Are oral health conditions associated with schoolchildren's performance and school attendance in the Kingdom of Bahrain? A life-course perspective.

BACKGROUND: The link between oral diseases and school performance and school attendance remains unclear among Middle Eastern children. AIM: To investigate the relationship of oral conditions with schoolchildren's school performance and attendance using the life-course approach. DESIGN: A cross-sectional study was conducted with 466 schoolchildren aged 7-8 years from Kingdom of Bahrain (KoB) and their parents. Questionnaire data on children's current and at-birth environmental characteristics were completed by their parents. Children's oral health measures, including ICDAS (International Caries Detection and Assessment System), PUFA (pulp, ulcer, fistula, abscess), and DDE (developmental defects of enamel) indices, were the exposure variables. School performance and school attendance data obtained from the school register were the outcome variables. The data were analysed using multivariate ordinal logistic regression. RESULTS: The odds of excellent school performance were significantly lower for children with untreated dentinal caries (OR = 0.98; 95% CI: 0.96-0.99). Children with caries-treated teeth showed greater odds of excellent school performance (OR = 1.41; 95% CI: 1.15-1.74). Disease Control and PreventionNone of the dental conditions were significantly associated with children's school attendance. A permissive parental style was associated with poor school attendance (OR = 2.63; 95% CI: 1.08-6.42). CONCLUSION: Dental caries was associated with poor school performance but not with school attendance. Treated caries was associated with good school performance.

Making white spots disappear! Do minimally invasive treatments improve incisor opacities in children with molar-incisor hypomineralisation?

BACKGROUND: Children with molar-incisor hypomineralisation (MIH) frequently seek aesthetic treatment for incisor opacities. Surprisingly, few studies have evaluated the clinical success of such interventions. AIM: To quantify the effectiveness of minimally invasive treatments in reducing enamel opacity visibility in children with MIH. DESIGN: This in vitro study used digital clinical images of 23 children aged 8-16 years with MIH who underwent microabrasion and/or resin infiltration for the management of incisor opacities. Standard images were taken pre-treatment and 6 months post-treatment. Image software (Image-Pro Plus® V7) was employed to convert 24-bit RGB images to 16-bit greyscale and 145× magnification. Measurement repeatability was assessed using intra-class correlation coefficients (ICCs). Post-treatment changes in visible opacity area (mm2 ) and brightness (greyscale value) were tested using the Wilcoxon signed-rank test for related samples. RESULTS: The mean total opacity surface area significantly reduced from 14.3 mm2 (SD = 7.5) to 9.4 mm2 (SD = 9.0) post-treatment. The proportion of tooth surface affected by the opacity also significantly reduced from 22.5% (SD = 10.5) to 14.7% (SD = 12.7). The mean maximum opacity brightness significantly reduced from 53 066 greyscale value (SD = 4740) to 49 040 (SD = 3796). ICC was good/excellent (0.75-1.0). CONCLUSION: Minimally invasive treatment is effective in reducing the size and brightness of discrete incisor opacities. Future research should compare objective findings with patient-reported outcomes.

Do psychological factors predict changes in oral health-related quality of life and clinical status after periodontal treatment?

AIMS: To determine psychological factors predicting changes in OHRQoL and clinical status after periodontal treatment. METHODS: Cohort of 140 patients with chronic periodontitis receiving non-surgical treatment consisting of scaling, root surface debridement and instruction in plaque control. Participants self-completed questionnaires enquiring about sense of coherence, locus of control, self-esteem and task-specific self-efficacy before treatment, and the Oral Health Impact Profile-14 before treatment, at oral hygiene review and end of study. Relationships among OHRQoL, clinical changes, individual factors (demographic and psychological) and environmental characteristics were analysed using latent growth curve modelling guided by the Wilson and Cleary model. RESULTS: OHRQoL and periodontal status improved after treatment. Being male and having a greater sense of coherence predicted better OHRQoL before treatment. Stronger internal dimension of locus of control predicted a greater rate of improvement in OHRQoL, whereas greater external dimensions predicted a slower rate of improvement. Greater task-specific self-efficacy predicted less gains in probing attachment and reductions in probing depth. CONCLUSIONS: Knowledge of psychological factors may be helpful in explaining individual differences in OHRQoL and clinical responses to periodontal treatment, and in identifying where health-promoting interventions may strengthen relevant factors to improve these outcomes.

