Impact of Early Childhood Caries and Parental Oral Health Literacy on the Use of Oral Health Care Services by Children. Caries, Health Literacy and Health Care / Impacto de la Caries de la Primera Infancia y la Alfabetización en Salud Bucal de los Padres en el Uso de los Servicios de Atención de la Salud Oral por Parte de los Niños Caries, Alfabetización en Salud y Cuidado de la Salud

The objective of this study was to verify the impact of early childhood caries (ECC) and parental oral health literacy (OHL) on the use of oral health care services by preschool children. A population-based study was conducted with 449 dyads of preschool children aged 4-6 years and their parents/caregivers in the city of Ribeirão das Neves, Brazil. Two examiners performed the diagnosis of ECC using the International Caries Detection and Assessment System (ICDAS- Epi). The Brazilian version of the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry was administered to measure parents' OHL. Parents/caregivers answered the question "When was your child's last visit to the dentist?" to measure the use of oral health care services by the preschool children. The multiple logistic regression (p<0.05) revealed that children with presence of cavitated caries lesions were 1.82-fold more likely to use oral health care services (OR=1.82; 95%CI: 1.23-2.70) compared to those with absence of cavitated caries lesions. Children whose parents/caregivers had lower OHL were 34 % less likely to use oral health care services compared to those whose parents had higher OHL (OR=0.66; 95%CI: 0.45-0.99). Preschool children Dental services are used more by preschool children with presence of cavitated caries lesions and whose parents/caregivers have higher scores of OHL.

El objetivo de este estudio fue verificar el impacto de la caries de la primera infancia (CPI) y la alfabetización en salud oral de los padres (ASB) en el uso de los servicios de salud oral por parte de los niños en edad preescolar. Se realizó un estudio de base poblacional con 449 díadas de preescolares de 4 a 6 años y sus padres/cuidadores en la ciudad de Ribeirão das Neves, Brasil. Dos examinadores realizaron el diagnóstico de CPI utilizando el Sistema Internacional de Evaluación y Detección de Caries (ICDAS-Epi). Se administró la versión brasileña de Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry para medir la ASB de los padres. Los padres/cuidadores respondieron la pregunta "¿Cuándo fue la última visita de su hijo al dentista?" medir la utilización de los servicios de salud oral por parte de los preescolares. La regresión logística múltiple (p<0,05) reveló que los niños con presencia de lesiones de caries cavitadas tenían 1,82 veces más probabilidades de utilizar los servicios de salud oral (OR=1,82; IC95%: 1,23-2,70) en comparación con aquellos con ausencia de lesiones de caries cavitadas. Los niños cuyos padres/cuidadores tenían un ASB más bajo tenían un 34 % menos de probabilidades de utilizar los servicios de atención de la salud bucodental en comparación con aquellos cuyos padres tenían un ASB más alto (OR = 0,66; IC del 95%: 0,45-0,99). Los servicios dentales para niños en edad preescolar son utilizados con mayor frecuencia por niños preescolares con presencia de lesiones cariosas cavitadas y cuyos padres/cuidadores tienen puntuaciones más altas de ASB.

Developmental Enamel Defects and Dental Caries in the Primary Dentition of Preterm Children.

Purpose: To assess developmental enamel defects (DED) and dental caries of preterm (PT) and/or low birth weight (LBW) children compared to full term (FT) and/or normal birth weight (NBW) infants, and to evaluate the association of DED with socioeconomic factors, gestational health, and postnatal factors.
Methods: This study included 84 two- to five-year-old children. The PT/LBW group included 42 children who received medical care at a university hospital, while FT/ NBW group included 42 subjects. Children were matched by sex and age (1:1 ratio). Descriptive statistics, bivariate analysis, and Poisson regression were used to analyse the data.
Results: Children in the PT/LBW group had a significantly higher number of teeth with DED than subjects in the FT/NBW group. No difference was observed between the groups regarding dental caries (P >0.05). Admission to the neonatal intensive care was significantly associated with DED unit (prevalence ratio = 0.21 [95 percent confidence interval = 0.1 to 0.5]).
Conclusion: PT/LBW children presented more DED than FT/NBW children. No differences were observed between the groups for dental caries. Admission to the neonatal intensive care unit was associated with DED.

Prevalence of Oral Inclusion Cysts in a Brazilian Neonatal Population.

