Understanding parental perspectives on young children's oral health (≤ 4 years) growing up in a disadvantaged neighbourhood of Amsterdam, the Netherlands: an exploratory study.

BACKGROUND: Families' understanding towards oral health problems among young children is poorly studied. More insight into parents' experiences, especially of those living in disadvantaged neighbourhoods, is needed to address persistent oral health inequalities. This qualitative study aims to explore parental perspectives on children's oral health (≤ 4 years) and the opportunities they see to improve children's oral health. METHODS: Forty-seven mothers and five fathers with different migration backgrounds from a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated in our study. Semi-structured interviews (n = 27), participant observations (n = 7) and one focus group discussion were conducted. A thematic data analysis was used. RESULTS: Parents describe their daily life with young children as busy, hectic and unpredictable. Parents seem to be most concerned about parenting. Mothers, in particular, feel fully responsible for raising their children and managing daily complexities. While most parents value their children's oral health, they all experience challenges. Parents find it hard to limit daily candy intake and to handle unwilling children during tooth brushing. They feel limited support for these issues from their household, social network and professionals. CONCLUSION: Parental struggles in children's oral health are complex and interrelated as they occur across family, societal, community and professional levels. Given the complex daily reality of families with young children, establishing and maintaining healthy oral health habits seems not at the top of parents' minds. They ask for advice in the upbringing of their children backed up by social support, increased attention to children's oral health within the community and professional assistance. Collaborating with parents as knowledgeable partners might be the first step in acting upon the endeavour to address oral health inequality among young children.

Efficacy of modified anterior maxillary segmental distraction osteogenesis based on 3D visualisation for the treatment of maxillary hypoplasia among adolescents with cleft lip and palate.

BACKGROUND: This study evaluates a three-dimensional (3D) visualisation design combined with customized surgical guides to assist anterior maxillary segmental distraction osteogenesis (AMSDO) in correcting maxillary hypoplasia in adolescents with cleft lip and palate (CLP), focusing on treatment outcomes, satisfaction and the validity of 3D planning. METHODS: This retrospective cohort study was conducted at a single hospital in China. Between January 2020 and December 2023, 12 adolescents with CLP with maxillary hypoplasia were included. An advanced 3D simulation was used to convey the treatment strategy to the patients and their families. A customized surgical guide and distraction osteogenesis device were designed. Cephalometric analysis evaluated AMSDO changes and long-term stability. Patient satisfaction was assessed. The Chinese version of the Child Oral Health Impact Profile was used to evaluate the children's oral health-related quality of life before and after treatment. The postoperative outcomes were compared with the planned outcomes by superimposing the actual postoperative data onto the simulated soft tissue models and calculating the linear and angular differences between them. RESULTS: One patient experienced postoperative gingivitis, yielding an 8.33% complication rate. Most patients (83.33%) were highly satisfied with the target position, with the rest content. Cephalometric analysis showed significant improvements in various indices post-traction. Quality-of-life scores significantly improved post-treatment. The discrepancies in facial soft tissue between the simulated and actual results were within clinically satisfactory ranges. CONCLUSIONS: Digitally designed surgical guides effectively treat maxillary hypoplasia in adolescents with CLP, ensuring stability, reducing complications, reducing dependency on operator experience, and enhancing satisfaction and health outcomes. Although the simulated results were clinically acceptable, it is important to inform patients of potential variations in the predicted soft tissue.

Food insecurity is associated with self-reported oral health in school-age Ecuadorian children and is mediated by dietary and non-dietary factors.