Periodontal treatment, psychological factors and oral health-related quality of life.

AIMS: To determine changes in OHRQoL and clinical status after periodontal treatment and the factors predicting these changes. METHODS: Cohort of 140 patients with chronic periodontitis receiving non-surgical treatment. Participant self-completed questionnaires: Sense of Coherence, Locus of Control, Self-esteem and Task-specific Self-efficacy before treatment, and Oral Health Impact Profile at treatment, oral hygiene review and end of study. Relationships between OHRQoL, clinical data, individual and environmental characteristics were analysed with structural equation modelling guided by the Wilson and Cleary model. RESULTS: OHRQoL and the periodontal status improved after treatment. Greater sense of coherence and age, better periodontal status, lower DMFT and being male predicted better OHRQoL after treatment. Better task-specific self-efficacy and self-esteem, but worse plaque score predicted better end periodontal status. CONCLUSIONS: OHRQoL and periodontal status improved after periodontal treatment, and this was predicted by individual demographic and psychological factors. These factors may assist with case selection and as possible points for intervention to improve clinical and subjective outcomes of periodontal treatment.

How peoples' ratings of dental implant treatment change over time?

OBJECTIVES: Dental implant treatment (DIT) improves peoples' oral health-related quality of life (OHQoL). Assessment of longitudinal changes in OHRQoL may be undermined by response shift (RS). RS is the process by which quality of life changes, independent of health status as a result recalibration, reprioritization or reconceptualization. Thus, this study aimed to describe RS in the OHRQoL and perceived oral health of individuals receiving DIT and to compare the then-test, a self-anchored scale and the classification and regression trees (CRT) approaches for assessing RS. METHODS: OHRQoL was assessed in 100 patients receiving DIT using the OHIP-Edent (n = 100) and a self-anchored scale (n = 45) before placement of the final restoration and 3 to 6 months after treatment was completed. The OHIP-Edent was also used as a retrospective assessment at follow-up. CRT examined changes in the OHIP-Edent total score as a dependent variable with global changes in oral health and each OHIP-Edent subscale score as independent variables. RESULTS: OHRQoL and perceived oral health improved after treatment. The OHIP-Edent score decreased from 36.4 at baseline to 12.7 after treatment. On average, participants recalibrated their internal standard downwards (- 4.0 OHIP-Edent points). CRT detected downwards recalibration in 5% of participants and upwards in 15%. Reprioritization was observed in the social disability and psychological discomfort aspects of OHRQoL. CONCLUSIONS: RS affects longitudinal assessments of OHRQoL in DIT, reducing the apparent magnitude of change. The then-test and CRT are valid and complementary methods to assess RS.

Socio-economic status, social support, social network, dental status, and oral health reported outcomes in adolescents.

This study explored the relationships between sex, socio-economic status, social support, social network, dental clinical status, dental pain, oral health-related quality of life (OHRQoL), and self-rated oral health (SROH) in adolescents. A cross-sectional study involving 542 adolescents, aged 12-14 yr, was conducted in Dourados, Brazil, to collect dental clinical measures (dental caries, missing teeth, and dental trauma), as well as measures of social support, social network, dental pain, OHRQoL, and SROH. Information on family income and parental education were collected from participant's parents. Structural equation modeling showed that higher income predicted better dental status and better SROH. Greater social support was linked to better dental status and better OHRQoL. Having more social networks was directly linked to better dental status. Poor dental status was linked to dental pain and poor OHRQoL. Dental pain predicted poor OHRQoL and worse SROH. Poor OHRQoL predicted worse SROH. Family income, social support, and social networks indirectly predicted dental pain via dental status. The latter was indirectly linked to OHRQoL and SROH via dental pain. Social support and social networks indirectly predicted OHRQoL and SROH via dental status and dental pain. Socio-economic factors and social relationships should be considered when planning health promotion and dental care provision to improve an adolescent's oral health.

