Factors Associated with Oral Health-related Quality of Life in Children and Preadolescents: A Cross-sectional Study.

PURPOSE: To evaluate the factors associated with the perceptions of oral health-related quality of life (OHRQoL) in children and preadolescents. MATERIALS AND METHODS: 167 students aged 8-14 years were recruited from the public schools of Piracicaba, Brazil. Participants were examined for caries, gingivitis, fluorosis, malocclusions and signs and symptoms of temporomandibular disorders (TMD). OHRQoL was measured using the Brazilian Portuguese version of the Child Perceptions Questionnaire (CPQ 8-10 and 11-14), where higher scores indicate worse OHRQoL. Symptoms of anxiety and depression were evaluated using self-applied questionnaires. Sociodemographic characteristics, dental history and oral hygiene habits were evaluated using a questionnaire. Bivariate and multivariate analyses were used to identify the variables associated with CPQ scores. RESULTS: Higher CPQ 8-10 scores were associated with fluorosis, TMD and symptoms of anxiety and depression. Higher CPQ 11-14 scores were associated with females, TMD and symptoms of anxiety and depression. Younger children (OR=0.32, p<0.05) with signs and symptoms of TMD (OR=4.38, p<0.01) and anxiety (OR=4.97, p<0.001) were more likely to present higher CPQ 8-10 scores. Poor OHRQoL was associated with TMD (OR=4.29, p<0.01) and depressive symptoms (OR=4.50, p<0.001) in preadolescents. CONCLUSIONS: The data indicate that experience of oral diseases and disorders as well as psychological phenomena, such as anxiety and depression, influenced oral health outcomes in this group of children and preadolescents.

Oral Health-related Quality of Life in Children and Preadolescents with Caries, Malocclusions or Temporomandibular Disorders.

PURPOSE: To compare the oral health-related quality of life (OHRQoL) of children (8- to 10-year-olds) and preadolescents (11- to 14-year-olds) with different oral conditions and to identify concepts associated with their perceptions of oral health (OH) and overall well being (OWB). MATERIALS AND METHODS: A cross-sectional study was conducted with 264 students who were distributed into four groups: caries, with the sum of the decayed, missing and filled teeth in the primary (dmft) and permanent dentitions (DMFT) ≥ 1 (n = 72); malocclusion, with the Dental Aesthetic Index (DAI) ≥ 26 (n = 40); temporomandibular disorders (TMD) with at least one sign and one symptom of TMD (n = 89); control, with dmft/DMFT = 0, DAI < 26 and without signs and symptoms of TMD (n = 63). OHRQoL was measured using Portuguese versions of Child Perceptions Questionnaires (CPQ) for children (CPQ8-10) and preadolescents (CPQ11-14). Differences in CPQ scores and in the frequency of responses to global ratings were assessed using Kruskal-Wallis and chi-square/Fisher's exact tests. Multiple linear regression analyses were used to identify items associated with CPQ and global scores. RESULTS: The OHRQoL of the TMD group was statistically different from controls. The malocclusion group reported more oral symptoms and social impacts compared to controls. The variables associated with CPQ scores varied according to clinical condition. CONCLUSIONS: OHRQoL was significantly different between clinical groups and controls for both age groups. However, when comparing clinical groups, TMD and caries differed only for preadolescents. The items associated with higher OHRQoL scores were mainly psychosocial for caries and TMD groups, and physical/functional and psychosocial for children and preadolescents with malocclusions, respectively.

Relationship among oral habits, orofacial function and oral health-related quality of life in children.

The objective was to evaluate the relationship among oral habits, oral function and oral health-related quality of life (OHRQoL) in children. Three hundred and twenty-eight subjects (8-14 years old) were assessed for orofacial function using the Brazilian version of the Nordic Orofacial Test-Screening (NOT-S). OHRQoL was assessed using the Child Perceptions Questionnaires (Brazilian versions) for the 8-10 (CPQ(8-10)) and 11-14 (CPQ(11-14)) year age groups. The subjects were distributed into a Habit group and a Habit-free group according to domain III (Habits) of the NOT-S. Oral habits were present in 71.3% of the sample (p = .0001), with a higher prevalence in females (62.8%, p = .001). The NOT-S, CPQ(8-10) and CPQ(11-14) scores were higher in the Habit group (P = .0001, P = .009 and p = .001, respectively). Domain I (Sensory Function) was significantly more affected in Habit group subjects (p = .001). The NOT-S scores were positively correlated with the CPQ(8-10) and CPQ(11-14) scores only in the Habit group (r = .32, p = .0003 and r = .30, p = .001, respectively). These results indicate that oral habits can impact OHRQoL. Moreover, orofacial dysfunctions were associated with worse OHRQoL in subjects with oral habits.

