Early Childhood Oral Health Research Articles

The Early Childhood Oral Health Impact Scale (ECOHIS): psychometric properties and application on preschoolers.

The concept of oral health related to quality of life involves the impact that oral health has on an individual's well-being. The Early Childhood Oral Health Impact Scale (ECOHIS) was developed to measure the impact of oral health problems on the lives of children and their families. To evaluate the psychometric properties of ECOHIS applied to mothers of preschool children and estimate the influence of demographic characteristics, caries experience, and plaque index on the ECOHIS score. The fit of ECOHIS to the data was assessed by confirmatory analysis. Chi-square for degrees of freedom ratio (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) were used. Reliability was estimated by the ordinal coefficients alpha (α) and omega (ω). The factorial invariance was estimated by the difference in CFI (ΔCFI). Comparisons of the ECOHIS mean scores according to the demographic characteristics, caries experience, and plaque index was performed using analysis of variance (ANOVA). A total of 371 children participated in the study. Mothers' mean age was 33.0 (SD = 7.04) years. The ECOHIS presented a good fit to the data (χ2/df = 4.31; CFI = 0.95; TLI = 0.94; RMSEA = 0.09) and a strict model invariance. Children without caries and from higher income class had lower oral health impact. The data obtained with the ECOHIS were valid, reliable, and invariant. Children with caries experience and from lower income families had a greater impact of oral problems.

Comparison of the Early Childhood Oral Health Impact Scale (ECOHIS-4D) and Child Health Utility Index (CHU-9D) in children with oral diseases.

Accurate assessment of child oral health is important for guiding economic evaluations and informing healthcare decision-making. Early Childhood Oral Health Impact Scale (ECOHIS-4D) is a preference-based instrument that measures the oral health-related quality of life of young children. The aim of this study was to compare the utility scores of ECOHIS-4D and Child Health Utility Index (CHU-9D), against an oral health indicator to evaluate which utility score corresponds better with the oral health indicator. The ECOHIS-4D and CHU-9D were applied to 314 parent/child dyads from preschools in a primary healthcare setting in Perth, Western Australia. Four parameters were used to assess which instrument corresponds better with the oral health indicator (decayed, missing and filled teeth score-dmft score): (i) discrimination, the ability to discriminate between different clinical severity groups, (ii) external responsiveness, how much the utility values relate to the changes in dmft scores, (iii) correlation, the association between the two instruments and the related dimensions and (iv) differences in the utility values across the two instruments. Most participants (81%) were 2-6 years old, and nearly 50% had a dmft score <3. ECOHIS-4D demonstrated a superior ability to differentiate between dmft severity groups and respond to changes in dmft scores. A significant weak correlation was observed between dmft and ECOHIS-4D (-0.26, 95%, CI -0.36 to -0.15) compared to a non-significant very poor correlation between dmft and CHU-9D (0.01, 95% CI -0.12 to 0.10). The utility scores of the two instruments had relatively good agreement towards good health and weak agreement towards poor health. ECOHIS-4D, the oral health-specific instrument, is more sensitive in assessing children's oral health-related quality of life than the generic CHU-9D. Thus, ECOHIS-4D is more appropriate for utility estimates in economic evaluations of oral health-related interventions and resource allocation decision-making.

The Development and Evaluation of the Slovenian Version of the Early Childhood Oral Health Impact Scale (ECOHIS-SVN).

There has been no valid and reliable instrument available to measure the impact of oral health on the quality of life of Slovenian preschool children. The main aim of this study was to develop and evaluate the validity and reliability of the first Slovenian instrument assessing Oral Health-Related Quality of Life (OHRQoL) preschool children: the ECOHIS-SVN. The ECOHIS-SVN was developed using forward-backward translations and with the participation of children aged under six and their parents. The children's teeth were examined, and parents were asked to complete questionnaires, including the ECOHIS-SVN. The internal consistency of ECOHIS-SVN was evaluated through the calculation of Cronbach's alpha (α), test-retest reliability with an intra-class-correlation coefficient (ICC), convergent validity with Spearman's rank correlation (r) and criterion validity with the Mann-Whitney test. The association between the ECOHIS-SVN score and parents' age, educational level, self-reported oral health and OHIP-SVN14 was estimated using multiple linear regression. In the study, 255 children participated, with a mean age of 4.8 years (±0.8). The ECOHIS-SVN questionnaire was completed by the parents of all 255 children and re-filled by 71 parents. The results of the total ECOHIS-SVN scale include α=0.85, ICC=0.85, and r=0.6-0.75. A statistically significant association was found between the ECOHIS-SVN and parents' age and between the ECOHIS-SVN and parents' OHIP-SVN14 in the whole group and in the subgroup of children with no teeth affected by cavitated caries (dmft=0) (p=0.025, p=0.028), respectively. ECOHIS-SVN enables further studies to assess the OHRQoL of preschool children in the Slovenian-speaking population.

