An evaluation of the Child Perceptions Questionnaire in the UK

OBJECTIVE: To assess the reliability and validity of the Child Perceptions Questionnaire (CPQ11-14), an oral health related quality of life measure for 11-14 year old children, for use in the UK. BASIC RESEARCH DESIGN: Cross-sectional questionnaire and clinical analytical study. CLINICAL SETTING: Orthodontic and paediatric dentistry clinics at a dental hospital and one general dental practice. PARTICIPANTS: Eighty-nine children between 11 and 14 years of age attending for an examination. MAIN OUTCOMES MEASURES: The children were invited to complete the CPQ11-14, global oral health and impact on life overall ratings. Clinical data on caries status, malocclusion and presence of dental opacities and gingivitis were collected. CPQ11-14 was summarised as the total score (sum of the item codes) and the number of impacts reported often or every day. RESULTS: The Cronbach's alpha for the total scale was 0.87 and ranged from 0.59 to 0.83 for the subscales indicating acceptable internal consistency. The intraclass correlation coefficient on repeated application of the measure was 0.83 (95% CI = 0.76-0.90) suggesting almost perfect agreement. Summary measures of CPQ11-14 correlated with the global oral health rating indicating acceptable criterion validity. Impact on life overall was related to all summary measures of CPQ11-14. Number of impacts correlated with the total number of missing teeth and missing teeth due to caries. No other relationships between clinical and CPQ11-14 data were apparent. CONCLUSION: The CPQ11-14 shows acceptable reliability, criterion and construct validity in relation to life overall. Relationships with clinical data were more tenuous. If this measure is to be used to compare the impacts of oral diseases in similar settings in the UK a large sample will be required.     

Oral health-related quality of life of children by dental caries and fluorosis experience

OBJECTIVE: To evaluate the oral health-related quality of life (OHRQoL) of children by dental caries and fluorosis status. METHODS: A random sample of South Australian 8- to 13-year-old children was selected. Caries data were collected from school dental service records to group children by combined deciduous and permanent tooth caries experience. Children were examined for fluorosis using the Thylstrup and Fejerskov (TF) Index to form groups by fluorosis scores on maxillary central incisors. Occlusal traits were recorded using the Dental Aesthetic Index. Children and their parents completed the Child Perception Questionnaire (CPQ) and the Parental Perception Questionnaire (PPQ) and a global rating of oral health (OH). OHRQoL indicators, rating OH as Excellent/Very good, and mean overall CPQ/PPQ scores were compared between groups by fluorosis scores and caries experience. Multivariate models were generated for both OH and CPQ/PPQ indicators. RESULTS: Two hundred forty-two children (43.0 percent) had 0 decayed, missing, and filled primary and permanent tooth surface (dmfs/DMFS), while 170 (23.9 percent) had 5+ dmfs/DMFS. The prevalence of TF scores 1, 2, and 3 were 14.5, 9.5, and 1.9 percent, respectively. The proportion of children/parents rating OH as Excellent/Very good was significantly associated with children's caries experience. That proportion increased when fluorosis severity increased from a TF score of 0 to 2, but decreased with a TF of 3. Having low caries experience and better dental appearance were associated with parents' perception of good OH. Having mild fluorosis and more acceptable appearance were significant factors for children's perception of good OH. Caries and malocclusion were associated with lower OHRQoL, while having a TF score of 2 was associated with better OHRQoL in multivariate models for overall CPQ/PPQ scores. CONCLUSION: Caries and less acceptable appearance showed a negative impact, while mild fluorosis had a positive impact on child and parental OHRQoL.     

