Influence of caries and molar incisor hypomineralization on oral health-related quality of life in children.

OBJECTIVES: This study was aimed to compare the impact of caries and molar incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) in children. MATERIAL AND METHODS: A total of 528 German children aged 7 to 10 years were recruited, half affected by caries and the other half affected by MIH. Both groups were matched according to age, sex, and social status and divided into 3 categories according to severity. The German version of the Child Perceptions Questionnaire for 8- to 10 years old (CPQ-G8-10) was used to analyze the impact on OHRQoL by applying ANOVA models. RESULTS: Patients with MIH showed a mean CPQ score of 10.7 (± 9.3). This was significantly higher compared to the caries group with 8.1 (± 9.8). The score increased linearly from the low severity category to the high severity category in both groups (caries, 4.1 to 13.8; MIH, 5.2 to 17.7, respectively). CONCLUSION: With increasing severity, both clinical conditions showed a greater negative impact on OHRQoL. MIH was associated with more impairments. CLINICAL RELEVANCE: Currently, the focus in pediatric dentistry is placed on the prevention and treatment of caries. Both diseases may have a negative influence on OHRQoL. Since children perceive the impairments by MIH as worse and the prevalence is equal to that of caries, which focus might be shifted in the future.

The severity and degree of hypomineralisation in teeth and its influence on oral hygiene and caries prevalence in children.

AIM: The purpose of this study was to investigate the relationship between the severity of hypomineralised teeth, plaque accumulation, hypersensitivity, associated caries risk, and oral health-related quality of life limitations of affected children. MATERIALS AND METHODS: A total of 250 children (mean age 9.0 years) presenting with at least one hypomineralised molar or incisor were included in the study. The hypersensitivity of the teeth was evaluated using the Schiff Cold Air Sensitivity Scale and the Wong-Baker Faces Scale. Furthermore, the Decayed, Missing, and Filled Teeth Index was documented, the Quigley Hein Index was obtained, and personal questioning was used to document the patients' limitations with intake of food. These data were analysed using general linear models that control influencing factors such as age and sex. RESULTS: The Quigley Hein Index increased with the severity of the hypomineralised teeth (1.64 in the unaffected, 2.77 in the moderately, and 3.63 in the severely affected teeth). Problems with intake of food were only observed in subjects with severe hypomineralisation. There was no immediate effect on dental caries. CONCLUSION: Increased severity of tooth hypomineralisation leads to increased hypersensitivity, which resulted in inadequate oral hygiene among children and limitations to their daily life.

Hypomineralized Teeth and Their Impact on Oral-Health-Related Quality of Life in Primary School Children.

BACKGROUND: Molar-incisor hypomineralization (MIH) has a strong negative effect on oral-health-related quality of life (OHRQoL). Malformed teeth can be hypersensitive, and the discoloration might affect children's appearances, reducing their well-being. The purpose of the study was to investigate how hypomineralized incisors and molars differ in children's perceived OHRQoL. MATERIALS AND METHODS: 252 children aged 7-10 years old were included and subdivided into three equal groups (n = 84). Group A included children with asymptomatic molars and affected incisors. Group B included children presenting only affected molars. Group C was the control group, with children showing no MIH. All participants were asked to complete the German version of the Child Perceptions Questionnaire (CPQ-G8-10) to measure OHRQoL. RESULTS: Participants in the posterior group showed a median total CPQ of 13.4 (±1.7), which was significantly higher than scores in the anterior and control group, which showed a median total CPQ of 8.4 (±1.4) and 4.2 (±0.7), respectively. Children in the posterior group suffered more from oral symptoms and functional limitations, whereas the anterior group dealt more with social and emotional well-being problems. CONCLUSIONS: The position of the MIH-affected teeth causes different influences on perceived OHRQoL.

Influence of customized therapy for molar incisor hypomineralization on children's oral hygiene and quality of life.

OBJECTIVE: The aim of this clinical follow-up study was to demonstrate the effects of different therapeutic strategies for hypomineralized teeth on patients' oral health. The treatment results were characterized by changes in the extent of hypersensitivity and plaque accumulation, as well as reductions in nutritional restrictions. MATERIAL AND METHODS: The impacts of therapy, including the use of fluoride varnish, fissure sealants, fillings, and stainless steel crowns, were evaluated in 78 children (mean age 8.5 years). We followed recommendations according to the Molar Incisor Hypomineralisation Treatment Need Index for customized treatment. The Quigley Hein Index, the Schiff Cold Air Sensitivity Scale, Wong-Baker Faces Scale, and dietary-limiting parameters were assessed before and after therapy for comparison. RESULTS: Plaque accumulation and hypersensitivity decreased after completion of therapy. The improvements were greater for individual teeth (Quigley Hein Index for teeth treated with stainless steel crowns from 4.19 to 2.54) than for those of the whole dentition (high-severity category from 2.67 to 2.20). Problems with food intake were minimized via therapy, with the greatest influence observed for patients who were also in the high-severity category. CONCLUSIONS: Therapy for affected teeth in children has positive effects on oral health and quality of life.

[The Role of Organizational Indicators within the Implementation of Cross-Sectoral Mental Health Care and Home Treatment in Germany - A Literature and Theory Review]. / Zur Rolle organisationaler Variablen bei der Implementierung sektorenübergreifender psychiatrischer Versorgung und stationsäquivalenter Behandlung in Deutschland.

OBJECTIVE: To elucidate organizational and human resource management-related drivers of community mental health services and home treatment in Germany. METHODS: Systematic review of psychiatric and organizational science literature, additional manual search. RESULTS: Relevant driver variables in community mental health services and home treatment have mostly been addressed. However, only a few have been evaluated and complex cause-and-effect models are missing so far. CONCLUSIONS: The proposed drivers, moderators, and throughputs should be integrated into an evaluation system that should be able to estimate effects of organizational and human resources on care-related and economic outcomes.