Purpose: To evaluate oral inclusion cysts in newborns and their association with birth weight, preterm birth, newborn health, maternal health, prenatal factors, and socio-economic factors.
Methods: The sample consisted of 411 pairs of mothers and their newborns born at a university hospital in Brazil. The oral inclusion cysts, diagnosed by clinical examination, were Epstein pearls, Bohn's nodules, and dental lamina cysts. Medical records and a questionnaire were used to collect data related to newborns and mothers. Data were analyzed using the chi-square, linear by linear, and Fisher's exact tests for bivariate analysis, while Poisson regression with robust variance was used for multivariate analysis (α =five percent).
Results: The prevalence of inclusion cysts was 56.7 percent. A total of 42 (62.7 percent) low birth weight (LBW) newborns, 192 (56.0 percent) normal weight newborns, 38 (63.3 percent) preterm newborns, and 187 (56.7 percent) full-term newborn had inclusion cysts. Epstein pearls (n=164, 39.9 percent) were more prevalent and associated with prematurity (P =0.025), LBW newborns (P =0.033), and mothers who worked during pregnancy (P =0.019). Bohn's nodules (n=80, 19.9 percent) were more prevalent in newborns of mothers who did not receive welfare support (P =0.004). Dental lamina cysts occurred in 5.6 percent (N=23) of the sample and were not associated with independent variables.
Conclusion: Epstein pearls were more common in LBW and preterm infants.

Implications for dental professionals when caring for paediatric patients.

This paper is a narrative review of relevant literature.

Parental perceptions of impact of oral disorders on Colombian schoolchildren's oral healthrelated quality of life.

There is no study assessing the impact of dental caries (DC), dental fluorosis (DF) and traumatic dental injuries (TDI) on oral healthrelated quality of life (OHRQoL) in school children from Colombia. The purpose of this study was to assess the impact of DC, DF and TDI on Colombian schoolchildren´s OHRQoL using their parents as proxies. The parents of 338 children aged 6 to 14 years from public and private schools of Cartagena, Colombia answered the ParentalCaregiver Perception Questionnaire (PCPQ) on child's OHRQoL adapted to Colombian Spanish language and a socioeconomic questionnaire. Three calibrated examiners performed the clinical assessment for DC, DF and TDI. Poisson regression associated clinical and socioeconomic conditions to the outcome. Overall, 90.24% of parents reported children's oral impact (total PCPQ score ≥ 1). The mean (standard deviation) PCPQ scores were 12.49 (14.04). The multivariate adjusted model showed that children from public schools and who have dental caries experience (RR= 1.28; p=0.04 and RR= 1.37; p= 0.018, respectively) were more likely to experience negative impact on total PCPQ scores. DC was found to be associated to parentalcaregiver perception of impact on their children's oral healthrelated quality of life, but DF and TDI were not.

No existen estudios que evalúen el impacto de la caries dental (CD), la fluorosis dental (FD) y el trauma dentoalveolar (TDA) sobre la calidad de vida relacionada con la salud bucal (CVRSB) de escolares de Colombia que pertenece a países de habla hispana. El propósito de este estudio fue evaluar el impacto de la caries dental (CD), la fluorosis dental (FD) y el trauma dentoalveolar (TDA) sobre la calidad de vida relacionada con la salud bucal de escolares colombianos usando sus padres como proxies. Los padres de 338 niños y niñas de 6 a 14 años de escuelas públicas y privadas de Cartagena, Colombia, contestaron el ParentalCaregivers Perception Questionnaire (PCPQ) on child's OHRQoL adaptado al español colombiano y un cuestionario socioeconómico. Tres examinadores calibra dos realizaron la evaluación clínica para CD, FD y TDA. La regresión de Poisson asoció las condiciones clínicas y socioeconómicas al puntaje total del PCPQ y sus dominios. En general, el 90,24% de los padres reportaron el impacto oral de los niños sobre la calidad de vida (puntaje PCPQ total ≥ 1). La media (DE) del PCPQ fue de 12,49 (14,04). El modelo multivariado ajustado mostró que los niños de escuelas públicas que tenían experiencia de caries dental (RR = 1,28, p = 0,04 y RR = 1,37, p = 0,018, respectivamente) tuvieron mayor probabi lidad de experimentar un impacto negativo en las puntuaciones totales del PCPQ. La CD mostró asociación con la percepción del impacto de los padrescuidadores sobre la salud oral de sus hijos en relación con la calidad de vida. Sin embargo, FD y TDA no se encon traron asociados.