Orthodontic treatment need, self-esteem, and oral health-related quality of life among 12-yr-old schoolchildren.

The aim of this study was to investigate the association between orthodontic treatment need and oral health-related quality of life (OHRQoL) among 12-yr-old children. The study also assessed whether self-esteem modifies and/or moderates this relationship. Cross-sectional data on 406 schoolchildren aged 12 yr were analyzed. Data on socio-economic and demographic characteristics, dental pain, self-esteem, and OHRQoL were collected using validated questionnaires. Orthodontic treatment need was assessed, through dental examinations, using the dental aesthetic index (DAI). Multiple negative binomial regression and path analysis were used to estimate the association of orthodontic treatment need and self-esteem with OHRQoL. A modifying effect of self-esteem on the relationship between DAI and OHRQoL was observed. Self-esteem did not mediate the abovementioned relationship. Children with lower scores of self-esteem had worse OHRQoL among those with lower orthodontic treatment need (a DAI score of < 31). However, self-esteem did not influence the association between DAI and OHRQoL in children with greater orthodontic treatment need (a DAI score of ≥ 31). Self-esteem attenuated the impact of malocclusion on OHRQoL in children with minor or definite malocclusion, but not among those with severe or very severe malocclusion. Self-esteem appears to buffer the impact of malocclusion on OHRQoL in children with minor orthodontic treatment need.

Oral health-related quality of life after prosthodontic treatment for patients with partial edentulism: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated. PURPOSE: The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments. MATERIAL AND METHODS: Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implant-supported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardized mean change, 95% confidence intervals). RESULTS: Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled standardized mean change OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases. CONCLUSIONS: TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP.

Using classification and regression tree modelling to investigate response shift patterns in dentine hypersensitivity.

BACKGROUND: Dentine hypersensitivity (DH) affects people's quality of life (QoL). However changes in the internal meaning of QoL, known as Response shift (RS) may undermine longitudinal assessment of QoL. This study aimed to describe patterns of RS in people with DH using Classification and Regression Trees (CRT) and to explore the convergent validity of CRT with the then-test and ideals approaches. METHODS: Data from an 8-week clinical trial of mouthwashes for dentine hypersensitivity (n = 75) using the Dentine Hypersensitivity Experience Questionnaire (DHEQ) as the outcome measure, were analysed. CRT was used to examine 8-week changes in DHEQ total score as a dependent variable with clinical status for DH and each DHEQ subscale score (restrictions, coping, social, emotional and identity) as independent variables. Recalibration was inferred when the clinical change was not consistent with the DHEQ change score using a minimally important difference for DHEQ of 22 points. Reprioritization was inferred by changes in the relative importance of each subscale to the model over time. RESULTS: Overall, 50.7% of participants experienced a clinical improvement in their DH after treatment and 22.7% experienced an important improvement in their quality of life. Thirty-six per cent shifted their internal standards downward and 14.7% upwards, suggesting recalibration. Reprioritization occurred over time among the social and emotional impacts of DH. CONCLUSIONS: CRT was a useful method to reveal both, the types and nature of RS in people with a mild health condition and demonstrated convergent validity with design based approaches to detect RS.

Multimorbidity patterns of oral clinical conditions, social position, and oral health-related quality of life in a population-based survey of 12-yr-old children.