OBJECTIVE: The main objective was to investigate the association of household food insecurity (HFI) with child oral health. A secondary objective was to explore potential dietary and non-dietary mediators of the HFI-child oral health relationship. DESIGN: Cross-sectional data from the nationally representative Ecuadorian National Health and Nutrition Survey (2018) were analysed. The data included self-reported child oral health, HFI (Food Insecurity Experience Scale), diet (FFQ) and oral care behaviours (toothbrushing frequency, toothpaste use). The association of HFI with the reported number of oral health problems was examined with stereotype logistic regression. Parallel mediation analysis was used to explore potential dietary (highly fermentable carbohydrate foods, plain water) and non-dietary (toothbrushing) mediators of the HFI-oral health relationship. Bias-corrected standard errors and 95 % CI were obtained using non-parametric bootstrapping (10 000 repetitions). Effect size was measured by percent mediation (PM). SETTING: Ecuador. PARTICIPANTS: 5-17-year-old children (n 23 261). RESULTS: HFI affected 23 % of child households. 38·5 % of children have at least one oral health problem. HFI was associated with a greater number of oral health problems: 1-2 problems (adjusted odds ratio (AOR) = 1·37; 95 % CI (1·15, 1·58); P = 0·0001), 3-4 problems (AOR = 2·21; 95 % CI (1·98, 2·44); P = 0·0001), 5-6 problems (AOR = 2·57; 95 % CI (2·27, 2·88); P = 0·0001). The HFI-oral health relationship was partially mediated by highly fermentable carbohydrate foods (PM = 4·3 %), plain water (PM = 1·8 %) and toothbrushing frequency (PM = 3·3 %). CONCLUSIONS: HFI was associated with poorer child oral health. The HFI-oral health relationship was partially mediated by dietary and non-dietary factors. Longitudinal studies are needed to replicate our findings and investigate the role of other potential mediators.

Do Maternal Beliefs, Knowledge and Practices for Own and Young Child Oral Care Reflect on Actual Child Oral Health?

AIM: The aim of the present study was to evaluate whether mother's oral health habits and knowledge for child oral care actually reflect on her young child's oral health and hence sought for direct evidence for this association. MATERIALS AND METHODS: One hundred mothers accompanied their children, aged 2-5 years to a University Pediatric Dentistry Clinic and completed a three-arm questionnaire. Child dental caries (decayed, missing, filled surfaces-dmfs) and gingival bleeding index (GBI) were recorded. Correlations were sought by the analysis of variance (ANOVA). RESULTS: A negative correlation was observed between maternal education and family income with child dmfs (p < 0.01). Additionally, other maternal factors such as age and correct knowledge of the appropriate age for a child's first dental visit, the initiation of toothbrushing, and fluoride exposure were positively associated with lower dmfs and GBI. Additionally, some maternal practices also contributed to these results. CONCLUSION: Maternal practices and knowledge are predictors of child oral health. CLINICAL SIGNIFICANCE: Mothers-to-be, especially those with low socioeconomic characteristics, should be involved in dental education and motivation interventions in order to practice proper oral hygiene for their children.

Impact of Orofacial Clefts on Oral Health Quality of Life: A Cross-sectional Survey Study in Saudi Arabia.

AIM: To evaluate the effect of facial clefts on the dental health quality of life of affected individuals, and to determine whether age and gender affect the oral health quality of life differently. MATERIALS AND METHODS: The cross-sectional survey included 50 participants (32 females and 18 males) from the northern region of Saudi Arabia, using a reliable and validated questionnaire, the Child Oral Health Impact Profile (COHIP), which measured self-reported oral health-related quality of life (OHRQoL) in children and adults using a five-point Likert scale. Statistical analysis was performed, and results were considered significant if the p-value was less than 0.05. RESULTS: The highest scores in the oral health domain were related to bad breath and reluctance in speaking or reading aloud in class within the school environment domain, with mean scores of 3.44 ± 1.3 and 3.52 ± 1.2, respectively. Most patients showed apprehension regarding necessary dental treatments (mean = 1.44 ± 0.07). The study found a non-statistically significant difference in tooth discomfort between age groups (p = 0.092), with individuals aged from 20 to 29 experiencing higher levels of discomfort than other age groups surveyed. CONCLUSION: The two topics with the highest mean scores in the oral health domain and the school environment domain were bad breath and not wanting to speak or read aloud in class. Females reported more discomfort, and there was a substantial association between gender and tooth pain/sensitivity. CLINICAL SIGNIFICANCE: Understanding the difficulties cleft patients face is crucial, as doing so will enable dentists to encourage and handle these issues more effectively.

Impacts of the COVID-19 Pandemic Exposure on Child Dental Caries: Difference-in-Differences Analysis.

