Impact of oral clefts on the oral health-related quality of life of preschool children and their parents.

OBJECTIVE: To assess the oral health-related quality of life (OHRQoL) of preschool children with cleft lip and palate (CLP) and their relatives. MATERIALS AND METHODS: In this cross-sectional study, 55 2-5-year-old children with the history of CLP were randomly selected from those referred to Shiraz Lip and Palate Cleft Research Center and treated with single-stage closure (Push back palatoplasty). Furthermore, same number of children with the same age who attended the Shiraz School of Dentistry for routine dental care were selected as control group using randomized sampling. Children's demographic data were obtained from their parents. Farsi version of the Early Childhood Oral Health Impact Scale (F-ECOHIS) was used for evaluating these children's QoL. RESULTS: We found a significant difference in OHRQoL between children with CLP and children without CLP in the overall score of F-ECOHIS and all of subscales. In the impact on children subscale, the difference between these groups was remarkable in limitations' domain. As for difficulties faced by children, question on "difficulty in pronouncing words" had the highest average score. Furthermore, in impact on family, in parental distress domain, the difference between these groups was remarkable. For difficulties faced by family, financial impact got the highest average score. No significant difference was found between boys and girls with CLP in all subscales. While according to the score of total F-ECOHIS in unilateral and bilateral CLP children, there was statistically significant difference in these groups. CONCLUSION: Since oral clefts affect the QoL of children and their families even after the usual treatments, the implementation and maintenance of multidisciplinary interventional strategies are required for establishment of facial esthetics, oral function, and psychological support for such individuals.

Computer-Based Oral Hygiene Instruction versus Verbal Method in Fixed Orthodontic Patients.

STATEMENT OF PROBLEM: Fixed orthodontic appliances in the oral cavity make tooth cleaning procedures more complicated. OBJECTIVES: This study aimed to compare the efficacy of computerized oral hygiene instruction with verbal technique among fixed orthodontic patients referred to the evening clinic of Orthodontics of Shiraz Dental School. MATERIALS AND METHODS: A single-blind study was performed in Orthodontic Department of Shiraz, Islamic Republic of Iran, from January to May 2015 following the demonstrated exclusion and inclusion criteria. The sample size was considered 60 patients with 30 subjects in each group. Bleeding on probing and plaque indices and dental knowledge were assessed in the subjects to determine pre-intervention status. A questionnaire was designed for dental knowledge evaluation. The patients were randomly assigned into the computerized and verbal groups. Three weeks after the oral hygiene instruction, indices of bleeding on probing and plaque index and the dental knowledge were evaluated to investigate post-intervention outcome. The two groups were compared by chi-square and student t tests. The pre- and post-intervention scores in each group were compared using paired t-test. RESULTS: In the computerized group, the mean score for plaque index and bleeding on probing index was significantly decreased while dental health knowledge was significantly increased after oral hygiene instruction, in contrast to the verbal group. CONCLUSIONS: Within the limitations of the current study, computerized oral hygiene instruction is proposed to be more effective in providing optimal oral health status compared to the conventional method in fixed orthodontic patients.

A model for oral health gradients in children: using structural equation modeling.

Detecting the underlying socioeconomic and behavioral determinants is essential for reducing oral health disparities in children. OBJECTIVE: To test a conceptual model in children to explore the interaction amongst social, environmental, behavioral factors and oral health outcomes. METHODS: This analytic cross-sectional study was performed in 2014-2015 in Shiraz, Iran. The sampling was conducted using a multistage stratified design to represent the whole 6-year-olds in Shiraz County. Participants were 830, 6-year-old first grade primary schoolchildren and their parents. Children were examined to register decayed, missing and filled teeth (dmft) and simplified oral hygiene index (OHI-S). Parents were asked for data on socio-cultural risk factors, oral health behaviors and children's oral health related quality of life (C-OHRQoL). Data on environmental risk factors were collected from several sources. The proposed model, a development of Peterson's, was tested using structural equation modeling (SEM). RESULTS: The tested model could empirically demonstrate the wide range of social and behavioral factors affecting C-OHRQoL. Socioeconomic status (SES) affected the OHRQoL of children through several pathways. Tooth brushing frequency, use of oral health services and consuming cariogenic foods were the mediators, through which SES affected dmft and subsequently C-OHRQoL. CONCLUSIONS: Using the modified Petersen's model and SEM, the paths in which different distal and proximal factors affect oral health outcomes in children could be clearly identified. It showed that addressing the underlying social, economic and behavioral determinants is essential for reducing oral health disparities among Iranian children.

Molar-incisor hypomineralisation: a prevalence study amongst primary schoolchildren of Shiraz, Iran.

AIM: To investigate the prevalence of molar-incisor hypomineralisation (MIH) amongst primary schoolchildren of Shiraz, Iran, taking into account the possible influence of biographic and socio-demographic parameters. STUDY DESIGN AND METHODS: A randomised cluster sample of 9- to 11-year-old children (N = 810) had their first permanent molars and incisors (index teeth) evaluated using the European Academy of Paediatric Dentistry criteria for MIH. The examinations were conducted at schools by a calibrated examiner. Prevalence of MIH was assessed based on biographic and socio-demographic parameters including area of residency, school type, father's level of education, weight-for-age and height-for-age. RESULTS AND STATISTICS: Of the children examined, 164/810 (20.2%) had MIH and 53.7% of them presented with MIH lesions in all first molars. Mild defects represented by demarcated yellow brown opacities comprised 35.5% of the total MIH lesions. The prevalence of MIH was significantly greater in girls, children with healthy body weight and height, those whose fathers did not have a tertiary education and from families of low socio-economic status. Regression analyses indicated that none of the biographic and socio-demographic variables represented a significant risk factor in the occurrence of MIH except for body weight. Obesity was negatively correlated to MIH (OR = 0.45; 95% CI 0.25-0.82). CONCLUSIONS: The prevalence of MIH in a group of Iranian children was 20.2%. Biographic and socio-demographic parameters appeared to have no significant correlation with MIH except body weight, which warrants further research.