Oral Health-Related Quality of Life in Celiac Portuguese Children: a cross-sectional study

PurposeCeliac Disease (CD) presents a wide variety of clinical signs and symptoms, including oral manifestations. This study pretended to characterize Oral Health-Related Quality of Life (OHRQoL) and reported oral manifestations in children with CD.MethodsTarget-population were children with CD. An online questionnaire, applied to children’s parents, collected information about OHRQoL (using the Early Childhood Oral Health Impact Scale—ECOHIS), oral health behaviours, and history of oral manifestations. Data analysis included descriptive statistics, Mann–Whitney, Kruskall-Wallis, and Spearman correlation tests (α = 0.05).ResultsThe sample included 146 celiac patients, with a mean age of 10.5 years (sd = 4.1). Mean ECOHIS score was 5.2 (sd = 6.8). The most frequently reported oral manifestations were recurrent aphthous stomatitis (46.6%), dental caries (45.2%) and dental opacity (39%). About one third of the participants mentioned improvements in oral health when a gluten-free diet was introduced. Most of the reported oral manifestations had a significant association with the ECOHIS score (p < 0.05).ConclusionsThe OHRQoL of children was good, however oral manifestations had a negative impact on OHRQoL. The most reported oral manifestations were recurrent aphthous stomatitis, dental caries, and dental opacities. Oral health professionals must be aware about the heterogeneity of the disease, to recognize oral manifestations associated and their importance in the early diagnosis to reduce complications and to an improvement in the OHRQoL of these patients.

The Impact of Dental Pain on the Oral Health-Related Quality of Life (OHRQoL) of Preschool Children in Austria.

Dental pain in children is a global public health burden with psychosocial and economic implications, challenging families and pediatric dentists in daily clinical practice. Previous studies have addressed the exclusive impact of either caries, dental trauma, malocclusion, or socioeconomic status on OHRQoL. Even though such examples can surely cause dental pain in children, so far only little research on the correlation of dental pain as a general symptom of different underlying causes and OHRQoL has been published. The aim of this study was to evaluate the impact of dental pain on the oral health-related quality of life (OHRQoL) of children between the ages of 0 and 6 years old and subsequently compare the results to a control group free of tooth ache. Children and their adult caregivers were recruited from the Emergency unit of the Department of Pediatric Dentistry at the University Clinic of Dentistry in Vienna. The caregivers completed the German version of the Early Childhood Oral Health Impact Scale (ECOHIS-G). Afterwards, the children were clinically examined. The cause for dental pain, dmf-t index, and plaque accumulation were collected. In total, 259 children with a mean age of 4.2 years (SD ± 1.5 years) were included in the study group. Their mean ECOHIS-G score was 9.0 (SD ± 7.4), while the control group only amounted to a score of 4.9 (SD ± 5.6). The difference between the two groups was statistically significant in both ECOHIS-G subsections, the child impact scale (CIS) and the family impact scale (FIS) as well as the ECOHIS-G sum score (p < 0.05). Dmf-t index and plaque accumulation significantly correlated with CIS and ECOHIS sum score (p ≤ 0.05). The reduction in quality of life was nearly twice as great in the children with dental pain as in the control children. The ECOHIS-G is a valid instrument for measuring the OHRQoL of children with dental pain between the ages of 0 to 6.

Changes in Oral-Health-Related Quality of Life of Egyptian Children Treated under Dental General Anesthesia: A Prospective Study.

