The effect of caries increment on oral health-related quality of life among adolescents in Brazil: a 3-year longitudinal study

PAULA, Janice Simpson de; ZINA, Lívia Guimarães; JAMIESON, Lisa; MIALHE, Fábio Luiz

doi:10.1590/1807-3107BOR-2020.vol34.0107

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Sumário

ORIGINAL RESEARCH, Community Dental Health • Braz. oral. res. 34 • 2020 • https://doi.org/10.1590/1807-3107BOR-2020.vol34.0107 copy

The effect of caries increment on oral health-related quality of life among adolescents in Brazil: a 3-year longitudinal study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ_11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ_11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ_11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ_11-14 instrument demonstrated acceptable responsiveness properties.

Adolescent; Dental Caries; Incidence; Longitudinal Studies; Quality of Life

Variable	Total		Followed		Not followed-up		p-value

	515		291		224

	n	%	N	%	n	%
Sex
Female	290	56.3	148	51.0	142	49.0	0.1588**
Male	225	43.7	143	63.5	82	46.5
School type
Public	363	70.5	238	65.6	125	34.4	< 0.0001**
Private	152	29.5	53	34.9	99	65.1
Self-rated oral health
Excellent	66	12.8	31	10.7%	35	15.6	0.0738**
Very good	91	17.7	49	16.8%	42	18.8
Good	179	34.8	97	33.3%	82	36.6
Global questions CPQ_11-14
Fair	148	28.7	91	31.3%	57	25.4
Poor	31	6.0	23	7.9%	8	3.6
Global impact of oral health on quality of life
Not at all	198	38.4	103	35.4%	95	42.4	0.1789**
Very little	144	28.0	91	31.3%	53	23.7
Some	129	25.0	73	25.1%	56	25.0
A lot	33	6.4	16	5.5%	17	7.6
Very much	11	2.2	8	2.7%	3	1.3
	mean	SD*	mean	SD*	mean	SD*
DMFT index
DMFT	1.1	1.7	1.0	1.7	1.2	1.7	0.1475***
D	0.3	0.8	0.3	0.8	0.3	0.9	0.2702***
M	0.0	0.2	0.0	0.2	0.0	0.2	0.4102***
F	0.7	1.4	0.7	1.3	0.8	1.5	0.1722***

Variable	Decayed		Missing		Filled		DMFT

	Baseline	Follow up	Baseline	Follow up	Baseline	Follow up	Baseline	Follow up
Mean	0.3	0.5	0.0	0.1	0.7	1.3	1.0	1.8
Standard deviation	0.8	1.1	0.2	0.3	1.3	1.7	1.7	2.3
p-value*	p = 0.0005		p = 0.0042		p < 0.0001		p < 0.0001

Variable	Baseline			Follow-up			p-value¹	ES²

	Mean (SD)	Median	Range	Mean (SD)	Median	Range
CPQ_11-14 (overall score)	25.5 (23.4)	18	0–106	20.9 (19.7)	15	0–90	< 0.0001	0.20
Domains
Oral Symptoms	5.8 (3.9)	5	0–24	5.5 (4.2)	5	0–18	0.0821	0.08
Functional limitation	5.2 (5.6)	3	0–28	4.8 (5.2)	3	0-24	0.2334	0.07
Emotional well-being	8.4 (8.7)	5	0–35	6.5 (7.8)	3	0–35	< 0.0001	0.22
Social well-being	6.0 (8.0)	3	0–38	4.2 (6.1)	1	0–26	< 0.0001	0.23

Groups	Baseline			Follow-up			Intra-group	ES***

	Mean (SD)	Median	Range*	Mean (SD)	Median	Range*	p-value**
G1 without DMFT increment
CPQ_11-14 (overall score)	25.8 (24.2)	17	0–106	18.4 (18.6)^****	13	0–84	< 0.0001	0.3
Oral symptoms	5.7 (4.1)	5	0–24	4.8 (4.2)^****	4	0–16	0.0013	0.2
Functional limitation	5.4 (5.9)	3	0–28	4.3 (4.9)^****	2	0–24	0.0031	0.2
Emotional well-being	8.6 (8.9)	5	0–35	5.6 (7.3)^****	2	0–32	< 0.0001	0.3
Social well-being	6 (8.2)	2	0–38	3.7 (5.7)^****	1	0–26	< 0.0001	0.3
G2 with DMFT increment
CPQ_11-14 (overall score)	24.9 (21.9)	19	0–94	25.6 (20.9)^****	20	0–90	0.1627	0.0
Oral symptoms	6.0 (3.6)	5	0–15	6.6 (3.9)^****	6	0–18	0.0945	0.2
Functional limitation	4.7 (5.0)	3	0–20	5.7 (5.6)^****	5	0–24	0.0330	0.2
Emotional well-being	8.2 (8.5)	6	0–33	8.2 (8.5)^****	7	0–35	0.4737	0.0
Social well-being	6.1 (7.6)	3	0–36	5.2 (6.8)^****	2	0–26	0.0397	0.1

Groups	Number of participants (%)	Mean of difference (= baseline score-follow-up score)

		OS	FL	EWB	SWB	CPQ_11.-14
G1 without DMFT increment
Total	190	0.9	1.1	3.0	2.4	7.4
Worsened	9 (4.7%)	-3.3^a	-4.1^a	1.3^ns	-0.3^ns	-6.4^a
No change	94 (49.5%)	1.1^ab	1.7^b	2.6^ns	2.2^ns	7.6^b
Improvement	87 (45.8%)	1.1^b	1.0^b	3.6^ns	2.8^ns	8.6^b
	p-value*	0.04	0.00	0.79	0.06	0.03
G2 with DMFT increment
Total	101	-0.6	-1.0	0.0	0.9	-0.7
Worsened	23 (22.8%)	-2.6^a	-3.1^a	0.7 ^ns	0.4 ^ns	-4.7 ^ns
No change	53 (52.5%)	0.3^b	-0.4^b	-0.9 ^ns	0.9 ^ns	-0.2 ^ns
Improvement	25 (24.7%)	-0.8^ab	-0.4^ab	1.5 ^ns	1.5 ^ns	1.8^ns
	p-value*	0.00	0.02	0.18	0.75	0.07

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[1] Corresponding Author: Janice Simpson de Paula E-mail: janicesimpson@ufmg.br