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      Orofacial functions and quality of life in children with unilateral cleft lip and palate

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          Abstract

          Abstract This study aimed to evaluate the orofacial functions and oral health-related quality of life (OHRQoL) of children with unilateral cleft lip and palate (UCLP). This case-control study included patients with UCLP matched by sex and age with controls (children without UCLP), resulting in the inclusion of a total of 108 eight- to ten-year-old children. Orofacial functions and OHRQoL were evaluated using the Nordic Orofacial Test-Screening (NOT-S) and the Child Perceptions Questionnaire (CPQ 8-1 0 ), respectively. Data normality was assessed by the Kolmogorov-Smirnov test. Differences and correlations in NOT-S and CPQ 8-1 0 scores between and within the groups were evaluated using Mann-Whitney and Spearman´s correlation tests, respectively. The distribution of NOT-S and global ratings of CPQ 8-1 0 for each group were assessed by Chi-squared/Fisher’s Exact tests. The UCLP group had a higher NOT-S total and examination scores than the controls. Dysfunctions related to breathing, facial symmetry/expression, and speech were more frequent in the UCLP patients than in the controls. The UCLP group had higher scores on the social well-being domain than the controls. There was a significant difference between the groups in their ratings in regards to the extent to which their oral condition affected their life overall, with controls perceiving it as somewhat better than patients. In both groups, NOT-S total and interview scores were positively correlated with CPQ 8-1 0 total and domain scores. The NOT-S examination score was only significantly correlated with social domain scores in the control group. The presence of UCLP was associated with clinical signs of orofacial dysfunctions related to breathing, facial symmetry/expression, and speech. Children with UCLP reported more orofacial dysfunctions and negative impacts on social well-being than controls.

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          Validity and reliability of the Child Perceptions Questionnaires applied in Brazilian children

          Background The Child Perceptions Questionnaires (CPQ8–10 and CPQ11–14) are indicators of child oral health-related quality of life. The aim of this study was to assess the validity and reliability of the self-applied CPQ8–10 and CPQ11–14 in Brazilian children, after translations and cultural adaptations in the Brazilian Portuguese language. Methods Schoolchildren were recruited from general populations for pre-testing (n = 80), validity (n = 210), and test-retest reliability (n = 50) studies. They were also examined for dental caries, gingivitis, fluorosis, and malocclusion. Results Children with greater dental caries experience in primary dentition had higher impacts on CPQ domains. Girls had higher scores for CPQ8–10 domains than boys. Mean CPQ11–14 scores were highest for 11-year-old children and lowest for 14-year-old children. Construct validity was supported by significant associations between the CPQ8–10 and CPQ11–14 scores and the global rating of oral health (r = 0.38, r = 0.43) and overall well-being (r = 0.39, r = 0.60), respectively. The Cronbach's alpha was 0.95 for both questionnaires. The test-retest reliabilities of the overall CPQ8–10 and CPQ11–14 scores were both excellent (ICC = 0.96, ICC = 0.92). Conclusion The Brazilian Portuguese version of CPQ8–10 and CPQ11–14 was valuable and reliable for use in the Brazilian child population, although discriminant validity was sporadic due to the fact that impacts are mediated by others factors, such personal, social, and environmental variables.
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            Reliability and convergent and discriminant validity of the Child Oral Health Impact Profile (COHIP Child's version).

