Chaffee Benjamin W, Rodrigues Priscila Humbert, Kramer Paulo Floriani, Vítolo Márcia Regina, Feldens Carlos Alberto
Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA, USA.
Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
Community Dent Oral Epidemiol. 2017 Jun;45(3):216-224. doi: 10.1111/cdoe.12279. Epub 2017 Jan 12.
(i) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience.
This study was a cross-sectional analysis of children in southern Brazil (n=456, mean age: 38 months) participating in an existing health centre-based intervention study. OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1-4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modelling, overall and within socioeconomic strata defined by maternal education, social class and household income.
Caries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 vs dmft=0, a pattern that persisted regardless of family socioeconomic status (P for interaction: all >0.3). However, adjusted for dental status and sociodemographic characteristics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0) or in lower income households (ratio: 0.8; 95% CI: 0.6, 1.3).
Dental caries was associated with negative child and family experiences and lower OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality-of-life impact at the same level of disease experience. Thus, subjective quality-of-life measures may differ under varying social contexts, with possible implications for service utilization, evaluating oral health interventions, or quantifying disease morbidity in low-SES groups.
（i）量化儿童龋齿经历与母亲报告的儿童口腔健康相关生活质量（OHRQoL）之间的相对关联；（ii）研究这种关联是否因家庭社会经济地位（SES）而异；（iii）探讨在儿童龋齿经历水平相似的情况下，绝对OHRQoL是否因家庭SES而有所不同。
本研究是对巴西南部参与一项现有基于健康中心的干预研究的儿童（n = 456，平均年龄：38个月）进行的横断面分析。OHRQoL影响通过巴西幼儿口腔健康影响量表（ECOHIS）的平均得分进行量化，并在龋齿经历类别（dmft：0、dmft：1 - 4、dmft：≥5）之间进行比较。使用回归模型计算龋齿类别之间调整后的ECOHIS比率，总体以及在由母亲教育程度、社会阶层和家庭收入定义的社会经济阶层内进行计算。
龋齿患病率（dmft > 0）为39.7%，ECOHIS平均得分为2.0（标准差：3.5），44.3%的母亲报告有OHRQoL影响（ECOHIS得分> 0）。儿童龋齿经历增加与儿童和家庭生活质量恶化相关：dmft≥5的儿童的ECOHIS得分比dmft = 0的儿童高3.0倍（95%置信区间：2.0，4.4），无论家庭社会经济地位如何，这种模式都持续存在（交互作用P值：均> 0.3）。然而，在调整了牙齿状况和社会人口学特征后，受教育程度较低的母亲报告的ECOHIS平均得分较低（比率：0.7；95%置信区间：0.5，1.0），社会阶层较低的母亲（比率：0.7；95%置信区间：0.5，1.0）或低收入家庭的母亲（比率：0.8；95%置信区间：0.6，1.3）报告的得分也较低。
龋齿与所有社会群体中儿童和家庭的负面经历以及较低的OHRQoL相关；然而，在相同疾病经历水平下，面临更大劣势的家庭报告的生活质量影响可能较小。因此，主观生活质量测量在不同社会背景下可能有所不同，这可能对服务利用、评估口腔健康干预措施或量化低SES群体中的疾病发病率产生影响。
