the establishment of treatment protocols. The aim of this study was to assess and quantify the impact of enamel fractures on overall OHRQoL and domain scores in adolescents.

MATERIALS AND METHODS

A cross-sectional study was conducted with 775 adolescents aged 11 to 14 years in the city of Santo Ângelo in southern Brazil. Sociodemographic variables were collected from parents/caregivers using a structured questionnaire. The adolescents answered the Child Perceptions Questionnaire (CPQ_11-14 ). Physical examinations were performed by an examiner who had undergone training and calibration exercises for the investigation of TDI (Andreasen criteria), dental caries (WHO criteria), and malocclusion (Dental Aesthetic Index). Data analysis involved Poisson regression with robust variance.

RESULTS

The prevalence of TDI was 11.9% and enamel fractures accounted for 79.3% of all injuries. In the multivariate analysis, adolescents with enamel fractures had 29% higher CPQ_11-14 scores (worse OHRQoL) than those without TDI, even after adjustment for sociodemographic and clinical variables (mean ratio = 1.29; 95% CI: 1.09-1.53; P = .003). Enamel fractures exerted a negative impact on the functional limitation, emotional well-being, and social well-being domains.

CONCLUSIONS

Enamel fractures exert a negative impact on the OHRQoL of adolescents, suggesting that subjective measures should be incorporated in the evaluation of patients with this traumatic injury.

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.

Evaluation of intraosseous computerized injection system (QuickSleeper™) vs conventional infiltration anaesthesia in paediatric oral health care: A multicentre, single-blind, combined split-mouth and parallel-arm randomized controlled trial

BACKGROUND

Conventional infiltration anaesthesia (CIA) is the most frequently used in paediatric oral health care. However, other techniques are available, such as intraosseous anaesthesia (IOA), that can beneficiate from newly developed technologies.

AIM

To compare the pain caused by CIA and IOA delivered by the computerized system (QuickSleeper™) in children.

DESIGN

We used an innovative design consisting in simultaneously conducting a multicentre split-mouth and parallel-arm randomized controlled trial (RCT) to allow for increased power. The primary outcome was pain reported by the patient on a visual analogue scale (0-10 cm) concerning the insertion of the needle and injection.

RESULTS

A total of 30 children were included in the split-mouth RCT and 128 in the parallel-arm RCT. We combined treatment effect estimates by using an inverse-variance weighting meta-analysis approach. Pain scores were significantly decreased with IOA vs CIA (mean difference -0.69 cm, 95% confidence intervals -1.13 to -0.25 cm). For each patient enrolled in the split-mouth RCT, about five were enrolled in the parallel-arm RCT, which allowed for not losing any eligible patients.

CONCLUSION

Pain during the insertion of the needle and injection was less with IOA vs CIA in children. The design of this study allowed for increasing statistical power and using all generated evidence. (ClinicalTrials.gov NCT02084433).

'Message to Dentist': Facilitating Communication with Dentally Anxious Children

Dental anxiety affects children worldwide and can have negative consequences on oral health. This study aimed to evaluate a novel communication aid ‘message to dentist’ (MTD), as part of a wider cognitive behavioural therapy approach to reduce dental anxiety in young patients. Dentally anxious children, aged 9–16 years, were invited to complete the MTD proforma, before and following their course of treatment. They scored how worried they were and their anticipated pain levels on a scale of 1–10 (10 being the worst outcome). They also wrote down their coping plans and post-treatment reflections. One hundred and five children, from a UK general dental practice and a hospital clinic, were included. They had a mean age of 11.6 years, and 65% were female. There was a significant reduction in self-report worry (from 4.9 to 2.1) and anticipated pain (from 5.1 to 2.0) scores (p < 0.05, paired t-test). Many children (30%) used listening to music/audiobook as a coping strategy. Thematic analysis revealed concerns around pain, uncertainty, errors and specific procedures. The MTD proforma proved an effective means of facilitating communication between anxious children and the dental team, allowing them to identify their worries and make personalised coping plans.

