The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life

Health and Quality of Life Outcomes, Jan 2012

Background The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL). Methods A sample of 515 schoolchildren, aged 12 years was randomly selected by conglomerate analysis from public and private schools in the city of Juiz de Fora, Brazil. The schoolchildren were clinically examined for presence of caries lesions (DMFT and dmft index), dental trauma, enamel defects, periodontal status (presence/absence of bleeding), dental treatment and orthodontic treatment needs (DAI). The SiC index was calculated. The participants were asked to complete the Brazilian version of Child Perceptions Questionnaire (CPQ11-14) and a questionnaire about home environment. Questions were asked about the presence of general diseases and children's self-perception of their general and oral health status. In addition, a questionnaire was sent to their parents inquiring about their socioeconomic status (family income, parents' education level, home ownership) and perceptions about the general and oral health of their school-aged children. The chi-square test was used for comparisons between proportions. Poisson's regression was used for multivariate analysis with adjustment for variances. Results Univariate analysis revealed that school type, monthly family income, mother's education, family structure, number of siblings, use of cigarettes, alcohol and drugs in the family, parents' perception of oral health of schoolchildren, schoolchildren's self perception their general and oral health, orthodontic treatment needs were significantly associated with poor OHRQoL (p < 0.001). After adjusting for potential confounders, variables were included in a Multivariate Poisson regression. It was found that the variables children's self perception of their oral health status, monthly family income, gender, orthodontic treatment need, mother's education, number of siblings, and household overcrowding showed a strong negative effect on oral health-related quality of life. Conclusions It was concluded that the clinical, socioeconomic and home environment factors evaluated exerted a negative impact on the oral health-related quality of life of schoolchildren, demonstrating the importance of health managers addressing all these factors when planning oral health promotion interventions for this population.

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The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life

Janice S Paula 0 Isabel CG Leite 1 Anderso B Almeida 1 Glaucia MB Ambrosano 0 Antnio C Pereira 0 Fbio L Mialhe 0 0 Department of Community Dentistry, Division of Health Education and Health Promotion, Piracicaba Dental School , P.O. BOX 52 , University of Campinas -UNICAMP , 13414-903, Piracicaba, SP , Brazil 1 Department of Public Health, Medicine School, Federal University of Juiz de Fora (UFJF) Juiz de Fora , MG , Brazil Background: The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL). Methods: A sample of 515 schoolchildren, aged 12 years was randomly selected by conglomerate analysis from public and private schools in the city of Juiz de Fora, Brazil. The schoolchildren were clinically examined for presence of caries lesions (DMFT and dmft index), dental trauma, enamel defects, periodontal status (presence/ absence of bleeding), dental treatment and orthodontic treatment needs (DAI). The SiC index was calculated. The participants were asked to complete the Brazilian version of Child Perceptions Questionnaire (CPQ11-14) and a questionnaire about home environment. Questions were asked about the presence of general diseases and children's self-perception of their general and oral health status. In addition, a questionnaire was sent to their parents inquiring about their socioeconomic status (family income, parents' education level, home ownership) and perceptions about the general and oral health of their school-aged children. The chi-square test was used for comparisons between proportions. Poisson's regression was used for multivariate analysis with adjustment for variances. Results: Univariate analysis revealed that school type, monthly family income, mother's education, family structure, number of siblings, use of cigarettes, alcohol and drugs in the family, parents' perception of oral health of schoolchildren, schoolchildren's self perception their general and oral health, orthodontic treatment needs were significantly associated with poor OHRQoL (p < 0.001). After adjusting for potential confounders, variables were included in a Multivariate Poisson regression. It was found that the variables children's self perception of their oral health status, monthly family income, gender, orthodontic treatment need, mother's education, number of siblings, and household overcrowding showed a strong negative effect on oral health-related quality of life. Conclusions: It was concluded that the clinical, socioeconomic and home environment factors evaluated exerted a negative impact on the oral health-related quality of life of schoolchildren, demonstrating the importance of health managers addressing all these factors when planning oral health promotion interventions for this population. - Background Nowadays, researches point out the need to consider the functional and psychosocial dimensions of oral health for the implementation and evaluation of public health dentistry interventions. In order to achieve these dimensions, instruments that evaluate the oral health-related impact on quality of life (OHRQoL) have been developed [1,2], among them, the Child Perception Questionnaire (CPQ11-14) to assess OHRQoL at a specific age [3]. Several studies focused on children and adolescents have confirmed that oral diseases could have an impact on their quality of life [2,4-9], as caries lesions [10-14] and malocclusion [15-18]. However, a direct relationship between OHRQoL and clinical indicators should be interpreted with caution, because these impacts could be mediated by other factors, such personal, social, and environmental variables [2,19-21]. For example, the socioeconomic status of the household in which the children live may confound the relationships between oral health and OHRQoL [14,22,23]. This could occur because several studies have shown associations between low income and poor oral health [8,24-30]. Relative to the home environment, some studies have verified the influence of family on the oral health outcomes of children, considering that their families play a central role in promoting their oral health [31,32]. The parental perceptions of their childrens oral health conditions may interfere in childrens oral health [33]. Other studies have found that parents socioeconomic characteristics are associated with their subjective perceptions related to their childrens oral health status [33,34]. Therefore, the family environment may have an impact on childrens self-perception about their OHRQoL, but there is scarcely any information on such association in the literature [14,32]. Although socioeconomic status and family environment could be linked to OHRQoL, this aspect has not yet been sufficiently investigated in studies to evaluate this association in schoolchildren. Only the research d (...truncated)


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Janice S Paula, Isabel CG Leite, Anderso B Almeida, Glaucia MB Ambrosano, Antônio C Pereira, Fábio L Mialhe. The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life, Health and Quality of Life Outcomes, 2012, pp. 6, 10, DOI: 10.1186/1477-7525-10-6