Impact of Traumatic Dental Injury on the Quality of Life of Brazilian Preschool Children
Abstract
:1. Introduction
2. Methods
2.1. Sample Characteristics
2.2. Eligibility Criteria
2.3. Training and Calibration Exercise
2.4. Pilot Study
2.5. Non-Clinical Data Collection
2.6. Clinical Data Collection
2.7. Statistical Analysis
2.8. Ethical Considerations
3. Results
Variable | Frequency | |
---|---|---|
N | % | |
• Gender of child | ||
Female | 392 | 48.2 |
Male | 422 | 51.8 |
• Number of residents in home | ||
<to 6 residents | 674 | 84.6 |
6 or more residents | 123 | 15.4 |
• Household income | ||
>3 times the minimum wage | 144 | 18.5 |
≤3 times the minimum wage | 634 | 81.5 |
• Parent/caregiver’s schooling | ||
>8 years of study | 437 | 54.0 |
≤8 years of study | 373 | 46.0 |
• Parent/caregiver’s assessment of child’s oral health | ||
Good | 759 | 93.4 |
Poor | 54 | 6.6 |
• Parent/caregiver’s assessment of child’s general health | ||
Good | 801 | 99.0 |
Poor | 8 | 1.0 |
• TDI | ||
Yes | 281 | 34.6 |
No | 533 | 65.4 |
• Type of TDI | ||
None | 533 | 65.4 |
Tooth discoloration | 91 | 11.2 |
Enamel fracture | 138 | 17.0 |
Enamel + dentin fracture | 39 | 4.8 |
Luxation | 9 | 1.1 |
Avulsion | 4 | 0.5 |
• Number of teeth affected by TDI | ||
2 or more teeth | 104 | 12.8 |
1 tooth | 177 | 21.7 |
None | 533 | 65.5 |
• History of toothache | ||
Yes | 71 | 36.6 |
No | 123 | 63.4 |
• History of dental visits | ||
Yes | 196 | 24.2 |
No | 614 | 75.8 |
• Type of preschool | ||
Public | 438 | 53.8 |
Private | 376 | 46.2 |
ECOHIS | ||||
---|---|---|---|---|
Domains, Items | SCORE Mean ± DP | Minimum–Maximum | n (%) Don’t Know | n (%) Prevalence of impact |
• Child Impact | 2.21 ± 4.18 | 0–31 | - | 31.1% |
Related to pain | 0.58 ± 0.979 | 0–4 | 14 (1.7%) | 176 (21.6%) |
Had difficulty drinking hot or cold beverages | 0.35 ± 0.816 | 0–4 | 10 (1.2%) | 101 (12.4%) |
Had difficulty eating some foods | 0.35 ± 0.830 | 0–4 | 11 (1.4%) | 103 (12.5%) |
Had difficulty pronouncing words | 0.21 ± 0.707 | 0–4 | 25 (3.1%) | 59 (7.2%) |
Missed preschool, daycare or school | 0.12 ± 0.466 | 0–3 | - | 29 (3.6%) |
Had trouble sleeping | 0.17 ± 0.596 | 0–4 | 8 (1.0%) | 45 (5.5%) |
Been irritable or frustrated | 0.29 ± 0.745 | 0–4 | 8 (1.0%) | 85 (10.4%) |
Avoided smiling or laughing | 0.08 ± 0.395 | 0–4 | 10 (1.2%) | 18 (2.2%) |
Avoided talking | 0.08 ± 0.00 | 0–4 | 9 (1.1%) | 19 (2.3%) |
• Family Impact | 1.13 ± 2.167 | 0–14 | 24.7% | |
Been upset | 0.39 ± 0.902 | 0–4 | 11 (1.4%) | 114 (14.0%) |
Felt guilty | 0.46 ± 0.938 | 0–4 | 11 (1.4%) | 141 (17.3%) |
Taken time off work | 0.16 ± 0.564 | 0–4 | 8 (1.0%) | 47 (5.8%) |
Financial impact | 0.14 ± 0.560 | 0–4 | 9 (1.1%) | 41 (5.0%) |
ECOHIS | TDI | ||||||
---|---|---|---|---|---|---|---|
Yes | No | Total | p-value | ||||
Domains, Items | N | % | N | % | N | % | |
• Child Impact | |||||||
No impact | 185 | (33.0) | 376 | (67.0) | 561 | (68.9) | 0.45 |
Impact | 92 | (36.4) | 161 | (63.6) | 253 | (31.1) | |
• Symptoms Domain | |||||||
Related to Pain | |||||||