The impact of the coronavirus disease 2019 (COVID-19) pandemic on dental caries is unknown. We investigated the effect of the pandemic on child dental caries in Japan by comparing the increase in dental caries from fourth to sixth grade between two cohorts, COVID-19 exposed cohort and COVID-19 unexposed cohort, using difference-in-differences analysis. Longitudinal data that followed elementary school children in Adachi City, Tokyo, were analyzed. The analysis consisted of two cohorts: those who were in fourth grade in 2016 and sixth grade in 2018 (COVID-19 unexposed cohort, N = 399) and those who were in fourth grade in 2018 and sixth grade in 2020 (COVID-19 exposed cohort, N = 3,082). Children's dental caries were examined by school dentists. A difference-in-differences analysis, adjusting for time-variant variables, i.e., household socioeconomic status, children's oral health behavior, and caregivers' psychological distress, was performed. In fourth grade, the number of Decayed, Missing, and Filled permanent Teeth (DMFT) was not different between the COVID-19 unexposed and exposed cohorts (mean = 0.241 and 0.242, respectively). In sixth grade, DMFT increased by 0.067 in the COVID-19 unexposed cohort and 0.180 in the COVID-19 exposed cohort. The interaction term of grade and cohorts for caries by difference-in-differences analysis showed that dental caries among the COVID-19 exposed cohort showed a significant increase in the number of dental caries by 0.116 (95% confidence interval 0.015, 0.216) compared to the COVID-19 unexposed cohort. Child dental caries slightly increased after the pandemic. Studies with longer follow-ups are needed to evaluate the impact of the pandemic on child dental caries.

Changes in oral health-related quality of life after treatment of molar incisor hypomineralisation using Glass Hybrid Restorations.

OBJECTIVE: To assess the changes in children's oral health-related quality of life following the treatment of severely affected molar-incisor hypomineralisation with Glass Hybrid Restorative System (GH) after selective caries removal. METHODS: The observational cross-sectional study was conducted at the Marmara University, School of Dentistry, Department of Pediatric Dentistry, Istanbul, Turkey.. Children aged 11-14 years (n = 55) who were diagnosed with MIH and had finished their dental treatment from November 2018 to December 2019, were included. The children's MIH-affected teeth were treated with GH after SCR. Participants answered the Child Perceptions Questionnaire (CPQ11?14) prior to their dental treatment and 6 months after the treatment. RESULTS: Of the fifty-five patients, 40 patients (24 girls-16 boys) completed baseline and follow-up data. The mean age of the children was 11.85 ±1.02 years. The overall CPQ score ranged from 3-83 (average 33.27 ± 16.46) at baseline and 0-61 (average 11.67 ± 11.21) at follow up. The emotional well-being among children was the highest score at baseline. A significant decrease (p < 0.001) in the mean values was observed for both the overall CPQ scores and for the scores of the oral symptoms, functional limitations, and social-emotional well-being limitation. All subdomains showed large effect sizes and oral symptom limitation domain presented the greatest effect. Wilcoxon Rank test was used to determine the statistical significance of the changes and the magnitude of change was determined by calculating and classifying the effect size. CONCLUSIONS: Restorative treatment with GH following selective caries removal positively influenced the oral health-related quality of life of children with severe molar-incisor hypomineralisation.

APPROVAL OF THE USE OF THE SHORT FORM 19 OF THE CHILD'S ORAL HEALTH IMPACT PROFILE (COHIP-SF 19) FOR DENTAL PUBLIC HEALTH NEEDS.

OBJECTIVE: The aim: Is an adaptation, determination of psychometric properties, and approbation of the use of COHIP-SF 19 for the needs of dental public health in the Ukrainian sample of children and teenagers. PATIENTS AND METHODS: Materials and methods: A cross-sectional validation study was conducted on a sample of 236 Ukrainian children aged 6 to 18. The psychometric indicators of the questionnaire were evaluated; analysis of the reliability and internal structure of the methodology based on correlation and factor analysis, calculation of Chronbach's alpha; reliability of re-testing (Intraclass Correlation Coefficient); assessment of convergent and discriminant validity (Mann-Whitney U test, ROC analysis, and correlation analysis). STATISTICA 6.1 (StatSoftInc., № AGAR909E415822FA) was used to analyze the results. The ethics of the study was confirmed by the conclusion of the relevant commission. RESULTS: Results: After cultural direct and reverse translation of the original version, the Ukrainian version of COHIP-SF 19 UK was obtained. The internal consistency of the subscales and COHIP-SF 19 UK was generally sufficient (Cronbach's alpha is greater than 0.7). Sufficient reliability of retesting, convergent and discriminant validity of the methodology was proved. The presence of a correlation between COHIP-SF 19 UK indicators and self-assessment of children's health and quality of life was determined. CONCLUSION: Conclusions: The study proved that COHIP-SF 19 UK is a reliable valid method for assessing the quality of life-related to oral health among Ukrainian children and adolescents, and its good psychometric properties are sufficient for research in the field of dental public health.

