Relationship between oral health literacy of caregivers and the oral health-related quality of life of children: a cross-sectional study.

BACKGROUND: Oral health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate oral health decisions. However, scientific evidence about the oral health literacy of caregivers and the children's oral health-related quality of life. The purpose of this study was to verify the relationship between the level of oral health literacy of caregivers and the children's oral health-related quality of life (OHRQOL). METHODS: This study was conducted with children aged 2 to 4 in Diadema, São Paulo, Brazil. Six hundred thirty children were examined to assess the prevalence of dental caries (dmft index). Parents were interviewed to obtain sociodemographic status, oral conditions, and oral health literacy (OHL). The variable outcome was the children's OHRQOL as assessed by the Early Childhood Oral Health Impact Scale (ECOHIS). We fitted zero-inflated negative binomial regression (ZINB) models to evaluate associations between the study outcome and covariates in terms of PR (Prevalence Ratios), RR (Rate Ratios), and their respective Confidence Intervals (95% CI). RESULTS: Children's OHRQOL was not associated with OHL. Dental caries had a negative impact on the children's quality of life (p < 0.05). A reduced impact on OHRQOL is also associated with having siblings (PR = 0.70, 95% CI 0.52-0.95). A higher age of the mother reduced OHRQOL impacts (PR = 0.72, 95% CI 0.52-0.98). CONCLUSIONS: The factors associated with children's OHRQOL were the number of siblings, the mothers' age, and dental caries. This study observed no association between parental OHL and children's OHRQOL.

Changes in the Oral Health-Related Quality of Life in Infants With Cleft Lip and/or Palate Before and After Surgical Treatment.

OBJECTIVE: To assess oral health-related quality of life (OHRQoL) changes before and after the primary surgical treatment in infants with cleft lip and/or palate (CL/P). DESIGN: Quasi-experimental study. METHODS: A total of 106 infants with CL/P younger than 2 years undergoing primary surgical treatment in the Plastic Surgery Service of the Instituto Nacional de Salud del Niño in Peru. The parent/caregiver answered a questionnaire about OHRQoL named the Peruvian version of the Early Childhood Oral Health Impact Scale (P-ECOHIS) in the pretreatment (baseline) and follow-up post-treatment. The total score of P-ECOHIS and their 2 sections (child impact and family impact) in the baseline and each follow-up period post-treatment scores were assessed. As well as, the type of the CL/P on OHRQoL, standardized effect sizes (ES) based on mean total change scores (difference between baseline and 12th month) were analyzed. RESULTS: Improvements in infant's OHRQoL after treatment were reflected in each follow-up period P-ECOHIS score compared to the baseline score. The total P-ECOHIS scores decreased significantly from 28.07 (baseline) to 7.7 (12th month; P < .0001), as did the individual domain scores (P < .0001). There were significant differences in the baseline and follow-up post-treatment scores of infants who reported improvement of the OHRQoL (P < .0001). The ES was large (3.79). The cleft lip had an improvement in the OHRQoL at 12th month post-treatment (P < .0001). CONCLUSIONS: Primary surgical post-treatment resulted in significant improvement of the infant's OHRQoL with CL/P.

Impact of demographic and clinical variables on the oral health-related quality of life among five-year-old children: a population-based study using self-reports.

BACKGROUND: Although SOHO-5 has been validated, there is no study testing this instrument in population-based samples. AIMS: To evaluate the impact of demographic and oral clinical variables on the oral health-related quality of life (OHRQoL) in 5-year-old children from a socially deprived Brazilian area using selfreports. DESIGN: Data from 588 children were analyzed. Examinations included untreated dental caries and occlusal deviations. Children answered the Brazilian SOHO-5 version and interviewers collected demographic characteristics of the child (sex and skin color). Robust Poisson regression associated outcome and exposures. RESULTS: General, the oral impacts were reported by 71.1% of children. The mean and standard deviation total score of the Brazilian SOHO-5 were 3.51 and 3.82, respectively. Children with untreated dental caries (PR = 1.28; P = 0.004) and increased overjet (PR = 1.35; P = 0.002) experienced a worse OHRQoL. Dark and mixed skin color children did not have a good impact on their OHRQoL (PR = 1.53; P = 0.006 and PR = 1.44; P < 0.000, respectively) compared to light ones. CONCLUSIONS: Untreated dental caries and increased overjet were independently associated with worst OHRQoL in 5-year-old children. As an indication of social deprivation, dark and mixed skin color children compared to light ones presented higher probability for reporting worst OHRQoL independently of the oral clinical conditions.