Treatment of young children under dental general anesthesia (DGA) is sometimes necessary due to lack of cooperation and the complexity of dental treatment. The aim of this study was to assess the changes in oral-health-related quality of life (OHRQoL) in children following treatment under DGA. A consecutive sample of 88 children aged 5 and younger who were referred to the department of pediatric dentistry, Cairo university, Egypt, for treatment under DGA was included. Parents were asked to complete the Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) questionnaire before and 4 weeks after treatment. The Wilcoxon signed-rank test was used to compare baseline and follow up scores. Effect sizes (ES) were also calculated. The overall ECOHIS scores decreased significantly from 16.72 (±7.07) to 0.9 (±3.08); (p < 0.001, Wilcoxon signed-rank test) after treatment under DGA, demonstrating a large effect size of 2.2. The scores of the two subscales of the ECOHIS, the child impact scale (CIS) and the family impact scale (FIS), also decreased significantly (p < 0.001). Treatment under DGA not only improved the OHRQoL of the Egyptian children in our sample significantly, but also had a positive effect on their families' quality of life.

An online survey of oral health behaviours and impact on young children and families in Wales.

Introduction Studies outside Wales have consistently reported reduced quality of life as measured by the Early Childhood Oral Health Impact Scale. With relatively high levels of tooth decay in Wales as found through the regular dental surveys, it is important to understand different oral health-related behaviours and impact so that findings can inform oral health promotion in Wales.Methods An oral health questionnaire was made available to volunteers registered with Health Wise Wales. Parents of children (2-6 years old) participated in the study. Frequency analyses were carried out to understand the oral health-related behaviours and regression analysis was carried out to understand the predictors of reported oral health impacts.Results Overall reported oral health impact was low in this study. In total, 20% of parents reported that their child brushed their teeth less than twice a day and 23% reported toothbrushing without adult supervision. Drinking plain water twice a day or more was associated with good oral health in children.Conclusion Overall, reported oral health impact was low, which is likely to be due to under-representation of study participants from the deprived areas in Wales. There is plenty of room for improvement in oral health-related behaviours.

Children's Oral Health Initiative: workers' perspectives on its impact in First Nations communities.

Since 2004, the Children's Oral Health Initiative (COHI) has been working in many First Nations and Inuit communities in Canada to address oral health disparities, specifically early childhood caries (ECC). The COHI community-based approach improves early childhood oral health (ECOH) by balancing prevention with minimally invasive dentistry. The goal is to reduce the burden of oral disease, mainly by minimizing the need for surgery. We investigated program success in First Nations communities in the province of Manitoba, from the perspective of COHI staff. First Nations community-based dental therapists and dental worker aides participated in three focus groups and an in-depth semistructured interview. The collected data were thematically analyzed. Data from 22 participants yielded converging and practitioner-specific themes. Participants reported that dental therapists and dental worker aides provide access to basic oral care in their communities including oral health assessments, teeth cleaning, fluoride varnish applications and sealants. The participants agreed that education, information sharing and culturally appropriate parental engagement are crucial for continuous support and capacity building in the community programs. Low enrolment, difficulty accessing homes and getting consent, limited human resources as well as lack of educational opportunities for dental worker aides were identified challenges. Overall, the participants reported that the COHI program positively contributes to ECOH in First Nations communities. However, increased community-based training for dental workers, community awareness about the program, and engagement of parents to facilitate culturally appropriate programming and consent processes are critical to improving program outcomes.

Comparison of Oral Health-Related Quality of Life scores in children treated for early childhood caries under general and local anesthesia: a quasi-experimental study.

The purpose of this study was to compare the changes in oral health-related quality of life (OHRQoL) scores in children treated for Early Childhood Caries (ECC) under general (GA) and local anesthesia (LA). A quasi-experimental study was carried out on 73 children, with 37 in the GA group and 36 in the LA group. The early childhood oral health impact scale (ECOHIS) was used to measure OHRQoL, with the type of anesthesia (LA or GA) serving as the explanatory variable. A Friedman test was used to assess the difference between the LA and GA groups at baseline, one-week, and one-month follow-up points. The results showed a significant difference in the overall mean ECOHIS scores between the LA and GA groups at 1-week (LAmean ± SD = 6.12 ± 1.11, GAmean ± SD = 5.50 ± 0.88; P = 0.01) and 1-month (LAmean ± SD = 5.87 ± 1.12, GAmean ± SD = 4.96 ± 0.99; P < 0.001) follow-up points. Irrespective of the administered anesthesia, a significant (P < 0.001) reduction in the mean score for dental pain was observed at both 1-week (mean ± SD = 1.30 ± 1.16) and 1-month (mean ± SD = 0.81 ± 0.89) timepoints after the treatment, as compared to the baseline assessment (mean ± SD = 2.02 ± 1.02). Early treatment for ECC reduces pain, restore normal activities, and improves the quality of life of affected children. Specifically, GA was found to be more beneficial for both children and parents. However, further studies using more robust study designs and carefully considering related factors are necessary to confirm these findings.

