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.     

Caries and background factors in Norwegian and immigrant 5-year-old children

Wigen TI, Wang NJ. Caries and background factors in Norwegian and immigrant 5‐year‐old children. Community Dent Oral Epidemiol 2010; 38: 19–28. © 2009 John Wiley & Sons A/S Abstract – Objectives: The purpose of this study was to assess the caries status of 5‐year‐olds in a low caries area, and study associations between dental caries and parent‐related factors: parents’ education, national origin, oral health behaviours and attitudes. Methods: The material consisted of 523 children and was a stratified random sample. Clinical and radiographic examination was performed in 2007. Enamel and dentine caries were recorded at surface level. Parents filled in questionnaires regarding socioeconomic status, their own oral health behaviours and attitudes. Results: Most participants (66%) had no caries experience and 16% had enamel caries only. Dentine caries experience was present in 18% of the children, and 5% had dentine caries experience in five or more teeth. Surfaces with enamel caries constituted half of all surfaces with caries experience. In multiple logistic regression, statistically significant risk indicators for the child having dentine caries experience at the age of five were: having one or both parents of non‐western origin (OR = 4.8), both parents (OR = 3.0) or one parent (OR = 2.1) with low education, parental laxness about the child’s tooth brushing (OR = 2.8), parents’ brushing their own teeth less than twice a day (OR = 2.2) and having parents with frequent sugar intakes (OR = 1.8). Conclusion: Caries prevalence in 5‐year‐olds was strongly associated with parent‐related factors signifying that information on parents’ socioeconomic status, dental behaviours and attitudes should be considered when planning dental services for young children. Our results suggest that the real high risk group is non‐western children whose parents have low education.     

Parental perceptions of their preschool-aged children's oral health

BACKGROUND: Parents have an important role in making decisions about their children's oral health. The purpose of the authors' study was to determine parental perceptions of their children's oral health status and factors correlated with these perceptions of health. METHODS: The authors analyzed data for 3,424 children (2-5 years of age) from the Third National Health and Nutrition Examination Survey. They based the dependent variable on a question asked of primary caregivers: "How would you describe the condition of [child's name]'s natural teeth?" Explanatory variables included demographic variables, dental visits, perception of child's general health, need for dental care and presence of tooth caries. RESULTS: Eighty-nine percent of parents rated their child's oral health as excellent, very good or good, and 11 percent rated it as fair or poor (mean = 2.7 on a five-point scale, with 1 being excellent and 5 being poor). Tooth caries, perceived need for dental cleaning and treatment, lower income and poorer general health perceptions were associated with poorer parental ratings. CONCLUSIONS: Actual disease and perceived need are associated significantly with parents' perceptions of their children's oral health. PRACTICE IMPLICATIONS: Understanding parents' perceptions of their children's oral health and factors that motivate these perceptions can help dentistry overcome barriers that parents encounter in accessing dental care for their children.     

Oral problems and quality of life of preschool children: self‐reports of children and perception of parents/caregivers

The purpose of this study was to evaluate the association between oral health problems and oral health‐related quality of life (OHRQoL) of preschool children according to both self‐reports and the reports of parents/caregivers. A school‐based, cross‐sectional study was conducted with 769 preschool children and their parents/caregivers. The OHRQoL was evaluated using the Scale of Oral Health Outcomes for Five‐Year‐Old Children (SOHO‐5). Based on logistic regression for complex samples, the following variables were found to be associated with poorer OHRQoL in the parent/caregiver version: toothache (OR = 6.77; 95% CI: 3.95–11.59); consequences of untreated dental caries (OR = 2.69; 95% CI: 1.27–5.70); and anterior open bite (OR = 2.01; 95% CI: 1.13–3.56). The following variables were associated with poorer OHRQoL in the child self‐report version: toothache (OR = 3.34; 95% CI: 2.11–5.29); cavitated lesions (anterior teeth) (OR = 2.20; 95% CI: 1.26–3.84); occurrence of traumatic dental injury (OR = 1.77; 95% CI: 1.19–2.61); and anterior open bite (OR = 1.95; 95% CI: 1.16–3.29). We conclude that children with dental caries (or its sequelae) had poorer OHRQoL. Having experienced a traumatic dental injury and having a malocclusion were also associated with a poorer OHRQoL.     

Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children

Background

Disparities in utilization of oral healthcare services have been attributed to socioeconomic and individual behavioral factors. Parents’ socioeconomic status, demographics, schooling, and perceptions of oral health may influence their children’s use of dental services. This cross-sectional study assessed the relationships between socioeconomic and psychosocial factors and the utilization of dental health services by children aged 1–5 years.