No impact | 218 | (34.2) | 420 | (65.8) | 638 | (78.4) | 0.873 |
Impact | 59 | (33.5) | 117 | (66.5) | 176 | (21.6) | |
• Function Domain | |||||||
Had difficulty drinking hot or cold beverages | |||||||
No impact | 236 | (33.6) | 467 | (66.4) | 703 | (87.4) | 0.543 |
Impact | 37 | (36.6) | 64 | (63.4) | 101 | (12.6) | |
Had difficulty eating some food | |||||||
No impact | 235 | (33.5) | 466 | (66.5) | 462 | (81.9) | 0.724 |
Impact | 36 | (35.3) | 66 | (64.7) | 102 | (18.1) | |
Had difficulty pronouncing words | |||||||
No impact | 239 | (32.7) | 491 | (67.3) | 730 | (92.5) | 0.213 |
Impact | 24 | (40.7) | 35 | (59.3) | 59 | (7.5) | |
Missing preschool | |||||||
No impact | 266 | (33.9) | 519 | (66.1) | 785 | (96.4) | 0.652 |
Impact | 11 | (37.9) | 18 | (62.1) | 29 | (3.6) | |
• Psychological Domain | |||||||
Had trouble sleeping | |||||||
No impact | 257 | (33.8) | 504 | (66.2) | 761 | (94.4) | 0.952 |
Impact | 15 | (33.3) | 30 | (66.7) | 45 | (5.6) | |
Been irritable or frustrated | |||||||
No impact | 244 | (33.8) | 477 | (66.2) | 721 | (95.7) | 0.959 |
Impact | 29 | (34.1) | 56 | (65.9) | 32 | (4.3) | |
• Self-image/Social Interaction Domain | |||||||
Avoided smiling or laughing | |||||||
No impact | 264 | (63.6) | 522 | (66.4) | 786 | (97.8) | 0.336 |
Impact | 8 | (44.8) | 10 | (55.6) | 18 | (2.2) | |
Avoided talked | |||||||
No impact | 265 | (33.7) | 521 | (66.3) | 786 | (97.7) | 0.445 |
Impact | 8 | (42.1) | 11 | (57.9) | 19 | (2.3) | |
Family Impact | |||||||
No impact | 205 | (33.7) | 403 | (66.3) | 608 | (75.1) | 0.874 |
Impact | 69 | (34.3) | 132 | (65.7) | 201 | (24.9) | |
• Distress Domain | |||||||
Been upset | |||||||
No impact | 229 | (33.2) | 460 | (66.8) | 689 | (85.8) | 0.349 |
Impact | 43 | (37.7) | 71 | (62.3) | 114 | (14.2) | |
Felt guilty | |||||||
No impact | 227 | (34.3) | 435 | (65.7) | 662 | (82.4) | 0.705 |
Impact | 46 | (32.6) | 95 | (67.4) | 141 | (17.6) | |
• Family Function Domain | |||||||
Taken time off work | |||||||
No impact | 256 | (33.7) | 503 | (66.3) | 759 | (94.2) | 0.521 |
Impact | 18 | (38.3) | 29 | (61.7) | 47 | (5.8) | |
Financial Impact | |||||||
No impact | 260 | (34.0) | 504 | (66.0) | 764 | (94.9) | 0.759 |
Impact | 13 | (31.7) | 28 | (68.3) | 41 | (5.1) |
Variable | Impact on child’s QoL | Bivariate | Multivariate | |||
---|---|---|---|---|---|---|
Present | Absent | Unadjusted prevalence ratio | Adjusted prevalence ratio | |||
n (%) | n (%) | p-value | (95% CI) | p-value | (95% CI) | |
• Gender of child | ||||||
Male | 131 (31.0) | 291 (69.0) | 1.00 | - | - | |
Female | 122 (31.1) | 270 (68.9) | 0.980 | 1.003 (0.817–1.230) | - | - |
• Mother’s schooling | ||||||
>8 years of study | 113 (25.9) | 324 (74.1) | 1.00 | - | - | |
≤8 years of study | 139 (37.3) | 234 (62.7) | 0.001 | 1.441 (1.173–1.771) | - | - |
• Monthly household income | ||||||
>3 times the minimum wage | 29 (20.1) | 115 (79.9) | 1.00 | - | - | |
≤3 times the minimum wage | 219 (34.5) | 415 (65.5) | 0.020 | 1.715 (1.218–2.416) | - | - |
• N° of residents in home | ||||||