Impact of parental attributes on the oral health-related quality of life of Brazilian preschool children.

Considering the importance of parental attitudes and their influence on children's oral health, it is important to know which characteristics may impact it. The aim of this population study was to evaluate the impact of the parental sociodemographic characteristics on the oral health-related quality of life (OHRQoL) of preschool children from southeastern Brazil. A population-based study was conducted with a sample of 321 children aged 2 to 5years old who underwent a calibrated clinical oral examination to assess oral health status and their parents were asked to answer the two following questionnaires: (1) sociodemographic conditions and (2) Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Descriptive analysis, Mann-Whitney and Kruskal-Wallis tests and adjusted Poisson regression models were used. Younger mothers (RP: 1.47; 95% CI: 1.11-1.95), lower household income (RP: 1.47; 95% CI: 1.11-1.96) and the presence of dental caries (RP: 2.28; 95% CI: 1.74-3.0) were more likely to have a negative impact on the OHRQoL B-ECOHIS total scores (P < 0.01). The characteristics of mothers, such as age, schooling and salary, influenced the mean B-ECOHIS total score; however, paternal attributes were not associated with a negative impact on the children's quality of life. Also, dental caries and household income influenced the children's oral health-related quality of life.

Does the severity of untreated dental caries of preschool children influence the oral health-related quality of life?

AimTo assess the impact of untreated dental caries and its severity on the oral health-related quality of life (OHRQoL) of Kuwaiti preschool children and their caregivers.MethodsParticipants were 4- and 5-year-old kindergarten children attending preselected public schools from one of the Governorates in Kuwait. Early childhood caries (ECC) was evaluated by clinical examinations and presented using decayed, missed, filled teeth/surface (dmft/dmfs). The clinical consequences of untreated dental caries were assessed using the pufa (pulp, ulcers, fistula, abscess) index for primary teeth. A structured questionnaire obtained demographic information of children and their caregivers. OHRQoL was assessed using the Arabic version of Early Childhood Oral Health Impact Scale (A-ECOHIS).ResultsAmong the 334 participants, 171 were kindergarten level-1 (KG1), and 163 were level-2 (KG2). The overall prevalence of dental caries was 78.9% for KG1 children and 67.4% for KG2 children. Decayed teeth were the main component for both dmft (84%) and dmfs (68%). The total mean (SD) pufa score was 0.54 (1.5), and about 19.2% of participants had at least one tooth with pufa > 0. A total of 207 A-ECOHIS were completed. Both family and child impact scores were significantly higher for children with a dmft score of 1 or more (p < 0.001) or with one or more pufa (p < 0.001). Child impact section scores were significantly higher with the increasing degrees of untreated caries (dt) (p = 0.004).ConclusionThe severity of untreated dental caries and caries experience had a negative impact on the OHRQoL of Kuwaiti preschool children and their families. Using the pufa index had provided additional information about the effect of the caries severity on the OHRQoL than assessing the caries experience alone.

The Impact of Child Dental Caries and the Associated Factors on Child and Family Quality of Life.