Methods

Data were collected through clinical exams and a structured questionnaire administered during the National Day of Children’s Vaccination. A Poisson regression model was used to estimate prevalence ratios and 95% confidence intervals.

Results

Data were collected from a total of 478 children. Only 112 (23.68%) were found to have visited a dentist; 67.77% of those had seen the dentist for preventive care. Most (63.11%) used public rather than private services. The use of dental services varied according to parental socioeconomic status; children from low socioeconomic backgrounds and those whose parents rated their oral health as “poor” used dental services less frequently. The reason for visiting the dentist also varied with socioeconomic status, in that children of parents with poor socioeconomic status and who reported their child’s oral health as “fair/poor” were less likely to have visited the dentist for preventive care.

Conclusion

This study demonstrated that psychosocial and socioeconomic factors are important predictors of the utilization of dental care services.

     

The association between low-socioeconomic status mother's Sense of Coherence and their child's utilization of dental care

da Silva AN, Mendonça MH, Vettore MV. The association between low‐socioeconomic status mother’s Sense of Coherence and their child’s utilization of dental care. Community Dent Oral Epidemiol 2011; 39: 115–126. © 2010 John Wiley & Sons A/S Abstract – Objectives: The objective of this study was to investigate the relationship of low‐socioeconomic status mother’s Sense of Coherence (SOC) and their child’s utilization of dental care services in a city of Southeast Brazil. Methods: A cross‐sectional study was conducted on a sample of 190 schoolchildren aged 11–12 and their mothers in Sao João de Meriti‐RJ, Southeast Brazil. The outcome variables were children’s use of dental care services and visiting dentists mainly for check‐ups. Demographic and socioeconomic characteristics and data regarding children’s dental care use were collected through interviews with mothers. Children’s oral health‐related behaviours as well as dental status (DMFS index), dental pain, Visible Dental Plaque and Bleeding on Probing Index were registered. Mother’s SOC was assessed through the validated short version (13‐item) of Antonovsky’s scale. Multiple logistic regression was used in the data analysis. Results: Of the mothers, 81.1% reported on their child’s utilization of dental care services. Of them, 42.9% considered check‐ups as the main reason for taking their children to dental services. Children whose mothers had higher levels of SOC were more likely to utilize dental care services (OR = 2.08 95%CI = 1.17–3.64) and visit a dentist mainly for check‐ups (except for dental treatment) (OR = 2.02 95%CI = 1.06–3.81) than those whose mothers had lower levels of SOC. These findings were adjusted for socioeconomic status, children’s oral health‐related behaviours and oral health measures. Conclusions: Mother’s SOC was a psychosocial factor associated with their child’s pattern of use of dental care services in low‐socioeconomic status families.     

Oral health-related quality of life and early childhood caries among preschool children in Trinidad

Background

Early childhood caries (ECC) is a public health problem in developed and developing countries. The purpose of this study was to describe the relationship between oral health-related quality of life (OHRQoL) and ECC among preschool children in a Caribbean population.

Method

Parents/primary caregivers of children attending nine, randomly selected preschools in central Trinidad were invited to complete an oral health questionnaire and have their child undertake an oral examination. The questionnaire included the Early Childhood Oral Health Impact Scale (ECOHIS). Visible caries experience was assessed using WHO criteria. Logistic regression models were used to determine the factors associated with OHRQoL and ECC.

Results

Three hundred nine parents/caregivers participated in the study (age-range 25–44 years) and 251 children (mean age 3.7 years) completed oral examinations. Adjusting for other factors, the odds for a child aged 4 years of having dental caries were greater than the odds for a child aged 3 years (OR 3.61; 95% CI (1.76, 6.83). The odds for children having difficulty drinking hot or cold drinks were greater for those with dental caries than the odds for children who have no such difficulty. Similarly, the odds for children who had difficulty eating were greater for those with dental caries than the odds ratios for children who had no difficulty eating (OR 8.29; 95% CI (2.00, 43.49). Adjusting for the effects of other factors, the odds of parents/caregivers feeling guilty were greater if their child had experienced dental caries in comparison to parents/caregivers whose child did not have dental caries (OR 3.50; 95% CI (1.32, 9.60). Adjusting for other factors, the odds of parents/primary caregivers having poor quality of life was increased when they had a child with a dmft in the range 1–3 (OR 2.68; 95% CI (1.30, 5.64) dmft?>?4 (OR 8.58; 95%CI (3.71, 22.45), in comparison to those whose child had a dmft?=?0.

