Effect of educational strategy combined with ART on oral health-related quality of life: a controlled clinical trial

Abstract

This study aimed to assess whether complementing atraumatic restorative treatment (ART) with oral health educational strategies (OHES) improves the perception of oral health-related quality of life (OHRQoL) and clinical oral outcomes. A controlled clinical trial included 93 six-to eight-year-old students from five public schools of Piracicaba, Saltinho, and Charqueada municipalities (State of São Paulo, Brazil) divided into 3 groups (31 children each) which received: OHES (caries-free), ART (dental caries), and ART plus OHES (dental caries). OHRQoL (CPQ8-10-ISF:16), dental caries, biofilm control, and gingivitis were assessed before and 1 month after interventions by one calibrated examiner. OHES consisted of an educational interactive activity performed once a week for four weeks. Data were analyzed using mixed model ANOVA, Chi-square, and Sign tests. After 1 month of follow-up, improvement in gingivitis status, OHRQoL total score, and Functional Limitations, Emotional Well-Being and Social Well-Being domains scores were found in all groups (p < 0.05). The improvement in biofilm control was observed only in the OHES group (p < 0.001; power = 0.98), while a decrease in Oral Symptoms scores was observed only in ART+OHES group (p <0.001; power = 0.99) and a significant change in the perception of oral health was observed in the two groups that received ART (p < 0.05). In conclusion, improvement in overall OHRQoL and oral status was observed in all children, although the effect of including health educational strategies in the treatment plan was determinant for the perception of an improved oral health after restorative treatment.

Association of Oral Health-Related Quality of Life with the Longevity of ART-Restorations in Children

“…Thus, in this study, the OHES may have increased the children's sense of coherence [34], favoring a more accurate perception of their oral problems and symptoms, as observed by Sousa et al [18].…”

“…Although some studies have already demonstrated the effect of conventional dental caries treatment on improving OHRQoL in children [15,16], there is little evidence of the influence of ART on OHRQoL in the child population [7,9,17]. In Sousa et al [18] study, including health educational strategies in the ART treatment plan was a determinant for the child's perception of improved oral health after restorative treatment.…”

“…Considering the benefits of the association between dental procedures and oral health educational strategies (OHES) for better cost-effectiveness [21,22], for better perception of oral health [18], and for stress modulation during ART steps for pediatric patients [23], it is important to assess the longevity of ART restorations after 18 months and their association with OHRQoL in children.…”