Parental perceptions of impact of oral disorders on Colombian preschoolers' oral health-related quality of life.

There is no study assessing the impact of dental caries (DC), traumatic dental injuries (TDI) and dental malocclusions (DM) on the oral health-related quality of life (OHRQoL) of preschool children from Spanish-speaking countries in population-based samples. The purpose of this study was to assess the impact of DC, TDI and DM, on Colombian preschool children's OHRQoL through a cross-sectional study. The clinical setting included private and public preschools in Cartagena,Colombia. The sample included 643 preschool children aged 1-5 years and their parents, who answered the Colombian version of the Early Childhood Oral Health Impact Scale (C-ECOHIS) and socioeconomic questionnaire. Three calibrated examiners performed clinical assessment of severity of DC according to decayed, missing and filled primary teeth index, TDI and DM. Poisson regression associated clinical and socio economic conditions to the outcome. Overall, 48. 2% of parents reported children's oral impacts (total C-ECOHIS score >1). The mean (standard deviation) C-ECOHIS scores were 2. 20 (0. 15). The multivariate adjusted model showed that children from non-nuclear families (RR=1. 51; p=0. 003),with low and high DC severity (RR=1. 51, p=0. 003; RR=1. 53, p=0. 009) and TDI (RR=1. 56, p=0. 003), were more likely to experience negative impact on total C-ECOHIS scores. DC and TDI have negative impact on Colombian preschool children's OHRQoL. Children from non-nuclear families have worse OHRQoL at this age, independently of the presence of oral conditions.

No existen estudios que evalúen el impacto de la caries dental (CD), el trauma dentoalveolar (TDA) y las maloclusiones dentales (MD) sobre la calidad de vida relacionada con la salud bucal (CVRSB) en niños preescolares en muestras de poblaciones de países hispanohablantes. El propósito de este estudio fue evaluar el impacto de CD, TDA y MD sobre la CVRSB en niños colombianos en edad preescolar a través de un estudio transversal. Las evaluaciones clínicas se realizaron en colegios privados y públicos de Cartagena, Colombia, en una muestra de 643 niños en edad de 1-5 años y sus padres quienes respondieron la versión colombiana de la Escala Early Childhood Oral Health Impact Scale (C-ECOHIS) y un cuestionario socioeconómico. Tres examinadores calibrados realizaron la evaluación clínica de la severidad de CD acorde con el Indice ceod para dentición decidua, TDA y MD. La regresión de Poisson asoció las condiciones clínicas y socioeconómicas al puntaje total del C-ECOHIS y sus dominios. En general, el 48,2% de los padres reportaron impactos orales de los niños (puntuación C-ECOHIS total >1). La media (DE) del C-ECOHIS fué de 2,20 (0,15). El modelo multivariado ajustado mostró que los niños de familias no nucleares (RR = 1,51; p = 0,003), que tienen baja y alta severidad de CD (RR = 1,51, p = 0,003; RR = 1,53, p = 0,009) y TDA(RR = 1,56, p = 0,003) tuvieron mayor probabilidad de experimentar un impacto negativo en las puntuaciones totales de C-ECOHIS. La CD y la TDA tienen un impacto negativo sobre la CVRSB en niños preescolares colombianos. Los niños de familias no nucleares tienen peor CVRSB a esta edad, independientemente de la presencia de las condiciones orales.

Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta-analysis.

