Kaewkamnerdpong Issarapong, Krisdapong Sudaduang
Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Community Dent Oral Epidemiol. 2018 Jun;46(3):270-279. doi: 10.1111/cdoe.12361. Epub 2018 Jan 8.
To assess the hierarchical associations between children's school performance and condition-specific (CS) oral health-related quality of life (OHRQoL), school absence, oral status, sociodemographic and economic status (SDES) and social capital; and to investigate the associations between CS OHRQoL and related oral status, adjusting for SDES and social capital.
Data on 925 sixth grade children in Sakaeo province, Thailand, were collected through oral examinations for dental caries and oral hygiene, social capital questionnaires, OHRQoL interviews using the Child-Oral Impacts on Daily Performances index, parental self-administered questionnaires and school documents. A hierarchical conceptual framework was developed, and independent variables were hierarchically entered into multiple logistic models for CS OHRQoL and linear regression models for school performance.
After adjusting for SDES and social capital, children with high DMFT or DT scores were significantly threefold more likely to have CS impacts attributed to dental caries. However, poor oral hygiene was not significantly associated with CS impacts attributed to gingival disease. High DMFT scores were significantly associated with lower school performance, whereas high Simplified Oral Hygiene Index scores were not. The final model showed that CS impacts attributed to dental caries and school absence accounted for the association between DMFT score and school performance.
Dental caries was associated with CS impacts on OHRQoL, and exerted its effect on school performance through the CS impacts and school absence. There was no association between oral hygiene and CS impacts on OHRQoL or school performance.
评估儿童学业成绩与特定疾病(CS)的口腔健康相关生活质量(OHRQoL)、缺课情况、口腔状况、社会人口学和经济状况(SDES)以及社会资本之间的分层关联;并在调整SDES和社会资本的情况下,研究CS OHRQoL与相关口腔状况之间的关联。
通过对泰国沙缴府925名六年级儿童进行龋齿和口腔卫生检查、社会资本问卷调查、使用儿童口腔对日常表现影响指数进行OHRQoL访谈、家长自填问卷以及学校文件收集数据。构建了一个分层概念框架,并将自变量分层纳入CS OHRQoL的多元逻辑模型和学业成绩的线性回归模型。
在调整SDES和社会资本后,DMFT或DT得分高的儿童因龋齿导致CS影响的可能性显著高出三倍。然而,口腔卫生差与牙龈疾病导致的CS影响无显著关联。高DMFT得分与较低的学业成绩显著相关,而高简化口腔卫生指数得分则不然。最终模型显示,因龋齿和缺课导致的CS影响解释了DMFT得分与学业成绩之间的关联。
龋齿与CS对OHRQoL的影响相关,并通过CS影响和缺课对学业成绩产生作用。口腔卫生与CS对OHRQoL或学业成绩的影响之间无关联。