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

Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report

Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child's dental home, and advocating for safe and accessible dental procedures.

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

BACKGROUND

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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

Impact of dental caries and nutritional status on oral health related quality of life in young Indian adolescents

Background

A combination of poor oral health status and malnourishment ultimately affect the quality of life of the person. Hence, these tools may help in identifying individuals at risk of poor quality of life and malnutrition caused by oral problems especially in adolescents.

Objective

To test the association between dental caries, nutritional status and Oral Health Related Quality of Life (OHRQoL) in 12-15 year-old school going adolescents.

Study design

A cross sectional study was conducted on 12-15-year-old school going adolescents. A total of 1214 adolescents participated in the study. Data on quality of life was collected using OHIP-14 and clinical examination was done to assess the DMFT status and Body Mass Index (BMI) as measure of nutritional status of the subjects.

Results

DMFT was found to be positively correlated with total OHIP score, however BMI was negatively correlated with OHIP. Controlling for BMI, partial correlation analysis revealed that there is a weak association between OHIP and DMFT scores which was found to be statistically significant.

Conclusion

Both caries experience and nutrition status had significant impact on Quality of Life. All the three parameters were found to be correlated to each other.

Special Care Patients and Caries Prevalence in Permanent Dentition: A Systematic Review

Due to the increase in the population with special needs and the significant difficulty in their dental management, it is essential to analyze the caries prevalence in this group of patients. The systematic review was conducted following the PRISMA statement. A search was performed on 9 May 2022 and updated on 5 June 2022, in three databases: Pubmed, Scielo, and Cochrane library. Studies involving the analysis of caries in permanent teeth in patients with special needs were included. A total of 1277 studies were analyzed and 21 studies were selected. Quality assessments were performed using an adapted version of the STROBE guidelines. Among the analyzed groups (intellectual disabilities, human immunodeficiency virus infection, schizophrenia, down syndrome, drug addicts, adult heart transplant, kidney disease, diabetic, autism, psychiatric patients, cerebral palsy, and hemophilia), the highest prevalence of caries was observed in patients with intellectual disability, without differences between genders. However, there is a need for more studies with standardized methods for caries diagnosis to further investigate the prevalence of caries in permanent teeth in patients with special needs.

Risk Indicators and Treatment Needs of Children 2-5 Years of Age Receiving Dental Treatment under General Anesthesia in Saskatchewan

BACKGROUND

When compared to national averages in Canada, Saskatchewan has one of the highest rates of dental treatment under general anesthesia (GA) and average costs per child. Thus, the purpose of this cross-sectional study is to explore the risk indicators and treatment needs of children receiving dental treatment under GA in Saskatchewan.

METHODS

In this cross-sectional study, we recruited caregivers of children between 24 and 71 months of age in Saskatoon, Canada. Caregivers completed a 40-item questionnaire, which was supplemented with clinical data and then subject to statistical analysis (independent t-tests and one-way ANOVA).

RESULTS

A total of 90 caregiver/child dyads were enrolled with the mean age for children being 49.5 ± 12.3 months. The mean age of a child's first dental visit was 34.7 ± 15.3 months with only 37.9% of children having a dental home. The mean deft index was 11.7 ± 3.4, with an average of 10.9 ± 3.5 teeth receiving treatment. Additionally, location of primary residence (p = 0.03), family income (p = 0.04), family size (p = 0.01), parental education (p = 0.03), dental home (p = 0.04), and body mass index (p = 0.04) had a statistically significant association with a higher mean deft.

CONCLUSIONS

Our cross-sectional study confirms that children who require dental treatment under GA have a high burden of disease. While individual risk indicators such as diet and oral hygiene play a role in the progression of early childhood caries (ECC), we also demonstrate that children who do not have access to early preventive visits or a dental home are at a higher risk. In addition to improving motivation for oral hygiene at home and nutritional education, improving access to oral health care should be addressed in strategies to reduce ECC.

Oral health-related quality of life among groups of foundling and delinquent children in comparison with mainstream children

AIM

This study envisages understanding about the Oral Health-Related Quality of Life (OHRQoL) among groups of foundling and delinquent children and compares them with mainstream children in Riyadh, Saudi Arabia.

METHOD

This is a cross-sectional, observational study of a group of foundling and delinquent children aged 11 to 14 years, in care houses in Riyadh, Saudi Arabia, and mainstream school children. Variables measured for each group were demographic data (age, gender), subjective oral health condition, and OHRQoL. An interview-based questionnaire was used for collecting the relevant data. The questionnaire was divided into four parts, oral symptoms, functional limitations, emotional well-being, and social well-being, with each response scored as per the following codes: (0) never, (1) once or twice, (2) sometimes, (3) often, and (4) every day. The top possible score for the total scale was 144, and the lowest was 0. A comparison group of mainstream school children was recruited from public schools. Data were analysed using SPSS version 25.0 statistical software, and one-way ANOVA was used for the analysis of data when three levels or more were categorical, and the response was numerical. A chi-square test was used to assess the correlation between any two categorical variables.

RESULTS

Out of the total 99 children, 33 were delinquents, 33 were foundling, and 33 were mainstream children included as a comparative group in the study. It was noted that the delinquents compared to the other children had significantly higher scores in accordance with the data collected, with a mean overall score of 30.61 compared to the score for foundling, which was 19.48, and mainstream children had a meager score of 9.18. Individual factorssuch as the oral symptoms, functional limitations, and emotional and social well-being were scored separately, with delinquents having the highest scores and mainstream children the least.

CONCLUSIONS

Health, including oral health, is a right everyone is equally subjected to, and while the concept of OHRQoL is relatively new, delinquents and foundling are definitely subjected to poorer standards in terms of their oral hygiene, on-time treatment, and diagnosis, which further deteriorates their quality of life.