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Child and adolescent perceptions of oral health over the life course

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To elicit perceptions of oral health in children and adolescents as an initial step in the development of oral health item banks for the Patient-Reported Oral Health Outcomes Measurement Information System project.


We conducted focus groups with ethnically, socioeconomically, and geographically diverse youth (8–12, 13–17 years) to identify perceptions of oral health status. We performed content analysis, including a thematic and narrative analysis, to identify important themes.


We identified three unique themes that the youth associated with their oral health status: (1) understanding the value of maintaining good oral health over the life course, with respect to longevity and quality of life in the adult years; (2) positive association between maintaining good oral health and interpersonal relationships at school, and dating, for older youth; and (3) knowledge of the benefits of orthodontic treatment to appearance and positive self-image, while holding a strong view as to the discomfort associated with braces.


The results provide valuable information about core domains for the oral health item banks to be developed and generated content for new items to be developed and evaluated with cognitive interviews and in a field test.

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  1. Evans, C. A., & Kleinman, D. V. (2000). The Surgeon General’s report on America’s oral health: opportunities for the dental profession. Journal of the American Dental Association, 131(12), 1721–1728.

    Article  CAS  PubMed  Google Scholar 

  2. Office of Disease Prevention and Health Promotion. (2010). Healthy People 2020. Washington, DC: US Department of Health and Human Services. Accessed 19 November 2014.

  3. Satcher, D. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health.

  4. Romer, M., Dougherty, N., & Amores-Lafleur, E. (2007). Predoctoral education in special care dentistry: Paving the way to better access? ASDC Journal of Dentistry for Children, 66, 132–135.

    Google Scholar 

  5. Reeve, B. B., Hays, R. D., Bjorner, J. B., Cook, K. F., Crane, P. K., Teresi, J. A., et al. (2007). Psychometric evaluation and calibration of health-related quality of life item banks: Plans for the Patient-Reported Outcomes Measurement Information System (PROMIS). Medical Care, 45(5 Suppl 1), S22–S31.

    Article  PubMed  Google Scholar 

  6. Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., et al. (2007). The Patient-Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH Roadmap cooperative group during its first two years. Medical Care, 45(5 Suppl 1), S3–S11.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Lalonde, M. (1974). A new perspective on the health of Canadians. A working document. Ottawa: Government of Canada.

    Google Scholar 

  8. Fisher-Owens, S. A., Gansky, S. A., Platt, L. J., Weintraub, J. A., Soobader, M.-J., Bramlett, M. D., et al. (2007). Influences on children’s oral health: A conceptual model. Pediatrics, 120(3), e510–e520.

    Article  PubMed  Google Scholar 

  9. Elder, G. H, Jr. (1994). Time, human agency, and social change: Perspectives on the life course. Social Psychology Quarterly, 57(1), 4–15.

    Article  Google Scholar 

  10. Shanahan, M. J. (2000). Pathways to adulthood in changing societies: Variability and mechanisms in life course perspective. Annual Review of Sociology, 26, 667–692.

    Article  Google Scholar 

  11. Osler, M. (2006). The life course perspective: A challenge for public health research and prevention. The European Journal of Public Health, 16(3), 230. Erratum in: Eur J Public Health 2006; 16(5):570.

  12. Havighurst, R. J. (1972). Developmental tasks and education (3rd ed., p. vi). New York: McKay.

    Google Scholar 

  13. Uhlendorff, U. (2004). The concept of developmental-tasks and its significance for education and social work. Social Work and Society International Online Journal, 2(1), 54–63.

    Google Scholar 

  14. Levin, H. M. (1975). Education, life chances, and the courts: The role of social science evidence. Law and Contemporary Problems, 39(2), 217–240.

    Article  Google Scholar 

  15. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge: Harvard University Press.

    Google Scholar 

  16. Walsh, T. R., Irwin, D. E., Meier, A., Varni, J. W., & DeWalt, D. A. (2008). The use of focus groups in the development of the PROMIS pediatrics item bank. Quality of Life Research, 17, 725–735.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Irwin, D. E., Varni, J. W., Yeatts, K., & DeWalt, D. A. (2009). Cognitive interviewing methodology in the development of a pediatric item bank: a patient reported outcomes measurement information system (PROMIS) study. Health and Quality of Life Outcomes, 7, 1–10. doi:10.1186/1477-7525-7-3.