儿童口腔健康影响程度量表的研制

目的评价儿童口腔健康影响程度量表（CPQ11- 14）中文版的信度和效度,探讨其在中国儿童中应用的可行性。方法对CPQ11- 14进行翻译、回译、文化调适和改造,建立儿童口腔健康影响程度量表中文版。使用该量表和口腔健康自我评价表对南宁市218名11～14岁中、小学生进行口腔健康检查和口腔健康相关生存质量调查,考评量表的信度和效度。结果口腔健康影响程度量表的重测信度系数为0.82（P<0.001）,内部一致性Cronbach′s α系数为0.79。通过因子分析提取的5个因子显示,口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康状态、自我感觉口腔健康对生活质量的影响间有明显相关性,其相关系数分别为- 0.33和0.50（P<0.000 5）。量表得分与龋失补牙指数呈明显正相关（P<0.001）,与中学组错畸形情况（美牙指数）也呈正相关（P<0.05）。结论本量表具有良好的信度和效度,为在中国进一步推广应用提供了理论依据。     

Disparities in oral health-related quality of life in a population of Canadian children

OBJECTIVES: To assess socioeconomic disparities in the oral health-related quality of life in a group of Canadian children. METHODS: Data were obtained as part of a study designed to assess the functional and psychosocial impact of traumatic dental injury. Clinical data were collected on a random sample of children during a school-based dental screening program that included measures of dental decay experience, treatment needs, dental trauma, fluorosis, and malocclusion. Children with dental trauma and a comparison group of trauma-free children were selected for follow-up. Their parents were mailed a questionnaire concerning the child's personal and family characteristics. Also enclosed was a questionnaire for the child that contained a short form of the Child Perceptions Questionnaire (CPQ) 11-14. Bivariate and multivariate analyses were undertaken to determine whether there were disparities in oral health-related quality of life according to household income. RESULTS: Complete data were collected from 370 children. Mean CPQ11-14 scores showed a gradient across income categories with children from low income households having poorer oral health-related quality of life. Children from households containing only one adult also had higher scores than children living with two or more adults. In both linear and logistic regression analyses household income and family structure remained significant predictors of CPQ11-14 scores after controlling for oral disease variables. Further analyses suggested that oral disorders had little impact on the health-related quality of life of higher income children but a marked impact on lower income children. The highest mean CPQ11-14 scores were observed among low income children with the more severe levels of oral disease. CONCLUSION: The data indicate that in this group of children there were socioeconomic disparities in oral health-related quality of life. A potential explanation may be differences in psychological assets and psychosocial resources.     

Validity of single-item parental ratings of child oral health

Objective. The aim of this study was to assess the validity of single-item parental ratings of child oral heath. Methods. Data were collected during a study to assess the impacts of dental injury. Clinical examinations of children aged 11–14 years were undertaken that included measures of trauma, decay, treatment needs, and fluorosis. Children with trauma and a group of trauma-free children were followed-up. Parents were mailed a questionnaire along with a questionnaire for the child that contained a short form of the Child Perceptions Questionnaire 11–14 (CPQ11–14). Bivariate analyses examined associations between parents’ ratings of their child's oral health, measures of dental disease, clinically defined treatment needs, and scores on the CPQ11–14. Logistic regression was used to see if the associations observed remained after controlling for access to dental care variables. Results. Complete data were collected from 370 children and their parents. Parental ratings showed significant associations with most of the clinical indicators used and CPQ11–14 scores. Similar results were obtained when the data were analysed for subgroups defined by household income and mother's education. These associations remained after controlling for access to dental services. Conclusion. The data suggest that single-item parental ratings of child oral health have adequate construct validity.     

Cross-cultural adaptation and psychometric properties of the child perceptions questionnaire 11-14 (CPQ11-14) for the peruvian spanish language