Early childhood caries and psychological perceptions on child's oral health increase the feeling of guilt in parents: an epidemiological survey.

AIM: To assess whether parents feel guilty for their children's oral problems, associating this feeling with socio-economic, demographic, and psychological factors. DESIGN: We included 1313 parent-and-child pairs in this study. The children were 2-4 years old. Parents answered questionnaires on socio-economic and demographic data, and on psychological variables. Sixteen trained dentists (κ > 0.8) examined the children for oral hygiene (the presence and absence of plaque), early childhood caries (ECC; no caries, low and high severity), malocclusion (the presence and absence), and traumatic dental injuries (TDI; the presence and absence). We analysed the data with a hierarchical regression. RESULTS: Twenty-four percentage of parents reported feeling guilty for the oral problems in their children; 26.3% of the children presented with caries, 39.8% malocclusion, 22.9% TDI. Of the parents who felt guilty, 54% thought that their children had problems in their teeth, and most of them (82%) thought that the problem could have been avoided. The feeling of guilt in parents was significantly associated with ECC and the psychological variables: the thought that the child had problems in his/her teeth and the thought that the problem could have been avoided. CONCLUSION: Parents feel more guilty with increased caries severity in their children, and the likelihood of feeling guilty increases when parents believe that their child has an oral problem or that this problem could have been avoided.

Trends in the prevalence of traumatic crown injuries and associated factors in Brazilian preschool children: 10-year observational data.

OBJECTIVE: To assess trends in the prevalence of traumatic crown injuries (TCI) in children aged 1-4 years living in Diadema city (Brazil) and to investigate whether TCI were associated with socio-demographic and clinical variables. METHODS: Six cross-sectional surveys with representative samples were carried out from 2002 to 2012 following the same criteria and methodology. A total of 6389 children were evaluated and systematically selected on the National Children's Vaccination day. Calibrated examiners performed the children's oral examination for TCI according to Andreasen's criteria. Chi-square test for trends was used to perform comparative analysis. Poisson regression was used to associate TCI to socio-demographic and clinical variables. RESULTS: The prevalence of TCI in 2002 for preschool children aged 1, 2, 3 and 4 years was 4.5%, 11.4%, 14% and 13.9%, respectively, and the prevalence in 2012 for the same age groups was 10.4%, 15.9%, 25.7% and 28.1%, respectively. There was a significant increase in the prevalence of TCI for all age groups and for the total sample (P < 0.05). Children's age was associated with TCI in all the surveys. Male gender, presence of anterior open bite and inadequate lip coverage were associated with TCI in some surveys along the years (P < 0.05). CONCLUSION: This study has shown an increase of TCI prevalence in Brazilian preschool children in the last 10 years and its association with children's age, male gender, presence of anterior open bite and inadequate lip coverage. However, this increase does not seem to be relevant to decisions on public policy.

Exploring the association between oral health problems and oral health-related quality of life in Peruvian 11- to 14-year-old children.

BACKGROUND: This is the first study that tested a Spanish version of the Child Perceptions Questionnaire (CPQ11-14 ) in a population-based sample. AIM: To assess the impact of oral health problems on OHRQoL in 11- to 14-year-old children. DESIGN: Data from 473 11- to 14-year-old children were analysed. They were interviewed using the CPQ11-14. Examinations included dental caries, malocclusion, and traumatic dental injuries. Adjusted Poisson regression was used to associate different clinical conditions to the outcome. RESULTS: Overall, 100% of children reported oral impacts (total CPQ11-14 score ≥ 1). Children aged 12- to 14 years old experienced a negative impact on all domains and total CPQ11-14 scores (P < 0.05); the increase in DMFT index showed a negative impact on the oral symptoms domain (RR = 1.01; P = 0.05, whereas Class III malocclusion showed a positive impact on the emotional well-being domain (RR = 0.71; P < 0.01). TDI (RR = 1.11; P = 0.01) and crown discoloration (RR = 1.23; P < 0.01) showed a negative impact on the emotional social well-being domain. CONCLUSION: Children aged 12- to 14 years old had a negative impact on all domains and total CPQ11-14 scores compared with those who are 11 years old. The increase in dental caries experience, presences of TDI and crown discoloration have a negative impact on some aspects of the children's OHRQoL. Class III malocclusion showed a positive impact on the emotional well-being domain.

