The objective of this investigation was to evaluate the effect on dental caries experience of using carbamide polyol chewing gum as a supplement to standard oral hygiene procedures for schoolchildren in a developing country (Madagascar). In 1994, grades 1 and 4 children of demonstration schools were allocated to experimental and control groups; all children participated in a school-based oral health education programme, including daily toothbrushing supervised by the classroom teacher. At grade 1, the test group (n = 125) also used chewing gum (V6: 55.5 per cent sorbitol, 4.3 per cent xylitol, 2 per cent carbamide) three times a day. At grade 4, one test group (n = 177) had chewing gum three times a day and an additional test group (n = 74) had chewing gum five times a day. The control groups included 117 children at grade 1 and 209 at grade 4. Dental caries was registered in 1994 and 1997 according to the Recording System for the Danish Child Dental Services. In grade 1 children, the preventive effect of the total DMFS was not statistically significant except for occlusal caries (-0.65 DMFS, P < 0.01). In the grade 4 test groups, non-significant reductions of dental caries experience were found when compared with controls. The present community trial indicates that the use of polyol chewing gum may be considered a supplement to the control of occlusal dental caries in young primary schoolchildren, particularly in developing countries with limited resources for dental care.

The Early Childhood Oral Health Impact Scale (ECOHIS) was developed to assess the impact of oral health conditions on the quality of life of preschool children and theirs families. The ECOHIS was originally developed in English language, translated and validated in several countries but no validated transcultural version of this questionnaire is currently available in Madagascar. The objectives of this cross-cultural study were to translate, validate and analyse the psychometric properties of the Malagasy version of ECOHIS. Method: The translation followed the forward-backward translation process. The Malagasy version obtained was pre-tested on ten mothers. Then, the questionnaire was administered by interview to 150 parents/guardians of children aged 3 to 5 years old frequenting two nursery schools in the town of Mahajanga to evaluate the reliability and validity of its psychometric characteristics. Reliability was assessed by the test-retest procedure with an interval of 15 days by using the intra-class correlation (ICC). Internal consistency was tested by Cronbach's alpha coefficient. The validity of construct, discriminant and criterion were evaluated. Construct validity was evaluated by Spearman rank correlation and tested using exploratory factor analysis and partial confirmatory factor analysis. Discriminant validity was tested between groups of children presenting consequences of untreated decayed teeth. Clinical examination was performed using the decayed, missing, filled teeth (dmft) and the pulpal involvement, ulceration, fistula, abscess (pufa) indices for assessing dental caries and consequences of untreated decayed teeth. Results: The cultural adaptation showed that the respondents understood the questions. The intraclass correlation coefficient for test retest was 0.91. The internal consistency demonstrated a good reliability of the Malagasy-ECOHIS version with a Cronbach's alpha coefficient of 0.88. The convergent validity evaluated by Pearson correlation coefficients provided positive and significant correlation values between all the items ranging from 0.26 to 0.72. Significant associations between the ECOHIS scores and the global rating of oral health supported the validity of the construct. Convergent and discriminant validity were obtained by testing the association of ECOHIS scores on the child and family sections with poor parental ratings of their child's oral health, high caries experience and untreated decayed teeth consequences which were to be statistically significant. Conclusion: The results showed that this Malagasy version of ECOHIS questionnaire has shown good psychometric properties and could be used on Malagasy parents of preschool children to measure the impact of oral health status on the child and family quality of life.

BackgroundThe Child Perceptions Questionnaire (CPQ) belongs to a set of questionnaires measuring Child Oral Health Quality of Life (COHQOL). The CPQ is used to collect the perceptions of children on the impact of oral diseases on their quality of life. This cross-sectional study was aimed to translate the CPQ8-10 into French language and evaluate its psychometric properties.MethodsThe translation process complied with international recommendations. The final French version was tested on children aged 8-10 years old attending consultations in a Parisian public hospital and divided into three groups: children with oral-facial clefts, children with dental anomalies linked to a rare disease other than clefts and children presumed to be healthy and without anomalies. The internal consistency relating to the reliability of CPQ8-10 was evaluated by Cronbach’s alpha. The intra-class correlation was used to measure reproducibility at the test-retest level. Construct validity was evaluated by Spearman’s correlation and tested using factor analysis. The discriminant validity was assessed using Kruskall Wallis test. Criterion validity was calculated using Spearman’s correlation.ResultsOne hundred seventy-six children participated in this study. During the translation process, minor changes were made. The French version showed good reliability with a Cronbach’s alpha of 0.81 for the total scale. The ICC of the test-retest was excellent (=0.90) demonstrating good reproducibility. The construct validity was acceptable with a statistically significant correlation between the scores of the French-CPQ8-10 and the evaluation of oral health (r = 0. 381 and p < 0.001) and its impact on oral health quality of life (r = 0.363 and p < 0.001). The loading weights obtained in the Exploratory Factor Analysis showed that this model revealed seven factors with eigenvalue greater than 1, explaining the 63,89% of the cumulative variance. The differences observed between the scores of the study groups revealed good discriminant validity. Criterion validity was supported by significant association between CPQ scores and pain.ConclusionThe French-CPQ8-10 is reliable and valid for use with the children of this age group.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0907-x) contains supplementary material, which is available to authorized users.