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A comparison of health-related quality of life in 5- and 10-year-old Swedish children with and without cleft lip and/or palate
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Department of Paediatrics, Skaraborg Hospital, Skövde, Sweden / Sahlgrenska Academy, Gothenburg's University, Gothenburg, Sweden.
Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
2016 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Background The current understanding on health-related quality of life (HRQoL) in young Swedish children with cleft lip and/or palate (CL/P) is sparse, and therefore, research on impact of CL/P on HRQoL in children is needed.

Aims To investigate HRQoL in 5- and 10-year-old Swedish children with CL/P in comparison with non-cleft controls. Also to analyse whether there were any differences in HRQoL between children with cleft lip (with or without cleft palate, CL ± P) and cleft palate only (CP) and/or gender differences. Design A total of 137 children with CL/P and 305 non-cleft controls participated. HRQoL was measured with KIDSCREEN-52.

Results All children in the study exhibited HRQoL within or above the age-matched reference interval of the method with similar results in both groups; however, in the dimension ‘social support and peers’, the 10-year-old children with CL/P perceived lower HRQoL than the non-cleft controls, but it did not reach statistical significance. Type of cleft or gender did not influence HRQoL.

Conclusions Both 5- and 10-year-old Swedish children with CL/P had HRQoL in the normal reference interval. Their general life situations were well adjusted to their clefts, but the older children with CL/P felt more excluded and less supported by peers.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016.
National Category
Surgery Dentistry
Identifiers
URN: urn:nbn:se:liu:diva-132622DOI: 10.1111/ipd.12253PubMedID: 27464906OAI: oai:DiVA.org:liu-132622DiVA: diva2:1047243
Available from: 2016-11-17 Created: 2016-11-17 Last updated: 2016-11-22Bibliographically approved
In thesis
1. Children with orofacial clefts: dental caries and health-related quality of life
Open this publication in new window or tab >>Children with orofacial clefts: dental caries and health-related quality of life
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background. The current understanding on caries and enamel developmental defects prevalence and frequency, caries risk, health-related quality life (HRQoL) and stress response in young children with cleft lip and/or palate (CL/P) are sparse. In this thesis these aspects were investigated in 5- and 10- year-old children with CL/P in comparison to non-cleft children in the same ages.

Design. The studies in this thesis have a cross-sectional case-control design. Participants. The study group consisted of 139 children with CL/P (80 children aged 5 years and 59 aged 10 years) and 313 non-cleft controls (144 children aged 5 years and 169 aged 10 years).

Method. Caries was scored according to International Caries Detection and Assessment System (ICDAS II) and developmental enamel defects were measured as presence and frequency of hypoplasia and hypomineralization. Oral hygiene was assessed using Quigley-Hein plaque index. Stimulated saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rates. Information regarding children’s oral hygiene routines, dietary habits and fluoride exposure were collected with questionnaires. Caries risk was evaluated with algorithm-based software, Cariogram while HRQoL was perceived with KIDSCREEN-52. Stress response was analyzed with cortisol concentration in saliva at three different time points using a commercial competitive radioimmunoassay.

Results. Caries prevalence (36% versus 18%) and caries frequency (1.2 dmfs versus 0.9 dmfs) was significantly higher in 5-year-old children with CL/P in comparison to non-cleft controls. In 10-yearolds no significant difference was found between children with CL/P and non-cleft controls in caries prevalence (47% versus 38%) or in caries frequency (0.7 DMFS versus 0.5 DMFS). Children with CL/P had significantly higher prevalence of enamel defects, higher counts of salivary lactobacilli and less good oral hygiene. The odds of being categorized with high caries risk were elevated in children with CL/P. Children with CL/P had similar HRQoL and salivary cortisol concentrations as non-cleft controls. However, 10-year-old boys with CL/P had significantly higher cortisol concentrations in the evening than non-cleft boys.

Conclusions. Preschool children with CL/P seem to have more caries in the primary dentition than non-cleft controls. Children with CL/P had increased odds of being categorized as high caries risk individuals compared to controls. Some of the contributing factors seem to be higher prevalence of enamel defects, impaired oral hygiene and elevated salivary lactobacilli. Furthermore, as measured with the help of cortisol concentrations in saliva, children with CL/P were not more stressed than noncleft controls and their HRQoL was comparable to a European norm population. It appears that regular comprehensive preventive oral care in children with CL/P is effective in preventing caries development in permanent teeth. However, children with CL/P are at risk of caries development and preventive oral care should be implemented and started earlier than today.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 68 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1547
Keyword
Children, cleft lip and/or palate, dental caries, caries risk, hypomineralization, hypoplasia, health-related quality of life, cortisol in saliva, stress.
National Category
Dentistry Otorhinolaryngology Pediatrics Public Health, Global Health, Social Medicine and Epidemiology Surgery Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-132623 (URN)10.3384/diss.diva-132623 (DOI)9789176856567 (Print) (ISBN)
Public defence
2016-12-09, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-11-17 Created: 2016-11-17 Last updated: 2016-11-21Bibliographically approved

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Sundell, Anna LenaMarcusson, Agneta
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Department of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesMaxillofacial Unit
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