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Impact of caries and dental fluorosis on oral health-related quality of life: a cross-sectional study in schoolchildren receiving water naturally fluoridated at above-optimal levels

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Abstract

Purpose

The purpose of this study was to evaluate the impact of caries and fluorosis on oral health-related quality of life (OHRQoL) among schoolchildren living in areas with high concentrations of fluoride in water.

Methods

Five hundred and twenty-four schoolchildren (8–12 year olds) residing in rural communities in central Mexico were examined for oral hygiene, caries (International Caries Detection and Assessment System, ICDAS II), and fluorosis (Thylstrup and Fejerskov Index, TFI). OHRQoL was evaluated with the Child Perceptions Questionnaire for two age groups (CPQ8–10 and CPQ11–14). Generalized structural equation models were constructed for data analysis.

Results

Overall prevalence of caries was 88.5% and fluorosis 46.9%. In the group of 8–10 year olds, 48% of the children had advanced carious lesions in primary or permanent teeth (ICDAS ≥4), 22.6% had moderate/severe fluorosis, and 59.9% of children had an impact on OHRQoL. Schoolchildren with ICDAS ≥4 were more likely [OR = 1.75, (95% CI 1.34–2.28)] to suffer a negative impact on OHRQoL. In the group of 11–12 year olds, 19.9% of children had advanced carious lesions and 23.2% showed moderate/severe fluorosis; 67.3% of children reported had an impact on OHRQoL. Children 11–12 year olds with fluorosis (TFI ≥4) [OR = 2.39 (95% CI 2.12–2.69)], caries (ICDAS ≥4) [OR = 2.18 (95% CI 2.13–2.24)], and low brushing frequency [OR = 2.04 (95% CI 1.21–3.44)] were more likely to have deterioration on OHRQoL.

Conclusion

A negative impact on OHRQoL was observed in children with caries and fluorosis.

Clinical relevance

Deterioration on OHRQoL found in children as a sequel of caries and fluorosis should be considered when designing health policies leading to prevention and effective health promotion programs and incorporated to clinical guidelines for timely dental treatment.

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Acknowledgements

The authors acknowledge the support of the Master and Doctor of Dental Medical Sciences and Health Programs, the National Autonomous University of Mexico (UNAM), and the Doctoral Program in Biological and Health Science, Metropolitan Autonomous University (UAM), Mexico.

Author information

Authors and Affiliations

  1. Department of Ocular Epidemiology and Visual Health, Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico

    Álvaro García-Pérez

  2. Health Care Department, Metropolitan Autonomous University—Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, Del. Coyoacán, Mexico City, Mexico

    María Esther Irigoyen-Camacho & Marco Antonio Zepeda-Zepeda

  3. Postgraduate Unit, Dental School, National Autonomous University of Mexico, Mexico City, Mexico

    S. Aída Borges-Yáñez

  4. Postgraduate Program in Biological and Health Science, Metropolitan Autonomous University—Xochimilco, Mexico City, Mexico

    Irvin Bolona-Gallardo

  5. School of Dentistry, Fairbanks School of Public Health, and Indiana University Network Science Institute, Indiana University, Indianapolis, IN, USA

    Gerardo Maupomé

Authors
  1. Álvaro García-Pérez
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  2. María Esther Irigoyen-Camacho
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  6. Gerardo Maupomé
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Corresponding author

Correspondence to María Esther Irigoyen-Camacho.

Ethics declarations

The Ethics Committee of the Division of Postgraduate Studies and Research, School of Dentistry, National Autonomous University of Mexico approved the study protocol (UNAM/PMDCMOS/221)

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

This study was not funded by an external grant mechanism.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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García-Pérez, Á., Irigoyen-Camacho, M.E., Borges-Yáñez, S.A. et al. Impact of caries and dental fluorosis on oral health-related quality of life: a cross-sectional study in schoolchildren receiving water naturally fluoridated at above-optimal levels. Clin Oral Invest 21, 2771–2780 (2017). https://doi.org/10.1007/s00784-017-2079-1

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