Evaluation of the ECOHIS and the CARIES-QC among an Australian "Aboriginal" population.

PURPOSE: An evaluation of the reliability and validity of two child oral health-related quality of life (COHRQoL) measures among Australian Aboriginal children who participated in a randomised trial was undertaken. METHODS: Study participants completed the Early Childhood Oral Health Impact Scale (ECOHIS) and the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC). The questionnaires were completed a second time to test the scales' test-retest reliability. Internal consistency, convergent and discriminant validity were evaluated through Cronbach's alpha, correlation of the scale scores with the global oral health evaluation, and comparison of scale scores among children with varying levels of caries experience, respectively. RESULTS: Worse COHRQoL was reported by parents who rated their child's oral health as poor and by children who rated their teeth as being a lot of problem. Cronbach's alpha for the child impact section (CIS), family impact section (FIS), total ECOHIS score and the total CARIES-QC scale were 0.88, 0.81, 0.91 and 0.84, respectively. Spearman's correlations between scale scores and global oral health ratings of the CIS, FIS, total ECOHIS and the CARIES-QC were 0.42, 0.34, 0.45 and 0.70, respectively, p < 0.001. The Kruskal-Wallis test of scale scores with grouped caries experience was statistically significant, p < 0.005. Test-retest reliabilities for the ECOHIS were CIS ICC = 0.91, FIS ICC = 0.89, total ECOHIS ICC = 0.93 and for the CARIES-QC, ICC = 0.61. CONCLUSIONS: Both the ECOHIS and the CARIES-QC were reliable and valid scales for use among an Australian Aboriginal population for assessing COHRQoL of preschool children. TRIAL REGISTRATION: ACTRN12616001537448, date of registration-08 November 2016.

Parental mental illness, attendance at preventive child healthcare and dental caries in the offspring: a nation-wide population-based cohort study.

PURPOSE: Severe mental illness (SMI) may interfere with parental caregiving practices and offspring development. Adhering to preventive well-child visits and maintaining good oral hygiene during early childhood requires parental involvement. Whether these activities are affected by parental SMI is unclear. The purpose of the present study was to determine whether children exposed to parental SMI are at increased risk of non-attendance to preventive well-child visits and vaccinations at age 0-5 years and of child dental caries experience at age 5 years. Furthermore, interactions between maternal psychiatric and sociodemographic variables in relation to an adverse child outcome were assessed. METHODS: Data were obtained from national Danish health registers. All children born in Denmark between January 1997 and December 2010 were followed from birth until their 6th birthday. RESULTS: 679,339 children were included in the study (51% male). Of these, 49,059 children (7.8%) had at least one parent with a lifetime SMI diagnosis. Children of parents with SMI had elevated odds of missing well-child visits and vaccinations (OR 1.41; 95% CI 1.39-1.44, p < 0.0001), and of child dental caries (OR 1.58; 95% CI 1.55-1.62, p < 0.0001). In the presence of maternal SMI, low socioeconomic classification and single-mother status added more to the elevated risk than specific maternal diagnosis or timing of last psychiatric contact. CONCLUSION: Parents with SMI are less compliant with preventive child healthcare activities than parents without SMI. This indicates a need for practical support to these families in order to prevent inequality in health among their offspring.

Evaluating the environmental impact of the Welsh national childhood oral health improvement programme, Designed to Smile.