The aim of this study was to describe the patterns of multimorbidities of oral clinical conditions in children. The association between social position and number of oral clinical conditions, and the relationship of social position and number of oral clinical conditions with oral health-related quality of life [OHRQoL, measured using the Brazilian Child-Oral Impacts on Daily Performance (Child-OIDP)] were also investigated. The study analysed data on 7,208 children, 12 yr of age, from the Brazilian Oral Health Survey (SBBrasil Project). Cluster analysis based on the observed/expected (O/E) ratios identified six significant clusters of oral clinical conditions: (i) dental caries and missing teeth; (ii) dental caries and dental trauma; (iii) dental trauma and gingivitis; (iv) dental caries, missing teeth, and dental trauma; (v) dental caries, dental trauma, and gingivitis; and (vi) all oral clinical conditions. Ordinal regression showed that poor social position was associated with a large number of oral clinical conditions. Poisson regression demonstrated that low social position and greater number of oral clinical conditions increased the likelihood of poor OHRQoL (Child-OIDP extent). The four oral clinical conditions clustered into six distinct clusters among Brazilian children. Multimorbidity of oral clinical conditions predicted poor OHRQoL. Social position was of high relevance to multimorbidity of oral clinical conditions and children's OHRQoL.

The relationship of children's dental clinical status with school performance and school attendance in the Kingdom of Bahrain: A life-course approach.

OBJECTIVES: To examine the association between dental clinical status and school performance and school attendance in the Kingdom of Bahrain (KoB) using a life-course framework. METHODS: This time-ordered cross-sectional study included 466 school children in Grade 2 (aged 7-8 years) and their parents in the KoB. Data were collected through parents' self-administered questionnaires, children's face-to-face interviews and dental clinical examinations. Data on children's school performance and school attendance were gathered from parents and school records. Structural equation modelling (SEM) examined the direct and indirect pathways between variables. RESULTS: Children born in families with high socio-economic status (SES) were less likely to have dental caries and more likely to have better school performance at 7-8 years of age. Dentine caries was directly linked with poor school performance. Treated teeth directly predicted high school performance. The presence of dentine caries mediated the relationship of SES with school performance. CONCLUSIONS: Birth and current socio-economic factors were significant predictors of dental clinical conditions and school performance. Dental caries and fewer treated teeth directly predicted poor school performance.

Longitudinal evidence of the influence of early life circumstances, family characteristics, social ties and psychological distress on healthy behaviours of Brazilian adults: The Pro-Saude cohort study.

BACKGROUND: This study examined the influence of early life circumstances, family characteristics, social ties and psychological distress in adulthood on adult's health-related behaviours. METHODS: A cohort study (Pro-Saúde Study) involving technical and administrative civil servants at university campuses in Rio de Janeiro State, Brazil was conducted in Rio de Janeiro, Brazil. Data from 2155 adults were collected at baseline (1999) and after a 13-year period (2012-13). Family characteristics at 12 years of age were assessed retrospectively in 1999. Gender, marital status, living situation, social support, social networks of relatives and psychological distress were also measured in 1999. Data collection in 2012-13 included information about marital status, social networks of relatives, cigarette smoking, fruit and vegetable consumption and physical exercise. A conceptual model testing the relationships between variables was assessed through structural equation modelling. RESULTS: Female gender (ß = 0.043), better social networks of relatives in 1999 (ß = 0.053) and 2012-13 (ß = 0.069) and low psychological distress (ß = -0.048) directly predicted less smoking. Better social networks of relatives in 2012-13 was directly linked to higher consumption of fruits (ß = 0.045) and vegetables (ß = 0.051) and being physically active (ß = 0.070). Low psychological distress directly predicted higher fruit consumption (ß = -0.040). Family characteristics at 12 years-old, marital status and living with other people were linked indirectly with health behaviours through social networks, social support and psychological distress. CONCLUSIONS: Adults with better early life family and social circumstances, and those who were married reported positive health behaviours through indirect pathways. Stronger social ties and lower psychological distress represented the pathways by which early life circumstances and relationship status influenced positive health behaviours.

Peri-implant bone loss in cement- and screw-retained prostheses: systematic review and meta-analysis.