Trends in the prevalence of erosive tooth wear in Brazilian preschool children.

OBJECTIVES: To report trends in the prevalence of ETW in Brazilian preschool children. METHODS: Three cross-sectional surveys were carried out on boys and girls aged 3-4 years living in Diadema, in the years 2008, 2010 and 2012 following the same criteria and methodology. A total of 2801 children were systematically examined during a National Day of Children's vaccination. Examiners were trained and calibrated to diagnose ETW using a modified version of the O'Brien index. RESULTS: The prevalence of ETW was 51.6% (95% CI 48.4-55.0) in 2008, 53.9% (95% CI 50.7-57.0) in 2010 and 51.3% (95% CI 47.8-54.7) in 2012. There was no significant association between prevalence of ETW from 2008 to 2012 (χ(2) for trend: P = 0.92). There was no significant association in the severity of ETW during this study's period. Most lesions were confined to enamel in all three studies. CONCLUSIONS: A high prevalence of ETW was found in this sample of preschool children in 2008, 2010 and 2012. No trends of increase or decrease in the prevalence and severity of ETW during this study's period.

Changes in preschool children's OHRQoL after treatment of dental caries: responsiveness of the B-ECOHIS.

BACKGROUND: Oral health-related quality of life (OHRQoL) measures should be tested for responsiveness to change if they are to be used as outcomes in randomized clinical trials. AIM: To assess the responsiveness of the Brazilian ECOHIS (B-ECOHIS) to dental treatment of dental caries. METHODS: One hundred parents of 3- to 5-year-old children completed the B-ECOHIS prior to their children's treatment and 7-14 days after completion of treatment. The post-treatment questionnaire also included a global transition judgment that assessed parent's perceptions of change in their children's oral health following treatment. Change scores, longitudinal construct validity, standardized effect sizes (ES) and standardized response mean (SRM) were calculated. RESULTS: Improvements in children's oral health after treatment were reflected in mean pre- and post-treatment B-ECOHIS scores. They declined considerably significantly from 17.4 to 1.6 (P < 0.0001), as did the individual domain scores (P < 0.0001). There were significant differences in the pre- and post-treatment scores of children who reported little improvement (P < 0.0001) as well as in those who reported large improvements (P < 0.0001). The ES and SRM based on change scores mean for total scores and for categories of global transitions judgments were large. CONCLUSIONS: Dental treatment resulted in significant improvement of the preschool children's OHRQoL. The B-ECOHIS is responsive.

Effectiveness of a preventive program based on caries risk assessment and recall intervals on the incidence and regression of initial caries lesions in children.

BACKGROUND: Evidence on caries risk assessment (CRA) and recall intervals are limited in terms of caries prevention. AIM: To assess the effectiveness of a program on the incidence and regression of initial caries lesions. DESIGN: A total of 296 children aged 1-12 years old were assessed by calibrated examiners for Gingival Bleeding Index, Dental Plaque Index, dmf-t/DMF-T Index, initial caries lesions, and caries lesion activity. Children were classified as low, moderate, and high caries risk with different recall interval visits. Statistical analysis included Cox regression and Kaplan-Meier curves. RESULTS: The mean (SD) time of total follow-up for the sample was 11.5(5.5). Higher dmft index at baseline showed a higher risk of new initial lesions (HR = 1.93; P < 0.0001). Higher number of active initial lesions, at baseline and during follow-up visits, is a higher risk predictor for new initial lesions (HR = 9.49; P < 0.0001), as well as for no arrestment of active lesions during follow-up (HR = 1.32; P < 0.0001). Each follow-up visit attended presented a 77% lower risk of initial lesions. The majority (94.8%) of patients did not show new initial lesions. CONCLUSIONS: The Program is effective on reducing the incidence and promoting regression of initial caries lesions in children.