            The purpose of the current study was to assess the reliability as well as the convergent and discriminant validity of the Child Oral Health Impact Profile (COHIP). The questionnaire consisted of five domains that assessed oral health, functional well-being, social-emotional well-being, school environment, and self-image. COHIP was designed to measure self-reported oral health-related quality of life (OHRQoL) of children between ages 8 and 15 years old, using both positively and negatively worded items. Children were recruited from pediatric, orthodontic, and craniofacial clinical settings in the USA and Canada. A comparison group of children not seeking dental treatment was recruited from two US elementary schools. Participants included 157 pediatric, 152 orthodontic and 110 patients with craniofacial anomalies, and 104 community-based participants. Scale reliability was assessed with Cronbach's alpha coefficient. Retest reliability was examined by intraclass correlation and paired t-test for a subset of participants who did not report a health change. Discriminant validity was assessed in two ways: (i) the COHIP scores of the four groups of children (three clinical and one community-dwelling) were compared by anova and (ii) for two of the clinical groups, the association between COHIP scores and clinical indices was calculated. Convergent validity was examined using partial Spearman correlations between COHIP scores and Global Health Ratings controlling for demographic variables. The children (n = 523) averaged 11.6 years (SD = 1.60); 51.6 % were female; and represented diverse ethnicities (black = 22.4%, Latino = 32.1%, white = 35.1%, other 10.4%). Overall COHIP scores ranged from 28 to 135 (mean +/- SD, 99.0 +/- 19.2) for the children. Scale reliability for the overall COHIP was excellent: Cronbach's alpha coefficient = 0.91 for the overall score. The test-retest reliability of the overall COHIP was also excellent (ICC = 0.84) and there was no statistically significant shift in scores over time. Discriminant validity was supported by significant differences (P = 0.003 overall COHIP) among the three clinical groups: the craniofacial group reported the lowest overall COHIP quality of life scores of the clinical groups. Within the pediatric dental group, children with greater dental decay reported lower COHIP scores suggesting a lower OHRQoL (r = -0.26, P = 0.02) and within the orthodontic group, children with larger overjet reported lower COHIP scores (r = -0.25, P = 0.005). Controlling for the effect of the participants' age, gender, and ethnicity, the association between the overall COHIP score and Global Health rating was statistically significant (P < 0.05) and similar in strength for the three clinical groups (pediatric dental = 0.29, orthodontic = 0.23, and craniofacial = 0.24) and highest for the community group (0.36). The overall COHIP showed excellent scale reliability overall and test-retest reliability. Both discriminant and convergent validity of the COHIP were supported by the comparisons among and within the four groups of children. Further testing will examine the utility of the instrument in both clinical and epidemiological samples.
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              Oral health-related quality of life in children: part II. Effects of clinical oral health status. A systematic review.

              Children are affected by numerous oral and orofacial disorders, which have the potential to compromise functioning, well-being and the quality of life (QoL). The purpose of this paper was to review the literature about children's clinical oral health status and health-related quality of life (HRQoL) and to assess the respective association. The authors searched Medline, ISI, Lilacs and Scielo for articles from 1985 to 2007. The inclusion criteria were randomized, cross-sectional, longitudinal or retrospective studies that used well-validated oral health-related QoL instruments, children self-applied questionnaires and quantitative measurements of clinical oral health status. Of the 402 articles that were critically assessed, 12 studies were included in the critical appraisal of the project. There is a relationship between clinical oral health status and HRQoL in children. In the studies that suggested weak relationships between children's oral conditions and HRQoL, the explanations were low disease levels in the sample, the conditions under investigation may have caused immeasurably low levels of impact or the impacts were mediated by inter- and intravariables according to culture and education. Moreover, relationships between biological or clinical variables and HRQoL outcomes are not direct, but mediated by a variety or personal, social and environmental variables, as well as by the child development, which have influence on the comprehension about the relationship among health, illness and QoL. So, longitudinal studies are necessary to determine validity, responsiveness and minimal clinically important difference.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                bor
                Brazilian Oral Research
                Braz. oral res.
                Sociedade Brasileira de Pesquisa Odontológica - SBPqO (São Paulo, SP, Brazil )
                1806-8324
                1807-3107
                2019
                : 33
                : e0061
                Affiliations
                [3] Governador Valadares Minas Gerais orgnameUniversidade Federal de Juiz de Fora orgdiv1Department of Dentistry Brazil
                [2] Bauru orgnameUniversidade de São Paulo orgdiv1Bauru School of Odontology orgdiv2Department of Pediatric Dentistry Brazil
                [1] Piracicaba orgnameUniversidade Estadual de Campinas orgdiv1Piracicaba Dental School orgdiv2Department of Pediatric Dentistry Brazil
                Article
                S1806-83242019000100266
                10.1590/1807-3107bor-2019.vol33.0061
                31531563
                0fee1cca-cdfa-4f0d-a55a-60ba97e3bc82

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 14 May 2019
                : 22 August 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 0
                Product

                SciELO Brazil

                Categories
                Original Research

                Facial Asymmetry,Quality of Life,Cleft Lip,Cleft Palate,Disability Evaluation

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