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.

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.

Impact of breathing patterns on the quality of life of 9- to 10-year-old schoolchildren.

BACKGROUND: Mouth breathing can cause a set of changes in craniofacial growth and development, with esthetic, functional, and psychological repercussions. OBJECTIVE: To determine the impact of mouth breathing on the quality of life of schoolchildren. METHODS: A school-based, cross-sectional study was conducted with 1911 children ages 9 and 10 years in the city of Recife, Brazil. The children answered the Mouth Breather Quality of Life questionnaire and a questionnaire that addressed sociodemographic data and health-related aspects. Clinical examinations were performed by an examiner who had undergone a training and calibration process for the diagnosis of mouth breathing (kappa = 0.90). Descriptive statistics were conducted to characterize the sample. Statistical analysis involved the Student's t-test and the F test (analysis of variance) (alpha = 5%). RESULTS: The prevalence of mouth breathing was 54.81%. Children with oral breathing demonstrated a poorer quality of life in comparison with children with nasal breathing (p < 0.001). The following variables were significantly associated with a poorer quality of life among the children with mouth breathing: a younger age (p < 0.001) and the use of medication (p = 0.002). CONCLUSION: Based on the present findings, children with the mouth-breathing pattern experience a greater negative impact on quality of life in comparison with those with the nose-breathing pattern. Thus, the early diagnosis and treatment of this clinical condition are fundamental to minimizing the consequences of mouth breathing on the quality of life of schoolchildren with respiration disorders.

Development of a questionnaire for measuring health-related quality of life among children and adolescents with mouth breathing.

BACKGROUND: Mouth breathing can exert an influence on quality of life and should be evaluated within a multidimensional context. However, there is no specific questionnaire to measure the impact of mouth breathing on quality of life. OBJECTIVE: To develop and validate a questionnaire for measuring the impact of mouth breathing on quality of life among children and adolescents. METHODS: Thirty-six items were evaluated by six health care professionals, one parent and one child with mouth breathing. After a qualitative evaluation, a modified set of 32 items was developed. The modified Mouth Breather Quality of Life (MBQoL) questionnaire was submitted to a pretest with a sample of 30 children and adolescents diagnosed with mouth breathing to evaluate comprehension, the order of the items, and the form of administration. The MBQoL questionnaire was then administered to 60 children and adolescents (30 mouth breathers and 30 nose breathers) for the evaluation of construct validity, internal consistency, and reproducibility. All the participants answered the questionnaire, and 50% of each group answered the questionnaire a second time after a 1-week interval (test-retest). RESULTS: Higher MBQoL scores (which indicated poorer quality of life) were significantly associated with mouth breathing. The Cronbach α coefficient for the items of the questionnaire was 0.88, and the Spearman correlation coefficient for test-retest reliability demonstrated that the questionnaire was reproducible (r = 0.993; p < 0.01). CONCLUSION: Through this validation study, the MBQoL questionnaire demonstrated a good performance in the evaluation of the quality of life of children and adolescents with mouth breathing and may be a useful tool in clinical studies as well as public health programs. However, further studies are needed to establish its applicability in other populations with respiration disorders.

Assessment of the association between overweight/obesity and traumatic dental injury among Brazilian schoolchildren.

The aim of this study was to evaluate the association between overweight/obesity and the occurrence of traumatic dental injury among schoolchildren aged 7 to 14 years. A cross-sectional study was carried out involving 590 students at public schools in the city of Campina Grande, Brazil. The classification proposed by O'Brien (1994) was used for the diagnosis of traumatic dental injury. Overweight/obesity was determined based on the body mass index. Clinical examinations were performed by two examiners who had undergone a calibration exercise (Kappa statistics of 0.87 and 0.90 for intra-examiner and inter-examiner, respectively). Data analysis involved the chi-square test and Fisher's exact test with a 5% level of significance. Traumatic dental injury was less prevalent among the schoolchildren with overweight/obesity than those without this condition (8.7% and 13.3%, respectively). When the sample was stratified by gender and age, traumatic dental injury was also more prevalent among schoolchildren without overweight/obesity. When the sample was stratified based on ethnicity, prevalence rates were similar between those with and without overweight/obesity. In the overall sample, no significant association was found between overweight/obesity and traumatic dental injury (p = 0.253). Overweight/obesity among schoolchildren aged 7 to 14 years was not associated with traumatic dental injury in this study. The analysis of physical activity may be important to gain a better understanding of this finding.

