Contextual and individual determinants of oral health-related quality of life among five-year-old children: a multilevel analysis

Abstract

BackgroundContextual factors may influence oral health-related quality of life (OHRQoL) in children. The aim of the present study was to evaluate the influence of individual and contextual determinants of OHRQoL based on the perceptions of children.MethodsA cross-sectional study was conducted with a representative sample of 769 five-year-old children from public and private preschools in a city in the countryside of northeast Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, sociodemographic data and aspects of the child’s oral health. The children answered the child version of the Scale of Oral Health Outcomes for five-year-old children and were submitted to oral examinations. Variables related to the context were obtained from the schools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models were used to investigate associations between variables.ResultsIn the adjusted analysis, parent’s/caregiver’s schooling, household income, parent’s/caregiver’s age, a history of dental pain, dental caries and its consequences and traumatic dental injury were considered individual determinants of OHRQoL according to the children’s self-reports. After the incorporation of the contextual determinants, the association between parent’s/caregiver’s schooling and OHRQoL lost its significance. Type of school was the context variable that remained associated with OHRQoL.DiscussionBesides the clinical and sociodemographic individual characteristics, characteristics of the school environment in which the child studies are associated with self-reported impacts on OHRQoL.

Diet, Nutrition, and Oral Health: What Influences Mother’s Decisions on What to Feed Their Young Children?

“…The 2016 Global Burden of Disease Study reported that oral diseases globally affect at least 3.58 billion people, with 486 million children experience dental caries in their primary teeth worldwide [2]. The rates of ECC are the highest among the socially disadvantaged groups, such as those from a lower socio-economic status (SES), refugees, and ethnic minorities [3,4]. If left untreated, ECC may results in severe pain, abscesses, and may adversely impact children's general health, growth, and quality of life [5,6].…”

Urgência e descontinuidade do cuidado em saúde bucal de crianças e adolescentes

“…Individuals who have used urgent dental services more than once have a greater probability of continuing to use such services as their main source of dental care 17 . Children and adolescents who seek healthcare services due to a toothache and for whom care is discontinued are subject to further episodes of pain and suffering, with impacts on daily activities, such as going to school, eating, playing and sleeping 10,11 . Besides treating and controlling the progression of dental caries, regular oral health follow-up by primary care services could avoid the recurrent demand for dental care due to episodes of pain in this age group.…”

“…The absence of pain/discomfort of a dental origin is an important oral health outcome 8 . The literature has demonstrated that quality of life 9,10 and the perception of oral health in children and adolescents are strongly impacted by episodes of toothache 8,11 , which also exert an impact on parents/guardians in the form of emotional distress and missed days of work 12 . Despite advances in recent years in the field of collective oral health in Brazil 13 , toothache still affects a significant portion of children 14 and adolescents 15 .…”

Can the school environment influence oral health–related behaviours? A multilevel analysis of the Brazilian National Adolescent School‐Based Health Survey 2015

“…Schoolchildren and adolescents in schools with structural, organizational, curricular or processual characteristics that are more favourable to the oral health promotion have a lower prevalence of caries, [7][8][9][10][11][12] dental trauma, 7 dental pain 8 and a better oral health-related quality of life. [13][14][15] Oral health-related behaviours among schoolchildren such as toothbrushing, 2,12,16 consumption of foods with added sugar, 2,12,[16][17][18] tobacco consumption 2,[19][20][21][22] and alcohol intake 2,22 have also been investigated. The results vary, depending on the context, highlighting the need for further research involving these factors.…”