    Article  Google Scholar 

  18. Matza, L. S., Patrick, D. L., Riley, A. W., Alexander, J. J., Rajmil, L., Pleil, A. M., & Bullinger, M. (2013). Pediatric patient-reported outcome instruments for research to support medical product labeling: report of the ISPOR PRO good research practices for the assessment of children and adolescents task force. Value in Health, 16, 461–479.

    Article  PubMed  Google Scholar 

  19. Hoppe, M. J., Wells, E. A., Morrison, D. M., Gillmore, M. R., & Wilsdon, A. (1995). Using focus groups to discuss sensitive topics with children. Evaluation Review, 19(1), 102–114.

    Article  Google Scholar 

  20. Pederson-Sweeney, K. (2005). The use of focus groups in pediatric and adolescent research. Journal of Pediatric Health Care, 19, 104–110.

    Article  Google Scholar 

  21. Heary, C. M., & Hennessy, E. (2002). The use of focus group interviews in pediatric health care research. Journal of Pediatric Psychology, 27(2), 47–57.

    Article  PubMed  Google Scholar 

  22. Detmar, S. B., Bruil, J., Ravens-Sieberer, U., Gosch, A., Bisegger, C., & the European KIDSCREEN group. (2006). The use of focus groups in the development of the KIDSCREEN HRQL questionnaire. Quality of Life Research, 15, 1345–1353.

    Article  CAS  PubMed  Google Scholar 

  23. Mayall, B. (1993). Keeping health at home and school: ‘It’s my body, so it’s my job’. Sociology of Health & Illness, 15(4), 464–487.

    Article  Google Scholar 

  24. Mauthner, M. (1997). Methodological aspects of collecting data from children: Lessons from three research projects. Children and Society, 11(1), 16–28.

    Article  Google Scholar 

  25. Darbyshire, P., Macdougall, C., & Schiller, W. (2005). Multiple methods in quality research with children: More insight or just more? Qualitative Research, 5(4), 417–436.

    Article  Google Scholar 

  26. Wang, C., & Burris, M. A. (1997). Photovoice: Concept, methodology, and use for participatory needs assessment. Health Education & Behavior, 24(3), 369–387.

    Article  CAS  Google Scholar 

  27. Fitzgerald, R. P., Thomson, W. M., Schafer, C. T., & Loose, M. (2004). An exploratory study of Otago adolescents’ views of oral health and oral health care. New Zealand Dental Journal, 100(3), 62–71.

    PubMed  Google Scholar 

  28. Stokes, E., Ashcroft, A., & Platt, M. J. (2006). Determining Liverpool adolescents’ beliefs and attitudes in relation to oral health. Health Education & Research, 21(2), 192–205.

    Article  CAS  Google Scholar 

  29. Gill, P., Stewart, K., Treaesure, E., & Chadwick, B. (2008). Conducting qualitative interviews with school children in dental research. British Dental Journal, 204(7), 371–374.

    Article  CAS  PubMed  Google Scholar 

  30. Forrest, C. B., Bevans, K. B., Tucker, C., Riley, A. W., Ranvens-Sieberer, U., Gardner, W., & Pajer, K. (2012). Commentary: The patient-reported outcomes measurement information system (PROMIS®) for children and youth: Application to pediatric psychology. Journal of Pediatric Psychology, 37(6), 614–621.

    Article  PubMed Central  PubMed  Google Scholar 

  31. NVivo qualitative data analysis software. QSR International Pty Ltd. Version 10, 2012.

  32. Richards, L. (1999). Using NVivo in qualitative research. London & Los Angeles: Sage Publications.

    Google Scholar 

  33. Richards, L. (2005). Handling quality data: A practical guide. London: Sage Publications.

    Google Scholar 

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This research was supported by an NIDCR/NIH grant to the University of California, Los Angeles (U01DE022648). We would like to acknowledge Dr. Suzanne Berger and Ms. Audrey Simons for their assistance in both developing our sample and providing the space for the focus groups.

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Correspondence to Carl A. Maida.

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Maida, C.A., Marcus, M., Hays, R.D. et al. Child and adolescent perceptions of oral health over the life course. Qual Life Res 24, 2739–2751 (2015).

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