Influence of two caries detection strategies on the quality of life of preschool children: An analysis of secondary outcomes of a 2-Year randomized clinical trial

Julia Gomes Freitas; Laura Regina Antunes Pontes; Carolina de Picoli Acosta; Tatiane Fernandes Novaes; Juan Sebastian Lara; Thais Gimenez; Thiago Machado Ardenghi; Mariana Minatel Braga; Daniela Prócida Raggio; Fausto Medeiros Mendes; CARDEC collaborative group

doi:10.1111/cdoe.12765

Influence of two caries detection strategies on the quality of life of preschool children: An analysis of secondary outcomes of a 2-Year randomized clinical trial

Community Dent Oral Epidemiol. 2023 Oct;51(5):804-812. doi: 10.1111/cdoe.12765. Epub 2022 Jun 7.

Affiliations

¹ Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
² Cruzeiro do Sul University, São Paulo, Brazil.
³ Indiana University School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, Indianapolis, Indiana, USA.
⁴ School of Dentistry, Ibirapuera University, São Paulo, Brazil.
⁵ Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil.

PMID: 35670271
DOI: 10.1111/cdoe.12765

Abstract

Objective: This randomized clinical trial aimed to evaluate the influence of two caries diagnosis strategies, and subsequent management, on oral health-related quality of life (OHRQoL) of preschoolers. Additionally, the association of the OHRQoL outcomes with the clinician-centred primary outcome used in the main study was also explored.

Materials and methods: This study refers to the OHRQoL secondary outcomes analyses of the so-called RCT 'CARDEC-1'. Three- to 6-year-old children were randomly allocated in two caries detection strategies in primary molars: visual inspection (VIS) or visual + radiographic (RAD) assessment. Participants were diagnosed and treated according to the allocated group and followed up for 2 years. Caregivers answered the Early Childhood Oral Health Impact Scale (ECOHIS) at baseline and after 2 years. Intention-to-treat analysis was performed. ECOHIS scores at baseline and 2 years later were compared using the Mann-Whitney test. Effect sizes, change scores and the minimally important difference (MID) were also compared between groups. Additional analysis was performed to assess if OHRQoL variables could reflect the primary clinical outcome (number of new operative interventions during the follow-up), observing if these met the Prentice criteria.

Results: Two hundred and five children had the ECOHIS answered in both period times (18.7% attrition rate). There was a decrease in total ECOHIS scores, as well as for different domains for both trial groups, with effect sizes varying from 0.43 to 0.77. Comparisons between groups, however, did not show significant differences. In the additional analysis, the OHRQoL variables met the Prentice criteria and presented the same trends observed with the clinician-centred primary endpoint.

Conclusion: Caries detection performed by visual inspection alone or associated with radiographic method does not influence the long-term impact on OHRQoL. Furthermore, OHRQoL variables reflect clinical outcomes in this type of clinical trial.

Clinicaltrials: gov NCT02078453.

Keywords: dental caries; patient-reported outcomes; preschool children; quality of life; randomized clinical trials.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Dental Caries Susceptibility
Dental Caries* / diagnosis
Dental Caries* / therapy
Humans
Oral Health
Quality of Life*
Surveys and Questionnaires

Associated data

ClinicalTrials.gov/NCT02078453