Objective: To explore the validity and reliability of the Child Perception Questionnaire as an oral health-related quality of life (OHRQoL) measure in adolescents with malocclusion.

BackgroundSeveral measures of oral health-related quality of life have been developed for children. The most frequently used are the Child Perceptions Questionnaire (CPQ), the Child Oral Impacts on Daily Performances (C-OIDP) and the Child Oral Health Impact Profile (COHIP). The aim of this study was to assess the methodological quality of the development and testing of these three measures.MethodsA systematic search strategy was used to identify eligible studies published up to December 2012, using both MEDLINE and Web of Science. Titles and abstracts were read independently by two investigators and full papers retrieved where the inclusion criteria were met. Data were extracted by two teams of two investigators using a piloted protocol. The data were used to describe the development of the measures and their use against existing criteria. The methodological quality and measurement properties of the measures were assessed using standards proposed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) group.ResultsThe search strategy yielded 653 papers, of which 417 were duplicates. Following analysis of the abstracts, 119 papers met the inclusion criteria. The majority of papers reported cross-sectional studies (n = 117) with three of longitudinal design. Fifteen studies which had used the original version of the measures in their original language were included in the COSMIN analysis. The most frequently used measure was the CPQ. Reliability and construct validity appear to be adequate for all three measures. Children were not fully involved in item generation which may compromise their content validity. Internal consistency was measured using classic test theory with no evidence of modern psychometric techniques being used to test unidimensionality of the measures included in the COSMIN analysis.ConclusionThe three measures evaluated appear to be able to discriminate between groups. CPQ has been most widely tested and several versions are available. COHIP employed a rigorous development strategy but has been tested in fewer populations. C-OIDP is shorter and has been used successfully in epidemiological studies. Further testing using modern psychometric techniques such as item response theory is recommended. Future developments should also focus on the development of measures which can evaluate longitudinal change.

The reliable assessment of children's dental anxiety can have many benefits for the dental team, service providers and dental public health practitioners. This study aimed to identify and evaluate self-report measures, which are available to assess children's dental anxiety. Systematic searches of the literature between 1998 and 2011 were conducted to identify relevant studies. The properties of each measure (reliability and validity) were assessed, and measures were evaluated against a theoretical framework of dental anxiety. Executing the search strategy generated 498 articles and of these 60 studies met all of the inclusion criteria. Seven 'trait' and two 'state' measures of dental anxiety had been employed to assess children's dental anxiety over the past decade. Reliability and validity estimates for the most widely used measures were good; however, many questionnaires had a limited focus in the aspects of anxiety they assessed. The paper summarizes the measures of children's dental anxiety which may be most useful for a number of different purposes and populations.

Background Dental caries affects 60–90% of children across the world and is associated with a variety of negative impacts. Despite its ubiquity, there has been surprisingly little exploration of these impacts from the child's perspective. Aim The aim was to allow children to describe the impact of dental caries on their daily lives and to describe the terminology they used. Design Children, aged 5–15 years, with caries experience were purposively sampled from primary and secondary care dental clinics. Focus groups (n = 5) and in‐depth interviews (n = 16) were recorded and transcribed verbatim. Data analysis took a narrative approach, and themes were derived from the data using framework analysis. Results Pain was the main theme to emerge. Within this, three subthemes were identified: impacts related to pain, strategies adopted to reduce pain, and emotional aspects resulting from pain. A second theme was also identified relating to the aesthetic aspects of caries. Conclusion Children as young as 5 years of age were able to competently discuss their experiences of dental caries. Participants reported a number of impacts affecting various aspects of their lives. These will be incorporated into the future development of a caries‐specific measure of oral health‐related quality of life.