Oral health-related quality of life in children using the child perception questionnaire CPQ11-14: a review

OBJECTIVES

The Child Perceptions Questionnaire 11-14 (CPQ11-14) is the most common and effective indicator of paediatric oral health-related quality of life. The aim of this review was to verify if CPQ11-14 can be considered a valid instrument for assessing the impact of oral health on the quality of life of adolescents for the paediatric population aged between 11 and 14 years old and which dental conditions mainly affect it.

STUDY DESIGN

A literature research from Pubmed Medline database was adopted to identify the eligible studies among the published articles related to CPQ 11-14 using keyword search strategy. From 170 initial articles, a total of 128 articles were included for the full text reading.

RESULTS

Conditions that mainly interest the oral health-related quality of life are untreated dental caries, dental trauma, increased dental protrusion, wearing orthodontic appliances, and severe periodontal disease.

CONCLUSION

CPQ 11-14 seems to be a solid and valid indicator to measure oral health-related quality of life, because it has been widely tested and validated in several states including developed, developing and underdeveloped countries.

Factors influencing anxiety levels in children undergoing dental treatment in an undergraduate clinic

Introduction:

Dental anxiety is a kind of fear exerted due to threatening stimuli. Assessing a child's dental anxiety level is very important to perform a particular treatment. The aim of this study is to examine the various factors that determine the anxiety levels in children and evaluate their anxiety levels.

Materials and Methods:

A total of 50 children participated in the survey conducted. Each participant had fulfilled the inclusion and exclusion criteria to answer the questionnaire. It included questions regarding their habits, fears, and dental visit experience. Evaluation of their anxiety levels was done using the facial image scale (FIS) and the modified dental anxiety scale and was correlated with various factors using the Statistical Package for Social Science Software.

Results:

Female children are more anxious than male children toward dental treatment. About 38% were anxious and 16% refused while undergoing radiographic examination and showed significant anxiety levels (P = 0.012). About 16% of the population were highly uncooperative and were necessary to implement behavioral shaping techniques on them. It influences the FIS anxiety score before initiation of the treatment (P = 0.003). About 48% of children had maintained a good rapport with the dentist and showed strong significance with the child's anxiety (P = 0.025).

Conclusion:

Gender and behavior of the child while diagnosis and radiographic examination, implementation of behavioral shaping techniques, and rapport developed between child and dentist are all influencing factors of dental anxiety. The number of visits to the dental clinic, socioeconomic status, kind of amount of consumption of sugars, and type of treatment being done do not contribute to a child's anxiety level.

The long-term effect of previous dental treatment under general anaesthesia on children's dental fear and anxiety

BACKGROUND

Dental treatment under general anaesthesia (DGA) is deemed to contribute to children's dental fear and anxiety (DFA), both in the short term and long term.

OBJECTIVE

To compare DFA between children who had previous DGA and those who did not.

METHODS

A cross-sectional survey included 5- to 12-year-old children who had undergone DGA (n = 43) and a control group who had not (n = 55). Questionnaires were completed by parents regarding sociodemographic and dental profiles. Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the Modified Child Dental Anxiety Scale (faces) (MCDASf) were completed by children.

RESULTS

The mean age of the control group and the DGA group was 9.5 ± 1.7 and 8.8 ± 1.5 years old, respectively (P > 0.05). The time passed since DGA was experienced ranged between 1.2 and 6.9 years ago (mean: 4.2 ± 1.1 years). The mean CFSS-DS and MCDASf scores for the DGA group (34.3 and 20.4, respectively) were significantly greater when compared to the control group (23.6 and 12.7, respectively) (P < 0.001).

CONCLUSION

Children who experienced DGA are a high-risk group for DFA several years after the procedure. The DGA status could be used for identifying anxious children to promote better behaviour management.