Objectives: Oral-Health-Related Quality of Life (OHRQoL) instruments, such as the Child Perceptions Questionnaire 11-14 (CPQ11-14), are broadly used in oral health surveys around the world. However, there is a lack of these instruments in Spanish language limiting the comparison of OHRQoL outcomes among countries, cultures and ethnic groups. The aim of the present study was to cross-culturally adapt the CPQ11-14 to the Peruvian Spanish language and assess its reliability and validity. Material and Methods: To test the translation and cross-cultural adaptation, 60 children aged 11-to-14-years answered the CPQ11-14 in two pilot tests. After that, the questionnaire was tested on 200 children of the same age, who were clinically examined for dental caries. The internal consistency was assessed by Cronbach’s alpha coefficient while repeat administration of the CPQ11-14 on the same 200 children facilitated the test-retest reliability via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the CPQ11-14 with global ratings of oral health and clinical groups respectively. Results: The mean (standard deviation) CPQ11-14 score was 20.18(13.07). Internal consistency was confirmed by a Cronbach’s alpha of 0.81. Test-retest reliability revealed excellent reproducibility (ICC= 0.92). Construct validity was confirmed demonstrating statistically significant associations between total CPQ11-14 score and global ratings of oral health (p=0.035) and overall well-being (p<0.001). The measure was also able to discriminate between children with dental caries experience and those without (mean scores: 26.32 and 12.96 respectively; p<0.001). Conclusions: The Spanish CPQ11-14 has satisfactory psychometric properties and is applicable to children in Peru. Key words:Oral health, quality of life, children, adolescent, validity, reliability.     

Health-related quality of life of children aged 11 to 14 years with orofacial conditions.

OBJECTIVE: To assess the health-related quality of life (HRQoL) of 11- to 14-year-old children with orofacial conditions. DESIGN: Thirty-nine patients with orofacial conditions were compared with 32 patients with dental caries. OUTCOME MEASURE: The multidimensional 37-item Child Perceptions Questionnaire for 11- to 14-year-old children (CPQ(11-14)). This forms one component of the Child Oral Health Quality of Life Questionnaire. RESULTS: The orofacial group had slightly higher scores on the CPQ(11-14) than the dental group (p < .05). The scores were slightly to moderately higher on the functional limitations (p < .01) and social well-being (p < .01) domains. The groups did not differ with respect to oral symptoms or emotional well-being. Mouth breathing, problems with speech, missing school, being teased, and being asked questions about their condition were the only issues reported more frequently by the orofacial group (p < .01). There was no evidence of social inhibition or withdrawal in the orofacial group. The children with orofacial conditions rated their oral health better than the children with dental decay (p < .05). In both groups, the majority of children reported that their condition had little impact on their life overall. CONCLUSIONS: Based on CPQ(11-14) scores, there were few differences in the HRQoL of 11- to 14-year-old children with orofacial conditions, compared with children with dental caries. This suggests that the majority of these children are well adjusted and able to cope with the adversities they experience as a result of their conditions. This may reflect the quality of the team approach used at the treatment setting at which they were recruited.     

Determinants of self-rated oral health status among school children in northern Tanzania

Summary. Objective . This study aimed to assess the perceived oral health status and to explore its relationship with clinically assessed dental fluorosis among school children in Arusha town, Tanzania.
Methods . A total of 478 students (mean age 15·7 years) completed questionnaires administered in the schools during May to July 2000. Clinical photos of the upper and lower incisors were taken under field conditions. A total of 461 slides were rated under laboratory conditions. The severity of dental fluorosis in the permanent maxillary central incisors was assessed using the Thylstrup & Fejerskov Index (TFI).
Results . The prevalence of dental fluorosis at TFI score ≥ 2 was 74%. A total of 67% of boys and 70% of girls rated their teeth as yellow to brown, 58% of boys and 68% of girls ( P  < 0·05) confirmed dissatisfaction with their dental appearance. Kappa values of 0·40–0·44 were obtained between dental fluorosis (TFI ≥ 2) and self-reported discoloration. The proportion of school children reporting dissatisfaction with oral condition and dental appearance increased with increasing TFI scores. Stepwise multiple logistic regression analysis explained 21% and 32% of the variance in the dissatisfaction with oral condition and dental appearance scores; TFI scores 11% and 15% of variation in points, and social and psychological variables 11% and 17%.
Conclusion . Whereas dental fluorosis at different diagnostic cut-off points impacts self-rated oral health negatively, social and personal factors are as important in shaping the responses of school children to oral condition and dental appearance.     

