Cláudia Marina Viegas

Influence of traumatic dental injury on quality of life of Brazilian preschool children and their families

AIM The aim of this study was to evaluate the impact of traumatic dental injury (TDI) on the oral health-related quality of life (OHRQoL) of Brazilian preschool children and their families. MATERIAL AND METHODS A cross-sectional study was carried out with 1632 children of both sexes aged 60-71 months in the city of Belo Horizonte, Brazil. Data on OHRQoL were collected using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), which was self-administered by parents/caregivers to record their perceptions regarding the oral health of their children. A questionnaire addressing demographic and socio-economic data was also sent to parents/caregivers. Oral examinations of the children were performed by a single, previously calibrated dentist (intraexaminer and interexaminer agreement: kappa ≥ 0.83) for the assessment of the prevalence and type of TDI using the diagnostic criteria proposed by Andreasen et al. [2007]. Bivariate and multiple Poisson regression analyses were performed, with the level of significance set at 5%. RESULTS The prevalence of negative impact from oral conditions on quality of life was 36.8% and 31.4% for children and families, respectively. TDI was not significantly associated with OHRQoL. Tooth avulsion remained in final multiple models of child OHRQoL [PR = 1.37, 95%CI = 1.02-1.85] and family OHRQoL [PR = 1.55, 95%CI = 1.12-2.14]. Tooth discolouration remained in the final multiple models of family OHRQoL [PR = 1.23, 95%CI = 1.05-1.44]. CONCLUSIONS The presence of TDI in Brazilian preschool children has no impact on quality of life of the children or their families. However, tooth avulsion is associated with a negative impact on OHRQoL in both groups, and tooth discolouration is associated with a negative impact on family OHRQoL.

Impact of Malocclusion on Oral Health-Related Quality of Life among Brazilian Preschool Children: a Population-Based Study

The purpose of the present study was to evaluate the impact of malocclusion on Oral Health-Related Quality of Life (OHRQoL) of children and their families. A population-based cross-sectional study was carried out in Belo Horizonte, MG, Brazil. A representative sample of 1069 male and female preschoolers aged 60 to 71 months was randomly selected from public and private preschools and daycare centers. Data were collected using the B-ECOHIS. In addition, a questionnaire addressing socioeconomic and demographic data was self-administered by the parents/guardians. The criteria used to diagnose malocclusion were based on Foster and Hamilton (1969), Graboswki et al. (2007) and Oliveira et al. (2008). Descriptive, univariate and multiple Poison logistic regression analyses were carried out. The prevalence of malocclusion was observed in 46.2% of the children and deep overbite was the most prevalent type of malocclusion (19.7%), followed by posterior crossbite (13.1%), accentuated overjet (10.5%), anterior open bite (7.9%) and anterior crossbite (6.7%). The impact of malocclusion on OHRQoL was 32.7% among the children and 27.1% among the families. In Poisson multiple regression model adjusted for socioeconomic status, no significant association was found between malocclusion and OHRQoL of the children (PR=1.09, 95% CI: 0.96-1.24) and their families (PR=1.11, 95% CI: 0.94-1.31). It is concluded that children with malocclusion in this sample did not have a negative impact on their OHRQoL and of their families.

Post-discharge adverse events following pediatric sedation with high doses of oral medication.

OBJECTIVE To compare the occurrence of post-discharge adverse events in children having received a high dose of either chloral hydrate (CH) or midazolam (MZ) during outpatient dental treatment. STUDY DESIGN A repeated-measures study design was carried out with 42 children treated at a sedation center. The sample comprised 103 dental sedation sessions among 22 male and 20 female patients, 1-8 years old, receiving either MZ (1.0-1.5 mg/kg) or CH (70.0-100.0 mg/kg). During treatment, a single observer recorded intraoperative adverse events. Twenty-four hours later, the observer called the childs main caregiver seeking information on further adverse events. Data analysis involved descriptive and bivariate statistics and the general estimating equation for repeated measures. RESULTS The most common intraoperative and post-discharge adverse events were hallucination (3.9%) and excessive sleep (41.9%), respectively. The chance of the occurrence of an adverse event following oral pediatric sedation was lesser among the children who received MZ than those who received CH (OR: 0.09; 95% CI: 0.01-0.88). CONCLUSIONS High doses of CH were associated with post-discharge adverse events in children having undergone pediatric dental sedation, whereas high doses of MZ were not associated with these events in pediatric patients.

The PedsQL™ Oral Health Scale: feasibility, reliability and validity of the Brazilian Portuguese version

BackgroundOral and orofacial problems may cause a profound impact on children’s oral health-related quality of life (OHRQoL) because of symptoms associated with these conditions that may influence the physical, psychological and social aspects of their daily life. The OHRQoL questionnaires found in the literature are very specific and are not able to measure the impact of oral health on general health domains. Consequently, the objective of this study was to evaluate the psychometric properties of the Portuguese version for Brazilian translation of the Pediatric Quality of Life Inventory™ (PedsQL™) Oral Health Scale in combination with the PedsQL™ 4.0 Generic Core Scales.MethodsThe PedsQL™ Oral Health Scale was forward-backward translated and cross-culturally adapted for the Brazilian Portuguese language. In order to assess the feasibility, reliability and validity of the Brazilian version of the instrument, a study was carried out in Belo Horizonte with 208 children and adolescents between 2 and 18 years-of-age and their parents. Clinical evaluation of dental caries, socioeconomic information and the Brazilian versions of the PedsQL™ Oral Health Scale, PedsQL™ 4.0 Generic Core Scales, Child Perceptions Questionnaire (CPQ11-14 and CPQ8-10) and Parental-Caregiver Perception Questionnaire (P-CPQ) were administered. Statistical analysis included feasibility (missing values), confirmatory factor analysis (CFA), internal consistency reliability, and test-retest intraclass correlation coefficients (ICC) of the PedsQL™ Oral Health Scale.ResultsThere were no missing data for both child self-report and parent proxy-report on the Brazilian version of the PedsQL™ Oral Health Scale. The CFA showed that the five items of child self-report and parent proxy-report loaded on a single construct. The Cronbachs alpha coefficients for child/adolescent and parent oral health instruments were 0.65 and 0.59, respectively. The test-retest reliability (ICC) for child self-report and parent proxy-report were 0.90 [95% confidence interval (CI) = 0.86-0.93] and 0.86 (95%CI = 0.81-0.90), respectively. The PedsQL™ Oral Health Scale demonstrated acceptable construct validity, convergent validity and discriminant validity.ConclusionsThese results supported the feasibility, reliability and validity of the Brazilian version of the PedsQL™ Oral Health Scale for child self-report for ages 5–18 years-old and parent proxy-report for ages 2–18 years-old children.