School environment and individual factors influence oral health related quality of life in Brazilian children

Abstract

The aim of this study was to verify the influence of school environment and individual factors on oral health related quality of life (OHRQoL) in a representative sample of Brazilian schoolchildren. A cross-sectional study was conducted with 1,134 12-year-old schoolchildren from Santa Maria, Southern Brazil. Clinical variables were obtained from examinations carried out by calibrated individuals. In addition, parents/guardians answered a semi-structured questionnaire about sociodemographic characteristics. Contextual variables were obtained from the city's official database, including the mean income of the neighborhood in which the school was located and the Basic School's Development Index (IDEB) of the school. The Brazilian version of the Child Perception Questionnaire (CPQ11-14) was used to access OHRQoL. Data analysis was conducted using multilevel Poisson regression. Children studying in schools with a higher classification on the IDEB presented a lower CPQ11-14 mean score (rate ratio 0.80, 95%CI 0.74-0.88) than those studying in schools with a lower IDEB. Regarding individual variables, children with carious cavities, malocclusion, and gingival bleeding presented higher CPQ11-14 mean values than their counterparts. The same was observed in children from families with low socioeconomic status. School environment, and individual clinical and socioeconomic factors were associated with schoolchildren's OHRQoL.

The school social environment and oral health‐related quality of life in children: a multilevel analysis

“…Moreover, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were used to guide the reporting of the study. The instrument used to assess OHRQoL has been previously validated (18), and, in this study, the appropriate version for each age range (CPQ [8][9][10] and CPQ [11][12][13][14] ) was used. On the other hand, the crosssectional design means that it was not possible to infer causality, but the inverse causal relationship (that is, the higher impact on OHRQoL, the higher the probability of children being enrolled in schools with a poor social environment) is not very plausible.…”

“…Previously trained interviewers applied the Child Perceptions Questionnaires 8-10 and 11-14 (CPQ 8-10 and CPQ [11][12][13][14] , respectively) (18), according to age group, to assess the association of oral health with quality of life. The CPQ 8-10 is composed of 25 questions and the CPQ [11][12][13][14] of 16 questions, all of which are answered on a 5-point Likert scale. The scales include four domains: oral symptoms; functional limitation; emotional well-being; and social well-being.…”

“…For questionnaires in which answers for up to two items were missing, a score for the missing items was imputed as an average of the remaining items. The total CPQ scores were calculated by adding the scores for each domain, with total scores ranging from 0 to 100 for the CPQ 8-10 and from 0 to 64 for the CPQ [11][12][13][14] . Higher scores indicate a greater impact of poor oral health on quality of life.…”

“…As the instruments have different maximum scores, a percentage score (ranging from 0 to 100) was obtained for each domain and for the total CPQ score to standardize the scores for comparison. For this purpose, the general CPQ [11][12][13][14] score was divided by 64 (i.e., the maximum possible score) and multiplied by 100.…”

The impact of cyberbullying on schoolchildren’s dental anxiety in Brazil: A cross‐sectional multi‐level study

“…School bullying, cyberbullying or both can increase the rate of suicidality in teenagers 8 and, when combined with physical threat, can also lead to increased depression and suicidality 9 . The school social environment has been shown to influence dental caries occurrence in children, 10 and the oral health‐related quality of life 11 ; however, no study has investigated the contextual effect of schools on dental anxiety.…”