Dental caries are considered as common health hazards and a serious lifelong threat to general health and quality of life. The present study aimed at identifying the impact of child dental caries and the associated factors on both child and family quality of life (QoL). Material and Methods. In this cross-sectional study, preschool children were selected randomly through clustered sampling from five educational districts in Tabriz, Iran, 2016. To assess the QoL related to oral health, the Early Childhood Oral Health Impact Scale (ECOHIS) was used. Clinical oral examination was performed to assess the presence of caries through the index of decayed, missing, and filled teeth (dmft). Descriptive and analytic statistical methods were used. To assess the underlying predictors of ECOHIS as a whole scale and the dimensions as a linear regression model were used as univariate and multivariate. : Out of 756 children under 7 years old, 51.5% boys, mean (M) standard deviation (SD) of age 5.76 (0.78). About 85% of children had dental caries. The predictors of suboptimal ECOHIS related to both general and child dimensions were child age 6 year and above: r (756) = 2.43, and P ≤ 0.001, low-socioeconomic status: r (756) = 3.36 and P < 0.001 and high dmft: r (756) = 9.10 and P < 0.001. The predictors of suboptimal ECOHIS related to family domain were sex (girl): r (756) = 0.39 and P = 0.047; mother education (under12): r (756) = -0.92 and P < 0.001; mother job (employed) as univariate: r (756) = 0.71 and P = 0.002); and dmft: r (756) = -0.58 and P = 0.035. Adverse oral health of children imposes adverse effects on the QoL of children and families. Children's age, family socioeconomic level, presence of dental caries, child's gender, and mother's educational level were associated with the impact on QoL.

Evaluation of oral health-related quality of life following dental rehabilitation under general anesthesia in Turkish children with early childhood caries.

Early childhood caries (ECC) is one of the most common dental problems, which often require dental rehabilitation with general anesthesia (DRGA). To assess the short- and long-term effects of DRGA on children and their families' oral health-related quality of life (OHRQoL) in preschool children, the incidence of complications on the first day, and the factors affecting them and parental satisfaction. A total of 150 children treated for ECC under DRGA were included in the study. OHRQoL was assessed on the day of DRGA, 4 weeks, and 1 year after treatment using the Early Childhood Oral Health Impact Scale (ECOHIS). The incidence of complications and parental satisfaction with DRGA were evaluated. The data were analyzed for statistical significance (p < .05). In total, 134 patients were re-evaluated at the end of the fourth week and 120 at the end of the first year. The average ECOHIS scores before and after DRGA (4 weeks and 1 year) were 18.1 ± 8.5, 3.1 ± 3.9, and 5.9 ± 6.2, respectively. After DRGA, 29.2% of the children reported at least one complication. Ninety-one percent of the parents reported that they were satisfied with DRGA. DRGA has a positive effect on the OHRQoL of Turkish preschool children with ECC and is highly evaluated by their parents.

Knowledge, Attitude, and Practice of Parents about Child’s Oral Health in Faridabad and its Correlation with Prevalence of Dental Caries in Children through a Questionnaire Survey

Background: An individual’s health and overall well-being are strongly correlated with their oral health. Parents’ knowledge, attitude, and practice have a great impact on the maintenance of child’s oral health. Objective and Aim: The aim of the study is to assess the knowledge, attitude, and practice of parents about child’s oral health in Faridabad and its correlation with prevalence of dental caries in children through a questionnaire survey in 3–6-year-old children. Materials and Methods: A cross-sectional study was conducted in Faridabad. The data were collected from the parents and their children 3–6 years old. A total sample of 400 parents and their children 3–6 years old residing in Faridabad was included. A questionnaire regarding knowledge, attitude, and practice about child’s oral health was given to the parents. The parents who volunteer to participate in the study their children were taken for the study examination. Results: Parental perception of early childhood oral health is critical for developing effective preventive measures. Parents play an important role in making decisions about their child’s oral health. The parents were given a self-administered questionnaire. The study included 400 parents and children aged 3–6 years. There was no significant difference in perception of their child’s oral health care between mothers and fathers. The majority of parents/caretakers had good knowledge about children’s oral hygiene, particularly fathers, but this knowledge did not appear to reflect in their attitude and practice. Conclusion: The current study concludes that parents are not well aware about dental disease prevention measures. As a result, it is the responsibility of the government and health-care providers to teach parents about oral health because they are role models for their children.

Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries.

