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Assessing individual and neighborhood social factors in child oral health-related quality of life: a multilevel analysis

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Abstract

Purpose

It has been suggested that subjective measures of oral health are influenced by both individual and contextual characteristics. This study assessed the relationship between neighborhood and individual social networks and child oral health-related quality of life (COHRQoL).

Methods

This study followed a cross-sectional design using a multistage sample of 478 children aged 1–5 years old. Caregivers completed the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) and answered questions related to socioeconomic status and social network. The dental examination provided information on the prevalence of dental caries, dental trauma, and occlusion. Contextual social determinants included the presence of cultural community centers and of workers’ association in the neighborhood. Data analysis considered the total ECOHIS scores as the outcome and neighborhood/individual social networks as the independent variables. A multilevel Poisson regression model was used to investigate the association among individual and contextual characteristics and COHRQoL.

Results

Total ECOHIS scores ranged from 0 to 41 (possible range 0–52). The mean ECOHIS score was low (mean = 1.8, SD = 3.9), and the functional domain presented the highest mean impact on COHRQoL (mean = 0.5, SD = 1.4). Following adjusted analysis, low household income, visiting a neighbor less than once a month, the presence of anterior open bite, dental trauma, and dental caries were identified as individual determinants of negative impact on a child’s quality of life. These variables remained associated with the outcome even after adding the contextual-level variables in the model. At the contextual level, the presence of community cultural centers was associated with overall mean ECOHIS score; higher impacts on COHRQoL were observed in those living in neighborhoods without cultural community centers.

Conclusion

There is a significant association between individual and contextual social determinants and COHRQoL; unfavorable social conditions and poor socioeconomic status have a negative impact on caregiver reports of children’s oral health-related quality of life.

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Abbreviations

OHRQoL:

Oral health-related quality of life

COHRQoL:

Child oral health-related quality of life

ECOHIS:

Child Perceptions Questionnaire

WHO:

World Health Organization

ICDAS:

International Caries Detection and Assessment System

BMW:

Brazilian minimum wage

RR:

Rate ratio

CI:

Confidence interval

dmf-t:

Decayed/missing/filled teeth

ICC:

Intraclass correlation coefficient

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Acknowledgments

The authors would like to thank all the children for their cooperation and the Health Authorities in Santa Maria for all information and authorization and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), process n. 2011/17068-1.

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Authors and Affiliations

  1. Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil

    Renata Saraiva Guedes

  2. Centro Universitário Franciscano (UNIFRA), Santa Maria, RS, Brazil

    Chaiana Piovesan

  3. Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil

    José Leopoldo Ferreira Antunes

  4. Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brazil

    Fausto Medeiros Mendes

  5. Universidade Federal de Santa Maria (UFSM), Rua Cel.Niederauer 917/208, Santa Maria, RS, 97.015-121, Brazil

    Thiago Machado Ardenghi

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  1. Renata Saraiva Guedes
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  2. Chaiana Piovesan
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  3. José Leopoldo Ferreira Antunes
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  4. Fausto Medeiros Mendes
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  5. Thiago Machado Ardenghi
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Correspondence to Thiago Machado Ardenghi.

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Guedes, R.S., Piovesan, C., Antunes, J.L.F. et al. Assessing individual and neighborhood social factors in child oral health-related quality of life: a multilevel analysis. Qual Life Res 23, 2521–2530 (2014). https://doi.org/10.1007/s11136-014-0690-z

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