Children oral health and parents education status: a cross sectional study

INTRODUCTION

Oral diseases are common and affect millions of people worldwide. They can range from mild and easily treatable conditions to more severe and serious diseases. Proper oral hygiene and regular dental monitoring are essential for maintaining good oral health. When it comes to children's health and well-being, parents' education level plays a critical role. Research has shown that parents' higher educational attainment is associated with better health outcomes for their children. Our aim is to evaluate whether parents' education level and employment influence children oral health and its impact on the family.

METHODS

We enrolled consecutively healthy subjects aged between 0-16 and their parents at the Dental Clinic of the University of Campania "L. Vanvitelli". The Italian version of the ECOHIS (I-ECOHIS) was administered to parents of the enrolled subjects referred to the Dental Clinic of the University of Campania "L. Vanvitelli". Linear regression models, adjusted for age and sex, were used to explore the association between parents' employment or education level and the ECOHIS scores. Statistical significance was accepted when p value < 0.05.

RESULTS

We found a significative association of a higher I-ECOHIS total score (coeff. 4.04244; CI 95%: 1.530855-6.554026; p = 0,002) and higher I-ECOHIS children section score (coeff. 3.2794; CI 95%: 1.29002-5.268; P = 0,002) and the father unemployed status. We also found that a higher education level of the father was associated with a lower ECOHIS total score (coeff. -1.388; IC 95%: -2.562115--0.214 p = 0.021) and a higher education level of the mother was associated with a lower ECOHIS in children section (coeff. -0.972; IC95%: -1.909356-0.034; p = 0.042).

CONCLUSIONS

Father unemployed status and a lower educational level for both parents may negatively affect oral health status.

Pediatric Dental Fluorosis and Its Correlation with Dental Caries and Oral-Health-Related Quality of Life: A Descriptive Cross-Sectional Study among Preschool Children Living in Belagavi

AIM

This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents' perceptions among preschool children in the 3-5-year-old preschool children living in the Belagavi district of Karnataka, a non-endemic fluorosis region.

METHODS

A descriptive cross-sectional questionnaire-based study was conducted among 1200 individuals of the preschool population from 48 government-sponsored child-care development centers in Belagavi, Karnataka, over a three-month period. They were examined following the Dean's fluorosis index (1942) and dmft (decayed, missed, and filled) scores of the participants were also recorded. Parents' perception of oral health was assessed using the self-administered Early Childhood Oral Health Impact Scale (ECOHIS). SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-way ANOVA test was used for multiple group comparisons. p < 0.05 was considered statistically significant.

RESULTS

Of the 1200 children examined, 10 (0.83%) children exhibited dental fluorosis. Of the 10 children having fluorosis, six had fluorosis present on two or more of their primary teeth, and four had fluorosis on four or more teeth. The mean dmft score was 3.01 ± 1.38 to 3.60 ± 1.72 in 3-5-year-old children, respectively, with statistical significance difference (p < 0.001). The mean score of oral health-related quality of life was 10.74 ± 2.06, which was significantly correlated to the child's age and parents' education level (p < 0.05).

CONCLUSION

The study shows a negligible amount of prevalence of dental fluorosis in the non-endemic fluorosis residential district. It also elucidates that children from lower and lower-middle socioeconomic status are more prone to suffer from dental fluorosis as compared to other groups. The mean score of ECOHIS increased proportionally with the caries experience, indicating a significant relationship between the dmft and ECOHIS score. Deciduous dentition fluorosis is often neglected, especially in areas that are not considered endemic for fluorosis and with only optimum fluoride levels in their groundwater, which supports the disease's nature as multi-factorial and shows that a broader perspective is of prime importance to assess, diagnose, and prevent dental fluorosis among the preschoolers, thereby appraising their overall health and hygiene status.

Effect of method of administration on the oral health-related quality of life assessment using the Early Childhood Oral Health Impact Scale (ECOHIS-G)

Objectives

The influence of the administration method used to collect oral health–related quality of life (OHRQoL) in children remains largely unknown. The aim of this study was to determine whether the OHRQoL information obtained using the Early Childhood Oral Health Impact Scale (ECOHIS) differed with different methods of data collection (face-to-face interview, telephone, or self-administered questionnaire).

Materials and methods

The OHRQoL of 38 preschool children, aged 1 to 5 years, was measured using the German version of the ECOHIS. The instrument was administered to the caregivers of these children using three different methods, with an interval of 1 week between each administration. Test-retest reliability for the repeated ECOHIS-G assessments across the three methods of administration, agreement, and convergent validity was determined.

Results

Kappa coefficients for agreement between two different methods of administration, respectively, ranged from moderate to substantial (0.47 to 0.65). Test-retest reliability was moderate (ICC 0.65–0.79).