INTRODUCTION: Designed to Smile (D2S) is a national oral health improvement programme, aimed to reduce the prevalence of dental caries in young children in Wales. D2S has a responsibility to consider the environmental impact of the service it provides and demonstrate adherence to the sustainable development principle legislated within the Wellbeing of Future Generations (Wales) Act. OBJECTIVE: To review the environmental impact of D2S by estimating the carbon footprint of the programme and identify carbon hotspots for future targeted action. RESEARCH DESIGN: Process mapping identified the steps to deliver the supervised toothbrushing and fluoride varnish elements of D2S. Annual estimates of business travel mileage, financial spend on procurement, total number of plastic consumables and waste disposal were made. An online survey enabled calculation of staff commuting behaviour. These contributors were converted to carbon emissions using established carbon conversion factors. RESULTS: The annual carbon footprint of D2S was estimated at 388 tonnes of CO²e (tCO²e) with 31% attributed to staff travel, 23% to business travel and 46% to procurement. An estimated 1 million plastic items were distributed. CONCLUSION: By promoting good oral care and preventing the need for future carbon intensive restorative dental treatments, D2S exemplifies a sustainable model of healthcare. Adopting reduce, reuse, recycle principles for plastic consumables and introducing sustainable procurement procedures could lead to further decarbonisation and reduction in plastic waste.

A comparative assessment of oral health-related quality of life of children born with orofacial clefts in Sudan and their caregivers'.

BACKGROUND: Cleft lip and palate(CL/P)is the most common orofacial malformation affecting one in every 700-1000 newborns worldwide. The aim of the study wasto evaluate the impact of CL/P on health- related quality of life (OHRQoL) in Sudanese children and the level of concordance between caregivers' and children and to investigate correlates of the caregivers' perceptions of OHRQoL with that of their children. METHODS: The sample consisted of 75 children with clefts (age range 8-16 years), (46 male, 29 female) and their caregivers' attending University of Science and Technology Dental Teaching Hospital. The children and their caregivers' were interviewed separately. The interview consisted of 38 questions adopted from the COHIP (Arabic version).The level of concordance between caregivers' and children was compared using paired t-tests and intraclass correlations. Predictive validity was assessed using Pearson correlations and linear regression analyses. RESULTS: The translated COHIP and its subscales, had Cronbach' alphas score ranged between (0.65 and 0.75) for caregivers' and children with cleft. COHIP scores for children and caregivers' were (89.41 ± 19.97) and (94.34 ± 19.52) respectively. Caregivers' and children differed significantly in the overall COHIP and oral symptoms subscale. There were high correlations between caregivers' and children ranged from (0.63 to 0.87). The correlation between all subscales was statistically significant (p = 0.05). CONCLUSIONS: Caregivers' had higher perceptions of oral symptoms and overall COHIP compared to their children using the Arabic version of the COHIP. Caregiver's reports have to be considered complementary to the reports of their children themselves.

Parent perceptions of minimally invasive dental treatment of Australian Aboriginal pre-school children in rural and remote communities.

