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.
Highlights
Oral health problems may impact children’ daily lives [1,2]
A multilevel analysis revealed a significant difference in oral health-related quality of life measures (OHRQoL) according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; Intraclass Correlation Coefficient (ICC) = 0.16)
Many assessment instruments have emerged for measuring the influence of oral conditions on the lives of individuals, more recently called oral health-related quality of life measures (OHRQoL)
Summary
Oral health problems may impact children’ daily lives [1,2]. In addition to the clinical measures of disease, it is necessary to document the impact of these oral health problems on their quality of life [3].The measures of quality of life have a very important role in clinical practice in terms of identifying needs, selecting best therapies, monitoring patients’ progress and helping clinicians to understand the magnitude of benefits that come with the treatment of oral conditions [3]. In addition to the clinical measures of disease, it is necessary to document the impact of these oral health problems on their quality of life [3]. Many assessment instruments have emerged for measuring the influence of oral conditions on the lives of individuals, more recently called oral health-related quality of life measures (OHRQoL). One of these instruments, the Child Perceptions Questionnaire 8–10 (CPQ8–10) was developed in Canada [4] and has been cross-culturally adapted and validated for use in Brazilian children [5]. Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children
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