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Published in: Clinical Oral Investigations 9/2017

01-12-2017 | Original Article

Impact of caries and dental fluorosis on oral health-related quality of life: a cross-sectional study in schoolchildren receiving water naturally fluoridated at above-optimal levels

Authors: Álvaro García-Pérez, María Esther Irigoyen-Camacho, S. Aída Borges-Yáñez, Marco Antonio Zepeda-Zepeda, Irvin Bolona-Gallardo, Gerardo Maupomé

Published in: Clinical Oral Investigations | Issue 9/2017

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Abstract

Purpose

The purpose of this study was to evaluate the impact of caries and fluorosis on oral health-related quality of life (OHRQoL) among schoolchildren living in areas with high concentrations of fluoride in water.

Methods

Five hundred and twenty-four schoolchildren (8–12 year olds) residing in rural communities in central Mexico were examined for oral hygiene, caries (International Caries Detection and Assessment System, ICDAS II), and fluorosis (Thylstrup and Fejerskov Index, TFI). OHRQoL was evaluated with the Child Perceptions Questionnaire for two age groups (CPQ8–10 and CPQ11–14). Generalized structural equation models were constructed for data analysis.

Results

Overall prevalence of caries was 88.5% and fluorosis 46.9%. In the group of 8–10 year olds, 48% of the children had advanced carious lesions in primary or permanent teeth (ICDAS ≥4), 22.6% had moderate/severe fluorosis, and 59.9% of children had an impact on OHRQoL. Schoolchildren with ICDAS ≥4 were more likely [OR = 1.75, (95% CI 1.34–2.28)] to suffer a negative impact on OHRQoL. In the group of 11–12 year olds, 19.9% of children had advanced carious lesions and 23.2% showed moderate/severe fluorosis; 67.3% of children reported had an impact on OHRQoL. Children 11–12 year olds with fluorosis (TFI ≥4) [OR = 2.39 (95% CI 2.12–2.69)], caries (ICDAS ≥4) [OR = 2.18 (95% CI 2.13–2.24)], and low brushing frequency [OR = 2.04 (95% CI 1.21–3.44)] were more likely to have deterioration on OHRQoL.

Conclusion

A negative impact on OHRQoL was observed in children with caries and fluorosis.

