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Impact of untreated dental caries on oral health-related quality of life of children with special health care needs

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      Abstract: The oral health status of children with special health care needs (SHCN) can affect their quality of life wich domains of the Brazilian version of the Early Childohood Oral Health Impact Scale (B-ECOHIS). A cross-sectional study was conducted in children with SHCN (aged 1 to 9 years), who underwent an oral examination for the assessment of dental caries severity. Parents/caregivers answered two questionnaires, one on oral health-related quality of life (OHRQoL) - B-ECOHIS, and one on socioeconomic characteristics. Statistical analyses were performed using the Kolmogorov-Smirnov test, Mann-Whitney U-test, Poisson regression, Point-biserial correlation coefficient, and Cronbach's alpha. A total of 128 children participated in the study and OHRQoL was affected in 68.75% of them. The function domain in the Child Impact Section (CIS) had a higher mean value. Caries severity was associated with worse quality of life (p=0.001). Severe dental caries was associated with a negative impact on the OHRQoL of disabled children and of their families. The impact of untreated dental caries and severity of dental caries was associated with the CIS domains (except for the self-image/social interaction domain).

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      The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

      Much of biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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        Parental perceptions of children's oral health: The Early Childhood Oral Health Impact Scale (ECOHIS)

        Background Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families. Methods Twenty-two health professionals evaluated a pool of 45 items that assess the impact of oral health problems on 6-14-year-old children and their families. The health professionals identified 36 items as relevant to preschool children. Thirty parents rated the importance of these 36 items to preschool children; 13 (9 child and 4 family) items were considered important. The 13-item ECOHIS was administered to 295 parents of 5-year-old children to assess construct validity and internal consistency reliability (using Cronbach's alpha). Test-retest reliability was evaluated among another sample of parents (N = 46) using the intraclass correlation coefficient (ICC). Results ECOHIS scores on the child and parent sections indicating worse quality of life were significantly associated with fair or poor parental ratings of their child's general and oral health, and the presence of dental disease in the child. Cronbach's alphas for the child and family sections were 0.91 and 0.95 respectively, and the ICC for test-retest reliability was 0.84. Conclusion The ECOHIS performed well in assessing OHRQL among children and their families. Studies in other populations are needed to further establish the instrument's technical properties.
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          Psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS)

          Background Oral disorders can have a negative impact on the functional, social and psychological wellbeing of young children and their families and cause pain/discomfort for the child. Oral health-related quality of life (OHRQoL) has emerged as an important health outcome in clinical trials and healthcare research. The Early Childhood Oral Health Impact Scale (ECOHIS) is a proxy measure of children's OHRQoL designed to assess the negative impact of oral disorders on the quality of life of preschool children. The objective of this study was to evaluate the psychometric properties of the Brazilian version of the ECOHIS (B-ECOHIS). Methods This investigation was carried out in preliminary and field studies. The preliminary study comprised a cross-sectional study carried out in the city of Petropolis, Brazil. A sample of 150 children from two to five years of age was recruited at a public hospital. In the field study, an epidemiological survey was carried out in public and private preschools of Belo Horizonte, Brazil. The B-ECOHIS was answered by 1643 parents/caregivers of five-year-old male and female preschool children. In both phases, oral examinations were performed by a single previously calibrated dentist. Reliability was determined through test-retest reliability and internal consistency. Validity was determined through convergent and discriminant validities. The correlation between the scores obtained on the child and family impact sections was assessed. Results In the preliminary (P) and field (F) study, test-retest reliability correlation values were 0.98 and 0.99 for the child impact section and 0.97 and 0.99 for the family impact section, respectively. The B-ECOHIS demonstrated internal consistency: child impact section (P: α = 0.74; F: α = 0.80) and family impact section (P: α = 0.59; F: α = 0.76). The correlation between the scores obtained on the child and family impact sections was statistically significant (P: rs = 0.54; F: rs = 0.62; p ≤ 0.001). In both phases of the study, B-ECOHIS scores were significantly associated with the decayed, missing and filled teeth index, decayed teeth and discolored upper anterior teeth (p < 0.05). Conclusion The B-ECOHIS proved reliable and valid for assessing the negative impact of oral disorders on the quality of life of preschool children.
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            Author and article information

            Affiliations
            Niterói Rio de Janeiro orgnameUniversidade Federal Fluminense orgdiv1School of Dentistry orgdiv2Department of Pediatric Dentistry Brazil
            Contributors
            Role: ND
            Role: ND
            Role: ND
            Journal
            bor
            Brazilian Oral Research
            Braz. oral res.
            Sociedade Brasileira de Pesquisa Odontológica - SBPqO (São Paulo, SP, Brazil )
            1806-8324
            1807-3107
            March 2019
            : 32
            : 0
            S1806-83242018000100304
            10.1590/1807-3107bor-2018.vol32.0117

            This work is licensed under a Creative Commons Attribution 4.0 International License.

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            Product Information: SciELO Brazil
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            Original Research

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