Matheus França Perazzo

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.

Association between psychological factors, socio-demographic conditions, oral habits and anterior open bite in five-year-old children

Abstract Objective: The aim of the present study was to evaluate association between psychological factors, socio-demographic conditions, oral habits and anterior open bite in five-year-old preschool children. Materials and methods: A cross-sectional study was conducted with 764 pairs of children and parents/caregivers in preschools. The parents/caregivers answered questionnaires addressing oral health-related quality of life (OHRQoL), sense of coherence, locus of control, oral habits and socio-demographic characteristics. The children answered a self-report questionnaire addressing OHRQoL and were submitted to a clinical examination for the anterior open bite by examiners. Descriptive analysis was conducted, followed by Poisson’s regression analysis. Results: The prevalence of anterior open bite was 15.2%. The following variables remained significantly associated with anterior open bite: pacifier use (PR = 7.09; 95% CI: 4.06–12.39), attending a public preschool (PR = 2.40; 95% CI: 1.68–3.43), digit sucking (PR = 2.15; 95% CI: 1.27–3.62), greater number of residents in the home (PR = 1.67; 95% CI: 1.18–2.36) and impact on OHRQoL according to child’s report (PR = 1.56; 95% CI: 1.11–2.20). Conclusions: Anterior open bite was associated with OHRQoL according to the children’s reports. Moreover, attending a public preschool, a greater number of residents in the home, digit sucking and pacifier sucking were associated with this type of malocclusion.

Contextual and individual determinants of oral health-related quality of life among five-year-old children: a multilevel analysis

Background Contextual factors may influence oral health-related quality of life (OHRQoL) in children. The aim of the present study was to evaluate the influence of individual and contextual determinants of OHRQoL based on the perceptions of children. Methods A cross-sectional study was conducted with a representative sample of 769 five-year-old children from public and private preschools in a city in the countryside of northeast Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, sociodemographic data and aspects of the child’s oral health. The children answered the child version of the Scale of Oral Health Outcomes for five-year-old children and were submitted to oral examinations. Variables related to the context were obtained from the schools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models were used to investigate associations between variables. Results In the adjusted analysis, parent’s/caregiver’s schooling, household income, parent’s/caregiver’s age, a history of dental pain, dental caries and its consequences and traumatic dental injury were considered individual determinants of OHRQoL according to the children’s self-reports. After the incorporation of the contextual determinants, the association between parent’s/caregiver’s schooling and OHRQoL lost its significance. Type of school was the context variable that remained associated with OHRQoL. Discussion Besides the clinical and sociodemographic individual characteristics, characteristics of the school environment in which the child studies are associated with self-reported impacts on OHRQoL.

Evaluation of determinant factors for the presence and activity of dental caries in five-year-old children: study with decision tree

AimThe aim of the present study was to investigate dental caries and caries activity as well as determine associations with sociodemographic factors and visits to the dentist among 5-year-old children.Subjects and methodsSeven hundred sixty-nine children enrolled in preschools in a medium-sized city in northeast Brazil participated in the study. Two examiners who had undergone training exercises performed the examinations using the ICDAS-II. Descriptive statistics and logistic regression for complex samples were performed (α = 5%). An inductive decision tree was created for the occurrence of cavitated lesions (J48 algorithm).ResultsThe prevalence of caries was 91.5% (59.5% cavitated lesions and 32.0% white spots). Among the children diagnosed with caries, 87.1% had active caries. In the multivariate analysis, low income (OR = 2.90; 95% CI: 1.05–8.05) and having visited a dentist for treatment (OR = 7.94; 95% CI: 2.58–24.39) were associated with dental caries (white spot and/or cavitated lesion). For caries activity, low income (OR = 4.63; 95% CI: 1.60–13.35) and having visited a dentist for treatment (OR = 4.80; 95% CI: 2.06–11.18) remained in the final model. In the decision tree, the following variables were predictors of cavitated lesions: lower parent schooling level (p < 0.001), reason for visiting the dentist (p = 0.003) and low income (p = 0.006).ConclusionLow income and having visited a dentist for treatment were determinants of dental caries as well as caries activity in 5-year-old children. In the decision tree, low income, reason for visiting a dentist and lower parent schooling level exerted an influence on the occurrence of cavitated lesions.

Evaluation of the association of bruxism, psychosocial and sociodemographic factors in preschoolers

The aim of the present study was to evaluate factors associated with sleep bruxism in five-year-old preschool children. A preschool-based cross-sectional study was conducted with 761 pairs of children and their parents/caregivers. Sleep bruxism was diagnosed using a questionnaire administered to the parents/caregivers, who also answered questionnaires addressing sociodemographic data and parents/caregivers sense of coherence. Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa: 0.81 to 1.00). Descriptive analysis and logistic regression for complex samples were carried out (α = 5%). The prevalence of sleep bruxism among the preschool children was 26.9%. The multivariate analysis revealed that bruxism was associated with poor sleep quality (OR = 2.93; 95 CI: 1.52-5.65) and tooth wear (OR = 2.34; 95%CI: 1.39-3.96). In the present study, sleep bruxism among preschool children was associated with tooth wear and poor sleep quality of the child. In contrast, psychosocial aspects (sense of coherence) were not associated with sleep bruxism.

How to Select a Questionnaire with a Good Methodological Quality

In the last decades, several instruments have been used to evaluate the impact of oral health problems on the oral health-related quality of life (OHRQoL) of individuals. However, some instruments lack thorough methodological validation or present conceptual differences that hinder comparisons with instruments. Thus, it can be difficult to clinicians and researchers to select a questionnaire that accurately reflect what are really meaningful to individuals. This short communication aimed to discuss the importance of use an appropriate checklist to select an instrument with a good methodological quality. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was developed to provide tools for evidence-based instrument selection. The COSMIN checklist comprises ten boxes that evaluate whether a study meets the standard for good methodological quality and two additional boxes to meet studies that use the Item Response Theory method and general requirements for results generalization, resulting in four steps to be followed. In this way, it is required at least some expertise in psychometrics or clinimetrics to a wide-ranging use of this checklist. The COSMIN applications include its use to ensure the standardization of cross-cultural adaptations and safer comparisons between measurement studies and evaluation of methodological quality of systematic reviews of measurement properties. Also, it can be used by students when training about measurement properties and by editors and reviewers when revising manuscripts on this topic. The popularization of COSMIN checklist is therefore necessary to improve the selection and evaluation of health measurement instruments.