Global perspective on child and adolescent oral health: a systematic review and meta-analysis of oral impacts on daily performance

OBJECTIVE

Several prevalence studies have estimated the region-specific impact of oral diseases on oral health-related quality of life. However, none of them reported and compared the same from a global perspective. This meta-analysis aims to evaluate pooled epidemiologic data about child-oral impacts on daily performance (C-OIDP) globally.

METHODS

A search was conducted in PubMed, Science Direct, SciELO, Semantic scholar, and Cochrane databases up to January 2023. Studies evaluating OIDP among 11-18-year-olds were included in the review. Quality of the included studies was evaluated using the health states quality index for cross-sectional studies. The meta-analysis used R package software version 4.3.0. A common effect model was used to calculate the pooled prevalence. The protocol was registered in the PROSPERO (CRD-NIHR) database with Reference ID CRD42023393798.

RESULTS

The systematic literature search yielded 257 unique citations. After screening titles and abstracts, 214 irrelevant citations were excluded, leaving 55 for full-text review. Overall, 43 studies from 23 countries were included. The meta-analysis reported a pooled prevalence impact C-OIDP of 53.36% (CI: 52.78-53.95, 43 studies, 16,622 participants). The prevalence of C-OIDP scores among South America, Asia, Europe, Africa and Oceania was 83%, 63%, 58%, 33% and 47%, respectively. The maximum prevalence was reported in South America while the least prevalence was noted in the African population.

CONCLUSION

Oral diseases affect the oral health-related quality of life of more than half of children and adolescents globally. Huge variations were noted in the prevalence of oral impacts across different regions. These findings can be utilized by policymakers to draft measures required for reducing impacts of oral diseases and improving the health-related quality of life.

Oral Health-Related Quality of Life in Adolescents as Measured with the Child-OIDP Questionnaire: A Systematic Review

Oral health-related quality of life (OHRQoL) refers to impacts of oral health on physical, psychological, functional and social aspects of individuals. Among specific measurement instruments to assess OHRQoL in adolescents, the C-OIDP (Child Oral Impact on Daily Performances) questionnaire has demonstrated validity, reliability and suitable psychometric properties. Our aim was to identify cross-sectional studies using the C-OIDP questionnaire to perform a qualitative synthesis and assessment of their methodology and results. A literature electronic search was carried out on the PubMed-Medline, Scopus, Web of Science (WoS), EMBASE, LILACS and SciELO databases, followed by a study selection process and quality assessment. OHRQoL perceived by adolescents is related to age, sex and sociodemographic factors. Eating is the most frequently affected dimension and toothache is the first cause of impact, showing a generally mild intensity and severity of impact. The impact on oral quality of life is greater in younger adolescents. Several factors such as previous caries experience, the DMFT (Decayed, Missed, Filled, Tooth) index, caries in primary teeth, canker sores, bleeding gums and malocclusion have been associated with a lower level of OHRQoL. More longitudinal studies are needed to clarify divergent results and complete our knowledge of oral impacts on quality of life.