Parental perceptions of children's oral health: The Early Childhood Oral Health Impact Scale (ECOHIS)

BACKGROUND: Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families. METHODS: Twenty-two health professionals evaluated a pool of 45 items that assess the impact of oral health problems on 6-14-year-old children and their families. The health professionals identified 36 items as relevant to preschool children. Thirty parents rated the importance of these 36 items to preschool children; 13 (9 child and 4 family) items were considered important. The 13-item ECOHIS was administered to 295 parents of 5-year-old children to assess construct validity and internal consistency reliability (using Cronbach's alpha). Test-retest reliability was evaluated among another sample of parents (N = 46) using the intraclass correlation coefficient (ICC). RESULTS: ECOHIS scores on the child and parent sections indicating worse quality of life were significantly associated with fair or poor parental ratings of their child's general and oral health, and the presence of dental disease in the child. Cronbach's alphas for the child and family sections were 0.91 and 0.95 respectively, and the ICC for test-retest reliability was 0.84. CONCLUSION: The ECOHIS performed well in assessing OHRQL among children and their families. Studies in other populations are needed to further establish the instrument's technical properties

Validation of a Farsi version of the Early Childhood Oral Health Impact Scale (F-ECOHIS)

<p>Abstract</p> <p>Background</p> <p>The Early Childhood Oral Health Impact Scale (ECOHIS) has recently been developed to assess oral health-related quality of life (OHRQoL) of pre-school children in English speaking communities. This study aimed to translate the ECOHIS into Farsi and test its psychometric properties for use on 2- to 5-year-old children of Farsi speaking Iranian families.</p> <p>Methods</p> <p>EHOHIS questionnaire was translated into Farsi using a standardized forward-backward linguistic translation method. Its face and content validity was tested in two small pilot studies. In the main study, a convenience sample of 260 parents of 2- to 5-year-old children in Isfahan and Tehran were invited to complete the final Farsi version of the ECOHIS (F-ECOHIS) and answer two global self-rating questions about their children's dental appearance and oral health. Association between F-ECOHIS scores and answers to the two self-rating questions, and the correlation between child (9 items) and family (4 items) sections of the F-ECOHIS were used to assess the concurrent and convergent validity of the questionnaire. Internal consistency reliability of the F-ECOHIS was tested using Cronbach's alpha coefficient test and item total and inter-item correlations. One third of participants were invited to complete the F-ECOHIS again after 2 weeks to evaluate the test-retest reliability of the questionnaire.</p> <p>Results</p> <p>Two hundred and forty six parents were included in the main study. The association between the F-ECOHIS scores and the two self-rating questions and the correlation between its child and family sections were significant (P < 0.001). Cronbach's alpha coefficient of the F-ECOHIS and its child and family sections were 0.93, 0.89, and 0.85 respectively. Coefficients did not increase by deleting any item. The corrected item total correlation coefficient ranged from 0.52 to 0.74. The inter-item correlation coefficient ranged between 0.30 and 0.73. Seventy three parents participated in the follow up study for re-testing the questionnaire. Comparison of their test and re-test scores had a weighted kappa of 0.81 and inter-class correlation (ICC) of 0.82.</p> <p>Conclusion</p> <p>The F-ECOHIS questionnaire was valid and reliable for assessing the OHRQoL of 2- to 5-year-old pre-school children of Farsi speaking parents.</p

Prevalence, intensity and extent of Oral Impacts on Daily Performances associated with self-perceived malocclusion in 11-12-year-old children

BACKGROUND: To determine the prevalence, intensity and extent of the Oral Impacts on Daily Performances associated with self-perceived malocclusion among Peruvian schoolchildren. METHODS: Eight hundred and five children aged 11 to 12 years attending 4 of 7 randomly selected schools linked to a Health Centre in Lima, Peru, participated in the study. The Spanish (Peru)Child-OIDP was used to assess the prevalence, intensity and extent of oral impacts on 8 daily performances (eating, speaking, teeth cleaning, sleeping, smiling, studying, emotion and social contact). Self-perceived malocclusion included complaints about position of teeth, spacing of teeth and deformity of mouth or face. The prevalence of oral impacts was compared by covariables using the Chi-square test, whereas the intensity and extent of oral impacts were compared by covariables through the Mann-Whitney test. RESULTS: Only 15.5% of children reported impacts associated with self-perceived malocclusion during the last 3 months. Of them, 18.4% reported impacts of severe or very severe intensity and 76.0% reported impacts on only one daily performance. Psychosocial activities such as smiling, emotion and social contact were the most frequently and severely impacted everyday activities. CONCLUSION: Impacts of self-perceived malocclusion primarily affected psychological and social everyday activities. These findings provide further evidence to support the importance of psychological and social components of oral health on children's lives