Relationship among oral habits, orofacial function and oral health-related quality of life in children

The objective was to evaluate the relationship among oral habits, oral function and oral health-related quality of life (OHRQoL) in children. Three hundred and twenty-eight subjects (8–14 years old) were assessed for orofacial function using the Brazilian version of the Nordic Orofacial Test-Screening (NOT-S). OHRQoL was assessed using the Child Perceptions Questionnaires (Brazilian versions) for the 8–10 (CPQ8-10) and 11–14 (CPQ11-14) year age groups. The subjects were distributed into a Habit group and a Habit-free group according to domain III (Habits) of the NOT-S. Oral habits were present in 71.3% of the sample (p = .0001), with a higher prevalence in females (62.8%, p = .001). The NOT-S, CPQ8-10 and CPQ11-14 scores were higher in the Habit group (P = .0001, P = .009 and p = .001, respectively). Domain I (Sensory Function) was significantly more affected in Habit group subjects (p = .001). The NOT-S scores were positively correlated with the CPQ8-10 and CPQ11-14 scores only in the Habit group (r = .32, p = .0003 and r = .30, p = .001, respectively). These results indicate that oral habits can impact OHRQoL. Moreover, orofacial dysfunctions were associated with worse OHRQoL in subjects with oral habits.

Assessment of orofacial functions in Brazilian children using the Nordic Orofacial Test-Screening (NOT-S) / Avaliação das funções orais em crianças brasileiras por meio do Nordic Orofacial Test-Screening (NOT-S)

PURPOSE: Orofacial function is the result of complex activities of the central nervous and neuromuscular systems. Orofacial dysfunction can compromise vital actions, such as breathing, chewing and swallowing, and facial expressions. The aim of this study was to apply the Brazilian version of the Nordic Orofacial Test-Screening (NOT-S), which assesses orofacial dysfunction, to a sample of Brazilian children and adolescents. METHODS: The Brazilian version of NOT-S was applied in 197 girls and 135 boys, aged from 8 to 14 years old. They were clinically examined for the phase of dentition and characteristics of occlusion. For assessing NOT-S reliability, a test-retest was performed in 50 subjects randomly selected from the total sample15 days after the first application. Descriptive statistics, Pearson's chi-squared, Mann-Whitney and Kappa tests were applied for data analysis at significant level of α=0.05. RESULTS: The scores ranged from 0 to 7; score 0 had a rate of 5%; the mean score was 2.64. The most frequent domains were III (Habits) and IV (Chewing and Swallowing) with a rate of 70 and 50%, respectively. No difference between genders was seen in relation to orofacial dysfunction, but subjects in mixed dentition and those with frontal open bite presented more orofacial dysfunction. The rate of intra-examiner agreement was 97.8% comparing the first and retest applications. CONCLUSION: No differences between genders were detected, but subjects in mixed dentition and in those with anterior malocclusion the orofacial dysfunction was more present. The Brazilian version of NOT-S was considered proper for application in Brazilian subjects.

