Tan Sharon Hui Xuan, Singh Ankur, Tan Kok Hian, Eriksson Johan Gunnar, Hsu Chin-Ying Stephen
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
Caries Res. 2025 Mar 29:1-13. doi: 10.1159/000545620.
The study aimed to assess the direct and indirect effect of parental locus of control (LoC) on child oral health-related quality of life.
As part of the Growing Up in Singapore towards Healthy Outcomes (GUSTO) multicenter longitudinal cohort study, sociodemographic characteristics of parents and their children were obtained at recruitment. Oral health status and dental caries outcomes were assessed at the 5th year post-natal visit and administered alongside the LoC questionnaire. Intraoral examinations were carried out by 3 trained calibrated dental professionals using the modified International Caries Detection and Assessment System (ICDAS-II) criteria. At the 6-year post-natal visit, the Early Childhood Oral Health Impact Scale (ECOHIS) was administered to mothers to assess the oral health-related quality of life (OHRQoL) of their child. Statistical analysis of the direct effects of parental LoC on OHRQoL and the causal mediation effects of dental caries were carried out using the potential outcomes approach with 1,000 simulations.
A total of 312 parent-child dyads were included in this prospective cohort study. At the 5th year post-natal visit, the median decayed, missing, and filled surfaces (dmfs) was 2 (IQR 0-5), while the median LoC was 47 (IQR 43-50). The total effect of parental LoC on ECOHIS was -2.05 (95% CI: -4.03 to -0.08), of which the direct effect through dmfs was -1.45 (95% CI: -3.41 to 0.47). The percentage of the total effect of parental LoC on ECOHIS that was mediated by the presence of dental caries was 29.5% for dmfs, including incipient caries (ICDAS 1-6). The proportion mediated was lower if only active decayed surfaces were considered (23.7%) and higher if only cavitated lesions (ICDAS 3-6) (30.1%) were considered.
The effect of parental LoC on child OHRQoL was mediated in part through the development of dental caries.
本研究旨在评估父母控制点（LoC）对儿童口腔健康相关生活质量的直接和间接影响。
作为新加坡迈向健康成长（GUSTO）多中心纵向队列研究的一部分，在招募时获取了父母及其子女的社会人口学特征。在产后第5年的访视中评估口腔健康状况和龋齿结果，并与控制点问卷一起进行。由3名经过培训且校准合格的牙科专业人员使用改良的国际龋齿检测和评估系统（ICDAS-II）标准进行口腔内检查。在产后第6年的访视中，向母亲发放幼儿口腔健康影响量表（ECOHIS），以评估其子女的口腔健康相关生活质量（OHRQoL）。使用具有1000次模拟的潜在结果方法，对父母控制点对OHRQoL的直接影响以及龋齿的因果中介效应进行统计分析。
本前瞻性队列研究共纳入312对亲子。在产后第5年的访视中，龋失补牙面（dmfs）的中位数为2（四分位间距0-5），而控制点的中位数为47（四分位间距43-50）。父母控制点对ECOHIS的总效应为-2.05（95%置信区间：-4.03至-0.08），其中通过dmfs的直接效应为-1.45（95%置信区间：-3.41至0.47）。对于包括早期龋齿（ICDAS 1-6）在内的dmfs，父母控制点对ECOHIS的总效应中由龋齿介导的百分比为29.5%。如果仅考虑活动性龋坏表面，介导比例较低（23.7%）；如果仅考虑龋洞病变（ICDAS 3-6），介导比例较高（30.1%）。
父母控制点对儿童OHRQoL的影响部分是通过龋齿的发生介导的。