A randomised control trial of the effectiveness of personalised letters sent subsequent to school dental inspections in increasing registration in unregistered children

Background

The Child Perceptions Questionnaires (CPQ_8–10 and CPQ_11–14) are indicators of child oral health-related quality of life. The aim of this study was to assess the validity and reliability of the self-applied CPQ_8–10 and CPQ_11–14 in Brazilian children, after translations and cultural adaptations in the Brazilian Portuguese language.

Methods

Schoolchildren were recruited from general populations for pre-testing (n = 80), validity (n = 210), and test-retest reliability (n = 50) studies. They were also examined for dental caries, gingivitis, fluorosis, and malocclusion.

Results

Children with greater dental caries experience in primary dentition had higher impacts on CPQ domains. Girls had higher scores for CPQ_8–10 domains than boys. Mean CPQ_11–14 scores were highest for 11-year-old children and lowest for 14-year-old children. Construct validity was supported by significant associations between the CPQ_8–10 and CPQ_11–14 scores and the global rating of oral health (r = 0.38, r = 0.43) and overall well-being (r = 0.39, r = 0.60), respectively. The Cronbach's alpha was 0.95 for both questionnaires. The test-retest reliabilities of the overall CPQ_8–10 and CPQ_11–14 scores were both excellent (ICC = 0.96, ICC = 0.92).

Conclusion

The Brazilian Portuguese version of CPQ_8–10 and CPQ_11–14 was valuable and reliable for use in the Brazilian child population, although discriminant validity was sporadic due to the fact that impacts are mediated by others factors, such personal, social, and environmental variables.     

Association of Gingivitis With Child Oral Health–Related Quality of Life

Background: Child oral health–related quality of life (COHRQoL) has been increasingly assessed. However, the full relationship between gingivitis and COHRQoL has been assessed by only a small number of studies. This study aims to assess the association between gingival bleeding and how a child perceives its OHRQoL. Methods: This cross‐sectional study used multistage random sampling to enroll 1,134 12‐year‐old schoolchildren from Santa Maria, a southern city in Brazil. Participants were examined for gingival bleeding according to the community periodontal index criteria, a full‐mouth clinical examination of six sites per tooth. COHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11‐ to 14‐Year‐Old Children (CPQ11–14), and data on socioeconomic status were collected. Multilevel Poisson regression models fitted the association of gingivitis with overall and domain‐specific CPQ11–14 scores. Results: In general, children with bleeding in ≥15% of sites had higher total CPQ11–14 scores and domain‐specific scores than their counterparts. This association persisted after adjustment for other potential confounders. The presence and extent of gingival bleeding was associated mainly with emotional limitation domains of the CPQ11–14; those with extended levels of gingivitis had a 1.20 times higher mean score than those with low‐level/no gingival bleeding (rate ratio = 1.20; 95% confidence interval = 1.10 to 1.31). Conclusion: The present results indicate that the presence of extensive levels of gingivitis might be negatively associated with how children perceive their oral health and their daily life.     

Changes in parent-assessed oral health-related quality of life among young children following dental treatment under general anaesthetic

Objective: To estimate the nature and magnitude of changes in oral health‐related quality of life (OHRQoL) among children having dental treatment under general anaesthetic (GA) and to examine the evaluative properties of the Child Oral Health‐related Quality of Life Questionnaire (COHQOL^©). Methods: Data from a consecutive clinical sample of the parents/caregivers of children receiving dental treatment under GA at Wellington and Kenepuru Hospitals were collected from parents using the Parental‐Caregivers Perception Questionnaire (P‐CPQ) and the Family Impact Scale (FIS), which both form part of the COHQOL^© Questionnaire. The first questionnaire was completed before treatment or while the participant's child was undergoing treatment. The follow‐up questionnaire was completed 1–4 weeks afterward. Treatment‐associated changes in OHRQoL were determined by comparing baseline and follow‐up data for the mean scores and the prevalence of impacts. The discriminative properties of the instrument were confirmed and then its evaluative properties were assessed (by examining its test–retest reliability, responsiveness and longitudinal construct validity). The minimally important difference was determined for the overall scale and subscales. Results: Complete baseline and follow‐up data were obtained for 202 and 130 participants, respectively (64.4% follow‐up rate). The evaluative properties of the P‐CPQ and FIS were acceptable. There were substantial and highly statistically significant reductions in mean P‐CPQ and FIS scores after treatment, with effect sizes ranging from moderate to large, depending on the subscale being examined. The minimally important difference was shown by almost two‐thirds of the children treated. Conclusion: The provision of dental treatment under GA for young children with severe dental caries experience is associated with substantial and highly significant improvements in both their OHRQoL and in the impact on their families. The P‐CPQ and the FIS show promise as evaluative measures for use in dental health services research.     

