Impact of Early Childhood Caries and Maternal Behaviors on Oral Health-Related Quality of Life of Children

Pereira, Joanna Tatith; Knorst, Jessica Klöckner; Luz, Patrícia Blaya; Bonfadini, Inaiá; Scapinello, Monique; Hugo, Fernando Neves; Araujo, Fernando Borba de

doi:10.1590/pboci.2020.065

Joanna Tatith Pereira Author to whom correspondence should be addressed: Joanna Tatith Pereira, Rua Joana Dar’c, 488, Nossa Senhora de Lourdes, Santa Maria, RS, Brazil. 97060-360. Phone: + 55 51 981714591. E-mail: contato@joanna.odo.br.

Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

http://orcid.org/0000-0002-2434-4305

Jessica Klöckner Knorst

Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.

http://orcid.org/0000-0001-7792-8032

Patrícia Blaya Luz

Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

http://orcid.org/0000-0001-8204-4231

Inaiá Bonfadini

Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

http://orcid.org/0000-0001-9466-0488

Monique Scapinello

Institute of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

http://orcid.org/0000-0003-2701-0092

Fernando Neves Hugo

Public Health Dentistry Department, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

http://orcid.org/0000-0003-2222-7719

Fernando Borba de Araujo

Pediatric Dentistry Department, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

http://orcid.org/0000-0003-2892-3256

Author to whom correspondence should be addressed: Joanna Tatith Pereira, Rua Joana Dar’c, 488, Nossa Senhora de Lourdes, Santa Maria, RS, Brazil. 97060-360. Phone: + 55 51 981714591. E-mail: contato@joanna.odo.br.

Academic Editors: Alessandro Leite Cavalcanti and Wilton Wilney Nascimento Padilha

Authors’ Contributions

JTP Conceptualization, Methodology, Investigation, Writing - Original Draft Preparation and Writing - Review and Editing.

JKK Writing - Original Draft Preparation and Writing - Review and Editing.

PBL Conceptualization, Methodology, Investigation, Writing - Original Draft Preparation and Writing - Review and Editing.

IB Investigation and Validation and Writing - Review and Editing.

MS Investigation and Validation and Writing - Review and Editing.

FNH Formal Analysis, Validation and Writing - Review and Editing.

FBA Conceptualization, Methodology and Writing - Review and Editing.

All authors declare that they contributed to critical review of intellectual content and approval of the final version to be published.

Conflict of Interest

The authors declare no conflicts of interest.

Variables	N	%
Sex
Male	74	45.4
Female	89	55.6
Maternal Education
< 9 Years	40	24.5
9-11 Years	72	44.2
> 11 Years	51	31.3
Household Income
≤ 2 BMW^a a BMW: Brazilian Minimum Wages;	56	34.4
> 2 ≤ 5 BMW	79	48.4
> 5 BMW	28	17.2
Number of Individuals in the House
≤ 4 People	82	50.3
> 4 People	81	49.7
Mother's Working Time Outside Home^b b Time for week.
> 30 Hours	97	59.5
≤ 30 Hours	66	40.5
Marital Status
Not Married	59	36.2
Married/Living Together	104	63.8
Breastfeeding Time
≤ 2 Years	133	81.6
> 2 Years	30	18.4
Agree that the Child is Able to Brush his or her Teeth Alone
Yes	27	16.6
No	136	83.4
Frequency of Child' Oral Brushing
More Than Once Daily	82	50.3
Once Daily	60	36.8
Occasionally or Never	21	12.9
Early Childhood Caries
Caries-free (ICDAS 0)	14	8.6
Enamel lesions (ICDAS 1, 2 or 3)	111	68.1
Dentin lesions (ICDAS 4, 5 or 6)	38	23.3
Cavitated lesions (ICDAS > 3)	52	32.0
Traumatic Dental Injury
Presence	62	38.0
Absence	101	62.0
Malocclusion
With	75	46.0
Without	88	54.0