Conclusion

In this sample of preschool children OHRQoL was associated with ECC. More negative impacts were found in children with a greater severity of visible caries experience. This suggests the need for strategies to prevent and manage ECC in this Caribbean population.

     

Parental stress as a predictor of early childhood caries among preschool children in India

International journal of Paediatric Dentistry 2013; 23: 160–165 Background. The health and well‐being of children are linked to their parents’ physical, emotional and social health in addition to child‐rearing practices. Objectives. To investigate the association of parental stress as a risk indicator to early childhood caries (ECC) prevalence among preschool children of Moradabad, India. Methods. A case–control study was conducted among 800 preschool children [400 cases (caries active) and 400 controls (caries free)] aged 4–5 years along with their parents. Using the Parental Stress Index‐Short Form (PSI/SF), we determined the stress of primary caregivers of young children. These children were clinically examined for dental caries using Dentition Status and Treatment needs. Student’s t‐test, Pearson’s correlation and linear regression were used for statistical analysis. Results. An overall mean parenting stress index was found to be 193.48 ± 59.63. Significantly higher mean stress scores were obtained among cases than among controls. Parental stress was significantly correlated with dmft scores and it was found to be one of the best predictors of ECC. Conclusion. This study provides data to suggest that parental stress has a pervasive impact on the children’s oral health. The practitioners should be aware of this possible relationship and be prepared to provide appropriate intervention.     

Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers

ABSTRACT: BACKGROUND: Little is known about oral health in early childhood in the West Indies or the views and experiences of caregivers about preventive oral care and dental attendance The aims of this study were to explore and understand parents and caregivers experience of oral healthcare for their preschool aged child and how, within their own social context, this may have shaped their oral health attitudes and behaviours. These data can be used to inform oral health promotion strategies for this age group. METHOD: After ethical approval, a qualitative study was undertaken using a focus group approach with a purposive sample of parents and caregivers of preschool children in central Trinidad. Group discussions were initiated by use of a topic guide. Audio recording and field notes from the three focus groups, with a total of 17 participants, were transcribed and analysed using a thematic approach. RESULTS: Despite some ambivalence toward the importance of the primary teeth, the role of fluoride and confusion about when to take a child for their first dental visit, most participants understood the need to ensure good oral hygiene and dietary habits for their child. Problems expressed included, overcoming their own negative experiences of dental care, along with finding affordable and suitable dental care for their child. There was difficulty in establishing good brushing routines and controlling sweet snacking in the face of many other responsibilities at home. Lack of availability of paediatric dental services locally and information on oral health care were also highlighted. Many expressed a need for more contact with dental professionals in non-clinic settings, for oral health care advice and guidance. CONCLUSION: Parents and caregivers in this qualitative study showed generally positive attitudes towards oral health but appear to have encountered several barriers and challenges to achieving ideal preventive care for their child, with respect to healthy diet, good oral, hygiene and dental attendance. Oral health promotion should include effective dissemination of oral health information, more practical health advice and greater access to dental care for families with preschool children. KEYWORDS: Preschool children, oral health, parents, caregivers, qualitative, focus groups, West Indies.     

Oral health status of rural–urban migrant children in South China

International Journal of Paediatric Dentistry 2011; 21: 58–67 Background. In China, there is a massive rural–urban migration and the children of migrants are often unregistered residents (a ‘floating population’). Aim. This pilot study aimed to profile the oral health of migrant children in South China’s principal city of migration and identify its socio‐demographic/behavioural determinants. Design. An epidemiological survey was conducted in an area of Guangzhou among 5‐year‐old migrant children (n = 138) who received oral examinations according to the World Health Organization criteria. Parents’ oral health knowledge/attitude, child practices, and impact of children’s oral health on their quality‐of‐life (QoL) were assessed. Results. The caries rate and mean (SD) dmft were 86% and 5.17 (4.16), respectively, higher than those national statistics for both rural and urban areas (P < 0.05). Oral hygiene was satisfactory (DI‐S < 1.0) in 3% of children. Oral health impacts on QoL were considerable; 60% reported one or more impacts. 58% variance in ‘dmft’ was explained by ‘non‐local‐born’, ‘low‐educated parents’, ‘bedtime feeding’, ‘parental unawareness of fluoride’s effect and importance of teeth’, and ‘poor oral hygiene’ (all P < 0.05). ‘Non‐local‐born’ and ‘dmft’ indicated poor oral health‐related QoL (both P < 0.05), accounting for 32% of variance. Conclusion. Oral health is poor among rural–urban migrant children and requires effective interventions in targeted sub‐groups.     

