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Objective: To assess the association between dental anxiety and caries experience from late childhood through adolescence and into early adulthood (12, 15 and 18 years old, respectively). Methods: A prospective cohort study was conducted among a population‐representative sample of Chinese in Hong Kong. A baseline survey was conducted at age 12 and follow‐up assessments were completed at ages 15 and 18. Caries experience was assessed as the number of decayed, missing and filled teeth (DMFT). Dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS). Participants' socio‐economic status and oral health‐related behaviours were ascertained using a self‐complete questionnaire. Negative binomial regression was used to explore the association between dental anxiety and subsequent caries status, controlling for other factors. Results: At baseline, 668 children participated; 279 (41.8%, comprising 57.0% females) completed all three phases of data collection. MDAS scores at age 18 were lower than at age 12. Caries experience increased as participants aged. At age 15 and 18, females had higher MDAS and DMFT scores than males. Reported frequency of snacking between meals was associated with MDAS scores at age 18. In regression analyses, dental anxiety at age 12 was not significantly associated with dental caries experience at age 15, controlling for socio‐demographic and oral‐health behaviour factors at age 12. Likewise, dental anxiety at age 15 was not significantly associated with dental caries experience at age 18, controlling for the same factors at age 15. Conclusion: Dental anxiety assessed by MDAS in late childhood and adolescence appears not to predict dental caries experience later in life in this population. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the impact of adaptive functioning and oral hygiene practices on tooth-brushing performance among preschool children with special health care needs (SHCN). Methods: A cross-sectional study was conducted in Special Child Care Centers. Children's tooth-brushing performance was assessed by a standardized 13-step pro forma. Information regarding children's socio-economic status, adaptive skills, and oral hygiene practices were collected. Bivariate analysis and ANCOVA were used to explore the potential factors which might be associated with children's tooth-brushing performance. Results: The tooth-brushing assessment was provided to 379 children with SHCN. Approximately 3% of the recruited children performed the whole tooth-brushing procedure independently. The number of tooth-brushing steps practiced by those children was 4.47 ± 3.56. Children who had established tooth-brushing habit before age one practiced more tooth-brushing steps than children who brushed their teeth after age one (p = 0.029). When children's age, gender, and socio-economic status were adjusted, children who had established regular tooth-brushing habit or children who had high levels of adaptive skills showed better tooth-brushing performance than their peers. Children who used gauze, cotton swab, or dental floss to clean their teeth practiced fewer key tooth-brushing steps than their peers who had never used additional cleaning approaches (p = 0.038). Conclusions for Practice: Children's tooth-brushing performance was associated with adaptive skills and oral hygiene practices. Tooth-brushing training should be provided to children with SHCN in early childhood. For children who had limitations in adaptive functioning, parental assistance or supervision is recommended to guarantee the efficacy and safety of daily tooth brushing. [ABSTRACT FROM AUTHOR]

Objective: To investigate the oral health status and associated factors among preschool children with special healthcare needs. Subjects and methods: This was designed as a cross‐sectional study. Dental examination was provided to 383 children at Special Child Care Centres. Covariates of interest included children's age, developmental profile, oral health‐related behaviours and family social‐economic status. The association between children's dental caries experiences, dental plaque deposition and gingival health status were analysed by negative binomial regression, multiple factor ANOVA and binary logistic regression when appropriate. Results: The proportion of children with caries, gingival inflammation and plaque were 30.3%, 89.6% and 95.0%, respectively. Final regression models indicated that (a) tooth decay was associated with dental visit experiences, night bottle‐feeding habit, fluoridated toothpaste and monthly income; (b) plaque deposition was associated with intellectual functioning, practical skills, night bottle‐feeding habit, use of toothpaste, initiation of toothbrushing habit, toothbrushing duration and additional cleaning habit; (c) gingival status was associated with children's intellectual functioning and toothbrushing frequency. Conclusions: Poor oral hygiene status existed among preschool children with special healthcare needs. Children's oral health status was associated with their developmental profile, oral health‐related behaviours and social‐economic status. [ABSTRACT FROM AUTHOR]