Clinical relevance

Deterioration on OHRQoL found in children as a sequel of caries and fluorosis should be considered when designing health policies leading to prevention and effective health promotion programs and incorporated to clinical guidelines for timely dental treatment.
Literature
1.
go back to reference Meredith P, Strong J, Ford P, Branjerdporn G (2016) Associations between adult attachment and: oral health-related quality of life, oral health behaviour, and self-rated oral health. Qual Life Res 25(2):423–433CrossRefPubMed Meredith P, Strong J, Ford P, Branjerdporn G (2016) Associations between adult attachment and: oral health-related quality of life, oral health behaviour, and self-rated oral health. Qual Life Res 25(2):423–433CrossRefPubMed
3.
go back to reference Rwenyonyi CM, Muwazi LM, Buwembo W (2011) Assessment of factors associated with dental caries in rural communities in Rakai District, Uganda. Clin Oral Investig 15(1):75–80CrossRefPubMed Rwenyonyi CM, Muwazi LM, Buwembo W (2011) Assessment of factors associated with dental caries in rural communities in Rakai District, Uganda. Clin Oral Investig 15(1):75–80CrossRefPubMed
4.
go back to reference Folayan M, Sowole A, Kola-Jebutu A (2008) Risk factors for caries in children from south-western Nigeria. J Clin Pediatr Dent 32(2):171–175CrossRefPubMed Folayan M, Sowole A, Kola-Jebutu A (2008) Risk factors for caries in children from south-western Nigeria. J Clin Pediatr Dent 32(2):171–175CrossRefPubMed
5.
go back to reference Martins MT, Sardenberg F, Vale MP, Paiva SM, Pordeus IA (2015) Dental caries and social factors: impact on quality of life in Brazilian children. Braz Oral Res 29(1):S1806-83242015000100310 Martins MT, Sardenberg F, Vale MP, Paiva SM, Pordeus IA (2015) Dental caries and social factors: impact on quality of life in Brazilian children. Braz Oral Res 29(1):S1806-83242015000100310
6.
go back to reference Li YJ, Gao YH, Zhang Y (2014) The impact of oral health status on the oral health-related quality of life (OHRQoL) of 12-year-olds from children’s and parents’ perspectives. Community Dent Health 31(4):240–244PubMed Li YJ, Gao YH, Zhang Y (2014) The impact of oral health status on the oral health-related quality of life (OHRQoL) of 12-year-olds from children’s and parents’ perspectives. Community Dent Health 31(4):240–244PubMed
7.
go back to reference Kolawole KA, Otuyemi OD, Oluwadaisi AM (2011) Assessment of oral health-related quality of life in Nigerian children using the Child Perceptions Questionnaire (CPQ 11-14). Eur J Paediatr Dent 12(1):55–59PubMed Kolawole KA, Otuyemi OD, Oluwadaisi AM (2011) Assessment of oral health-related quality of life in Nigerian children using the Child Perceptions Questionnaire (CPQ 11-14). Eur J Paediatr Dent 12(1):55–59PubMed
8.
go back to reference Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB (2007) The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 35(3):170–178CrossRefPubMed Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB (2007) The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 35(3):170–178CrossRefPubMed
9.
go back to reference Narwaria YS, Saksena DN (2013) Prevalence of dental fluorosis among primary school children in rural areas of Karera Block, Madhya Pradesh. Indian J Pediatr 80(9):718–720CrossRefPubMed Narwaria YS, Saksena DN (2013) Prevalence of dental fluorosis among primary school children in rural areas of Karera Block, Madhya Pradesh. Indian J Pediatr 80(9):718–720CrossRefPubMed
10.
go back to reference Anuradha B, Laxmi GS, Sudhakar P, Malik V, Reddy KA, Reddy SN, Prasanna AL (2011) Prevalence of dental caries among 13 and 15-year-old school children in an endemic fluorosis area: a cross-sectional study. J Contemp Dent Pract 12(6):447–450CrossRefPubMed Anuradha B, Laxmi GS, Sudhakar P, Malik V, Reddy KA, Reddy SN, Prasanna AL (2011) Prevalence of dental caries among 13 and 15-year-old school children in an endemic fluorosis area: a cross-sectional study. J Contemp Dent Pract 12(6):447–450CrossRefPubMed
11.
go back to reference Levy SM (2003) An update on fluorides and fluorosis. J Can Dent Assoc 69(5):286–291PubMed Levy SM (2003) An update on fluorides and fluorosis. J Can Dent Assoc 69(5):286–291PubMed
12.
13.