Impact of traumatic dental injuries and malocclusions on quality of life of preschool children: a population-based study.

BACKGROUND: Few studies assessed the impact of traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) in preschool children. AIM: To assess the impact of the presence of TDI and malocclusions, as well as its severity and types, respectively, on the OHRQoL of preschool children. DESIGN: The study was conducted in 1215 children aged 1-4 years old who attended the National Day of Children Vaccination in Diadema, Brazil. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and socio-demographic conditions. Calibrated dental examiners performed the oral examinations for TDI and malocclusions. Poisson regression models adjusted by dental caries associated the clinical and socio-demographic conditions with the outcome. RESULTS: The multivariate adjusted models showed associations between some individual domains of the B-ECOHIS and clinical and socio-demographic conditions (P < 0.05). The severity of TDI showed a negative impact on the symptoms domain and self-image/social interaction domain (P < 0.05). Children with complicated TDI were more likely to experience a negative impact on total B-ECOHIS scores (PR = 2.10; P = 0.048). CONCLUSIONS: The presence of complicated TDI and dental caries were associated with worse OHRQoL of Brazilian preschool children, whereas malocclusions do not.

Correlation and comparative analysis of discriminative validity of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Early Childhood Oral Health Impact Scale (ECOHIS) for dental caries.

BACKGROUND: The perceptions of parents and children regarding oral health are useful to oral public health and clinical practice in pediatric dentistry. The primary aim of the present study was to evaluate the correlation between the total and item scores of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) (parental version and child's self-reports) and the Early Childhood Oral Health Impact Scale (ECOHIS). Subsequently, the discriminative validity of these assessment tools regarding dental caries was compared. METHODS: One hundred twenty-one children randomly selected in the city of Diamantina (Brazil) were submitted to oral examinations. Parents answered the ECOHIS and SOHO-5p (parental version) and children answered the SOHO-5c (child's self-reports). Statistical analysis involved the Mann-Whitney test as well as the calculation of Spearman's correlation coefficients. RESULTS: A significant correlation was found between the SOHO-5p and ECOHIS (r = 0.85), whereas no significant correlations were found between the SOHO-5c and SOHO-5p (r = 0.00) or between the SOHO-5c and ECOHIS (r = -0.41). Significant differences in the impact on quality of life were found between children with severe decay and no severe decay (caries free, with initial or established caries) both the ECOHIS and SOHO-5p (p ≤ 0.05), whereas no difference was found in SOHO-5c (p > 0.05). CONCLUSIONS: The ECOHIS and SOHO-5p were correlated with each other. The accounts of the children differed from their parents' reports and were not capable of discriminating dental caries in advanced stages of progression.

Agreement between children aged 5-6 years and their mothers in rating child oral health-related quality of life.

BACKGROUND: Studies have assessed parent-child agreement on ratings of school-aged children's OHRQoL. There are, however, no studies on children younger than 7 years of age. AIMS: The aim was to assess the agreement between children aged 5-6 years and their mothers regarding child's oral health-related quality of life (OHRQoL). DESIGN: In this cross-sectional study, a total of 298 mother-child pairs (MCP), seeking the pediatric dental screening at the Dental School, University of São Paulo, completed the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5), validated for children aged 5-6 years in Brazil. Agreement between total and items' scores was assessed using comparison and correlation analyses, by comparing the mean directional differences and by computing the intraclass correlation coefficient (ICC) values, respectively. RESULTS: The mean directional difference in the total scores was 0.13 (CI 95% -0.076; 0.338) and therefore not significant for MCP. The mean absolute difference for MCP was 1.26, representing 11% of the maximum possible score. The ICC for total score was 0.84 (CI 95% 0.798; 0.867) for MCP. CONCLUSIONS: Mothers do rate their young children's OHRQoL similarly to children's self-reports. When assessing OHRQoL of children aged 5-6 years, mothers may be reliable proxies for their young children.

Parental-caregiver perceptions of child oral health-related quality of life (P-CPQ): Psychometric properties for the peruvian spanish language.