Validity and reliability of a questionnaire for measuring child oral-health-related quality of life

Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.     

Validation of the Child Perceptions Questionnaire (CPQ 11-14)

While the use of adult oral-health-related quality-of-life (OHRQoL) measures in supplementing clinical indicators has increased, that for children has lagged behind, because of the difficulties of developing and validating such measures for children. This study examined the construct validity of the Child Perceptions Questionnaire (CPQ(11-14)) in a random sample of 12- and 13-year-old New Zealanders. It was hypothesized that children with more severe malocclusions or greater caries experience would have higher overall (and subscale domain) CPQ(11-14) scores. Children (N = 430) completed the CPQ(11-14) and were examined for malocclusion (Dental Aesthetic Index) and dental caries. There was a distinct gradient in mean CPQ(11-14) scores by malocclusion severity, but there were differences across the four subscales. Children in the worst 25% of the DMFS distribution had higher CPQ(11-14) scores overall and for each of the 4 subscales. The construct validity of the CPQ(11-14) appears to be acceptable.     

Validity and reliability of the Arabic translation of the child oral-health-related quality of life questionnaire (CPQ11-14) in Saudi Arabia

AIM: The purpose of this study was to test the validity and reliability of an Arabic translation and adaptation of the child oral-health-related quality of life questionnaire (CPQ(11-14)) in Saudi Arabia. DESIGN: The modified questionnaire included two global ratings (oral health and oral-health-related well-being), and a battery of 36 questions in four domains (oral symptoms, functional limitations, emotional well-being and social well-being). The study population consisted of 174, 11-14-year-old children (65% healthy and 35% medically compromised). Clinical data on caries status and malocclusion were collected for 138 of the children, and 47 completed the questionnaire a second time. RESULTS: There was a significant difference in mean total scale scores between children with and without malocclusions (P < 0.05). Significant relationships were identified between caries status and oral symptoms subscale scores, and between malocclusion and total scale and social well-being subscale scores (P < 0.05). Correlation was highly significant between scale scores and global ratings (P < 0.01). Cronbach's alpha was 0.81 and the test-retest reliability was substantial (r = 0.65, P < 0.001). However, problems were encountered in Saudi Arabia regarding self-reporting of age, and the questionnaire was too long for many of the medically compromised patients. CONCLUSIONS: The questionnaire is valid and reliable for use in Saudi Arabia, although development of a shorter version is recommended.     

Oral health-related quality of life of 11- and 12-year-old public school children in Rio de Janeiro