go back to reference Martins CC, Paiva SM, Lima-Arsati YB, Ramos-Jorge ML, Cury JA (2008) Prospective study of the association between fluoride intake and dental fluorosis in permanent teeth. Caries Res 42(2):125–133CrossRefPubMed Martins CC, Paiva SM, Lima-Arsati YB, Ramos-Jorge ML, Cury JA (2008) Prospective study of the association between fluoride intake and dental fluorosis in permanent teeth. Caries Res 42(2):125–133CrossRefPubMed
14.
go back to reference Weyant RJ (2004) Seven systematic reviews confirm topical fluoride therapy is effective in preventing dental caries. J Evid Base Dent Pract 4(2):129–135CrossRef Weyant RJ (2004) Seven systematic reviews confirm topical fluoride therapy is effective in preventing dental caries. J Evid Base Dent Pract 4(2):129–135CrossRef
15.
go back to reference Mascarenhas AK, Mashabi S (2008) High fluoride concentration in drinking water may increase the prevalence and severity of dental fluorosis, and decrease occurrence of caries. J Evid Based Dent Pract 8(1):15–16CrossRefPubMed Mascarenhas AK, Mashabi S (2008) High fluoride concentration in drinking water may increase the prevalence and severity of dental fluorosis, and decrease occurrence of caries. J Evid Based Dent Pract 8(1):15–16CrossRefPubMed
16.
go back to reference Irigoyen ME, Molina N, Luengas I (1995) Prevalence and severity of dental fluorosis in a Mexican community with above-optimal fluoride concentration in drinking water. Community Dent Oral Epidemiol 23(4):243–245CrossRefPubMed Irigoyen ME, Molina N, Luengas I (1995) Prevalence and severity of dental fluorosis in a Mexican community with above-optimal fluoride concentration in drinking water. Community Dent Oral Epidemiol 23(4):243–245CrossRefPubMed
17.
go back to reference Pontigo-Loyola AP, Islas-Márquez A, Loyola-Rodríguez JP, Maupomé G, Márquez-Corona ML, Medina-Solís CE (2008) Dental fluorosis in 12- and 15-year-olds at high altitudes in above-optimal fluoridated communities in Mexico. J Public Health Dent 68(3):163–166CrossRefPubMed Pontigo-Loyola AP, Islas-Márquez A, Loyola-Rodríguez JP, Maupomé G, Márquez-Corona ML, Medina-Solís CE (2008) Dental fluorosis in 12- and 15-year-olds at high altitudes in above-optimal fluoridated communities in Mexico. J Public Health Dent 68(3):163–166CrossRefPubMed
18.
go back to reference Grimaldo M, Borja-Aburto VH, Ramírez AL, Ponce M, Rosas M, Díaz-Barriga F (1995) Endemic fluorosis in San Luis Potosi, Mexico: identification of risk factors associated with human exposure to fluoride. Environ Res 68(1):25–30CrossRefPubMed Grimaldo M, Borja-Aburto VH, Ramírez AL, Ponce M, Rosas M, Díaz-Barriga F (1995) Endemic fluorosis in San Luis Potosi, Mexico: identification of risk factors associated with human exposure to fluoride. Environ Res 68(1):25–30CrossRefPubMed
19.
go back to reference Soto-Rojas AE, Ureña-Cirett JL, Martínez-Mier EA (2004) A review of the prevalence of dental fluorosis in Mexico. Rev Panam Salud Pública 15(1):9–18CrossRefPubMed Soto-Rojas AE, Ureña-Cirett JL, Martínez-Mier EA (2004) A review of the prevalence of dental fluorosis in Mexico. Rev Panam Salud Pública 15(1):9–18CrossRefPubMed
20.
go back to reference Vallejos-Sánchez AA, Medina-Solís CE, Casanova-Rosado JF, Maupomé G, Minaya-Sánchez M, Pérez-Olivares S (2006) Dental fluorosis in cohorts born before, during, and after the national salt fluoridation program in a community in Mexico. Acta Odontol Scand 64(4):209–213CrossRefPubMed Vallejos-Sánchez AA, Medina-Solís CE, Casanova-Rosado JF, Maupomé G, Minaya-Sánchez M, Pérez-Olivares S (2006) Dental fluorosis in cohorts born before, during, and after the national salt fluoridation program in a community in Mexico. Acta Odontol Scand 64(4):209–213CrossRefPubMed
21.
go back to reference Foster-Page LA, Thomson WM, Jokovic A, Locker D (2005) Validation of the Child Perceptions Questionnaire (CPQ 11-14). J Dent Res 84(7):649–652CrossRefPubMed Foster-Page LA, Thomson WM, Jokovic A, Locker D (2005) Validation of the Child Perceptions Questionnaire (CPQ 11-14). J Dent Res 84(7):649–652CrossRefPubMed
22.
go back to reference Gherunpong S, Tsakos G, Sheiham A (2004) Developing and evaluating an oral health-related quality of life index for children; the CHILD-OIDP. Community Dent Health 21(2):161–169PubMed Gherunpong S, Tsakos G, Sheiham A (2004) Developing and evaluating an oral health-related quality of life index for children; the CHILD-OIDP. Community Dent Health 21(2):161–169PubMed