OBJETIVO: A função orofacial é resultado de atividades complexas integradas ao Sistema Nervoso Central e ao Sistema Neuromuscular. A disfunção orofacial pode comprometer ações vitais, como a respiração, a mastigação, a deglutição e as expressões faciais. O objetivo deste estudo foi traduzir o protocolo do Nordic Orofacial Test-Screening (NOT-S), que avalia disfunção orofacial, para o Português do Brasil e aplicá-lo à uma amostra de crianças e adolescentes (8 a 14 anos). METODOLOGIA: A versão brasileira do NOT-S foi aplicada em 197 meninas e 135 meninos na faixa etária de 8 a 14 anos. Estes foram examinados clinicamente considerando as fases da dentição e características da oclusão. Para avaliar a reprodutibilidade do NOT-S foi aplicado o teste-reteste em 50 indivíduos aleatoriamente selecionados da amostra 15 dias após a primeira avaliação. Estatística descritiva, qui-quadrado, os testes Mann-Whitney e Kappa foram aplicados para análise dos dados, com nível de significância de α=0.05. RESULTADOS: Os escores variaram de 0 a 7; o escore 0 apresentou frequência de 5% e o escore médio foi 2,64. Os domínios III (Hábitos) e IV (Mastigação e Deglutição) foram os mais frequentes e apresentaram taxa de 70 e 50%, respectivamente. Não houve diferença entre os gêneros em relação à disfunção orofacial, porém os escores do NOT-S foram maiores na dentição mista quando comparada à dentição permanente. A taxa de concordância intra-examinador foi de 97,8% comparando a primeira aplicação com a do re-teste. CONCLUSÃO: Não houve diferença entre gêneros, mas nos indivíduos na dentição mista e aqueles com mordida aberta anterior a disfunção orofacial foi mais presente. A versão brasileira do NOT-S foi considerada adequada para aplicação em indivíduos brasileiros.

Versão Brasileira do The Nordic Orofacial Test – Screening (NOT-S) para Avaliação de Disfunções Orofaciais / Brazilian Version of the Nordic Orofacial Test - Screening (NOT-S) for Evaluationof Orofacial Dysfunctions

Objetivo: Traduzir o instrumento The Nordic Orofacial Test – Screening (NOT - S) , que avalia disfunções orofaciais, para a língua portuguesa e realizar a adaptação transcultural em crianças brasileiras. Método: O instrumento foi submetido às seguintes etapas: tradução para português (Brasil), tradução reversa, revisão por comitê (composto por três professores universitários de Odontologia e um paciente formalmente instruído) e pré-teste. Para a fase de equivalência cultural (pré-teste), a cada um dos itens do instrumento foi acrescentada a alternativa “não entendi” ou “não aplicável”, se o índice dessas repostas fosse superior a 15%, a questão deveria ser reformulada pelo comitê e reaplicada em outro grupo de crianças. O NOT – S foi aplicado em uma amostra de 20 crianças de 8 a 14 anos, de escolas da rede pública de Piracicaba, selecionadas aleatoriamente. Resultados: A comparação entre o instrumento original e o resultado da tradução reversa mostrou forte concordância entre ambos. As mudanças realizadas pelo comitê revisor foram o acréscimo de palavras e frases e a substituição de advérbios e palavras por sinônimos para facilitar o entendimento. No pré-teste, duas questões tiveram um índice de respostas “não entendi” de 15%, foram reformuladas e, a partir disso, o índice de resposta “não entendi” foi nulo. Conclusão: A versão em português do NOT-S foi criteriosamente traduzida e adaptada à cultura brasileira e mostrou-se ser de fácil compreensão pela população de crianças brasileiras avaliada.

Objective: To translate the instrument The Nordic Orofacial Test Screening (NOT-S), which evaluates orofacial dysfunctions, into Brazilian Portuguese and o perform the cross - cultural adaptation for Brazilian children. Method: The instrument was subjected to the following stages: translation into Brazilian Portuguese, back-translation, revision by a committee (composed by three Professors of Dentistry and a formally instructed patient) and pretest. For the phase of cultural equivalency (pretest), a “did not understand” or “does not apply” item was added to each one of the items of the instrument; if the rate of these answers was 15% or above, the question should be reformulated by the committee and reapplied to another group of children. The NOT-S was applied to a sample of randomly selected 20 children aged 8 to 14 years from public schools of the city of Piracicaba, SP, Brazil. Results: There was a strong agreement between the original instrument and its back translated version. The changes made by the revising committee were the addition of words and sentences and the substitution of adverbials and words by synonyms to facilitate the understanding. In the pretest, two questions had 15% of “did not understand” answers and were reformulated; thereafter, the rate of “did not understand” answers was null. Conclusion: The final Portuguese version of NOT-S was rigorously translated and adapted to the Brazilian culture, and was easily understood by the sample of Brazilian children evaluated.