	Responses
ECOHIS Domains	Never	Hardly Ever	Occasionally	Often	Very Often	Don´t Know	Mean (SD)
	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)
Child Section
1. Has your child had pain in the teeth, mouth or jaws? (Symptom)	103 (63.2)	36 (22.1)	20 (12.3)	3 (1.8)	1 (0.6)	0 (0.0)	0.55 (0.8)
2. Has your child had difficulty drinking hot or cold beverages because of dental problems or dental treatments? (Function)	148 (90.8)	10 (6.1)	3 (1.8)	0 (0.0)	1 (0.6)	1 (0.6)	0.15 (0.6)
3. Has your child had difficulty eating some foods because of dental problems or dental treatments? (Function)	147 (90.2)	13 (8.0)	1 (0.6)	3 (1.8)	0 (0.0)	0 (0.0)	0.13 (0.4)
4. Has your child had difficulty pronouncing any words because of dental problems or dental treatments? (Function)	152 (93.3)	3 (1.8)	13 (1.8)	2 (1.2)	3 (1.8)	0 (0.0)	0.17 (0.7)
5. Has your child missed preschool, daycare or school because of dental problems or dental treatments? (Function)	149 (91.4)	8 (4.9)	4 (2.5)	0 (0.0)	0 (0.0)	2 (1.2)	0.16 (0.7)
6. Has your child had trouble sleeping because of dental problems or dental treatments? (Psychology)	155 (95.1)	4 (2.5)	2 (1.2)	1 (0.6)	1 (0.6)	0 (0.0)	0.09 (0.5)
7. Has your child been irritable or frustrated because of dental problems or dental treatments? (Psychology)	141 (86.5)	15 (9.2)	5 (3.1)	2 (1.2)	0 (0.0)	0 (0.0)	0.19 (0.5)
8. Has your child avoided smiling or laughing because of dental problems or dental treatments? (Self-image/social interaction)	157 (96.3)	4 (2.5)	2 (1.2)	0 (0.0)	0 (0.0)	0 (0.0)	0.05 (0.3)
9. Has your child avoided talking because of dental problems or dental treatments? (Self-image/social interaction)	157 (96.3)	2 (1.2)	3 (1.8)	1 (0.6)	0 (0.0)	0 (0.0)	0.07 (0.4)
Family Section
10. Have you or another family member been upset because of your child's dental problems or dental treatment? (Parental distress)	147 (90.2)	11 (6.7)	3 (1.8)	0 (0.0)	2 (1.2)	0 (0.0)	0.15 (0.6)
11. Have you or another family member felt guilty because of your child's dental problems or dental treatment? (Parental distress)	139 (85.3)	9 (5.5)	8 (4.9)	2 (1.2)	5 (3.1)	0 (0.0)	0.31 (0.9)
12. Have you or another family member taken time off from work because of your child's dental problems or dental treatment? (Family function)	155 (95.1)	4 (2.5)	2 (1.2)	1 (0.6)	1 (0.6)	0 (0.0)	0.09 (0.5)
13. Has your child had dental problems or dental treatments that had a financial impact on your family? (Family function)	158 (96.9)	3 (1.8)	2 (1.2)	0 (0.0)	0 (0.0)	0 (0.0)	0.04 (0.3)

