Oral Health-Related Quality of Life and Traumatic Dental Injuries in Young Permanent Incisors in Brazilian Schoolchildren: A Multilevel Approach

Abstract

BackgroundTraumatic dental injury (TDI) during childhood may negatively impact the quality of life of children.ObjectiveTo describe the association of oral health-related quality of life (OHRQoL) and domains (oral symptons, functional limitation, emotional- and social-well-being) of children with individual and contextual variables.MethodsA cross-sectional study was performed using a representative sample of 1,201 schoolchildren, 8–10 years-old, from public and private schools of Belo Horizonte, Brazil. The CPQ8–10 was used to assess OHRQoL, dichotomized in low and high impact. Sociodemographic information was collected through questionnaires to parents. Children were examined at schools, using the Andreasen criteria. Individual variables were gender, age, number of residents in home, parents/caregivers’ level of education, family income, and TDI (dichotomized into without trauma/mild trauma and severe trauma). Dental caries and malocclusion were considered co-variables. Contextual variables were the Social Vulnerability Index and type of school. Ethical approval and consent forms were obtained. Data were analyzed using SPSS for Windows 19.0 and HLM 6.06, including frequency distribution, chi-squared test and multilevel approach (p < 0.05).ResultsThe prevalence of a negative impact on OHRQoL in children with severe trauma was 55.9%. The TDI negatively impacted emotional and social domains of OHRQoL. A multilevel analysis revealed a significant difference in OHRQoL according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; ICC = 0.16). The negative impact on OHRQoL was higher in girls (p = 0.009), younger children (p = 0.023), with severe TDI (p = 0.014), those from public schools (p = 0.017) and whose parents had a lower education level (p = 0.001).ConclusionSevere trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.

Impact of traumatic dental injuries on quality of life in preschoolers and schoolchildren: A systematic review and meta‐analysis

“…However, we believe that this was minimized due to the sensitive search strategy used, the additional search of references by hand and the double independent review process used. Second, three cross‐sectional studies could not be included in any of the meta‐analyses mainly because of the lack of the specific estimator needed, but their data were consistent with our findings . Third, the internal validity of the summary provided by a meta‐analysis depends on the quality of primary studies.…”

The impact of crown fracture in the permanent dentition on children’s quality of life

“…14 To obtain a representative sample, a comparison of the 2 proportions was performed based on a previous study 15 where 55.9% of children had a negative impact on the OHRQoL and TDI, and 44.1% of children without negative impact on the OHRQoL and TDI. The city has 421 240 habitants and 16 234 schoolchildren in primary education.…”

Prevalence of early loss of primary molar and its impact in schoolchildren's quality of life

“…Many studies have studied the impact of different oral health problems on oral health‐related quality of life (OHRQoL) of children from 8 to 10 years old . Even though dental caries has been the oral health disease that provoke higher negative impact on OHRQoL, other conditions have also presented negative impact on children's quality of life, such as traumatic injuries, temporomandibular disorder and malocclusions …”