Assessment of the association between overweight/obesity and traumatic dental injury among Brazilian schoolchildren

The aim of this study was to evaluate the association betweenoverweight/obesity and the occurrence of traumatic dentalinjury among schoolchildren aged 7 to 14 years. A cross-sectionalstudy was carried out involving 590 students at publicschools in the city of Campina Grande, Brazil. The classificationproposed by O’Brien (1994) was used for the diagnosis oftraumatic dental injury. Overweight/obesity was determinedbased on the body mass index. Clinical examinations were performedby two examiners who had undergone a calibrationexercise (Kappa statistics of 0.87 and 0.90 for intra-examinerand inter-examiner, respectively). Data analysis involved thechi-square test and Fisher’s exact test with a 5% level of significance.Traumatic dental injury was less prevalent among theschoolchildren with overweight/obesity than those without thiscondition (8.7% and 13.3%, respectively). When the sample wasstratified by gender and age, traumatic dental injury was alsomore prevalent among schoolchildren without overweight/obesity.When the sample was stratified based on ethnicity,prevalence rates were similar between those with and withoutoverweight/obesity. In the overall sample, no significant associationwas found between overweight/obesity and traumaticdental injury (p = 0.253). Overweight/obesity among schoolchildrenaged 7 to 14 years was not associated with traumaticdental injury in this study. The analysis of physical activity maybe important to gain a better understanding of this finding...

O objetivo do presente estudo foi avaliar a associação entre osobrepeso/obesidade e a ocorrência do trauma dentário entreescolares de 7 a 14 anos de idade. Caracterizou-se como um estudotransversal realizado com 590 escolares de escolas públicasde Campina Grande, Brasil. Utilizou-se como critério de diagnósticopara traumatismo dentário a classificação proposta porO’Brien (1994) e para sobrepeso/obesidade o índice IMC. Osexames clínicos foram feitos por dois examinadores previamentecalibrados (Kappa intra e inter de 0,87 e 0,90, respectivamente).Os testes estatísticos utilizados foram Qui-quadrado e exato deFisher (significância de 5%). Os indivíduos sem sobrepeso/obesidadeapresentaram mais lesões de trauma dentário que aquelescom sobrepeso/obesidade (13,3% vs 8,7%). Quando estratificadaa amostra em relação ao sexo, idade e grupo étnico, otraumatismo dentário foi mais prevalente entre crianças/adolescentessem sobrepeso/obesidade, com exceção do grupo étnico,que apresentaram prevalências similares. No grupo total não foiobservada associação entre sobrepeso/obesidade e trauma dentário(p=0,253). A presença de sobrepeso/obesidade em escolaresde 7 a 14 anos não foi associada ao traumatismo dentário. Aanálise da atividade física pode ser um fator importante paramelhor elucidar a temática...

Malocclusion and quality of life in Brazilian preschoolers.

The aim of the present study was to assess the impact of malocclusion on oral health-related quality of life (OHRQoL) among preschool children and their families. This study involved 732 preschoolers. Parents/caregivers filled out the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire addressing sociodemographic data. Overbite, overjet, and crossbite were recorded during the clinical examination. Bivariate and multiple Poisson regression analyses were performed and prevalence ratio (PR) were calculated (α = 5%). The prevalence of negative impact from malocclusion on OHRQoL was 27.6% among the children and 22.3% among the families. Mother's schooling (PR = 1.37; 95% CI: 1.10-1.70), parent's/caregiver's assessment of child's oral health (PR = 2.07; 95% CI: 1.60-2.58), history of toothache (PR = 3.84; 95% CI: 2.34-6.30), and visits to the dentist (PR = 0.59; 95% CI: 0.37-0.94) remained significantly associated with OHRQoL in the final model for the children, whereas parent's/caregiver's assessment of child's oral health (PR = 2.32; 95% CI: 1.71-3.14) and history of toothache (PR = 2.28; 95% CI: 1.69-3.09) remained significantly associated with OHRQoL for the families. Malocclusion was not associated with a negative impact on OHRQoL. In contrast, parents'/caregivers' perceptions regarding the oral health of their children and a history of toothache were predictors of a negative impact on the OHRQoL.

Assessment of the association between overweight/obesity and traumatic dental injury among Brazilian schoolchildren. / Assessment of the association between overweight/obesity and traumatic dental injury among Brazilian schoolchildren.

The aim of this study was to evaluate the association between overweight/obesity and the occurrence of traumatic dental injury among schoolchildren aged 7 to 14 years. A cross-sectional study was carried out involving 590 students at public schools in the city of Campina Grande, Brazil. The classification proposed by OBrien (1994) was used for the diagnosis of traumatic dental injury. Overweight/obesity was determined based on the body mass index. Clinical examinations were performed by two examiners who had undergone a calibration exercise (Kappa statistics of 0.87 and 0.90 for intra-examiner and inter-examiner, respectively). Data analysis involved the chi-square test and Fishers exact test with a 5

level of significance. Traumatic dental injury was less prevalent among the schoolchildren with overweight/obesity than those without this condition (8.7

and 13.3

, respectively). When the sample was stratified by gender and age, traumatic dental injury was also more prevalent among schoolchildren without overweight/obesity. When the sample was stratified based on ethnicity, prevalence rates were similar between those with and without overweight/obesity. In the overall sample, no significant association was found between overweight/obesity and traumatic dental injury (p = 0.253). Overweight/obesity among schoolchildren aged 7 to 14 years was not associated with traumatic dental injury in this study. The analysis of physical activity may be important to gain a better understanding of this finding.