OBJECTIVES: The aim of the study was to cross-culturally adapt the Parental-Caregiver Perceptions Questionnaire (P-CPQ) to the Peruvian Spanish language and assess its reliability and validity. STUDY DESIGN: To translate and cross-cultural adapt the instrument, 60 parents answered the P-CPQ in two pilot tests. The final version of the P-CPQ was evaluated in 200 parents of children aged 11 to 14 years, who were clinically examined for dental caries. The internal consistency was assessed by Cronbach's alpha coefficient while repeat administration of the P-CPQ 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 P-CPQ with global ratings of oral health and clinical groups, respectively. RESULTS: The mean (standard deviation) P-CPQ score was 15.64(11.89). Internal consistency was confirmed by a Cronbach's alpha of 0.84. Test-retest reliability revealed excellent reproducibility (ICC= 0.94). Construct validity was satisfactory, demonstrating significant correlations between global ratings (oral health and overall well-being) and the total scale and for subscale. Discriminant validity was significant (p<0.001), supporting its ability to discriminate between clinical groups. CONCLUSIONS: The Peruvian Spanish P-CPQ has satisfactory psychometric properties to assess parental-caregivers perceptions on their children's oral health-related quality of life.

Impact of pulpectomy versus tooth extraction in children's oral health-related quality of life: A randomized clinical trial.

AIM: The aim of this randomized clinical trial was to compare the impact of two management options for primary molars with pulp necrosis (pulpectomy or extraction) on children's oral health-related quality of life (OHRQoL). DESIGN: A total of 100 children aged 3-5 years with at least one necrotic primary molar were selected and randomized into the study groups. The Brazilian version of early childhood oral health impact scale (B-ECOHIS) was completed by the parent proxy reports at baseline and after 4, 8 and 12 months. Differences between the trial groups were assessed through bootstrap linear regression for B-ECOHIS scores, logistic regression for dental pain self-reports and anxiety scores (α = 5%). RESULTS: The mean (SD) B-ECOHIS scores at baseline and after 12 months were 17.7 (6.5) and 3.0 (4.0) in the pulpectomy group and 18.8 (7.7) and 7.9 (7.7) in the extraction group. Both treatments significantly improved OHRQoL, but tooth extraction group showed higher scores in total B-ECOHIS (p < .001) and most domains, indicating lower OHRQoL. Furthermore, higher anxiety levels were reported for dental extraction compared to pulpectomy (OR = 2.52; p = .008). CONCLUSION: Pulpectomy resulted in an improved OHRQoL scores after 12 months when compared to tooth extraction and should be considered as the treatment of choice for necrotic primary molars.

Adolescent pregnancy in Cruzeiro do Sul, Acre, Brazil: socioeconomic characteristics, prenatal and obstetric care. / Parturientes adolescentes em Cruzeiro do Sul, Acre, Brasil: características socioeconômicas e obstétricas.

The present study aimed to investigate the socioeconomic and obstetric characteristics of adolescent mothers and the complications they cause to maternal and neonatal health. This baseline data analysis of the MINA-Brazil birth cohort was conducted in the municipality of Cruzeiro do Sul, state of Acre, Brazil. The chi-square test was used to compare characteristics of adolescent and adult postpartum women, and multiple Poisson regression models with robust variance were used to assess associated factors. Among the postpartum women, 26.2% (95%CI: 24.0-28.4) were adolescents. Factors associated with childbirth in adolescence included: nine years or less of schooling (adjPR:1.36; 95%CI: 1.14-1.61), belongs to the lowest quartiles of the wealth index (1st quartile: adjPR:1.40; 95%CI: 1.08-1.80) (2nd quartile: adjPR:1.37; 95%CI: 1.08-1.74), primigravidae (adjPR:3.69; 95%CI: 2.98-4.57), low pre-pregnancy BMI (adjPR:1.28; CI95%: 1.04-1.57), urinary tract infection during pregnancy (adjPR:1.25; CI95%: 1.07-1.46) and less than six prenatal consultations (adjPR:1.42; 95%CI: 1.21-1.66). Poverty, little schooling, primigravidae, low pre-pregnancy BMI, urinary tract infection during pregnancy and few prenatal consultations were associated with childbirth during adolescence in a municipality in the Northern region of Brazil.