<6 | 199 (29.5) | 475 (70.5) | 1.00 | - | - | |
≥6 | 50 (40.7) | 73 (59.3) | 0.010 | 1.377 (1.079–1.756) | - | - |
• Type of school | ||||||
Public | 153 (34.9) | 285 (65.1) | 1.00 | - | - | |
Private | 100 (26.6) | 276 (73.4) | 0.011 | 1.313 (1.064–1.622) | - | - |
• Caregiver’s perception of child’s general health | ||||||
Good | 247 (30.8) | 554 (69.2) | 1.00 | - | ||
Poor | 6 (75.0) | 2 (25.0) | 0.001 | 2.432 (1.609–3.677) | - | - |
• Caregiver’s perception of child’s oral health | ||||||
Good | 205 (27.0) | 554 (73.0) | 1.00 | 1.00 | ||
Poor | 48 (88.9) | 6 (11.1) | 0.001 | 2.432 (1.609–3.677) | 0.23 | 1.210 (1.027-1.426) |
• TDI | ||||||
Yes | 95 (33.8) | 186 (66.2) | 1.00 | - | - | |
No | 158 (29.6) | 357 (70.4) | 0.342 | 1.108 (0.897–1.368) | - | - |
• Type of trauma | ||||||
Avulsion/Luxation | 6 (46.2) | 7 (53.8) | 0.139 | 1.572 (0.864–2.861) | - | - |
Discoloration | 37 (40.7) | 54 (59.3) | 0.020 | 1385 (1.052–1.822) | - | - |
Enamel + dentin fracture | 13 (33.3) | 26 (66.7) | 0.588 | 1.135 (0.717–1.797) | - | - |
Enamel fracture or no trauma | 197 (29.4) | 474 (70.6) | 1.00 | - | - | |
• Number of teeth with trauma | ||||||
None | 158 (29.6) | 375 (70.4) | 1.00 | - | - | |
One | 52 (29.4) | 125 (70.6) | 0.947 | 0.991 (0.762–1.289) | - | - |
Two or more | 43 (41.3) | 61 (58.7) | 0.013 | 1.395 (1.072–1.816) | - | - |
• Dental caries | ||||||
No | 45 (16.1) | 235 (83.9) | <0.001 | 2.424 (1.817–3.232) | - | - |
Yes | 208 (39.0) | 326 (61.0) | 1.00 | - | - | |
• Malocclusion | ||||||
No | 80 (28.6) | 200 (71.4) | 1.00 | - | - | |
Yes | 173 (32.4) | 361 (67.6) | 0.267 | 1.134 (0.908–1.416) | - | - |
• History of toothache | ||||||
No | 15 (12.2) | 108 (87.8) | - | 1.00 | - | 1.00 |
Yes | 62 (87.3) | 9 (12.7) | 0.001 | 7.161 (4.420–11.600) | 0.001 | 4.997 (2.943-8.483) |
• History of visits to dentist | ||||||
No | 173 (28.2) | 441 (71.8) | 1.00 | - | - | |
Yes | 78 (39.8) | 118 (60.2) | 0.002 | 1.412 (1.41–1.749) | - | - |
Variable | Impact on family’s QoL | Bivariate | Multivariate | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Present | Absent | Unadjusted prevalence ratio | Adjusted prevalence ratio | |||||||
n (%) | n (%) | p-value | (95% CI) | p-value | (95% CI) | |||||
• Gender of child | ||||||||||
Male | 94 (24.2) | 294 (75.8) | 1.00 | - | - | |||||
Female | 107 (25.4) | 314 (74.6) | 0.696 | 1.049 (0.825–1.334) | - | - | ||||
• Mother’s schooling | ||||||||||
>8 years of study | 97 (22.3) | 338 (77.7) | 1.00 | - | - | |||||
≤8 years of study | 103 (27.8) | 267 (72,2) | 0,070 | 1.248 (0.982–1.587) | - | - | ||||
• Monthly household income | ||||||||||
>3 times the minimum wage | 31 (21.5) | 113 (78.5) | 1.00 | - | - | |||||
≤3 times the minimum wage | 165 (26.2) | 464 (73.8) | 0.252 | 1.219 (0.869–1.709) | - | - | ||||
• N° of residents in home | ||||||||||
<6 | 160 (23.9) | 510 (76.1) | 1.00 | - | - | |||||
≥6 | 38 (30.9) | 85 (69.1) | 0.089 | 1.294 (0.961–1.741) | - | - | ||||
• Type of school | ||||||||||