23.
24.
go back to reference Tellez M, Santamaria RM, Gomez J, Martignon S (2012) Dental fluorosis, dental caries, and quality of life factors among schoolchildren in a Colombian fluorotic area. Community Dent Health 29(1):95–99PubMed Tellez M, Santamaria RM, Gomez J, Martignon S (2012) Dental fluorosis, dental caries, and quality of life factors among schoolchildren in a Colombian fluorotic area. Community Dent Health 29(1):95–99PubMed
25.
go back to reference Do LG, Spencer A (2007) Oral health-related quality of life of children by dental caries and fluorosis experience. J Public Health Dent 67(3):132–139CrossRefPubMed Do LG, Spencer A (2007) Oral health-related quality of life of children by dental caries and fluorosis experience. J Public Health Dent 67(3):132–139CrossRefPubMed
26.
go back to reference Astrøm AN, Mashoto K (2002) Determinants of self-rated oral health status among school children in northern Tanzania. Int J Paediatr Dent 12(2):90–100CrossRefPubMed Astrøm AN, Mashoto K (2002) Determinants of self-rated oral health status among school children in northern Tanzania. Int J Paediatr Dent 12(2):90–100CrossRefPubMed
27.
go back to reference Aguilar-Díaz FC, Irigoyen-Camacho ME, Borges-Yáñez SA (2011) Oral-health-related quality of life in schoolchildren in an endemic fluorosis area of Mexico. Qual Life Res 20(10):1699–1706CrossRefPubMed Aguilar-Díaz FC, Irigoyen-Camacho ME, Borges-Yáñez SA (2011) Oral-health-related quality of life in schoolchildren in an endemic fluorosis area of Mexico. Qual Life Res 20(10):1699–1706CrossRefPubMed
28.
go back to reference Kline RB (2005) Principles and practice of structural equation modelling, 2nd edn. The Guildford Press, New York Kline RB (2005) Principles and practice of structural equation modelling, 2nd edn. The Guildford Press, New York
29.
go back to reference Qiu RM, Lo EC, Zhi QH, Zhou Y, Tao Y, Lin HC (2014) Factors related to children’s caries: a structural equation modeling approach. BMC Public Health 14:1071CrossRefPubMedPubMedCentral Qiu RM, Lo EC, Zhi QH, Zhou Y, Tao Y, Lin HC (2014) Factors related to children’s caries: a structural equation modeling approach. BMC Public Health 14:1071CrossRefPubMedPubMedCentral
32.
go back to reference Fleiss JL, Tytun A, Ury HK (1980) A simple approximation for calculating sample sizes for comparing independent proportions. Biometrics 36(32):343–346CrossRefPubMed Fleiss JL, Tytun A, Ury HK (1980) A simple approximation for calculating sample sizes for comparing independent proportions. Biometrics 36(32):343–346CrossRefPubMed
33.
go back to reference Del Carmen Aguilar-Díaz F, Irigoyen-Camacho ME (2011) Validation of the CPQ8-10ESP in Mexican schoolchildren in urban areas. Med Oral Patol Oral Cir Bucal 16(3):e430–e435CrossRefPubMed Del Carmen Aguilar-Díaz F, Irigoyen-Camacho ME (2011) Validation of the CPQ8-10ESP in Mexican schoolchildren in urban areas. Med Oral Patol Oral Cir Bucal 16(3):e430–e435CrossRefPubMed
34.
go back to reference Thylstrup A, Fejerskov O (1978) Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol 6(6):315–328CrossRefPubMed Thylstrup A, Fejerskov O (1978) Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol 6(6):315–328CrossRefPubMed
35.
go back to reference Shoaib L, Deery C, Ricketts DN, Nugent ZJ (2009) Validity and reproducibility of ICDAS II in primary teeth. Caries Res 43(6):442–448CrossRefPubMed Shoaib L, Deery C, Ricketts DN, Nugent ZJ (2009) Validity and reproducibility of ICDAS II in primary teeth. Caries Res 43(6):442–448CrossRefPubMed
36.
go back to reference Del Carmen Aguilar-Díaz F, Foster Page LA, Thomson NM, Borges-Yáñez SA (2013) Differential item functioning of the Spanish version of the Child Perceptions Questionnaire. J Investig Clin Dent 4(1):34–38CrossRefPubMed Del Carmen Aguilar-Díaz F, Foster Page LA, Thomson NM, Borges-Yáñez SA (2013) Differential item functioning of the Spanish version of the Child Perceptions Questionnaire. J Investig Clin Dent 4(1):34–38CrossRefPubMed
37.
go back to reference Kohn WG, Harte JA, Malvitz DM, Collins AS, Cleveland JL, Eklund KJ, Centers for Disease Control and Prevention (2004) Guidelines for infection control in dental health care settings—2003. J Am Dent Assoc 135(1):33–47CrossRefPubMed Kohn WG, Harte JA, Malvitz DM, Collins AS, Cleveland JL, Eklund KJ, Centers for Disease Control and Prevention (2004) Guidelines for infection control in dental health care settings—2003. J Am Dent Assoc 135(1):33–47CrossRefPubMed