AIM: The aim of this systematic review and meta-analysis was to assess and compare peri-implant marginal bone loss in cement- and screw-retained prostheses. MATERIAL AND METHODS: Electronic database and manual searches were undertaken to identify trials, prospective or retrospective studies reporting on radiographic marginal bone loss around dental implants restored with cement- and/or screw-retained prostheses. Two reviewers independently conducted the article selection and data extraction. Random-effects models were used to obtain estimates of peri-implant marginal bone loss [mean, 95% confidence intervals (CI)]. RESULTS: Of the 1217 identified studies, nine finally met the inclusion criteria. Only two studies included both cement- and screw-retained prostheses, three assessed only screw-retained prostheses, and four evaluated only cement-retained prostheses. Pooled mean marginal bone loss was 0.53 mm (CI 95%, 0.31-0.76 mm) for cement-retained prostheses and 0.89 mm (CI 95%, 0.45-1.33 mm) for screw-retained prostheses. CONCLUSION: There is no evidence to support differences in the marginal bone loss through indirect comparison between cement and screw-retained restorations.

The association of neighbourhood and individual social capital with consistent self-rated health: a longitudinal study in Brazilian pregnant and postpartum women.

BACKGROUND: Social conditions, social relationships and neighbourhood environment, the components of social capital, are important determinants of health. The objective of this study was to investigate the association of neighbourhood and individual social capital with consistent self-rated health in women between the first trimester of pregnancy and six months postpartum. METHODS: A multilevel cohort study in 34 neighbourhoods was performed on 685 Brazilian women recruited at antenatal units in two cities in the State of Rio de Janeiro, Brazil. Self-rated health (SRH) was assessed in the 1st trimester of pregnancy (baseline) and six months after childbirth (follow-up). The participants were divided into two groups: 1. Good SRH--good SRH at baseline and follow-up, and, 2. Poor SRH--poor SRH at baseline and follow-up. Exploratory variables collected at baseline included neighbourhood social capital (neighbourhood-level variable), individual social capital (social support and social networks), demographic and socioeconomic characteristics, health-related behaviours and self-reported diseases. A hierarchical binomial multilevel analysis was performed to test the association between neighbourhood and individual social capital and SRH, adjusted for covariates. RESULTS: The Good SRH group reported higher scores of social support and social networks than the Poor SRH group. Although low neighbourhood social capital was associated with poor SRH in crude analysis, the association was not significant when individual socio-demographic variables were included in the model. In the final model, women reporting poor SRH both at baseline and follow-up had lower levels of social support (positive social interaction) [OR 0.82 (95% CI: 0.73-0.90)] and a lower likelihood of friendship social networks [OR 0.61 (95% CI: 0.37-0.99)] than the Good SRH group. The characteristics that remained associated with poor SRH were low level of schooling, Black and Brown ethnicity, more children, urinary infection and water plumbing outside the house. CONCLUSIONS: Low individual social capital during pregnancy, considered here as social support and social network, was independently associated with poor SRH in women whereas neighbourhood social capital did not affect women's SRH during pregnancy and the months thereafter. From pregnancy and up to six months postpartum, the effect of individual social capital explained better the consistency of SRH over time than neighbourhood social capital.

Gender differences in the association of perceived social support and social network with self-rated health status among older adults: a population-based study in Brazil.

BACKGROUND: Older adults are more likely to live alone, because they may have been predeceased by their spouse and friends. Social interaction could also be reduced in this age group due by limited mobility caused by chronic conditions. Therefore, aging is frequently accompanied by reduced social support, which might affect health status. Little is known about the role of gender in the relationship between social support and health in older adults. Hence, the present study tests the hypothesis that gender differences exist in the relationship between perceived social support, social network, and self-rated health (SRH) among older adults. METHODS: A cross-sectional study using two-stage probabilistic sampling recruited 3,649 individuals aged 60 years and above. Data were collected during the national influenza vaccination campaign in Rio de Janeiro, Brazil, in 2006. Individual interviews collected information on SRH, perceived social support, social network, and other covariates. Multivariate logistic regression analyses using nested models were conducted separately for males and females. Independent variables were organised into six blocks: (1) perceived social support and social network, (2) age group, (3) socioeconomic characteristics, (4) health-related behaviours, (5) use of health care services, (6) functional status measures and somatic health problems. RESULTS: Older men who did not participate in group activities were more likely to report poor SRH compared to those who did, (OR = 1.63; 95% CI = 1.16-2.30). Low perceived social support predicted the probability of poor SRH in women (OR = 1.64; 95% CI = 1.16-2.34). Poor SRH was associated with low age, low income, not working, poor functional capacity, and depression in both men and women. More somatic health problems were associated with poor SRH in women. CONCLUSIONS: The association between social interactions and SRH varies between genders. Low social network involvement is associated with poor SRH in older men, whereas low perceived social support is associated with poor SRH in older women. The hypothesis that the relationship of perceived social support and social networks to SRH differs according to gender has been confirmed.

Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks.

BACKGROUND: Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. METHODS: A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group--employed women with paid work, and, 2. home-based social network group--women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. RESULTS: There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥ 4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥ 4 [OR 1.73 (95% CI: 1.23-2.42)]. CONCLUSIONS: Pregnant and post-partum Brazilian women in paid employment outside the home and having social supports had better OHRQoL than those with home-based social networks.

Social capital and oral health in children and adolescents: A systematic review and meta-analysis.

OBJECTIVES: To systematically evaluate the association of individual and contextual social capital with oral health outcomes in children and adolescents. METHODS: Electronic searches were performed in PubMed/Medline, Embase, Web of Science and Scopus databases for articles published from 1966 up to June 2021. Two calibrated reviewers screened and critically appraised the identified papers. Observational studies that evaluated the relationship of individual or/and contextual social capital or their proxies with oral health outcomes in children and adolescents using validated methods were included. Quality assessment was conducted using the Newcastle-Ottawa Scale. Data were extracted for narrative synthesis and meta-analysis followed by a meta-regression model. Meta-analysis using random effects method was used to estimate pooled prevalence ratio (PR) and 95% confidence intervals (CI). RESULTS: Of the 3060 studies initially retrieved, 31 were included in the systematic review and 21 in the meta-analysis, totalling 81 241 individuals. The clinical outcomes included dental caries and gingival bleeding and subjective outcomes were oral health-related quality of life (OHRQoL) and self-rated oral health (SROH). Individuals with lower levels of individual social capital had a higher prevalence of poor clinical (PR 1.11; 95%CI 1.02-1.22) and subjective (PR 1.25; 95%CI 1.09-1.45) oral health conditions. The prevalence of worse clinical (PR 1.34; 95%CI 1.11-1.61) and subjective (PR 1.56; 95%CI 1.13-2.16) oral health outcomes were also associated with lower levels of contextual social capital. In general, the contextual level of social capital exerted more impact, and the subjective oral health outcomes were the more affected. CONCLUSIONS: Contextual and individual social capital were positively related to oral health outcomes, such as dental caries, gingival bleeding, SROH and OHRQoL in children and adolescents.

Common Determinants of Dental Caries and Obesity in Children: A Multi-Ethnic Nested Birth Cohort Study in the United Kingdom.

The article examines the common determinants of childhood dental caries and obesity. Longitudinal data from the Born in Bradford cohort study (BiB1000) (n = 1735) and dental data (dental general anaesthetics (GA) and oral health survey 2014/15) (n = 171) were used to test a framework on the social determinants of childhood dental caries (decayed, missing, filled teeth (dmft) index) and obesity (body mass index (BMI)). The BiB1000 data were collected at pregnancy week 26-28 and after birth at 6, 12, 18, 24 and 36 months. The determinants were demographics, wellbeing, socio-economic status (SES), dietary behaviours and physical activity behaviour of the children. Missing data were accounted for through multiple imputation (MI). The framework was tested through structural equation modelling. Overall, the model fit was adequate. No alcohol consumption of the mother after giving birth, higher frequency of child drinking sugar-sweetened beverages, emotional and behavioural difficulties of the child and being male were directly associated with both BMI and dental caries. Caregivers uninvolved or indulgent feeding style were associated with higher BMI and less dental caries. Social deprivation was associated with lower BMI and higher dmft. Five determinants were directly associated with BMI only. Fifteen indirect paths were significant for both child dental caries and BMI. The findings suggest common determinants for both childhood obesity and dental caries. Common risk factor approach seems appropriate for planning future health promotion programmes.