O objetivo do estudo foi investigar as características socioeconômicas e obstétricas de parturientes adolescentes e suas complicações sobre a saúde materna e neonatal. Trata-se de uma análise de dados da linha de base da coorte de nascimentos MINA-Brasil conduzida no município de Cruzeiro do Sul, estado do Acre. Utilizou-se teste qui-quadrado para comparar características das puérperas adolescentes com as adultas e modelos múltiplos de regressão de Poisson com variância robusta para avaliar fatores associados. Entre as puérperas estudadas, 26,2% (IC95%: 24,0-28,4) eram adolescentes. Os fatores associados ao parto na adolescência foram ter nove anos ou menos de estudo (RPaj:1,36; IC95%: 1,14-1,61), pertencer aos menores quartis do índice de riqueza (1° quartil: RPaj:1,40; IC95%: 1,08-1,80) (2° quartil: RPaj:1,37; IC95%: 1,08-1,74), ser primigesta (RPaj:3,69; IC95%: 2,98-4,57), baixo IMC pré-gestacional (RPaj:1,28; IC95%: 1,04-1,57), infecção urinária na gravidez (RPaj:1,25; IC95%: 1,07-1,46) e menos de seis consultas de pré-natal (RPaj:1,42; IC95%: 1,21-1,66). Pobreza, baixa escolaridade, primigestação, baixo IMC pré-gestacional, infecção urinária na gestação e menor número de consultas de pré-natal foram associados ao parto na adolescência em município da região Norte do Brasil.

Cross-cultural adaptation and psychometric properties of the Brazilian version of the scale of oral health outcomes for 5-year-old children (SOHO-5).

BACKGROUND: Most of the instruments available to measure the oral health-related quality of life (OHRQoL) in paediatric populations focus on older children, whereas parental reports are used for very young children. The scale of oral health outcomes for 5-year-old children (SOHO-5) assesses the OHRQoL of very young children through self-reports and parental proxy reports. We aimed to cross-culturally adapt the SOHO-5 to the Brazilian Portuguese language and to assess its reliability and validity. FINDINGS: We tested the quality of the cross-cultural adaptation in 2 pilot studies with 40 children aged 5-6 years and their parents. The measurement was tested for reliability and validity on 193 children that attended the paediatric dental screening program at the University of São Paulo. The children were also clinically examined for dental caries. The internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.90 for the children's self-reports and 0.77 for the parental proxy reports. The test-retest reliability results, which were based on repeated administrations on 159 children, were excellent; the intraclass correlation coefficient was 0.98 for parental and 0.92 for child reports. In general, the construct validity was satisfactory and demonstrated consistent and strong associations between the SOHO-5 and different subjective global ratings of oral health, perceived dental treatment need and overall well-being in both the parental and children's versions (p<0.001). The SOHO-5 was also able to clearly discriminate between children with and without a history of dental caries (mean scores: 5.8 and 1.1, respectively; p<0.001). CONCLUSION: The present study demonstrated that the SOHO-5 exhibits satisfactory psychometric properties and is applicable to 5- to 6-year-old children in Brazil.

Responsiveness to change for the Brazilian Scale of Oral Health Outcomes for 5-year-old children (SOHO-5).

BACKGROUND: The responsiveness of oral health-related quality of life (OHRQoL) instruments has become relevant, given the increasing tendency to use OHRQoL measures as outcomes in clinical trials and evaluations studies. The purpose of this study was to assess the responsiveness of the Brazilian Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) to dental treatment. METHODS: One hundred and fifty-four children and their parents completed the child self- and parental' reports of the SOHO-5 prior to treatment and 7 to 14 days after the completion of treatment. The post-treatment questionnaire also included a global transition judgment that assessed subject's perceptions of change in their oral health following treatment. Change scores were calculated by subtracting post-treatment SOHO-5 scores from pre-treatment scores. Longitudinal construct validity was assessed by using one-way analysis of variance to examine the association between change scores and the global transition judgments. Measures of responsiveness included standardized effect sizes (ES) and standardized response mean (SRM). RESULTS: The improvement of children's oral health after treatment are reflected in mean pre- and post-treatment SOHO-5 scores that declined from 2.67 to 0.61 (p<0.001) for the child-self reports, and 4.04 to 0.71 (p<0.001) for the parental reports. Mean change scores showed a gradient in the expected direction across categories of the global transition judgment, and there were significant differences in the pre- and post-treatment scores of those who reported improving a little (p<0.05) and those who reported improving a lot (p<0.001). For both versions, the ES and SRM based on change scores mean for total scores and for categories of global transitions judgments were moderate to large. CONCLUSIONS: The Brazilian SOHO-5 is responsive to change and can be used as an outcome indicator in future clinical trials. Both the parental and the child versions presented satisfactory results.