The Influence of Oral Health Knowledge on Parental Practices among the Saudi Parents of Children Aged 2-6 Years in Riyadh City, Saudi Arabia

AIMS AND OBJECTIVES

The parent's oral health knowledge has a great influence on their children, so the aim of the study was to estimate the parental knowledge about oral health care and its influence in maintaining the diet and hygiene practices on their children and also to access how the demographic variables will influence them in taking their child to dental visits.

MATERIALS AND METHODS

The self-administered pretested questionnaire was distributed among Saudi parents whose children are in the age group of 2-6 years vising primary health care centers (PHCCs) in Riyadh city. The PHCCs were divided into five zones (Central, East, West, South, and North). 240-250 samples were randomly selected from each zone to reach the prescribed sample size of 1200. The survey will be composed of self-administered pretested questionnaires seeking for age, gender, educational level, and their financial status followed by 26 questions related to parent knowledge about oral health (14), dietary (5), and hygiene (7) practices what they implement on their child. The data collected were analyzed using SPSS software SPSS 25.0 (SPSS, Inc., Chicago, IL, USA).

RESULTS

Demographic information showed that the average age of the parents who participated in the study is 32.2 years. The mothers were 942 (75.7%) and fathers were 303 (24.3%) among the participants. The mean knowledge score among the mothers (34.85) is slightly greater than fathers (34.76). Similar results with dietary and hygiene practices were not statistically significant (>0.05). The parents having more than one child have better knowledge, of which the parents with more than three children have better scores, which is statistically significant. 69.3% of the parents prefer taking to a dentist only when they have a problem. Moreover, these findings found to be statistically significant (P < 0.05).

CONCLUSION

Parents should get access to oral health knowledge to put in practice on their children so as to influence them in gaining better oral health.

Variables associated with the oral impact on daily performance of adults in the state of São Paulo: A population-based study

OBJECTIVE

This study aimed to assess the oral impact on daily performance and its association with sociodemographic characteristics, tooth pain, need for prosthesis, and periodontal disease of adults in the state of São Paulo, Brazil.

METHODS

This was a cross-sectional epidemiological study with secondary data obtained from the Oral Health Conditions Project- 2015 conducted in 163 municipalities in the state of São Paulo with the participation of 17,560 individuals. This study evaluated adults in the age-range between 35-44 years (n = 5,855), selected by means of probabilistic cluster sampling in two stages. The outcome variable was the OIDP (Oral Impacts on Daily Performances), obtained by using this instrument to assess daily activities (eating, speaking, oral hygiene, relaxation, sports practice, smile, study/work, social contact, and sleep). The independent variables were collected and grouped into three blocks: Block 1 (sex, age group, and ethnic group); Block 2 (household income and education); and Block 3 (tooth pain, need for prosthesis, bleeding, calculus, and periodontal pockets). A hierarchical multiple logistic regression analysis was performed considering the complex cluster sampling plan. Each observation was assigned a specific weight, depending on the location, which resulted in weighted frequencies adjusted for the effect of outlining.

RESULTS

the female sex (p<0.0001), ethnic group black/mulatto (p<0.0001), low household income (p = 0.0112), up to 8 years of education (p<0.0001), tooth pain (p<0.0001), presence of bleeding (p<0.0001), and presence of periodontal pockets (p<0.0001) had greater oral impact on daily performance.

CONCLUSION

sociodemographic characteristics, tooth pain, and presence of periodontal disease were associated with oral impact on daily performance of the adult population in the state of São Paulo, Brazil.

Oral health self-perception, dental caries, and pain: the role of dental fear underlying this association

BACKGROUND

Oral health perception has multidimensional nature and can be influenced not only by clinical conditions but also by psychosocial characteristics.

HYPOTHESIS

Dental fear could modify the association between dental caries and dental pain and the perception of negative impact.

DESIGN

A cross-sectional study was conducted with (n = 1,196) children aged 8-12 years attending public and private schools in Pelotas/Brazil. Children were interviewed and examined. Oral health perception was assessed using a global oral health impact item. Crude and adjusted multivariable regression models were built and effect modification of dental fear in the association between clinical indicators and perception of impact was tested.

