Perception of children with visible untreated and treated caries

Tschammler, Claudia; Zimmermann, David; Batschkus, Sarah; Wiegand, Annette; Folta-Schoofs, Kristian

doi:10.1016/j.jdent.2018.05.006

Cited by 4 publications

(9 citation statements)

References 28 publications

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“…The main reasons were the different assessment techniques used, such as EMHMM and fixed ROI and, importantly, attentional differences between children and adults. Nevertheless, a hypothetical assessment based on Tschammler et al [2018], would require 142 participants to obtain a power of 0.85, which the present study qualifies with 157 participants. Furthermore, a sensitivity analysis indicated to recruit approximately 94 children for an expected sensitivity of 0.9, a prevalence 0.2, and a confidence level of 85%.…”

Section: Discussionmentioning

confidence: 75%

“…Previous studies have investigated children's eye movements, fixations, and qualitative analysis using heatmaps related to choose tasks, namely dentists' attire and dental operatory [Celine et al, 2018;Celine et al, 2021]. Recently, Tschammler et al [2018] et al reported that dentists and laypeople rated children with healthy teeth as more attractive, pleasant, and calm than children with untreated or treated dental caries. However, the authors only analyzed the first fixation, total fixation time, and the number of fixations in the areas of interest, namely, eyes, nose, and mouth.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, therefore, it was impossible to estimate the sample size. Recently, Tschammler et al [Tschammler et al, 2018] investigated the perception of dental caries among 20 dentists and 18 laypeople using standard eye-tracking metric analysis, which we considered inappropriate for possible sample size estimation. The main reasons were the different assessment techniques used, such as EMHMM and fixed ROI and, importantly, attentional differences between children and adults.…”

Section: Discussionmentioning

confidence: 99%

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Understanding Children’s Attention to Dental Caries through Eye-Tracking

Cho

Hsiao²,

Chan

et al. 2022

Caries Res

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Visual attention is a significant gateway to a child's mind, and looking is one of the first behaviours young children develop. Untreated caries and the resulting poor dental aesthetics can have adverse emotional and social impacts on children's oral health-related quality of life due to its detrimental effects on self-esteem and self-concept. Therefore, we explored preschool children's eye movement patterns and visual attention to images with and without dental caries via eye movement analysis using hidden Markov models (EMHMM). We calibrated a convenience sample of 157 preschool children to the eye-tracker (Tobii Nano Pro) to ensure standardisation. Consequently, each participant viewed the same standardised pictures with and without dental caries while an eye-tracking device tracked their eye movements. Subsequently, based on the sequence of viewed regions of interest (ROIs), a transition matrix was developed where the participants previously viewed ROI informed their subsequently considered ROI. Hence, an individual's HMM was estimated from their eye movement data using a variational Bayesian approach to determine the optimal number of ROIs automatically. Consequently, this data-driven approach generated the visual task participants' most representative eye movement patterns. Preschool children exhibited two different eye movement patterns, distributed (78%) and selective (21%), which was statistically significant. Children switched between images with more similar probabilities in the distributed pattern while children remained looking at the same ROI than switching to the other ROI in the selective pattern. Nevertheless, all children exhibited an equal starting fixation on the right or left image and noticed teeth. The study findings reveal that most preschool children did not have an attentional bias to images with and without dental caries. Furthermore, only a few children selectively fixated on images with dental caries. Therefore, selective eye-movement patterns may strongly predict preschool children's sustained visual attention to dental caries. Nevertheless, future studies are essential to fully understand the developmental origins of differences in visual attention to common oral health presentations in children. Finally, EMHMM is appropriate for assessing inter-individual differences in children's visual attention.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Understanding Children’s Attention to Dental Caries through Eye-Tracking

Cho

Hsiao²,

Chan

et al. 2022

Caries Res

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“…19 Regarding dental caries, some studies have suggested that a similar stigmatisation process occurs for children. Tschammler et al 21 and Clovis et al 22 found that dental professionals (dentists and hygienists) have negative beliefs; for example, children with ECC are considered to have difficult behavioural issues 22 and to be less attractive, less pleasant, and less calm than caries-free children. 21 Health professionals have also reported that parents of children with ECC lack interest in their child's oral health, 22 23 have failed motivations, 24 and shift authority and responsibility for the disease onto their child.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

What are health professionals’ perceptions and attitudes regarding children with early childhood caries and their families? A qualitative research protocol to assess oral health stigma in the medical setting

et al. 2022

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IntroductionDental caries is one of the most common non-communicable diseases in children. The disease management of caries relies on both a preventive individual approach (fluoridation, risk evaluation) and the surgical treatment of established carious lesions. Similar to other non-communicable diseases (obesity, mental diseases, etc), health professionals’ negative perceptions of patients have been shown to affect the quality of disease management. Regarding dental caries in children, some data have indicated the presence of discriminating beliefs and behaviours towards these children and their families in the medical setting. However, oral health stigma related to dental care remains a largely unexplored issue.Methods and analysisThis study presents an exploratory research protocol focusing on the perceptions and attitudes of health professionals towards children with early childhood caries (ECC) and their parents. Semistructured interviews will be conducted among medical and dental health professionals, and verbatim quotations obtained from audio transcriptions will be analysed to identify health professionals’ perceptions of ECC and the influence of these perceptions on clinical care for these children.Ethics and disseminationThe research ethics committee of the Department of Family Medicine at University Lyon 1 approved this protocol. The results will be published in peer-reviewed journals and presented at scientific meetings.Trial registration numberNCT05284279.

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“…However, alternative outcomes are also considered clinically relevant, since they are perceived by children and/or their caregivers and have presented a significantly negative impact on children's quality of life 20‐22 . A clinically relevant outcome related to dental caries is frankly cavitated lesions 20,23 .…”

Section: Why Researchers Must Select Clinically Relevant Outcomes?mentioning

confidence: 99%

How researchers should select the best outcomes for randomised clinical trials in paediatric dentistry?

Mendes

Braga

Pássaro

et al. 2020

Int J Paed Dentistry

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Randomised clinical trial (RCT) is the best study design to evaluate the effect of the treatment and preventive healthcare procedures. The effects of the tested treatments on patient's health are compared in terms of outcomes, which are used to evaluate the participants' health changes. However, these outcomes should be relevant for the target population. In that way, RCTs represent the type of primary study design that provides the most reliable evidence to implement therapies into the clinical practice. In this review, an outline of some aspects related to the choice of RCTs' outcomes was presented, focusing on the conduction of relevant trials in Paediatric Dentistry. The importance and necessity of defining a primary outcome were addressed, preferentially a clinically relevant endpoint. The patients should perceive this outcome, and changes in this variable should reflect directly patient's health improvement or impairment. Moreover, considerations about the objective or subjective variables, use of surrogate outcomes, and the increasing tendency to develop core outcome sets were also presented in this review. The main idea of this manuscript is the RCTs must evaluate outcomes relevant to the children's oral health in order to contribute to the implementation of treatments in the evidence‐based health practice.

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Perception of children with visible untreated and treated caries

Cited by 4 publications

References 28 publications

Understanding Children’s Attention to Dental Caries through Eye-Tracking

Understanding Children’s Attention to Dental Caries through Eye-Tracking

What are health professionals’ perceptions and attitudes regarding children with early childhood caries and their families? A qualitative research protocol to assess oral health stigma in the medical setting

How researchers should select the best outcomes for randomised clinical trials in paediatric dentistry?

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