Conclusion

In conclusion, the three methods of administration (face-to-face interview, telephone interview, or self-administered questionnaire) of the ECOHIS-G were comparable in 1- to 5-year-old preschool children.

Clinical relevance

All three methods of administration can be used to obtain valid and reliable OHRQoL information in German speaking countries.

Changes in oral health-related quality of life among Austrian preschool children following dental treatment under general anaesthesia

Objectives

To analyse possible changes in oral health-related quality of life (OHRQoL) before and after dental treatment under dental general anaesthesia (DGA) among Austrian preschool children.

Methods

A consecutive sample of 89 parents of children aged 2 to 5 years, suffering from early childhood caries (ECC) and scheduled for DGA, were recruited from two locations in Austria (Vienna and Salzburg). Parents self-completed the German version of the ECOHIS before (baseline) and 4 weeks (T4) after their child’s dental treatment. The ECOHIS consists of 13 questions and is divided into two main parts, namely, the child impact section (9 items) and the family impact section (4 items).

Results

A total of 80 children (89%) completed a sufficient number ECOHIS questions at baseline and the follow-up assessment after 4 weeks. “Pain in the teeth, mouth, and jaws” and “difficulty eating some foods” from the child section and parents’ ratings of “feeling upset” and “guilty” were the most frequently reported impacts at baseline. The ECOHIS total score decreased significantly from a mean of 14.60 to 9.89 (p < 0.001) after DGA treatment, revealing a large effect size for the child (0.8) section, family (0.6) section, and the total score (0.8). Parents rated their child’s overall and oral health significantly higher after the DGA treatment (p < 0.001).

Conclusions

Significant improvements in oral health-related quality of life were observed 4 weeks after DGA in children suffering from ECC.

Clinical relevance

ECC has an impact on OHRQoL. Rehabilitation under general anaesthesia makes a sustainable improvement.

Early Childhood Oral Health Impact Scale (ECOHIS): Literature review and Italian validation

OBJECTIVE

The Early Childhood Oral Health Impact Scale (ECOHIS) is a questionnaire to elucidate the relationship between parental perception of the quality of life of their preschool children and their oral health status. Aim of the present work was to validate an Italian ECOHIS version and review the literature.

METHODS

After adapting the original ECOHIS questionnaire from English to Italian (I-ECOHIS), I-ECOHIS was administered to parents of children afferent to the Dental Clinic of the University of Campania "Luigi Vanvitelli," regardless of age. Children under 6 years of age underwent anamnestic survey and physical examination, to correlate the dmft index with the ECOHIS score.

RESULTS

366 children have come to our observation. I-ECOHIS was administered to all parents to establish its comprehensibility. 87 children (44 females and 43 males) under 6 years (5.2 ± 1.4 years) underwent dmft evaluation to determine I-ECOHIS/oral health status correlation. Among the 87 children examined, the higher total score reached was 25/50. ANOVA analysis confirmed statistically significant correlations between ECOHIS score and dmft = 0 vs dmft equal/higher than 4.

CONCLUSION

The present pilot study validated the I-ECOHIS questionnaire and revealed to be a good tool to distinguish children without caries experience from those with a high dmft. However, it was not correlated with the intermediate dmft level, thus confirming the importance of screening for caries.

The German version of Early Childhood Oral Health Impact Scale (ECOHIS-G): translation, reliability, and validity

OBJECTIVES

The aims of this study were to develop a German version of the Early Childhood Oral Health Impact Scale (ECOHIS), a measure of oral health-related quality of life in pre-school-age children, and to assess the instrument's reliability and validity.

METHODS

The original English version of the ECOHIS questionnaire was translated into German (ECOHIS-G) by a forward-backward translation method. A total of 336 children aged 0 to 5 years and their caregivers who were recruited at the Department of Paediatric Dentistry in Vienna, Austria, participated in this study. The caregivers completed the ECOHIS-G and their children were clinically examined for the presence of dental caries and plaque accumulation. Reliability of ECOHIS was investigated in a subsample of 59 subjects after 3 weeks.

RESULTS

Questionnaire summary score test-retest reliability was 0.81 (intraclass correlation coefficient, 95% confidence interval (CI) ranging from 0.68 to 0.89) and internal consistency was 0.83 (Cronbach's alpha, lower limit of the 95% CI 0.80). Validity of the ECOHIS-G questionnaire was supported by correlation coefficients with global ratings of oral health of - 0.42 (95% CI - 0.45 to - 0.35) and overall well-being of - 0.29 (95% CI - 0.34 to - 0.22) which met the expectations. Mean ECOHIS-G scores were statistically significantly higher in children with caries compared with caries-free children.

CONCLUSIONS

The German version of the ECHOHIS was found to be reliable and valid in children aged 0 to 5 years.

CLINICAL RELEVANCE

These findings enable assessments of oral health-related quality of life in German-speaking pre-school children.