Castro RAL, Portela MC, Leão AT, Vasconcellos MTL. Oral health–related quality of life of 11‐ and 12‐year‐old public school children in Rio de Janeiro. Community Dent Oral Epidemiol 2011; 39: 336–344. © 2010 John Wiley & Sons A/S Abstract – Objectives: The objective of this study was to assess the association between oral health–related quality of life (OHRQoL), measured through the Child‐OIDP, and demographic characteristics, self‐reported oral problems, and clinical oral health measures, among 11‐ to 12‐year‐old school children in the city of Rio de Janeiro, Brazil. Methods: A cross‐sectional study was conducted, having as its target population 11‐ and 12‐year‐old students of both sexes, formally enrolled in 6‐ and 7‐year school classes at public schools. A probabilistic sample with complex design was used. OHRQoL was assessed by the Brazilian version of Child‐OIDP. Oral exams were conducted, and the presence of dental biofilm, gingival bleeding, DMFT, fluorosis, enamel defects, dental trauma, and malocclusion were recorded. Results: A total of 571 school children participated with a mean age of 12.0 years and 95% confidence interval (95% CI) from 11.9 to 12.1. A total of 88.7% of the school children presented the impact of oral problems in at least one of the eight daily performances. The activities that had most impacts were eating (81.3%), cleaning mouth (40.5%), and smiling (32.2%). The mean Child‐OIDP index was 7.1 with 95% CI from 6.2 to 8.1. The highest scores were in relation to eating (mean = 25.0; 95% CI from 22.4 to 27.6), cleaning mouth (mean = 12.0; 95% CI from 9.1 to 14.9), and smiling (mean = 10.0; 95% CI from 7.5 to 12.5). In the logistic regression model, the Child‐OIDP was associated with dental caries experience and with the perception of sensitive teeth, perception of gingival bleeding, and perception of inadequate position of the teeth. In the multinomial regression, we found that the odds of having higher levels of Child‐OIDP were positively associated with dental caries experience. Self‐reported dental caries, mobile milk teeth, tooth position, bleeding gums, and bad breath were associated with worst OHRQoL. Conclusions: It can be concluded that there is an association between dental caries experience and the Child‐OIDP index. This association indicates the impact of this condition on the quality of life of school children. Moreover, the Child‐OIDP index is explained more by self‐reported oral problems than by clinical normative measures.     

Evaluation of a quality of life measure for children with malocclusion

OBJECTIVE: To explore the validity and reliability of the child perception questionnaire as an oral-health-related quality of life (OHRQoL) measure in adolescents with malocclusion. DESIGN: A cross-sectional study comparing two groups of individuals. SETTING: One group of children with malocclusion was recruited from the orthodontic departments at the Charles Clifford Dental Hospital (CCDH), Sheffield and Chesterfield Royal Hospital (CRH), Chesterfield. A second group with no malocclusion was recruited from the Paediatric Department at CCDH and one General Dental Practice in Sheffield. SUBJECTS AND METHODS: The malocclusion group consisted of 116 patients aged 11-14 years about to commence orthodontic treatment. The non-malocclusion group consisted of 31 11-14-year-old patients with index of orthodontic treatment need (IOTN) 1 and 2, and DMFT 相似文献   

Impact of oral diseases and disorders on oral‐health‐related quality of life of children with cerebral palsy

The aim of this study was to investigate the impact of oral diseases and disorders on the oral‐health‐related quality of life (OHRQoL) of children with CP, adjusting this impact by socioeconomic factors. Data were collected from 60 pairs of parents–children with CP. Parents answered the child oral health quality of life questionnaire (parental‐caregivers perception questionnaire and family impact scale) and a socioeconomic questionnaire. Dental caries experience, traumatic dental injuries, malocclusions, bruxism, and dental fluorosis were also evaluated. The multivariate adjusted model showed that dental caries experience (p < 0.001) and the presence of bruxism had a negative impact (p = 0.046) on the OHRQoL. A greater family income had a positive impact on it (p < 0.001). Dental caries experience and bruxism are conditions strongly associated with a negative impact on OHRQoL of children with CP and their parents, but a higher family income can improve this negative impact.     