To evaluate the change in quality of life, dental fear, and dental anxiety in young children following full-mouth dental rehabilitation under general anesthesia for early childhood caries. About 200 children who were diagnosed with early childhood caries requiring full-mouth rehabilitation under general anesthesia were recruited after obtaining parental consent. Oral health-related quality of life (OHRQoL) was measured using the Early Childhood Oral Health Impact Scale (ECOHIS). Dental fear was evaluated using Children's Fear Survey Schedule-Dental Subscale and dental anxiety was evaluated using the Facial Image Scale. Scores were taken on the day of intervention, and after 14 days when the child reported for posttreatment follow-up. All 200 participants returned for a follow-up visit after 2 weeks. The child impact section was reduced from 15.7 ± 4.1 to 7.7 ± 1.9 after treatment. The family impact section was reduced from 9.6 ± 2.7 to 3.5 ± 2.6 after treatment. A statistically significant difference was seen in both sections when pre-and posttreatment values were compared (p < 0.001). The total ECOHIS showed statistically significant improvement as the pretreatment score of 21.6 ± 9.5 reduced to 11.2 ± 4.2 showing 51.9% improvement in OHRQoL after full-mouth rehabilitation under general anesthesia was done (p < 0.001). Dental fear and anxiety among the participants showed a statistically significant reduction after treatment was done and most participants were found to be less fearful of doctors, dentists, and injections after treatment. Full-mouth rehabilitation was found to be a reliable treatment modality to improve the OHRQoL of children suffering from early childhood caries. Significant improvement was seen in the OHRQoL within 2 weeks after treatment and most participants were found to be less anxious and fearful toward dentists and dental treatment. Comprehensive dental rehabilitation under general anesthesia has been proven to be an effective treatment modality for early childhood caries and a productive treatment technique to reduce dental fear and anxiety.

Association Between Dental and Oral Care Behavior Towards Quality of Life in Stunting Toddlers

Introduction: Dental and oral health is an important thing that must be considered, especially in stunted children who need more attention because they have a less level of awareness, are susceptible to disease, and have a low intellectual level compared to children with balanced nutrition. If the problem of dental and oral health in stunted children is not addressed, it will cause malnutrition to get worse and the quality of life for stunted children to get lower. Methods: This research is an analytic observational study with a cross sectional approach. This study used the Early Childhood Oral Health Impact Scale (ECOHIS) Questionnaire and was conducted on stunted toddlers which would be filled out by the parents of these toddlers in Sumberjambe District, Jember Regency. The sampling technique uses total sampling. Of the 9 villages in Sumberjambe sub-district, 3 villages were taken randomly. Each village takes 1 posyandu with the most participants. Results: There is a significant relationship between the behavior of maintaining oral and dental health and the quality of life of stunting toddlers. Most of the respondents had poor dental and oral health maintenance behavior and a very impactful quality of life. Conclusion: The behavior of stunting toddlers in maintaining healthy teeth and mouth is still in the low category and the majority of respondents have a very impactful quality of life.

Evaluation of oral health-related quality of life in children with acute lymphocytic leukemia/acute myelocytic leukemia: A cross-sectional study.

Chemotherapy and radiotherapy, used to treat childhood hematological malignancies (acute lymphocytic leukemia [ALL] and acute myelocytic leukemia [AML]) can negatively affect oral tissues and organs. This study aimed to evaluate the oral health-related quality of life in children with ALL/AML. A total of 99 children, including 49 undergoing ALL/AML (41 with ALL and eight with AML) and 50 healthy volunteers, were included in this cross-sectional study. The mean age of the entire study group was 78.63 ± 34.41 months. The mean age of the ALL/AML and control groups was 87.12 ± 35.04 and 70.95 ± 34.85 months, respectively. The Simplified Oral Hygiene Index (SOHI), the Decayed, Missing, and Filled Teeth (DMFT/dmft) index, and the Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS-T) were administered to all children. The data were analyzed using SPSS software (version 22.0). The Pearson chi-square and Fisher's exact tests were used to compare demographic data. The age and gender distributions of the two groups were similar. According to ECOHIS-T, the children in the ALL/AML group had significantly more loss of function (eating, drinking, sleeping, etc.) than those in the control group. Oral health and self-care were negatively affected by childhood ALL/AML and its treatment.

