Assessing association of dental caries with child oral impact on daily performance; a cross-sectional study of adolescents in Copperbelt province, Zambia

BACKGROUND

Dental caries and child oral impact on daily performance (C-OIDP) have been linked in several studies. However, the studies used caries indices, which limit the ability to examine how C-OIDP prevalence varies across various stages of the dental caries process. Furthermore, cross-cultural differences between Zambia and other African countries where the C-OIDP instrument has been widely used necessitate testing its pychometric properties. This study's primary aim was to evaluate the association between dental caries and C-OIDP. Secondarily, the study reports the psychometric properties of the C-OIDP index among Zambian adolescents.

METHODS

A cross-sectional study was conducted between February and June 2021 among grade 8-9 adolescents in Copperbelt province, Zambia. A multistage cluster sampling method was used to select participants. Using a pretested self-administered questionnaire, socio-demographics, oral health behaviors, self-reported oral health, and C-OIDP were evaluated. The test-retest and internal consistency reliability of the C-OIDP were evaluated. The Caries Assessment and Treatment Spectrum (CAST) was used to evaluate dental caries. Adjusted odd ratios and 95% confidence intervals were used to evaluate the association between dental caries and C-OIDP after adjusting for confounders identified by a directed acyclic graph.

RESULTS

Among 1,794 participants, 54.0% were females, while 56.0% were aged 11-14 years. About a quarter (24.6%) had one or more teeth at the pre-morbidity stage, 15.2% at the morbidity, 6.4% at the severe morbidity and 2.7 at the mortality stage. The internal consistency reliability of the C-OIDP Cohen's Kappa was 0.940, while the Kappa coefficients of the C-OIDP items ranged from 0.960 to 1.00. Participants with severe caries had a high prevalence of C-OIDP, with rates for morbidity, severe morbidity, and mortality stages being 49.3%, 65.3%, and 49.3%, respectively. Oral impacts were 2.6 times (AOR 2.6, 95% CI 2.1-3.4) more likely to be reported by participants with dental caries than those without caries.

CONCLUSIONS

Dental caries was associated with high reporting of C-OIDP, and C-OIDP prevalence was high among participants in the severe stages of the caries process. The English version of the C-OIDP demonstrated adequate psychometric characteristics for assessing OHRQoL among Zambian adolescents.

Validation and Reliability Testing of the Child Oral Impacts on Daily Performances (C-OIDP): Cross-Cultural Adaptation and Psychometric Properties in Pakistani School-Going Children

Background: This study aimed to develop an Urdu version of Child-Oral Impact on Daily Performance (C-OIDP) and assess its reliability and validity for children’s oral health-related quality of life (OHRQoL) assessment in Pakistan. Methods: A total of 200 school-going children aged 11−14 were recruited from two public schools. For the adaptation process, the original English version of C-OIDP was translated into Urdu, reviewed by an expert committee, back-translated into Urdu, and then reviewed again by the same expert committee and pilot tested on 10 children. A clinical examination was carried out to record dental and gingival status followed by a face-to-face interview to measure oral health-related quality of life in children using C-OIDP-U. Reliability, internal consistency, construct and discriminant validity were assessed. Results: The Cronbach’s alpha for C-OIDP-U was 0.69, the mean C-OIDP-U score was 10.2 ± 8.1 and 77.3% of the children reported at least one oral impact. Eating (40.3%) and difficulty in cleaning mouth (38.7%) were the two most impacted daily performances. For construct validity, the associations were significant between the C-OIDP-U score and all subjective oral health measures (p < 0.001). For discriminant validity, a significant association was observed between the C-OIDP-U score and clinical oral variables, children with DMFT + dmft ≥ 1, Gingival index > 1 and having malocclusion reported a higher C-OIDP-U score when compared to their counterparts. Conclusion: This study showed that C-OIDP is a valid, reliable and efficient instrument of OHRQoL for use in Pakistani children.

Psychometric evaluation of the child oral impacts on daily performances (C-OIDP) for use in Turkish primary school children: a cross sectional validation study

BACKGROUND

As patient-reported outcome, the Child Oral Impacts on Daily Performances (C-OIDP) has been commonly used for assessing children's oral health needs in order to facilitate oral health service planning. It was translated and cross-culturally adapted into Turkish in 2008. Since then, there is no study to assess its psychometric properties in Turkish child population. This cross-sectional study aimed to investigate the psychometric properties and factor structure of the Turkish version of the C-OIDP for use in Turkish primary school children.

METHODS

The Turkish translated version was tested on a convenience sample of primary school children aged 11 to 12 years attending two public schools in Istanbul. Data were collected by clinical examinations, face-to-face interviews and self-completed questionnaires. The internal consistency, test-retest reliability, construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), criterion related validity (concurrent and discriminant) were evaluated.

RESULTS

A total of 208 children were subjected to the tested the C-OIDP. Overall, 93.7% of them reported at least one oral impact in the last 3 months. The most frequently affected performances were "eating" (72.1%) and "cleaning mouth", while the performance with the lowest impact was "studying" (13%). The internal consistency and reproducibility of the C-OIDP were acceptable, with a Cronbach's alpha of 0.73 and an intra-class correlation coefficient of 0.83. The EFA yielded a two-factor model termed "functional limitation" and "psychosocial limitation". CFA identified the two- factor model which fit the data better than the previously proposed three-factor model, namely physical, psychological and social health. Having malocclusion, the presence of gum disease, reported history of oral problems in the mouth, dissatisfaction with oral health, bad self-rated oral health and having a problem-oriented pattern of dental attendance were found to be the most important factors related to worse oral health- related quality of life, supporting its criterion-related validity.

CONCLUSION

This study provided preliminary evidence the psychometric properties of the C-OIDP index among Turkish school children aged 11-12 years. It may be applied to evaluate the oral health impact on quality of life in this population.

Oral Health & Quality of Life in preadolescents with hearing impairment in Uttarakhand, India

Background

"Better teeth better health" is a guiding dictum for the 21st century that has been well adopted by WHO and emulated world over by numerous health care agencies. Hence its of paramount importance to assess the impact of oral health on the quality of life. Keeping this in mind the present study was done to gauge the impact of prevalence of dental diseases amongst 9-15 year old institutionalized hearing impaired children in districts of Uttarakhand, India.

Materials & methodology

250 hearing impaired institutionalized 9-15 year old children were examined using WHO type III clinical examination for DMFT/dmft, Traumatic dental injuries using TDI index and dentofacial anomalies using Angle's classification of malocclusion. The Hindi version of the C-OIDP questionnaire was used in this study.

Results

There was a high dental caries prevalence of 56% with significant male predilection. TDI index was 40.8% and the most common molar relation was class I with 90.4%. With 49.6% crowding was the most common dentofacial anomaly. Deformity of face or mouth has maximum impact on the daily life of these children. The overall oral health related quality of life was less favorable in this group.

Conclusion

Oral health has a significant impact on daily life of these children with hearing impairment and those children having dental diseases showed unfavorable OHRQoL.