Association of children's oral health and school environment on academic performance in 12-year-old schoolchildren of Quito, Ecuador

OBJECTIVES

The primary aim of this study was to evaluate if children's oral health and oral health-related quality of life (OHRQoL) were associated with school performance. Moreover, the study aimed to examine whether school environment factors influenced this association.

METHODS

This cross-sectional study was based on a population-based sample of 998 12-year-old schoolchildren from 31 public schools in Quito, Ecuador. Trained and calibrated examiners conducted clinical exams for dental caries, dental trauma and malocclusion. Furthermore, children completed the Spanish version of the Child Perception Questionnaire (CPQ11-14 ), and their parents answered questions about socio-economic status. School coordinators provided information on the physical environment, promotion of health practices and the occurrence of negative episodes in the school. There were three outcomes: grades obtained in Spanish language and mathematics and the number of missed school days. Multilevel linear and Poisson regression models were conducted using a hierarchical approach to include the variables guided by a previously created direct acyclic graph.

RESULTS

Children with dental trauma and higher CPQ11-14 scores showed lower grades and school attendance. Schoolchildren from schools with episodes of vandalism had more school days missed.

CONCLUSION

The school performance of 12-year-old children is affected by dental trauma and by a worse OHRQoL, as well as a negative school environment. Therefore, supportive environments and promoting health measures in schools could overcome this worse academic performance in children with oral health problems.

Influence of school environment on occurrence of traumatic dental injuries in 12 years old children

BACKGROUND/AIM

Since children spend most of their time in school, some environmental characteristics of the schools may influence the occurrence of traumatic dental injuries (TDI). Therefore, the aim of this cross-sectional study was to assess the prevalence of TDI in 12 years old children in Quito, Ecuador, and its association with some school environmental aspects.

MATERIAL AND METHODS

Six calibrated examiners evaluated 998 children from 31 public schools of Quito, to evaluate the occurrence of TDI in anterior teeth. School coordinators answered questionnaires on school physical conditions, promotion of health practices and the occurrence of negative episodes in school. The occlusion and socioeconomic status of the participants were also evaluated. Prevalence of TDI, unadjusted and adjusted by the design effect was calculated. Association between individual and contextual explanatory variables and presence of TDI were evaluated using multilevel Poisson regression analysis (P < .05).

RESULTS

TDI prevalence adjusted by design effect was 20.7%. Children studying in schools with patio floor of grass and with access ramps had significantly lower prevalence of TDI than children studying in schools with patio floor of cement and with only stairs, respectively. The prevalence of TDI was also lower in children from schools that offered healthy meals or that had a proper place for oral hygiene.

CONCLUSIONS

Schools with adequate physical structures and that promote health practices to their students have a lower prevalence of TDI.

Oral health of 12-year-old children in Quito, Ecuador: a population-based epidemiological survey

BACKGROUND

There is a paucity of population-based surveys on oral health conditions in Ecuador. Thus, the aim of this study was to conduct an epidemiological survey with a representative sample of children aged 12 years from public schools of Quito, Ecuador. The aim of this initial report was to describe the methodology used in the survey, as well to present results regarding calibration procedures and prevalence of oral-health related outcomes.

METHODS

We invited 33 public schools' coordinators from the urban area of Quito, and 1100 children (12 years old) to take part in this study. Six trained and calibrated examiners conducted clinical examinations using oral mirrors and ball-ended probes to assess: dental caries, traumatic dental injuries, malocclusion, gingival bleeding, presence of calculus and fluorosis. Children also responded a questionnaire on Oral Health-Related Quality of Life (OHRQoL). Individual sociodemographic data was collected through a questionnaire sent to parents. Moreover, some contextual data on school environment (infrastructure conditions, promotion of health practices and negative episodes) were also evaluated. Prevalence values, crude and weighted by sampling weights, and 95% confidence intervals (95%CI) were calculated.

RESULTS

Nine hundred and ninety-eight children from 31 schools were examined from March to May 2017. The adjusted prevalence values (95%CI) for the six outcomes evaluated were: dental caries = 60.3% (55.3 to 65.0%); traumatic dental injuries = 20.7% (17.2 to 24.8%); dental fluorosis = 63.7% (58.5 to 68.5%); gingival bleeding = 92.0% (87.1 to 95.2%); presence of calculus = 69.9 (60.5 to 77.9%); and malocclusion = 25.8% (21.8 to 30.3%). Adjusted mean of number of decayed, missed or filled permanent teeth (DMF-T) was 1.61 (1.37 to 1.84). Results on OHRQoL and other contextual variables will be reported in other articles.

CONCLUSION

The prevalence of the majority of oral health problems in 12-year-old children from public schools in Quito-Ecuador was compatible with those observed in other similar cities. However, periodontal health and fluorosis seem to be highly prevalent in children from Quito.