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.

Prolonged breastfeeding, sugar consumption and dental caries at 2 years of age: A birth cohort study.

OBJECTIVES: Previous cohort studies have found a positive association between prolonged breastfeeding (≥12 months) on dental caries, but few of them analysed the mediated effect of sugar consumption on this association. This study investigated whether prolonged breastfeeding is a risk factor for caries at 2-year follow-up assessment (21-27 months of age) and whether this effect is mediated by sugar consumption. METHODS: A birth cohort study was performed in the Brazilian Amazon (n = 800). Dental caries was assessed using the dmf-t index. Prolonged breastfeeding was the main exposure. Data on baseline covariables and sugar consumption at follow-up visits were analysed. We estimated the OR for total causal effect (TCE) and natural indirect effect (NIE) of prolonged breastfeeding on dental caries using the G-formula. RESULTS: The prevalence of caries was 22.8% (95% CI: 19.8%-25.8%). Children who were breastfed for 12-23 months (TCE = 1.13, 95% CI: 1.05-1.20) and for ≥24 months (TCE = 1.27, 95% CI: 1.14-1.40) presented a higher risk of caries at age of 2 years than those breastfed <12 months. However, this risk was slightly mediated by a decreased frequency of sugar consumption at age of 2 years only for breastfeeding from 12 to 23 months (NIE; OR = 0.95, 95% CI: 0.91-0.97). CONCLUSIONS: In this study, the effect of prolonged breastfeeding on the increased risk of dental caries was slightly mediated by sugar consumption. Early feeding practices for caries prevention and promoting breastfeeding while avoiding sugar consumption should be targeted in the first 2 years of life.

Dental Caries, Tooth Loss and Quality of Life of Individuals Exposed to Social Risk Factors in Northeast Brazil.

This study aimed to investigate the impact of dental caries and tooth loss on oral health-related quality of life (OHRQoL) in socioeconomically disadvantaged people. A population-based, cross-sectional survey was conducted in 28 cities at social risk in Northeast Brazil. All permanent residents aged 12, 15-19, 35-44, and 65-74 years were eligible, and 3063 were included. Participants answered a questionnaire on socioeconomic status, beliefs, and behaviors. Trained local dentists performed oral clinical examinations during home visits. Caries and tooth loss were evaluated using the decayed, missing, and filled teeth (DMFT) index and OHRQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Poisson regression analysis was performed to assess the relationship between individual domains, OHIP-14 scores, dental caries, tooth loss, and socioeconomic/demographic characteristics. Mean DMFT (standard deviation) scores were 2.68 (4.01), 4.84 (4.30), 15.35 (7.26), and 26.72 (8.03) for groups aged 12, 15-19, 35-44, and 65-74 years, respectively. Most participants (70%) were partially edentulous and 13% were completely edentulous. Caries and tooth loss significantly increased with age and impacted OHRQoL. Physical pain (5.8%) and psychological discomfort (5.8%) were the most commonly reported on the OHIP-14. Untreated caries (prevalence ratio (PR), 1.54; 95% confidence interval (CI), 1.37-1.72) and edentulism (PR, 1.29; 95% CI, 1.08-1.53) had a significant negative impact on OHRQoL. Income, level of education, sex, age, and oral hygiene habits were also related to OHRQoL. There was a high prevalence of dental caries and edentulism in all age groups except 12-year-olds. OHRQoL was negatively impacted by these oral conditions across the lifespan, with a trend towards more negative scores and higher impact in older adults.