SummaryObjectives: To examine the relationships between dental appearance, characteristics of the individual and their environment and OHQoL in young people over time.Methods: 374 young people (122 boys, 252 girls) aged 11-12 years from 7 different UK schools were recruited at baseline and 258 (78 boys, 180 girls) followed-up 3 years later, aged 14-15 years (69% response rate). Participants completed a measure of OHQoL (CPQ11-14 ISF-16) and self-esteem (SE, CHQ-CF87). A clinical examination was undertaken, including clinician and self-assessed normative measures of need (IOTN) and dental caries. The Index of Multiple Deprivation was used to indicate socio-economic status (SES).Results: There was a general improvement between baseline and follow-up in the measures of malocclusion, as well as OHQoL. Multiple linear regression indicated that there were significant cross-sectional associations at baseline between OHQoL and SES (rho = -0.11; P=0.006), SE (rho = -0.50; P<0.001) and self-assessed IOTN (rho = 0.27; P<0.001). There were significant longitudinal associations between the change in OHQoL and change in SE (rho = -0.46; P<0.001) and change in the DMFS (rho = -0.24; P=0.001). The mean improvement in the total CPQ11-14 ISF-16 score for those with a history of orthodontic treatment was 3.2 (SD 6.9; P=0.009) and 2.4 (SD 8.8; P<0.001) for those with no history of treatment. The difference was not statistically significant (P=0.584).Conclusions: OHQoL improved in young people over time, whether they gave a history of orthodontic treatment or not. Individual and environmental characteristics influence OHQoL and should be taken into account in future studies.

Globally, dental caries is one of the most prevalent diseases and is more common in children living in deprived areas. Dental caries is preventable, and guidance in the United Kingdom recommends parental supervised brushing (PSB): a collection of behaviors-including twice-daily toothbrushing with fluoridated toothpaste-that should begin upon eruption of the first tooth (approximately 6 to 12 mo of age) and for which children need to be helped or supervised by an adult until at least 7 y of age. The aim of this study was to explore parents' experiences of toothbrushing with their young children and to establish barriers and facilitators to PSB at individual, interpersonal, and environmental levels according to the theoretical domains framework. Qualitative semistructured interviews guided by the framework were conducted with 27 parents of young children (<7 y) in 2 deprived areas of the United Kingdom. Framework analysis was used. Parents were not aware of national guidance concerning their active involvement in toothbrushing; however, they did have detailed knowledge of toothbrushing practices for children, and their intentions were to brush their children's teeth themselves twice every day as part of a family routine. Nonetheless, parents' difficulties experienced in managing their children's challenging behavior and the environmental context of their stressful lives meant that many parents adopted a role of simply reminding their children to brush or watching them brush. As such, the main barriers to PSB among parents living in deprived areas were skills in managing their children's behavior and environmental influences on family life. The results of our study have clear implications for the development of appropriate interventions to address the modifiable barriers to improve parental adoption of PSB. The results of this study will be used to develop a behavior change intervention to encourage parental supervised brushing. The intervention-which is likely to be delivered through health practitioners rather than dental teams-will be developed to reduce dental caries among young children and will require evaluation in terms of its clinical and cost effectiveness.

Background Dental anxiety is common among children. Although there is a wealth of research investigating childhood dental anxiety, little consideration has been given to the child's perspective. Aim This qualitative study sought to explore with children their own experiences of dental anxiety using a cognitive behavioural therapy assessment model. Design Face‐to‐face, semi‐structured interviews were conducted with dentally anxious children aged 11–16 years. The Five Areas model was used to inform the topic guide and analysis. Data were analysed using a framework approach. Results In total, 13 children were interviewed. Participants described their experiences of dental anxiety across multiple dimensions (situational factors and altered thoughts, feelings, physical symptoms, and behaviours). Participants placed considerable value on communication by dental professionals, with poor communication having a negative influence on dental anxiety and the dentist–patient relationship. Conclusions This study confirms the Five Areas model as an applicable theoretical model for the assessment of childhood dental anxiety. Children provided insights about their own dental anxiety experiences that have not previously been described.

Variations in the impact of DDE were related to defining aspects of sense of self rather than the enamel defects. This research is the first to discover that the sense of self explains variation in the impact of DDE.