Changes in oral-health related quality of life, oral hygiene status and body growth in children with special health care needs following oral rehabilitation under general anaesthesia

Aim: To assess changes in oral health related quality of life, oral hygiene status and body growth in children with special health care needs following dental treatment under general anaesthesia. Methodology: Twenty children with special health care needs undergoing dental treatment undergoing general anaesthesia at the Unit of Pediatric Dentistry and those with Special needs, Faculty of Dentistry, Cairo University were selected in this study. For each patient oral hygiene status (assessed by Plaque index), weight, height and body mass index were assessed at baseline and at 3,6 and 9 months. OHRQoL was assessed using the early childhood oral health impact scale (ECOHIS) at baseline as well as 3, 6 and 9 months intervals. Results: At follow up, there was a slight increase in body weight in 100% of patients, 87.5% in height, 25% in body mass index that their percentile curve had been changed while in 75% of cases remain the same percentile curve but higher BMI. The overall Early Childhood Oral health impact scale scores decreased significantly (P &lt; 0.001) demonstrating large effect sizes, at baseline score was significantly higher than at 3, 6 and 9 months respectively.

Psychosocial associated factors of early childhood caries and oral health-related quality of life: Structural equation model approach

ObjectiveTo identify a structural model for the identification of psychosocial associated factors of early childhood caries (ECC) and oral health-related quality of life (OHRQoL) in preschool children and their families. MethodsA population-based cross-sectional study was conducted with 533 preschool children from 4 to 6 years-old public and private preschools, from Ribeirão das Neves, MG. Parents/caregivers self-completed the Brazilian versions of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and Resilience Scale as well as a structured questionnaire addressing socioeconomic status and child's oral health behavior. Two dentists who had undergone training and calibration exercises for ICDAS‑epi and pufa index (Kappa≥0.95) performed the examinations for ECC. Stages of ECC were classified as free of visible carious lesion, initial caries, moderate caries, extensive caries without pulp consequences and extensive caries with pulp consequences. Data were analyzed using structural equation modeling, using Mplus version 8.6. ResultsLower socioeconomic status (b=-0.250; p<0.001) and higher frequency of free sugar consumption (b = 0.122; p = 0.033) were directly associated with a more severe stage of ECC. Lower parental resilience had an indirect impact on more severe stage of ECC which was mediated by the variable ‘frequency of free sugar consumption’ (b=-0.089; p = 0.048). ECC was associated with lower child's OHRQoL (b = 0.587; p<0.001) and lower family's OHRQoL (b = 0.506; p<0.001). ConclusionStructural modeling revealed that the severity of ECC negatively impacted the OHRQoL of preschoolers and their families. The main associated factors of the severity of ECC were lower socioeconomic status, higher frequency of free sugar consumption and lower parental resilience. Clinical SignificanceT The findings indicate that psychosocial and behavior variables can be associated with the severity of ECC, and ECC can be associated with negative impact on wellbeing and ability to perform daily activities of preschoolers and their families.

The Impact of Socio-Environmental, Individual, and Biological Factors on Oral Health-Related Quality of Life among Preschool Children: A Cohort Study with 3-Year Follow-Up

This study assessed impact of socio-environmental, individual, and biological factors on the worsening and severe worsening of oral health-related quality of life (OHRQoL) among preschoolers and their families. A cohort study was conducted in Diamantina, Brazil, with 151 children between 1 and 3 years of age and their mothers, who were evaluated at baseline (2014) and re-evaluated after 3 years (2017). The children were clinically examined to assess the presence of dental caries, malocclusion, dental trauma, and enamel defects. The mothers answered the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire addressing individual characteristics of the child and socio-environmental factors. Extensive caries found in the follow-up (relative risk [RR] = 1.91; 95% confidence interval [CI] = 1.26–2.91) and failure to undergo the dental treatment recommended at baseline (RR = 2.49; 95% CI = 1.62–3.81) were associated with worsening of OHRQoL over 3 years. An increase in the number of children in the household (RR = 2.95; 95% CI = 1.06–8.25), occurrence of extensive caries in the follow-up (RR = 2.06; 95% CI = 1.05–4.07), and failure to undergo the dental treatment recommended at baseline (RR = 3.68; 95% CI = 1.96–6.89) were associated with a severe worsening of OHRQoL. In conclusion, the risk of worsening and severe worsening of OHRQoL was higher in preschoolers with extensive caries at follow-up and among those who did not undergo dental treatment. Furthermore, severe worsening of OHRQoL was also impacted by an increase in the number of children in the household.