Tooth brushing, tongue cleaning and snacking behaviour of dental technology and therapist students

Objective: To determine the tooth brushing, tongue cleaning and snacking behaviour of dental technology and therapist students. Methods: A descriptive cross-sectional study of students of Federal School of Dental Therapy and Technology Enugu, Nigeria. Self-administered questionnaire was used to obtain information on demography, frequency, duration and technique of tooth brushing and tongue cleaning as well as information on consumption of snacks. Results: A total of 242 students responded. Dental technology students made up 52.5% of the respondents and dental therapist in training made up 47.5%. Majority (63.2%) of the respondents considered the strength of tooth brush when purchasing a tooth brush and 78.9% use tooth brushes with medium strength. Seven-tenth (71.9%) of the respondents brush their teeth twice daily and 52.1% brush for 3&#x2013;5 minutes. About one-third (30.2%) brush their teeth in front of a mirror. Chewing stick was used by 51.7% of respondents in addition to the use of tooth brush. Tongue cleaning was done by 94.2% with only 9.5% using a tongue cleaner. Only 20.2% reported regular snacks consumption. Nine-tenth (90.4%) of respondents were previously involved in educating others, apart from their colleagues, on tooth brushing. Conclusion: This survey revealed that most of the dental therapy and technology students had satisfactory tooth-brushing behaviour. The zeal to educate others about proper tooth brushing revealed in this study suggests that the students may be helpful in oral health promotion

Oral Antimicrobial Peptides and Biological Control of Caries

The presence of antimicrobial peptides (AMPs) in saliva may be a biological factor that contributes to susceptibility or resistance to caries. This manuscript will review AMPs in saliva, consider their antimicrobial and immunomodulatory functions, and evaluate their potential role in the oral cavity for protection of the tooth surface as well as the oral mucosa. These AMPs are made in salivary gland and duct cells and have broad antimicrobial activity. Alpha-defensins and LL37 are also released by neutrophils into the gingival crevicular fluid. Both sources may account for their presence in saliva. A recent study in middle school children aimed to determine a possible correlation between caries prevalence in children and salivary concentrations of the antimicrobial peptides human beta-defensin-3 (hBD-3), the cathelicidin, LL37, and the alpha-defensins. The levels of these AMPs were highly variable in the population. While levels of LL37 and hBD-3 did not correlate with caries experience, the mean alpha-defensin level was significantly higher in children with no caries than in children with caries (p < 0.005). We conclude that several types of AMPs that may have a role in oral health are present in unstimulated saliva. Low salivary levels of alpha-defensin may represent a biological factor that contributes to caries susceptibility. Our observation could lead to new ways to prevent caries and to a new tool for caries risk assessment

Assessment of the quality of measures of child oral health-related quality of life

Background Several measures of oral health-related quality of life have been developed for children. The most frequently used are the Child Perceptions Questionnaire (CPQ), the Child Oral Impacts on Daily Performances (C-OIDP) and the Child Oral Health Impact Profile (COHIP). The aim of this study was to assess the methodological quality of the development and testing of these three measures. Methods A systematic search strategy was used to identify eligible studies published up to December 2012, using both MEDLINE and Web of Science. Titles and abstracts were read independently by two investigators and full papers retrieved where the inclusion criteria were met. Data were extracted by two teams of two investigators using a piloted protocol. The data were used to describe the development of the measures and their use against existing criteria. The methodological quality and measurement properties of the measures were assessed using standards proposed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) group. Results The search strategy yielded 653 papers, of which 417 were duplicates. Following analysis of the abstracts, 119 papers met the inclusion criteria. The majority of papers reported cross-sectional studies (n = 117) with three of longitudinal design. Fifteen studies which had used the original version of the measures in their original language were included in the COSMIN analysis. The most frequently used measure was the CPQ. Reliability and construct validity appear to be adequate for all three measures. Children were not fully involved in item generation which may compromise their content validity. Internal consistency was measured using classic test theory with no evidence of modern psychometric techniques being used to test unidimensionality of the measures included in the COSMIN analysis. Conclusion The three measures evaluated appear to be able to discriminate between groups. CPQ has been most widely tested and several versions are available. COHIP employed a rigorous development strategy but has been tested in fewer populations. C-OIDP is shorter and has been used successfully in epidemiological studies. Further testing using modern psychometric techniques such as item response theory is recommended. Future developments should also focus on the development of measures which can evaluate longitudinal change