Flow chart of the cross-cultural validation steps.

<p>Flow chart of the cross-cultural validation steps.</p

Multiple Poisson regression to assess the association between BREALD-30 and dental outcomes (n = 258).

<p>*Reference category</p><p>Significant results at 5% level in bold type; OHRQoL: oral health-related quality of life; RR: rate ratio; PR: prevalence ratio; CI: confidence interval (obtained by adjusted Poisson regression with robust variance)</p><p>Multiple Poisson regression to assess the association between BREALD-30 and dental outcomes (n = 258).</p

Dental caries remains as the main oral condition with the greatest impact on children’s quality of life

<div><p>Purpose</p><p>The objective of this study was to assess the negative impact of dental caries on the OHRQoL of 8- to 10-year-old Brazilian children.</p><p>Methods</p><p>This population-based case-control study involved 546 children (8–10 years old), 182 cases with a high negative impact on OHRQoL and 364 controls with a low negative impact on OHRQoL. Children’s OHRQOL was measured using the Child Perceptions Questionnaire (CPQ_8-10). Cases and controls (1x2 ratio) were individually matched by school and gender. Dental caries experience, malocclusion, and traumatic dental injuries were used as independent variables. Dental examinations were carried out at school during daytime hours by two calibrated examiners (Kappa = 0.93-interexaminer and 0.95- intraexaminer). The data were analyzed by descriptive statistics, conditional bivariate and multiple logistic regression, with the significance level set at 5%.</p><p>Results</p><p>There was no significant difference in traumatic dental injuries and malocclusion between the case and control groups (p>0.05). Children with DMFT/dmft ≥3 had a 2.06-fold (95%CI = 1.28–3.31, p = 0.003) greater chance of experiencing a high negative impact on OHRQoL than those with DMFT/dmft = 0</p><p>Conclusion</p><p>Children with high dental caries experience are more likely to present a high negative impact on OHRQoL than those with no dental caries experience.</p></div

Multiple conditional logistic regression model^a explaining the influence of dental caries on children’s OHRQoL in a matched case-control analysis (n = 546).

<p>Multiple conditional logistic regression model<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0185365#t002fn001" target="_blank">^a</a> explaining the influence of dental caries on children’s OHRQoL in a matched case-control analysis (n = 546).</p

Frequency distribution of independent variables for matched case and control groups (n = 546).

<p>Frequency distribution of independent variables for matched case and control groups (n = 546).</p

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

<div><p>Background</p><p>Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children.</p><p>Objective</p><p>To 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.</p><p>Methods</p><p>A 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 CPQ_8–10 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).</p><p>Results</p><p>The 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).</p><p>Conclusion</p><p>Severe trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.</p></div

Bivariate multilevel models for individual and contextual variables associated with OHRQoL in children (n = 1,156): Belo Horizonte, 2010.

<p>Bivariate multilevel models for individual and contextual variables associated with OHRQoL in children (n = 1,156): Belo Horizonte, 2010.</p

Explanatory variables: individual and contextual variables.

<p>Explanatory variables: individual and contextual variables.</p

Final estimation of variance components in the multilevel analysis (“null-model”).

<p>^aIntraclass correlation coefficient (ICC): fraction of the total variance that is due to the contextual level</p><p>Final estimation of variance components in the multilevel analysis (“null-model”).</p

Final multilevel model for individual and contextual variables associated with impact on domains OS, FL, EWB, SWB of OHRQoL in children (n = 1,156): Belo Horizonte, 2010.

<p>Final multilevel model for individual and contextual variables associated with impact on domains OS, FL, EWB, SWB of OHRQoL in children (n = 1,156): Belo Horizonte, 2010.</p