38.
go back to reference Abanto J, Tsakos G, Paiva SM, Carvalho TS, Raggio DP, Bönecker M (2014) Impact of dental caries and trauma on quality of life among 5- to 6-year-old children: perceptions of parents and children. Community Dent Oral Epidemiol 42(5):385–394CrossRefPubMed Abanto J, Tsakos G, Paiva SM, Carvalho TS, Raggio DP, Bönecker M (2014) Impact of dental caries and trauma on quality of life among 5- to 6-year-old children: perceptions of parents and children. Community Dent Oral Epidemiol 42(5):385–394CrossRefPubMed
39.
go back to reference Mota-Veloso I, Soares ME, Alencar BM, Marques LS, Ramos-Jorge ML, Ramos-Jorge J (2016) Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years. Qual Life Res 25(1):193–199CrossRefPubMed Mota-Veloso I, Soares ME, Alencar BM, Marques LS, Ramos-Jorge ML, Ramos-Jorge J (2016) Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years. Qual Life Res 25(1):193–199CrossRefPubMed
40.
go back to reference Ismail AI, Sohn W, Tellez M, Willem JM, Betz J, Lepkowski J (2008) Risk indicators for dental caries using the International Caries Detection and Assessment System (ICDAS). Community Dent Oral Epidemiol 36(1):55–68PubMed Ismail AI, Sohn W, Tellez M, Willem JM, Betz J, Lepkowski J (2008) Risk indicators for dental caries using the International Caries Detection and Assessment System (ICDAS). Community Dent Oral Epidemiol 36(1):55–68PubMed
42.
go back to reference Chankanka O, Levy SM, Warren JJ, Chalmers JM (2010) A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol 38(2):97–109CrossRefPubMed Chankanka O, Levy SM, Warren JJ, Chalmers JM (2010) A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol 38(2):97–109CrossRefPubMed
43.
go back to reference Walsh T, Worthington HV, Glenny AM, Applelbe P, Marinho VCC, Shi X (2010) Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews Issue 1. Art. No.: CD007868 Walsh T, Worthington HV, Glenny AM, Applelbe P, Marinho VCC, Shi X (2010) Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews Issue 1. Art. No.: CD007868
44.
go back to reference Groeneveld A (1985) Longitudinal study of prevalence of enamel lesions in a fluoridated and non-fluoridated area. Community Dent Oral Epidemiol 13(3):159–163CrossRefPubMed Groeneveld A (1985) Longitudinal study of prevalence of enamel lesions in a fluoridated and non-fluoridated area. Community Dent Oral Epidemiol 13(3):159–163CrossRefPubMed
45.
go back to reference Shaghaghian S, Bahmani M, Amin M (2015) Impact of oral hygiene on oral health-related quality of life of preschool children. Int J Dent Hyg 13(3):192–198CrossRefPubMed Shaghaghian S, Bahmani M, Amin M (2015) Impact of oral hygiene on oral health-related quality of life of preschool children. Int J Dent Hyg 13(3):192–198CrossRefPubMed
46.
go back to reference Castro Rde A, Portela MC, Leão AT, de Vasconcellos MT (2011) Oral health-related quality of life of 11- and 12-year-old public school children in Rio de Janeiro. Community Dent Oral Epidemiol 39(4):336–344CrossRefPubMed Castro Rde A, Portela MC, Leão AT, de Vasconcellos MT (2011) Oral health-related quality of life of 11- and 12-year-old public school children in Rio de Janeiro. Community Dent Oral Epidemiol 39(4):336–344CrossRefPubMed
47.
go back to reference Montero J, Rosel E, Barrios R, López-Valverde A, Albaladejo A, Bravo M (2016) Oral health-related quality of life in 6- to 12-year-old schoolchildren in Spain. Int J Paediatr Dent 26(3):220–230CrossRefPubMed Montero J, Rosel E, Barrios R, López-Valverde A, Albaladejo A, Bravo M (2016) Oral health-related quality of life in 6- to 12-year-old schoolchildren in Spain. Int J Paediatr Dent 26(3):220–230CrossRefPubMed
Metadata
Title
Impact of caries and dental fluorosis on oral health-related quality of life: a cross-sectional study in schoolchildren receiving water naturally fluoridated at above-optimal levels
Authors
Álvaro García-Pérez
María Esther Irigoyen-Camacho
S. Aída Borges-Yáñez
Marco Antonio Zepeda-Zepeda
Irvin Bolona-Gallardo
Gerardo Maupomé
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 9/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-017-2079-1

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