Socioeconomic status and oral health-related quality of life: A systematic review and meta-analysis.

OBJECTIVES: To systematically review observational studies assessing the association between socioeconomic status (SES) and oral health-related quality of life (OHRQoL) in children, adolescents and adults. METHODS: Electronic searches were performed in the PubMed, Embase, Web of Science, LILACS and Scopus databases for articles published up to September 2020. Two independent reviewers performed the search and critical appraisal of the studies. The inclusion criteria were observational studies that evaluated the effect of SES on the OHRQoL in all age groups using validated methods. Quality assessment was conducted using the Newcastle-Ottawa Scale. Data were extracted for meta-analysis followed by a meta-regression analysis. A random-effects model was used to estimate the pooled calculate prevalence ratio (PR) and respective 95% confidence intervals (CI) for each study. RESULTS: The search strategy retrieved 6114 publications. Some 139 articles met the eligibility criteria and were included in the systematic review. Of those, 75 were included in the general meta-analysis they represented a total sample of 109 269 individuals. People of lower SES had worse OHRQoL (PR 1.30; 95% CI 1.26-1.35). In the meta-analyses of different subgroups, an association was found between low SES and worse OHRQoL in countries of all economic classifications, in all age groups and irrespective of the socioeconomic indicator used. A socioeconomic gradient in OHRQoL was also observed, in which the lower the individuals' socioeconomic position, the poorer their OHRQoL. CONCLUSIONS: Individuals of low SES had poorer OHRQoL, regardless of the country's economic classification, SES indicator and age group. Public policies aiming to reduce social inequalities are necessary for better OHRQoL throughout life.

Determinants of children's oral health-related quality of life following aesthetic treatment of enamel opacities.

OBJECTIVES: To identify clinical and psychosocial predictors of oral health-related quality of life (OHRQoL) in children with molar incisor hypomineralisation (MIH) following aesthetic treatment of incisor opacities. METHODS: Participants were 7- to 16-year-old children referred to a UK Dental Hospital for management of incisor opacities. Prior to treatment (To), participants completed validated questionnaires to assess OHRQoL and overall health status (C-OHIP-SF19), and self-concept (Harter's Self-Perception Profile for Children [SPPC]). Interventions for MIH included microabrasion, resin infiltration, tooth whitening or composite resin restoration. Children were reviewed after six months (T1) when they re-completed the C-OHIP-SF19 and SPPC questionnaires. The relationships of predictors with improvement of children's OHRQoL (T1-To) and children's overall health status at T1 were assessed using linear and ordinal logistic regression respectively, guided by the Wilson and Cleary's theoretical model. RESULTS: Of 103 participants, 86 were reviewed at T1 (83.5 % completion rate). Their mean age was 11-years (range = 7-16) and 60 % were female. Total and domain OHRQoL scores significantly increased (improved OHRQoL) following MIH treatment. There was a significant positive change in SPPC physical appearance subscale score between To and T1. A higher number of anterior teeth requiring aesthetic treatment were associated with poor improvement of socio-emotional wellbeing at T1 (Coef =-0.43). Higher self-concept at To was associated with greater improvement of socio-emotional wellbeing at T1 (ß = 3.44). Greater orthodontic treatment need (i.e. higher IOTN-AC score) at T0 was linked to worse overall oral health at T1 (OR = 0.43). CONCLUSIONS: Psychosocial factors and dental clinical characteristics were associated with change in children's OHRQoL following minimal interventions for incisor opacities. CLINICAL SIGNIFICANCE: MIH is a common condition and clinicians should be aware of the negative impacts some children experience, particularly those with multiple anterior opacities, poor tooth alignment and low self-concept. However, simple, minimally invasive treatments can provide good clinical and psychosocial outcomes and should be offered to children reporting negative effects.