Sociodemographic and behavioural correlates of severe dental fluorosis

OBJECTIVES: The aim of this study was to identify sociodemographic and behavioural factors associated with the prevalence of severe dental fluorosis in moderate- and high-fluoride areas of the Ethiopian Rift Valley. METHODS: Three hundred and six adolescents (12-15 years) and 233 mothers participated in the study. The children were examined for dental fluorosis according to the Thylstrup-Fejerskov Index (TFI). The children and their mothers were subsequently interviewed. Sixty mothers had more than one participating child. In order to perform a paired parent/child analysis, a total of 73 younger siblings had to be excluded. RESULTS: Among the remaining 233 children, the prevalence of severe dental fluorosis (TFI >or= 5) was 24.1% and 75.9% in the moderate- and high-fluoride areas, respectively. According to bivariate as well as multivariate analyses, a number of sociodemographic and behavioural factors were related to severe fluorosis. The odds for having severe fluorosis varied according to the fluoride concentration of the drinking water, age, consumption of tea, length of breastfeeding and method of storing water. The adjusted odds ratios ranged from 2.6 to 26.1. Breastfeeding for > 18 months and the use of clay pots for storing drinking water helped protect against severe dental fluorosis. Bivariate analyses indicated that being male and consuming fish might be associated with higher TFI scores. CONCLUSION: In order to avoid dental fluorosis, low-fluoride drinking water should be provided in the relevant villages. A prolonged period of breastfeeding, the use of clay pots for storing water, and possibly a reduced intake of tea and whole fish in infants might also help to avoid severe fluorosis in children growing up in traditionally fluoride-endemic areas.     

Agreement between mothers and children aged 11-14 years in rating child oral health-related quality of life

OBJECTIVES: To assess the agreement between mothers and children concerning the child's oral health-related quality of life. METHODS: A total of 42 pairs of mothers and children aged 11-14 years with oral and orofacial conditions completed the parental (PPQ) and child (CPQ(11-4)) components of the Child Oral Health Quality of Life Questionnaire. The PPQ and CPQ(11-14) are analogous questionnaires with 31 common items. Agreement between overall and subscale scores derived from the questionnaires were assessed in comparison and in correlation analyses. The former used mean directional differences between mothers and children to assess bias and mean absolute differences to assess agreement at the group level. The latter used intraclass correlation coefficients (ICCs) to assess agreement at the level of individual mother-child pairs. RESULTS: At the group level, agreement between mothers and children was good. There was little evidence of bias in mothers' reports compared to those of their children. The mean absolute difference in overall scores constituted 9% of the possible range of scores. However, the significance of this difference is difficult to interpret. The ICC for overall scores was 0.70 indicating substantial agreement between mother and child pairs. However, the ICCs for the emotional and social well-being subscales indicated moderate agreement only. There was a suggestion that the level of agreement varied according to the characteristics of the child. CONCLUSION: Although mothers may be used as proxies for their children in some circumstances and for some purposes, the views of both should be obtained in order to fully represent child oral health-related quality of life.     

What do children's global ratings of oral health and well‐being measure?

OBJECTIVES: To explore the constructs children incorporate in the responses to global ratings of their oral health (OH) and OH-related overall well-being (OWB). METHODS: Data were collected as part of a project to validate the Child Perceptions Questionnaire for ages 11-14 (CPQ11-14), a self-report measure of OH-related quality of life. Its 37 questions are organized in the symptoms, functional limitations, emotional and social well-being domains. Children were recruited from paediatric dentistry, orthodontic and orofacial dental clinics. To identify the CPQ11-14 domain scores and questions predicting the global ratings, correlation and multiple regression analyses were used. RESULTS: Of the 123 children, 22.8% rated their OH as 'Fair/Poor' and 30.1% reported that their OWB was affected by their oral/orofacial condition. Positive significant correlations were observed between the OH ratings and the CPQ11-14 oral symptoms and emotional well-being domains, and between the OWB ratings and all four CPQ11-14 domains. The number of the CPQ11-14 questions significantly correlated with the OH and OWB ratings were 8 and 19, respectively. Only the symptoms domain entered the model for the OH (R2=0.05), while age, functional limitations and emotional well-being domains predicted the OWB (R2=0.18). The OH model included three questions (R2=0.13) and the OWB model included age and six questions (R2=0.25). In both models all but one of the questions came from the emotional and social well-being domains. CONCLUSIONS: These findings suggest that children view OH and its impact on well-being as multidimensional concepts. Further research, including qualitative studies, is needed to better understand the referents children use when responding to global ratings and the factors that determine their responses.