Background: Oral health-related quality of life (OHRQoL) could be affected not only by oral health but also by demographic and ecosocial factors. This research aimed to analyze the sociodemographic and clinical factors that may influence the OHRQoL of 12-year-old children.Methods: A representative sample was selected from Hong Kong. Periodontal status and caries were examined according to WHO criteria. Four orthodontic indices were used to assess malocclusion. Child Perception Questionnaires (CPQ11-14-ISF:8 and CPQ11-14-RSF:8) including four domains, namely oral symptoms (OS), functional limitations (FL), emotional well-being (EWB), and social well-being (SWB), were used to measure OHRQoL. Adjusted OR was calculated by ordinal logistic regression.Results: Totally 589 eligible subjects (305 females, 284 males) were recruited. Males tended to rank higher in OS domain but lower in EWB domain (adjusted OR = 1.89 and 0.67). Mother's education was linked more closely with children's CPQ scores. Higher education levels were associated with better quality of life (adjusted OR = 0.45 and 0.37). Household income showed no effect on CPQ scores. Unhealthy periodontal conditions had a negative effect on EWB and total CPQ (adjusted OR = 1.61 and 1.63). High caries experience only had a negative effect on SWB (adjusted OR = 1.60). Malocclusion affected FL, EWB, SWB and total CPQ: all malocclusion severities affected SWB; only severe malocclusions affected FL, EWB and total CPQ.Conclusion: Males were more tolerant of oral symptoms than females were. Higher levels of mother's education led to better OHRQoL of their children. Unhealthy periodontal conditions affected emotional well-being, while high caries experience affected social well-being. All malocclusion severities had an effect on social well-being; severe malocclusion further caused functional limitations, worse emotional well-being, and hence worse OHRQoL. [ABSTRACT FROM AUTHOR]

Objectives Studies investigating influencing factors of permanent tooth eruption/emergence have primarily focused on anthropometric measurements while less attention has been paid to the effect of perinatal factors. We aimed to explore early factors associated with eruption status of permanent teeth among 12-year-olds through a population-representative prospective cohort. Methods A community sample of Hong Kong children born in 1997 was obtained by random sampling from local secondary schools. Participants' background information including birth characteristics, prenatal and early childhood exposures, family socioeconomic status and medical records was prospectively collected. Clinical examination of tooth emergence was conducted in 2010. Children were divided into complete emergence (of 28 permanent teeth) and partial emergence groups based on clinical examinations. Bivariate analyses were used to assess the association of tooth emergence status with each putative predictor. Unadjusted and adjusted logistic regression models were applied to select the best predictors for tooth emergence status at age 12. Results Complete background information and clinical data were available from 514 children (76.9% of the invited participants). Bivariate analyses showed that the average birthweight in the partial emergence group was significantly lower than the complete emergence group (mean difference 0.2 kg, P = 0.006). The finding was confirmed by logistic regression analyses. In the adjusted regression model, it was found that for every 1 kilogram increase in birthweight, the odds of having partial emergence would be lowered by 0.49 (odds ratio 0.49, P = 0.006). Conclusions Birthweight is associated with status of permanent tooth emergence at 12 years of age, as observed from a population-representative sample of Hong Kong children. [ABSTRACT FROM AUTHOR]

Background To date, research on the relationship between dental caries experience and adiposity status is debated. Aim To determine associations between dental caries experience and adiposity status among a community sample of preschool children in Hong Kong. Design Among a random sample of 5-year-old children, clinical assessment for dental caries was conducted using WHO criteria. Anthropometric measurements for body weight, body height, waist circumference ( WC), hip circumference, and triceps skinfold thickness ( TRSKF) were performed to assess general adiposity, central adiposity, and peripheral adiposity. Associations between adiposity status and caries were examined in regression analyses. Results The response rate was 83.1% (324/390). Regression analyses (adjusted for tooth brushing habits, snacking habits, and socio-demographic factors) identified that weight/height ratio z-score was associated with caries experience: prevalence of dental caries experience (dmft > 0), OR 1.41 (95% CI 1.04, 1.91), and 'very high' caries experience (dmft ≥ Si C10 Index value), OR 1.62, (95% CI 1.05, 2.50). In addition, WC z-score was associated with 'very high' caries experience (dmft ≥ Si C10 Index value), OR 1.72, 95% CI 1.06, 2.81. Conclusion In a Hong Kong community sample of preschool children, dental caries experience was associated with general adiposity (as assessed by weight/height ratio) and central adiposity (as assessed by WC). [ABSTRACT FROM AUTHOR]