OBJECTIVES: To conduct a systematic review and meta-analysis regarding the association of oral health literacy (OHL) with oral health behaviors, perception, knowledge, and dental treatment related outcomes. METHODS: Eight electronic databases were searched up until June 2017. Studies regarding the aforementioned outcomes measuring OHL through a validated instrument and in which OHL was an explanatory variable were included. Two independent reviewers selected studies, extracted data, and analyzed the risk of bias of the studies. Meta-analysis using random effect modeling was undertaken. Pooled estimates were calculated with 95 percent confidence interval (CI) and odds ratios (OR). RESULTS: Twenty-five studies were included in the systematic review and three in the meta-analysis. Most studies were cross-sectional (n = 21) and had a high risk of bias (n = 17). The meta-analysis showed no association between OHL and frequency of visit to the dentist for adults, either through bivariate analysis (OR = 1.25; 95 percent CI: 0.95-1.63) or multivariate analysis (OR = 1.90; 95 percent CI: 0.77-4.84). Dental anxiety and night bottle-feeding were associated with low OHL (P < 0.05). Most studies regarding tooth brushing frequency found no association with OHL. Most studies regarding oral health knowledge related outcomes reported an association with higher OHL. The literature was inconclusive regarding the association between OHL and dental treatment outcomes, oral health behaviors, and oral health perception. CONCLUSIONS: The current scientific evidence suggests that no association exists between OHL and any of the outcomes investigated. Further prospective studies with a higher methodological quality are necessary to confirm the evidence.

Impact of Oral Health Status on the Oral Health-Related Quality of Life of Brazilian Male Incarcerated Adolescents.

PURPOSE: To assess the impact of oral health status on the oral health-related quality of life (OHRQoL) of incarcerated Brazilian male adolescents. MATERIALS AND METHODS: A cross-sectional survey with 102 male adolescents incarcerated at the São Francisco Juvenile Detention Facility, Piraquara, Brazil in 2010 was carried out. Dental caries, oral hygiene, periodontal status, malocclusion, dental fluorosis and dental trauma were analysed. The Oral Health Impact Profile (OHIP-14) was administered to measure OHRQoL, along with a questionnaire addressing sociodemographic variables, health-related aspects and dental experience. Descriptive statistical analysis and univariate and multiple Poisson regression with robust variance were performed. RESULTS: The prevalence of adolescents who reported an impact on OHRQoL was 64% (95% CI: 54-73) and the mean OHIP-14 score was 6.69 (SD = 8.79; median = 3.00). In the multiple regression model, the prevalence of a negative impact on OHRQoL was significantly higher among individuals with untreated caries (PR = 1.74; 95% CI: 1.10-2.77), those who reported having discomfort in the teeth or mouth (PR = 1.33; 95% CI: 1.03-1.73), using tobacco prior to internment (PR = 1.53; 95% CI: 1.04-2.24) and maintaining a stable relationship (PR = 1.31; 95% CI: 1.01-1.70) in comparison to individuals who did not exhibit these conditions. Moreover, each month of internment represented an increase in the prevalence of an impact on OHRQoL (PR = 1.03; 95% CI: 1.01-1.06). CONCLUSION: Incarcerated male adolescents reported that oral health problems exerted an influence on quality of life, with untreated caries exhibiting the greatest impact.

Cross-cultural adaptation and psychometric properties of the Child Perceptions Questionnaire 11-14 (CPQ11-14) for the Peruvian Spanish language.

OBJECTIVES: Oral-Health-Related Quality of Life (OHRQoL) instruments, such as the Child Perceptions Questionnaire 11-14 (CPQ11-14), are broadly used in oral health surveys around the world. However, there is a lack of these instruments in Spanish language limiting the comparison of OHRQoL outcomes among countries, cultures and ethnic groups. The aim of the present study was to cross-culturally adapt the CPQ11-14 to the Peruvian Spanish language and assess its reliability and validity. MATERIAL AND METHODS: To test the translation and cross-cultural adaptation, 60 children aged 11-to-14-years answered the CPQ11-14 in two pilot tests. After that, the questionnaire was tested on 200 children of the same age, who were clinically examined for dental caries. The internal consistency was assessed by Cronbach's alpha coefficient while repeat administration of the CPQ11-14 on the same 200 children facilitated the test-retest reliability via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the CPQ11-14 with global ratings of oral health and clinical groups respectively. RESULTS: The mean (standard deviation) CPQ11-14 score was 20.18(13.07). Internal consistency was confirmed by a Cronbach's alpha of 0.81. Test-retest reliability revealed excellent reproducibility (ICC= 0.92). Construct validity was confirmed demonstrating statistically significant associations between total CPQ11-14 score and global ratings of oral health (p=0.035) and overall well-being (p<0.001). The measure was also able to discriminate between children with dental caries experience and those without (mean scores: 26.32 and 12.96 respectively; p<0.001). CONCLUSION: The Spanish CPQ11-14 has satisfactory psychometric properties and is applicable to children in Peru.