Oral health-related quality of life and caries experience of Hong Kong preschool children

Objective: This study aimed to investigate the association between oral health-related quality of life (OHRQoL) and caries experience of Hong Kong preschool children. Methods: Parents or primary caregivers of Hong Kong preschool children were invited to complete a self-administered dental health questionnaire. The study children were examined in their classrooms. The decayed, missing and filled primary teeth (dmft) index was used for documenting the caries status. The questionnaire included the Chinese Early Childhood Oral Health Impact Scale (ECOHIS) and collected sociodemographic information on the parents and children. Logistic regression analysis was used to determine the association between OHRQoL and caries experience of preschool children. Results: A total of 434 preschool children were invited to participate in the study; 336 (77.4%) received a dental examination and returned a parental questionnaire. The mean (SD) age of the study children was 4.7 (0.3) years. An OHRQoL impact (ECOHIS score of >0) for at least one item was reported by 236 (70.2%) parents/caregivers of the children included in the study. The overall mean (SD) ECOHIS score was 5.8 (6.2). A caries prevalence (dmft > 0) of 36.9% and a mean (SD) dmft score of 1.7 (3.2) were calculated for the study children. In the final logistic regression model, children with a higher dmft score had a significantly higher chance of having a poorer OHRQoL (OR = 1.20, 95% CI: 1.07–1.35, P = 0.002), whereas children’s sex, parent’s education levels and the respondent’s relationship to the child were not associated with OHRQoL (P > 0.05). Conclusion: Caries experience is associated with lower OHRQoL of Hong Kong preschool children.Key words: Child, dental caries, early childhood caries, oral health, quality of life     

Impact of oral diseases and disorders on oral health-related quality of life of preschool children

Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bönecker M, Raggio DP. Impact of oral diseases and disorders on oral health‐related quality of life of preschool children. Community Dent Oral Epidemiol 2011; 39: 105–114. © 2010 John Wiley & Sons A/S Abstract – Background: The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well‐being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. Objective: To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health‐related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors. Methods: Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children’s OHRQoL and socioeconomic conditions. Two calibrated dentists (κ > 0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0 = caries free; 1–5 = low severity; ≥6 = high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome. Results: In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (P < 0.001). TDI and AMT did not show a negative impact on OHRQoL nor in each domain (P > 0.05). The increase in the child’s age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (P < 0.05). The multivariate adjusted model showed that the high severity of ECC (RR = 3.81; 95% CI = 2.66, 5.46; P < 0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR = 0.93; 95% CI = 0.87, 0.99; P < 0.001). Conclusions: The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents.     

Maternal perception about child oral health is associated to child dental caries and to maternal self-report about oral health

Objective: To test the association between maternal perception about child’s oral health and child dental caries experience and maternal self-perception about oral health.

Materials and methods: A cross-sectional study was performed with mothers and their children aged six to 13 years. A questionnaire was applied to mothers. Children were dentally examined using the DMF-T/dmf-t Index. For analysis, Poisson regression models with robust variance were employed for each variable of interest (child dental caries experience and maternal self-report about oral health). Magnitudes of associations were estimated through Prevalence Ratio (PR) as effect measure with 95% confidence intervals (CI). A significant level of p?≤?.05 was adopted.

Results: Overall, 131 mothers-children dyads were included. Most of children were girls (52.7%) and aged between 10 to 13 years (60.3%). Negative maternal perception about child’s oral health was associated to maternal negative self-perception about oral health (PR 2.54; 95%CI 1.54–4.30) and to higher child dental caries experience (PR 2.21; 95%CI 1.41–3.47).

Conclusion: Maternal perception about child oral health was associated to child dental caries and to maternal self-report about oral health.     

Oral-health-related background factors and dental service utilisation among Sudanese children with and without a congenital heart defects

Background

Sudanese children with congenital heart defects (CHDs) were found to have poorer oral health than those without CHDs. The aims of this study were to: describe the patterns of oral-health-related background factors in children with and without CHD and explore any differences, and to evaluate the effects of background factors on caries and gingivitis prevalence and dental services utilisation.

Methods

In this analytical cross-sectional study, caregivers of children aged 3–12 years with (CHD cases n?=?111) and without CHDs (Controls n?=?182), underwent face-to-face interviews using a structured questionnaire. The questionnaire items covered several oral health background factors (independent variables) including: child’s health status, oral hygiene practices, dental services utilization, mother’s level of education, and caregiver’s perception and awareness of their child’s oral health. The relationship between these factors and occurrence of ‘caries’ and ‘gingivitis’ as well as ‘child’s dental services utilisation’ (dependent variables) were explored using multiple adjusted and hierarchal logistic regression analyses.

