Assessing association of dental caries with child oral impact on daily performance using directed acyclic graphs; a cross-sectional study of adolescents in Copperbelt province, Zambia

Abstract

Purpose To assess the association between dental caries and Child Oral Impact on Daily Performance (C-OIDP). Secondarily, the study evaluated psychometric properties, prevalence, and factors associated with C-OIDP. Methods A cross-sectional study was conducted among adolescents in Copperbelt province, Zambia. Socio-demographics, oral health behaviors, self-reported oral health, and C-OIDP were assessed using a self-administered questionnaire. Dental caries was assessed according to Caries Assessment & Treatment Spectrum (CAST). A directed acyclic graph (DAG) was used to determine a minimum set of covariates for the adjusted analysis. Data analysis was done using Stata/SE (version 17). Results Among 1,794 participants, 54.0% were females, while 56.0% were aged 11–14 years. Prevalence of self-reported poor teeth health, clinically assessed dental caries and, C-OIDP were 18.3%, 46.2% and 31.5%, respectively. The highest prevalence of oral impacts were with eating (26.5%), cleaning teeth (16.4%), and sleeping (12.5%). Child -OIDP Spearman's correlations of the items ranged from 0.399 to 0.641. The participants with dental caries were 2.6 times (AOR 2.6, 95% CI 2.1, 3.2) more likely to report oral impacts than those without caries. Consuming a sugary diet five times or more per day increased the odds of C-OIDP by 1.5 times (AOR 1.5, 95% CI 1.2, 1.9) while, dental visits in the past year decreased the odds of C-OIDP by 30% (AOR 0.7, 95% CI 0.6, 0.9). Conclusions The English version of C-OIDP is a reliable index for assessing OHRQoL among Zambian adolescents. Prevalence of C-OIDP was high, and problems with eating, cleaning teeth, and sleeping were the most frequently reported items. Dental caries was associated with increased C-OIDP. Covariates selected based on DAGs showed consuming a sugary diet more than five times per day increased the odds of C-OIDP, while dental visits at least once per year decreased the likelihood of reporting C-OIDP.