INTRODUCTION: Aboriginal* children in rural and remote communities in Australia have a higher burden of dental decay and poorer access to dental services than their non-Aboriginal counterparts. In the Kimberley region of Western Australia (WA), Aboriginal children experience six times the rate of untreated dental decay of non-Aboriginal children. Access to dental care is challenged by the availability and appropriate delivery of services in remote locations. This study elicited the experiences and perceptions of parents and carers who participated in a project that tested the minimally invasive atraumatic restorative treatment and the Hall technique approaches (ART-HT) to manage early childhood dental caries among Australian Aboriginal preschool children. METHODS: The core study design was a stepped-wedge, cluster-community-randomised controlled trial. Consenting communities in the Kimberley region of WA were randomised into early and delayed intervention groups. Children were clinically examined at study commencement; the early intervention group was offered dental treatment using the ART-HT approach, and the delayed group was advised to seek dental care from their usual service provider. At the 12-month follow-up, children in both groups were re-examined and offered care using the minimally invasive model of care, and parents and carers were invited to take part in focus group or one-to-one interviews. Semistructured interviews, guided by the yarning approach, were conducted with consenting parents and carers in community locations of convenience to participants. The same open-ended questions were asked of all participants, and the interviews were audio-recorded with permission and transcribed by an independent agency. Thematic analysis was undertaken, the transcripts were coded by NVivo software, and emergent themes were identified and developed. RESULTS: One-to-one interviews were conducted with 29 parents and carers (10 from five test communities; 19 from eight control communities). Interview participants consisted of 3 males and 26 females. Following thematic analysis, three main themes (and subthemes) were identified: (1) access to care (barriers, service availability, impact on family due to lack of access); (2) experience of care (cultural safety, child-centred care, comprehensiveness of care); (3) community engagement (service information, engagement, oral health education). Structural and system factors as well as geography were identified as barriers by parents and carers in accessing timely and affordable dental care in culturally safe environments; parents and carers also identified the impacts from lack of access to care. They valued comprehensive care delivered within community, underpinned by child- and family-centred care. Of equal importance was the holistic approach adopted through the building of community engagement and trusting relationships. CONCLUSION: A high level of satisfaction was reported by parents and carers with their experience of dental care for their children with the minimally invasive approach. Satisfaction was expressed around ease of accessing services delivered in a child- and family-centred manner, and that were well supported by appropriate engagement between service providers, communities and families. The findings from this study suggest a minimally invasive dental care model can be considered effective and culturally acceptable and should be considered in delivering oral health services for young children in rural and remote locations. * The term Aboriginal is inclusive of Aboriginal and Torres Strait Islander peoples.

The development, validation, and psychometric properties of the Japanese version of the Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) for school-age children.

BACKGROUND: This study was performed to develop and validate a Japanese version of Child Oral Health Impact Profile-Short Form (COHIP-SF) 19 and to assess its psychometric properties in Japanese school-age children. METHODS: The original English COHIP-SF 19 was translated into Japanese (COHIP-SF 19 JP) using a standard forward and backward translation procedure. The psychometric properties of the COHIP-SF 19 JP were assessed in 379 public school students between 7 and 18 years of age in Fukuoka, Japan. Internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficient, ICC) were the metrics used for evaluation of this questionnaire. The discriminant validly was examined using the Wilcoxon rank sum test to identify significant differences in COHIP-SF 19 JP scores according to the results of dental examinations. The convergent validity was examined using the Spearman correlations to determine the relationships between COHIP-SF 19 JP scores and the self-perceived oral health ratings. Confirmatory factor analyses (CFA) were performed to verify the factor structure of the questionnaire. RESULTS: The COHIP-SF 19 JP revealed good internal consistency (Cronbach's alpha, 0.77) and test-retest reliability (ICC, 0.81). Discriminant validity indicated that children with dental caries or malocclusion had significantly lower COHIP-SF 19 JP scores (P <  0.05); convergent validity indicated that the self-perceived oral health rating was significantly correlated with the COHIP-SF 19 JP total score and subscores (rs = 0.352-0.567, P <  0.0001), indicating that the questionnaire had a sufficient construct validity. CFA suggested that the modified four-factor model had better model fit indices than the original three-factor model. CONCLUSION: The collected data showed that the COHIP-SF 19 JP possesses sufficient psychometric properties for use in Japanese school-age children.

Association between malocclusion and orofacial myofunctional disorders of pre-school children in Latvia.

OBJECTS: Abnormal use of muscles of tongue and lips is called orofacial myofunctional disorders (OMD). In this study, we aimed to investigate the interrelation between occlusal findings and OMD in primary and mixed dentition and to find out the reasons for malocclusions, and the effect modification of these associations by the number of sources that parents used to receive the information on child oral health issues (NSI). SETTING AND SAMPLE POPULATION: Cross-sectional study was performed in one kindergarten in Latvia (cluster sampling). The study sample comprised 141 children-mothers' pairs of pre-school children aged 4-7 years. MATERIALS AND METHODS: Children' myofunctional situation, occlusion and speech defects were assessed during an examination. Children's mothers were interviewed on their socio-demographic situation, feeding and habits of the child, history of diseases and NSI. Multiple logistic regression models adjusted for lip power, swallowing, breathing and speech cases of long respiratory diseases, age and gender were built to investigate associations between the types of occlusion and OMD/health characteristics. Effect modification of these associations by NSI was analysed. RESULTS: Types of occlusion associated with OMD/health characteristics were as follows: normal occlusion with prolonged respiratory diseases (odds ratio, OR = 0.345 [95% confidence interval, CI 0.16; 0.75]); combined type with tongue thrust habits (OR = 3.11 [0.99; 9.90]), lip-closing strength (OR = 0.99 [0.98; 0.99]); and cross-bite with speech (OR = 3.55 [1.07; 11.78]). These associations remained stable when parents used two or less sources of information on children's oral health. CONCLUSIONS: To facilitate occlusal stability, early interdisciplinary examinations should be performed to prevent time-consuming and cost-consuming treatment.