Results

Compared with controls, CHD cases had lower frequencies of brushing and use of fluoridated toothpaste, and their caregivers were less knowledgeable about caries. Among CHD cases, the variables (brushing and fluoridated toothpaste use) had significant impacts on caries prevalence (odd ratio (OR) =5.6, 95% confidence interval (CI): 1.4–22.8 and OR?=?0.3, 95% CI: 0.1–0.8 for infrequent compared to frequent ones, respectively) as well as the mother’s level of education (OR?=?2.6, 95% CI: 1.0–6.4). When differences in background factors were controlled for, the adjusted ORs for caries and gingivitis prevalence in CHD cases compared with controls were 1.8, (95% CI: 1.1–3.2) and 5.3 (95% CI: 2.9–9.4), respectively. Among CHD cases, the child’s age (8–12 years: OR?=?11.9, 95% CI: 1.9–71.6), and the mother’s level of education (lower education: OR?=?0.2, 95% CI: 0.03–0.9) were significantly associated with the child’s dental services utilisation.

Conclusions

Lower frequencies of brushing and use of fluoride tooth paste were reported among CHD cases, and brushing had the predominant significant impact on caries prevalence. The child’s age and the mother’s level of education were the main factors affecting the child’s (CHD cases) dental services utilisation.

     

Oral health and 22q11 deletion syndrome: thoughts and experiences from the parents’ perspectives

International Journal of Paediatric Dentistry 2010; 20: 283–292 Background. 22q11 deletion syndrome (22q11DS) is one of the most common multiple anomaly syndromes, and many dentists are likely to meet patients with the syndrome. Odontological research has focused on describing and analysing conditions/concepts based on the current state of knowledge within the dental profession. Yet, these research topics are not necessarily the most important issues for the patients. Aims. To explore and describe, by use of Grounded theory, parents’ experiences of oral health issues and needs for dental care in their children with 22q11DS. Design. Twelve parents from different regions in Sweden were interviewed. Analyses were carried out according to Grounded theory. Results. Parents recognised good oral health as important for the wellbeing of their children. Oral health was a concern and the parents described the fight for this as struggling in vain for good oral health in their child. Conclusions. Parents not only described their children’s oral health as important but also hard to gain. Thus, it is important that all patients with disabilities, regardless of whether there is a defined medical diagnosis or not, are identified and well taken care of in the dental care system.     

Follow-up of children’s oral health-related quality of life after dental general anaesthesia treatment

Objective: Our aim was to analyze longitudinally the impact of young children’s dental general anaesthesia (DGA) treatment on their OHRQoL and to determine their post-operative oral health status at the six-month follow-up together with parental ratings of their children’s oral health.

Material and methods: We conducted a prospective follow-up study of OHRQoL among Lithuanian child patients treated under general anaesthesia (n?=?144). The study consisted of clinical dental examinations performed by two examiners at the time of DGA and at the six-month recall, along with OHRQoL surveys and data collected from the patients’ files. The dmft index and Silness–Löe plaque index served as clinical measures. The survey tool for assessing the children’s OHRQoL was the previously tested Lithuanian version of the ECOHIS. The Wilcoxon signed-rank test served for the statistical analysis (p?Results: The ECOHIS scores clearly decreased post-operatively, indicating a significant (p?p?Conclusions: This longitudinal study showed a sustained improvement in the children’s OHRQoL six months after their DGA treatment. Post-operative parental ratings of their child’s oral health were higher after the DGA treatment, but the children exhibited insufficient oral hygiene and new caries lesions. An appropriate follow-up system for children receiving DGA treatment with special focus on preventive care is needed.     

Parents' perception of dental caries in intellectually disabled children

The aim of this study was to evaluate the parents’ perception of dental caries in children with intellectual disability. This cross‐sectional study was conducted with 6 to 14 years old schoolchildren: Group 1 (50 children diagnosed with intellectual disabilities) and Group 2 (50 children without it). The dental caries was assessed by the World Health Organization (WHO) criteria for primary and permanent teeth. Parents’ psychosocial perception was assessed by Early Childhood Oral Health Impact Scale (ECOHIS). Similar prevalence of caries free children was found between groups in both dentitions. In primary dentition the caries index was higher in Group 2, and the opposite occurred in permanent teeth. Group 1 presented higher impact (p < .05) in the dimension drinking, eating and pronunciation, whereas in Group 2 there was higher impact (p = .01) on pain, sleep, irritation, the smile and family finances. Findings showed significant impact of dental caries on parents’ perception of the oral health related quality of life of children with intellectual disabilities.