	Domains
Variables	SD	FD	PD	SSD	PDD	FFD	ECOHIS
	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)
Socioeconomic Variables
Maternal Education
< 9 Years	0.67 (0.88)	0.27 (0.51)	0.27 (0.66)	0.22 (0.51)	0.42 (0.88)	0.06 (0.32)	0.28 (0.47)
9-11 Years	0.52 (0.85)	0.12 (0.26)	0.08 (0.22)	-	0.15 (0.47)	0.11 (0.37)	0.13 (0.19)
> 11 Years	0.47 (0.73)	0.09 (0.21)	0.11 (0.35)	0.00 (0.07)	0.18 (0.61)	0.00 (0.07)	0.11 (0.19)
p-value	0.541	0.310	0.369	0.008^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.	0.117	0.118	0.396
Household Income
≤ 2 MW	0.69 (0.85)	0.25 (0.45)	0.22 (0.58)	0.13 (0.42)	0.34 (0.78)	0.13 (0.45)	0.25 (0.41)
>2 ≤ 5 MW	0.48 (0.82)	0.11 (0.26)	0.10 (0.30)	0.02 (0.15)	0.22 (0.62)	0.04 (0.19)	0.13 (0.21)
> 5 MW	0.42 (0.74)	0.07 (0.16)	0.08 (0.23)	-	0.03 (0.13)	-	0.07 (0.09)
p-value	0.149	0.063	0.582	0.046^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.	0.051	0.125	0.067
Number of Individuals in the House
≤ 4 People	0.58 (0.88)	0.13 (0.29)	0.14 (0.37)	0.04 (0.27)	0.21 (0.61)	0.10 (0.40)	0.16 (0.30)
> 4 People	0.50 (0.76)	0.16 (0.38)	0.14 (0.45)	0.07 (0.27)	0.25 (0.67)	0.02 (0.13)	0.16 (0.28)
p-value		0.828	0.702	0.157	0.651	0.117	0.555
Mother's Working Time Outside Home
> 30 Hours	0.54 (0.81)	0.19 (0.38)	0.15 (0.48)	0.06 (0.30)	0.25 (0.71)	0.04 (0.24)	0.18 (0.33)
< 30 Hours	0.54 (0.84)	0.09 (0.23)	0.12 (0.30)	0.05 (0.21)	0.19 (0.51)	0.09 (0.37)	0.14 (0.22)
p-value	0.980	0.119	0.859	0.616	0.700	0.314	0.830
Marital Status
Not Married	0.67 (0.91)	0.16 (0.33)	0.18 (0.55)	0.05 (0.32)	0.26 (0.75)	0.11 (0.43)	0.20 (0.37)
Married/Living Together	0.47 (0.76)	0.14 (0.34)	0.11 (0.31)	0.05 (0.24)	0.21 (0.57)	0.03 (0.18)	0.14 (0.24)
p-value	0.173	0.454	0.974	0.533	0.869	0.187	0.386
Behaviors Variables
Breastfeeding
≤ 2 Years	0.51 (0.78)	0.14 (0.33)	0.12 (0.40)	0.03 (0.21)	0.19 (0.57)	0.03 (0.16)	0.14 (0.24)
> 2 Years	0.70 (0.98)	0.17 (0.36)	0.20 (0.48)	0.15 (0.43)	0.41 (0.88)	0.21 (0.59)	0.25 (0.45)
p-value	0.294	0.918	0.457	0.020^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.	0.038^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.	0.015^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.	0.324
Agree that the child is able to brush his or her teeth alone
Yes	0.59 (0.79)	0.19 (0.47)	0.25 (0.68)	0.05 (0.28)	0.18 (0.60)	0.03 (0.13)	0.18 (0.34)
No	0.53 (0.83)	0.14 (0.30)	0.11 (0.34)	0.05 (0.27)	0.24 (0.65)	0.07 (0.32)	0.16 (0.28)
p-value	0.534	0.788	0.316	0.770	0.497	0.930	0.706
Frequency of Child' Oral Brushing
More than Once a Day	0.52 (0.86)	0.10 (0.23)	0.07 (0.25)	0.01 (0.11)^A	0.09 (0.27)	0.06 (0.23)	0.11 (0.16)
Once Daily	0.53 (0.76)	0.22 (0.44)	0.20 (0.47)	0.08 (0.34)^AB	0.36 (0.85)	0.09 (0.41)	0.22 (0.38)
Occasionally or Never	0.66 (0.85)	0.13 (0.29)	0.21 (0.68)	0.16 (0.42)^B	0.38 (0.86)		0.20 (0.37)
p-value	0.682	0.297	0.144	0.035^* * Kruskal-Wallis test;	0.073	0.702	0.545
Oral Conditions
Early Childhood Caries
Caries-Free	0.57 (0.75)	0.12 (0.21)^A	0.14 (0.30)	0.00 (0.00)	0.00 (0.00)^A	0.10 (0.28)	0.12 (0.16)^A
Enamel Lesions	0.45 (0.78)	0.13 (0.35)^A	0.08 (0.25)	0.03 (0.18)	0.13 (0.39)^B	0.02 (0.14)	0.11 (0.19)^A
Dentin Lesions	0.78 (0.93)	0.22 (0.33)^B	0.30 (0.71)	0.14 (0.46)	0.59 (1.07)^C	0.17 (0.53)	0.31 (0.47)^B
p-value	0.087	0.037^* * Kruskal-Wallis test;	0.193	0.148	0.001^* * Kruskal-Wallis test;	0.062	0.027^* * Kruskal-Wallis test;
Caries-free/Non-cavitated Lesions	0.45 (0.77)	0.11 (0.27)	0.07 (0.21)	0.02 (0.16)	0.13 (0.39)	0.04 (0.18)	0.11 (0.17)
Cavitated Lesions	0.73 (0.90)	0.23 (0.42)	0.27 (0.65)	0.12 (0.41)	0.45 (0.95)	0.12 (0.46)	0.27 (0.43)
p-value	0.052	0.025^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.	0.062	0.054	0.003^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.	0.302	0.015^† † Mann-Whitney test; The different letters mean statistically significant difference between groups.
Traumatic Dental Injury
Presence	0.46 (0.76)	0.16 (0.36)	0.18 (0.49)	0.07 (0.31)	0.23 (0.64)	0.05 (0.33)	0.17 (0.33)
Absence	0.67 (0.90)	0.13 (0.28)	0.06 (0.21)	0.03 (0.17)	0.22 (0.64)	0.08 (0.24)	0.15 (0.21)
p-value	0.095	0.789	0.083	0.427	0.700	0.081	0.339
Malocclusion
With	0.61 (0.90)	0.11 (0.26)	0.15 (0.39)	0.06 (0.30)	0.22 (0.62)	0.08 (0.36)	0.16 (0.31)
Without	0.46 (0.72)	0.19 (0.40)	0.12 (0.44)	0.04 (0.23)	0.24 (0.66)	0.04 (0.20)	0.16 (0.27)
p-value	0.367	0.312	0.395	0.622	0.857	0.515	0.578