Oral Health-Related Quality of Life in Chinese Children With Orofacial Cleft.

OBJECTIVE: To measure the validity and reliability of a Chinese version of Child Oral Health Impact Profile (COHIP) and to assess oral health-related quality of life (OHRQoL) with regard to gender, age, and cleft types in Chinese children with orofacial cleft (OFC). DESIGN: A total of 120 patients with OFC (8-15 years old) and their parents were investigated with COHIP in the West China Hospital of Stomatology. Items were divided into oral symptoms, functional well-being, emotional well-being, school, and peer interaction subscales, and scores on all subscales were compared between and within groups. RESULTS: The internal consistency measured by Cronbach α was satisfactory in children's sample (0.85) and parents' sample (0.90). The correlation between children's and parents' questionnaires was moderate to weak (Pearson r = 0.34), which was also supported by moderate intraclass correlation coefficients. The OHRQoL of children differed significantly from parents on the overall COHIP, functional well-being, emotional well-being, and school subscales. Older children had poor OHRQoL, functional well-being, and emotional well-being. Girls had poor emotional well-being. Children with cleft lip and palate and cleft palate performed worse on the overall COHIP, functional well-being, and school subscales. Parents, boys, and younger children had better treatment expectations and global health perceptions. CONCLUSION: The Chinese version of COHIP is a reliable and valid tool to assess OHRQoL in Chinese children with OFC. Parents' reports could not replace children's answers but add complementary information. Children's gender, age, and cleft types should be considered in OHRQoL assessment and individual treatment plan.

Psychosocial factors and oral health practices of preschool-aged children: a qualitative study with Hispanic mothers.

OBJECTIVE: This qualitative study sought to gain an in-depth understanding of Hispanic mother's parenting experiences and perceptions about select psychosocial factors. How psychosocial factors influence mothers' engagement in recommended oral health-related behaviors for their preschool-aged children (3-5 years) was explored. Psychosocial resources and barriers explored included maternal knowledge about children's oral health, beliefs such as perceived self-efficacy and health locus of control, and parenting experience and stress. DESIGN: Six focus groups and one individual interview with lower-income, Hispanic mothers of preschoolers (n = 36 total participants) were conducted in Spanish at a community health clinic on the California-Mexico border during summer 2010. A bilingual dentist led all sessions using a set of open-ended guiding questions. All sessions were audio-taped, translated and transcribed in English. Transcripts were coded and analyzed for common themes. RESULT(S): Six themes were identified around dental knowledge, the mothers' primary role in performing the child's oral hygiene among multiple caregiving priorities, parenting challenges, perceived self-efficacy, perceived future outlook for their child's oral health, and family influences. Mothers recognized the importance of caring for primary teeth. However, few were knowledgeable about preventive practices to promote young children's oral health, such as the recommended ages for brushing or first dental visit. Mothers that were more knowledgeable expressed feeling more efficacious about maintaining their child's oral hygiene. All mothers believed they were primarily responsible for their child's oral health, and most held positive future expectations for their child's oral health. CONCLUSION: These findings provide insight into how Hispanic mothers of young children perceive their role as caregiver. Maternal knowledge and perceptions affect their ability to care for their child's oral health and should be accounted for in future interventions.

Oral health-related quality of life of children and adolescents with and without migration background in Germany.

OBJECTIVES: To compare oral health-related quality of life (OHRQoL) in children and adolescents with and without migration background, and to assess whether potential differences in OHRQoL can be sufficiently explained by oral health characteristics. MATERIALS UND METHODS: A consecutive sample of 112 children and adolescents was recruited in a German university-based orthodontic clinic, and a convenience sample of 313 children and adolescents of German public schools was enrolled in the study (total N = 425, age range 7-17 years). However, 29 participants were excluded due to insufficient information regarding migration background. Accordingly, the non-migrant group consisted of 262 participants (61.6%). For children with migration background, two groups were classified: (i) one parent born in a foreign country (N = 41, 9.6%, single-sided migration background), and (ii) both parents and/or child born in a foreign country ( N= 93, 21.9%, double-sided migration background). OHRQoL was assessed using the German 19-item version of the Child Oral Health Impact Profile (COHIP-G19). Additionally, physical oral health of 269 children with classified migration background was determined in a dental examination. RESULTS: Overall, OHRQoL was significantly lower in the group with double-sided migration background indicated by lower COHIP-G19 summary scores (mean: 58.6 points) than in the group with single-sided migration background (mean: 63.3 points) or the non-migrant group (mean: 63.2 points). Likewise, the summary scores of the subscale "oral health well-being" and the subscale "social/emotional, school, and self-image" were also lower in the double-sided migrant group than in the other two groups. Linear regression analysis showed an association between double-sided migration background and impaired OHRQoL, even after statistically controlling for demographic, socioeconomic, and oral health characteristics. CONCLUSION: Children and adolescents with double-sided migration background have poorer OHRQoL than comparably aged migrants with single-sided migration background or non-migrations. Between-group differences in OHRQoL could not be sufficiently explained by effects of socioeconomic status or physical oral health characteristics. Thus, other methodological, cultural, or immigration-related factors might also play an important role for the observed effects.

Child, caregiver, and family factors associated with child dental utilization among Mexican migrant families in California.

OBJECTIVE: To identify associations between child, caregiver, and family-level factors and child dental utilization. RESEARCH DESIGN: Cross-sectional oral health survey. PARTICIPANTS: Caregivers and one study child (ages 0-17) from Mexican migrant families in northern San Diego county, CA (n=142). METHODS: Caregivers reported on child's dental care utilization history and related factors, including: child (age, gender, dental insurance, source of care, believed to have cavities), caregiver (marital status, income, education, acculturation level, depressive symptoms), and family cohesion. Descriptive and logistic regression models identified predisposing, enabling, and need factors associated with child dental utilization during the past year. RESULTS: Most (76%) children had visited the dentist in the past year, while 8.6% had never been. Child factors (gender, insurance), caregiver factors (education, depressive symptoms), and family cohesion were each associated with child dental utilization in the bivariate analyses. In the final adjusted model, uninsured children were less likely to have a past year dental visit compared to insured children (Odds Ratio (OR) = 0.23, 95% Confidence Interval (CI) = 0.06-0.96). Children whose caregivers visited the dentist were 4.29 times more likely to visit the dentist in the past year (CI=1.36-13.61). Higher caregiver education was positively associated with child dental utilization (OR=4.50, CI=1.50-13.55). CONCLUSION: Child age and dental insurance, and caregiver education and dental utilization history were associated with whether or not a child had a past year dental visit. Ensuring child dental coverage and caregiver access to dental care may promote regular dental utilization by children.

Oral Health-Related Quality of Life of Children Born With Orofacial Clefts in Ethiopia and Their Parents.

OBJECTIVE: To assess the oral health-related quality of life (OH-RQoL) using a translated standardized measure in an understudied population of Ethiopian children born with orofacial clefts (OFCs) and their parents. METHODS: Using a descriptive study design, we assessed the OH-RQoL of 41 patients with OFCs between the ages of 8 and 17 years and their parents. Participants received multidisciplinary cleft care from 2008 to 2016. They completed an Amharic translation of the Child Oral Health Impact Profile (COHIP). RESULTS: There was strong internal reliability with the translated COHIP for parents and patients. Parents' COHIP scores ranged from 67 to 186, and patients' scores were 78 to 190. The mean for patients and parents was 155, indicating good OH-RQoL. CONCLUSION: The Amharic translation of the COHIP appears appropriate for use with families in Ethiopia. Both parents and patients reported OH-RQoL at similar levels as other international populations.