RESULTS

Compared with children without fear and caries, children with fear and dental caries presented a 1.45 higher prevalence of negative impact (95% CI: 1.18-1.79) while those without fear and with dental caries had a 1.31 higher prevalence (95% CI: 1.11-1.54) after adjustments. Also, the prevalence of negative perception was higher for children with fear and dental pain (PR: 2.95; 95% CI: 1.59-2.39) and for children without fear and with pain (PR: 1.53; 95% CI: 1.29-1.80), compared to children without fear and pain.

CONCLUSION

The presence of fear increased the effect of pain and caries on children's oral health perception.

Effects of child characteristics and dental history on dental fear: cross-sectional study

Background

Dental fear (DF) is a challenging problem in dentistry. It is multifactorial in origin and many contributing factors have been identified. The aim of the study was to assess dental fear among 12–15 years old Arabic speaking children in Jeddah, Saudi Arabia and its relation to demographic variables, previous dental experience, and child behaviour.

Methods

In this cross-sectional study, a total of 1522 boys and girls from middle schools in Jeddah, Saudi Arabia participated in this study during the period of 2014 to 2016. The Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS) was used to assess DF. A parental questionnaire was used to record the children’s previous dental experience. Children were examined for caries and the children’s behaviour was assessed during dental examination using Frankl Behaviour Rating Scale. The associations between different variables and the CFSS-DS scores were analysed using t-tests, ANOVA, and multiple linear regression analysis.

Results

The response rate of the questionnaires was 78.6%. The mean CFSS-DS score was 25.99 ± 9.3 out of a maximum of 75. Bivariate analysis showed that younger children, girls, and public-school students were significantly more fearful than older children, boys, and private school children, respectively (P < 0.001). Children who showed poor behaviour during dental examination were significantly more fearful than those with good behaviour (P < 0.001). Regression analysis showed that children who had significantly higher scores of dental fear were the children who did not visit the dentist in the past year due to dental fear; who never visited the dentist or those who only visited the dentist on pain; who were reported by parents as crying, screaming, or resistant during their previous dental visit; and those who were described to be in pain during previous dental treatment. Dental caries showed no significant association with DF.

Conclusions

This study confirms that DF is low among 12–15 years old Arabic speaking children in Jeddah, Saudi Arabia. DF is associated with age, gender, school type, irregular patterns of dental visits, painful experiences during previous dental visits and negative behaviours during dental examinations.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0496-4) contains supplementary material, which is available to authorized users.

Association between Global Life Satisfaction and Self-Rated Oral Health Conditions among Adolescents in Lithuania

Background: This study aims to explore the extent to which the perceived oral conditions predict adolescent global life satisfaction (GLS); Methods: The sample in a cross-sectional survey consisted of 1510 Lithuanian adolescents (41.7% boys) aged 11-18. The survey was conducted by means of self-report questionnaires that were administrated in school classrooms ensuring confidentiality and anonymity of the participants. The schoolchildren rated their GLS and answered the questions about perceptions of their oral health. The relationship between GLS and oral health variables was estimated using unadjusted and adjusted binary logistic regression and nonparametric correlation analyses; Results: The research showed that the majority of adolescents rated their GLS highly; however, girls, older adolescents and adolescents from less affluent families were less likely to report high scores. GLS was significantly associated with subjective overall oral health assessment. The odds of reporting low GLS were 50% higher for adolescents with good oral health (OR = 1.51; p < 0.001; 95% CI = 1.18-1.93), and two and half time as higher for adolescents with perceived fair/poor oral health (OR = 2.78; p < 0.001; 95% CI = 1.72-4.50) compared to adolescents with subjectively excellent/very good oral health. Nonparametric correlations indicated lower GLS to be significantly associated with higher scores of Child Perceptions Questionnaire (.