Variables	Unadjusted		Adjusted
	RR (95% CI)	p-value	RR (95% CI)	p-value
Demographic Variables
Sex		0.57	#
Female	1.00
Male	1.16 (0.67-2.01)
Socioeconomic Variables
Maternal Education		0.173		<0.01
< 9 Years	1.00		1.00
9-11 Years	0.53 (0.28-1.02)		0.49 (0.30-0.81)
> 11 Years	0.54 (0.23-1.30)		0.38 (0.21-0.69)
Household Income^c		<0.01
≤ 2 Minimum Wages	1.00		#
> 2 ≤ 5 Minimum Wages	0.61 (0.37-0.99)
> 5 Minimum Wages	0.36 (0.18-0.75)
Number of Individuals in the House		0.78
≤ 4 People	1.00		#
> 4 People	0.92 (0.50-1.67)
Mother's Working time Outside Home^d		0.15		<0.05
> 30 Hours	1.00		1.00
< 30 Hours	0.66 (0.38-1.16)		0.54 (0.30-0.96)
Marital Status		0.97
Not Married	1.00
Married/Living Together	0.99 (0.59-1.65)		#
Behaviors Variables
Breastfeeding
≤ 2 Years	1.00	<0.05	1.00	<0.05
> 2 Years	2.03 (1.12-3.69)		2.15 (1.16-3.96)
Agree that the child is able to brush his or her teeth alone		0.54
Yes	1.00		#
No	0.82 (0.44-1.53)
Frequency of Child' Oral Brushing		<0.05		0.06
More Than Once a Day	1.00		1.00
Once Daily	1.66 (1.03-2.65)		1.54 (0.98-2.42)
Occasionally or Never	1.58 (0.76-3.25)		1.40 (0.69-2.86)
Clinical Conditions
Early Childhood Caries		<0.01		<0.01
Caries-free/Non-cavitated Lesions	1.00		1.00
Cavitated Lesions	2.18 (1.34-3.54)		2.2 (1.43-3.41)
Traumatic Dental Injury		0.60
Presence	1.13 (0.70-1.80)		#
Absence	1.00
Malocclusion		0.18		0.11
With	1.41 (0.85-2.36)		1.48 (0.91-2.40)
Without	1.00		1.00

[1] Author to whom correspondence should be addressed: Joanna Tatith Pereira, Rua Joana Dar’c, 488, Nossa Senhora de Lourdes, Santa Maria, RS, Brazil. 97060-360. Phone: + 55 51 981714591. E-mail: contato@joanna.odo.br.

Brasil

Brasil

Impact of Early Childhood Caries and Maternal Behaviors on Oral Health-Related Quality of Life of Children

Abstract

Objective:

Material and Methods:

Results:

Conclusion: