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.     

深圳市成人牙科畏惧症患者的口腔健康相关生活质量研究

目的：研究牙科畏惧症（DF）患者的口腔健康相关生活质量。方法：选择在深圳市第五人民医院口腔科门诊就诊的358名18～75岁初诊患者,应用口腔焦虑量表（CDAS）和口腔健康影响程度量表（OHIP-14中文版）、人口统计学一般项目表进行调查。结果：DF患者的OHIP-14的分值中位数为21.25,明显高于一般就诊患者（中位数11.20）。且在生理性疼痛、心理不适和心理障碍等领域影响最大。CDAS与OHIP-14分值间的相关系数为0.255。结论：在牙科畏惧症患者中,牙科畏惧程度与口腔健康影响程度之间存在相关性,焦虑程度越高的患者口腔健康相关生活质量越差。对牙科畏惧症患者进行有效的心理干预可以提高其相关生活质量。     

Oral health-related quality of life and severe hypodontia

The aims of the study were to assess oral health-related quality of life (ohqol) impact among patients with severe hypodontia and to determine the association between ohqol and the number of missing teeth. Twenty-five patients with severe hypodontia (four or more missing permanent teeth) self-completed the child perception questionnaire (CPQ) to assess oral symptoms (OS), functional limitation (FL), emotional well-being (EWB) and social well-being (SWB). Correlation between CPQ scores (overall and at domain level) and the number of missing teeth was assessed. All participants reported ohqol impact, 100% reported experiencing OS, 88% FL, 55% EWB and 100% SWB impacts. The correlation between the number of missing permanent teeth and the CPQ scores was moderate: overall CPQ score (r = 0.54), OS (r = 0.41), FL (0.52), EWB (0.52), SWB (0.49), P < 0.05. Having accounted for retained primary teeth (where a retained primary tooth was considered to have compensated for a missing permanent tooth), the correlation between the number of missing teeth and CPQ scores was strong: overall CPQ score (r = 0.94), OS (r = 0.78), FL (0.88), EWB (0.92), SWB (0.70), P < 0.001. Subjects with severe hypodontia report considerable ohqol impact. The number of missing permanent teeth was moderately correlated with ohqol. However, when retained primary teeth were taken into account, the number of missing teeth was highly correlated with ohqol. This study has implications in understanding the impact of hypodontia on quality of life and highlights the importance of retaining primary teeth in children and adolescents with severe hypodontia.     

Oral health-related quality of life in patients with dental anxiety

OBJECTIVES: To investigate the frequency of impaired oral health-related quality of life (OHRQoL) in patients with dental anxiety. METHODS: OHRQoL was measured with the German version of the 14-item Oral Health Impact Profile (OHIP) developed by Slade and Spencer (1994) in 173 adult patients with dental anxiety [Dental Anxiety Scale (DAS) score 15 or above and Dental Fear Survey (DFS) score 60 or above]. The OHIP summary scores were characterized with an empirical cumulative distribution function and compared with the level of impaired OHRQoL in the general population (n = 2026, age: 16-79 years). In addition, OHIP item prevalences (responses 'fairly often'/'very often') were compared between patients and population subjects. The correlation between DAS, DFS and OHIP scores was calculated using the Pearson correlation coefficient. RESULTS: A median value of 1 and a 90th percentile value of 13 were observed for general population subjects. In contrast, patients with phobic dental anxiety had a median OHIP-14 of 21 and the 90th percentile of 40. All problems mentioned in the OHIP-14 were more prevalent in patients than in population subjects. The most frequently occurring items in patients were 'self-conscious', 'life in general was less satisfying', and 'feeling tense' with prevalences of 50% or greater. In contrast, these items had prevalences of only 1-3% in the general population. A low to moderate relationship between OHRQoL and both dental anxiety measures (DAS and DFS) was observed (r = 0.25/0.26, P < 0.01). CONCLUSIONS: Patients with dental anxiety/fear suffer considerably from impaired OHRQoL and the degree of this impairment is related to the extent of dental anxiety/fear.     

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.     

Oral health-related quality of life in Germany

The prevalence of impaired oral health-related quality of life (OHRQoL) in Germany is unknown. The aim was to determine the OHRQoL distribution in the population and to derive population-based norms. OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G, 53 items) which was administered in a personal interview to 2050 subjects (response proportion: 60%) 16-79 yr of age. Subjects were sampled using a multistage sampling technique in a national survey. Prevalence was calculated for any impairment on the item (OHIP answer categories ranging from 'hardly ever' to 'very often') and for frequent problems (categories 'fairly often' and 'very often'). Norms for the OHIP-G summary score (sum of all item responses in the English-language OHIP, range 0-196) were described by percentiles. Past-month prevalence of any impairment in OHRQoL ranged from 13% to 46% across all items. Frequent problems were rare (/= 5 OHIP-G score points and 10% had >/= 38 points. For subjects with removable dentures the scores were 15 and 60 points, respectively, and for subjects with complete dentures, 23 and 85 points, respectively. The results provide the first overview of impaired OHRQoL in Germany.     

Oral health-related quality of life of children with neutropenia

This study evaluated the oral health-related quality of life (OHQoL) in children with neutropenia. Twenty-seven children with neutropenia were compared to 33 healthy, age-matched control subjects. Previously validated age- specific, multidimensional and self -reporting child OHQoL questionnaires were used. Overall and subscale scores were compared between the two groups. Respondents in the group of children with neutropenia reported that their disease had a significant impact on their oral health in terms of oral symptoms (p<0.0001), functional limitations (p<0.0001), and social well-being (p<0.0001). In global ratings, they rated their oral health to be markedly worse than that of the healthy subjects (p<0.0001). However, there was no difference between the groups in the extent to which their oral condition affected their lives overall. These results, along with responses to individual measures of social and emotional well-being, suggest that children in this group with neutropenia have psychologically adapted to the oral health challenges they experience because of their condition.     

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression

The aim of this cross‐sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3–5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health‐related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio‐economic characteristics of the family. Statistical analyses were performed using the chi‐square test, Kruskal–Wallis test, Mann–Whitney U‐test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children.     

Oral health status of homeless people in Hong Kong

The authors report on an oral health survey among Hong Kong Chinese homeless people. A total of 140 homeless men underwent clinical examination and were interviewed with a structured questionnaire. More than 90% had evidence of caries experience; most (75%) were related to untreated caries. The mean DMFT score was 9.0 (DT=3.2, MT=5.2. FT=0.6). Periodontal disease was highly prevalent, with 96% having periodontal pockets. The dental problems most frequently reported by the homeless were: bleeding gums or drifting teeth (62%), dental pain (52%) and tooth trauma (38%). More than 70% of the study's participants perceived a need for dental care. The population surveyed had poorer oral health compared to the general population. High levels of dental needs, both normative and perceived, were found. There is a need to provide more accessible and affordable oral health services to this group of people.