Public | 85 (22.8) | 287 (77.2) | 1.00 | - | - | |||||
Private | 116 (26.5) | 321 (73.5) | 0.227 | 1.162 (0.911–1.482) | - | - | ||||
• Caregiver’s perception of child’s general health | ||||||||||
Good | 194 (24.4) | 602 (75.6) | 1.00 | - | - | |||||
Poor | 5 (62.5) | 3 (37.5) | 0.001 | 2.564 (1.479–4.447) | - | - | ||||
• Caregiver’s perception of child’s oral health | ||||||||||
Good | 161 (21.4) | 593 (78.6) | 1.00 | - | - | |||||
Poor | 40 (74.1) | 14 (25.9) | 0.001 | 3.469 (2.815–4.275) | - | - | ||||
• TDI | ||||||||||
Yes | 131 (24.7) | 400 (75.3) | 1.00 | - | - | |||||
No | 70 (25.2) | 208 (74.8) | 0.874 | 1.121 (0.793–1.313) | - | |||||
• Type of trauma | ||||||||||
Avulsion/Luxation | 5 (38.5) | 8 (61.5) | 0.185 | 1.606 (0.797–3.236) | - | - | ||||
Discoloration | 28 (31.5) | 61 (68.5) | 0.111 | 1.313 (0.939–1.836) | - | - | ||||
Enamel + dentin fracture | 8 (20.5) | 31 (79.5) | 0.631 | 0.856 (0.455–1.612) | - | - | ||||
Enamel fracture or no trauma | 160 (24.0) | 508 (76.0) | 1.00 | - | - | |||||
• Number of teeth with trauma | ||||||||||
None | 131 (24.7) | 400 (75.3) | 1.00 | - | - | |||||
One | 40 (23.0) | 134 (77.0) | 0.655 | 0.932 (0.683–1.270) | - | - | ||||
Two or more | 30 (28.8) | 74 (71.2) | 0.362 | 1.169 (0.835–1.637) | - | - | ||||
• Dental caries | ||||||||||
No | 34 (12.3) | 243 (87.7) | <0.001 | 2.557 (1.822–3.589) | 0.022 | 2.305 (1.130–4.702) | ||||
Yes | 167 (31.4) | 365 (68.6) | 1.00 | - | 1.00 | |||||
• Malocclusion | ||||||||||
No | 61 (22.0) | 216 (78.0) | 1.00 | - | - | |||||
Yes | 140 (26.3) | 392 (73.7) | 0.185 | 1.195 (0.918–1.555) | - | - | ||||
• History of toothache | ||||||||||
No | 22 (18.0) | 100 (82.0) | - | 1.00 | 1.00 | |||||
Yes | 48 (67.6) | 23 (32.4) | 0.001 | 3.749 (2.485–5.656) | 0.001 | 2.791 (1.801–4.325) | ||||
• History of visits to dentist | ||||||||||
No | 129 (21.1) | 481 (78.9) | 1.00 | - | - | |||||
Yes | 71 (36.4) | 124 (63.6) | 0.001 | 1.772 (1.354–2.190) | - | - |
4. Discussion
5. Conclusions
Acknowledgments
Conflicts of Interest
References
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Siqueira, M.B.; Firmino, R.T.; Clementino, M.A.; Martins, C.C.; Granville-Garcia, A.F.; Paiva, S.M. Impact of Traumatic Dental Injury on the Quality of Life of Brazilian Preschool Children. Int. J. Environ. Res. Public Health 2013, 10, 6422-6441. https://doi.org/10.3390/ijerph10126422
Siqueira MB, Firmino RT, Clementino MA, Martins CC, Granville-Garcia AF, Paiva SM. Impact of Traumatic Dental Injury on the Quality of Life of Brazilian Preschool Children. International Journal of Environmental Research and Public Health. 2013; 10(12):6422-6441. https://doi.org/10.3390/ijerph10126422
Chicago/Turabian StyleSiqueira, Maria B., Ramon T. Firmino, Marayza A. Clementino, Carolina C. Martins, Ana F. Granville-Garcia, and Saul M. Paiva. 2013. "Impact of Traumatic Dental Injury on the Quality of Life of Brazilian Preschool Children" International Journal of Environmental Research and Public Health 10, no. 12: 6422-6441. https://doi.org/10.3390/ijerph10126422