Wong HM, McGrath CPJ, King NM. Rasch validation of the early childhood oral health impact scale. Community Dent Oral Epidemiol 2011; 39: 449-457. © 2011 John Wiley & Sons A/S Abstract - Objectives: The early childhood oral health impact scale (ECOHIS), a proxy measure to assess the impact of oral health problems and on the quality of life of preschool children and their families, has been translated into Chinese and validated employing the classical test theory. However, some invariable problems are related to this theory. The objective of this study was to assess the metric properties of the ECOHIS by applying the item response theory. Methods: A random sample of 1296 Chinese preschool children in Hong Kong participated in the study and were subjected to an oral examination for their caries status. Their parents were asked to respond to the ECOHIS and an extra set of questions concerning their socio-demographic backgrounds. The collected data were analysed using Rasch model. Results: The obtained results support the interpretation of adequate total fit of persons and items, because the mean infit MNSQ (1.08) and outfit MNSQ (0.94) for persons, and the mean infit MNSQ (0.99) and outfit MNSQ (0.94) for items, are within the acceptable ranges (0.6-1.4). The difficulty spread of the items was between −0.81 and 1.96 logits, and the levels of respondents spanned from −5.56 to 6.72 logits on the person-item map. The spread of respondents was skewed and mistargeting, between the items and respondents, was confirmed. Combination of responses of 'often' and 'very often' was suggested because of their flat probability showing on the characteristic curves. Conclusions: Rasch model has been shown to be a feasible and practicable way of assessing the metric properties of the ECOHIS. The results allow the use of ECOHIS to be recommended for clinical research in oral health-related quality of life in young children with minor modifications. [ABSTRACT FROM AUTHOR]

Background: There is no consensus opinion regarding the association between obesity and periodontal diseases among children and adolescents in the literature. Methods: A prospective observational cohort study was conducted in a Hong Kong cohort at age 12, 15 and 18. CPI and various obesity indices including BMI, WC, WHR, WHtR, and TRSKF were recorded during each wave of data collection. Information on socioeconomic status and oral health behaviors were collected through self-completed questionnaires. Results: Two hundred and eighty-two (male: 122 and female: 160) participants completed all three rounds of data collection. Prevalence of overweight/obesity was 27.0, 19.1, and 14.2% at 12, 15, and 18 years, respectively. 19.9% participants had healthy periodontal conditions at age 12. While the percentage dropped to 10.3% at 15 years and 5.7% at 18 years. The proportion of 15-year-old adolescents who brushed teeth more than twice a day was significantly higher among participants belonging to the lower BMI, WC, WHR, and WHtR category (P < 0.05). The fully adjusted model revealed that participants with lower BMI at age 15 had higher probability of having more than 50% index teeth free from periodontal diseases at age 18 (OR: 2.78; 95% CI: 1.16, 6.64; P = 0.022). Conclusions: Although higher BMI at 15 years was associated with more extensive periodontal inflammation at age 18, this was believed to be an indirect association confounded by the poor oral health care among overweight/obese individuals. Oral health promotions should be directed to improve periodontal conditions of overweight/obese secondary school students. [ABSTRACT FROM AUTHOR]

Background: Socio-economic status, health awareness, and dietary habits have been reported as common risk factors of dental caries and obesity. The present study aimed to explore shared mediators between caries and obesity and to estimate the effects of caries-related factors on adiposity. Methods: This was a cross-sectional study among adolescents aged 18 years. The study was nested in a population-representative cohort of Chinese in Hong Kong. The number of decayed, missing, and filled permanent teeth (DMFT) was recorded during the oral examinations. Body Mass Index (BMI), Waist Circumference (WC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), and Triceps Skinfold Thickness (TRSKF) were used as adiposity indices. Data on socio-economic status, oral health behavior (tooth brushing habit, use of fluoride toothpaste, dental flossing habit, and mouth rinse habit), and dietary record (frequency and amount of different food) were collected through self-completed questionnaires. Chi-square tests and binary logistic regressions were used for analysis. Results: Three hundred eighty-three participants were included. The mean (standard deviation, SD) of BMI, WC, WHR, WHtR, TRSKF, and DMFT were 21.26 (3.72), 69.11 (9.25), 0.77 (0.06), 0.42 (0.05), 15.72 (6.33), and 2.06 (2.43), respectively. Males were more likely to be overweight/obese than females. Various factors including gender, parental employment status, mouth rinse habit, frequency and amount of meat intake, frequency of oil intake, use of fluoride toothpaste, and DMFT were found significant (p < 0.05) in different final models of adiposity status. Conclusions: More mediators should be included in future research to elucidate mechanism of the association between caries and obesity. [ABSTRACT FROM AUTHOR]