Difference and relation between adolescents' and their parents or caregivers' reported oral health-related quality of life related to orthodontic treatment: a prospective cohort study

Abstract

Background: Parents/caregivers play an important role in deciding whether their children will undergo orthodontic treatment or not. Their perceptions also have an influence on other choices involving orthodontic treatment. The purpose of this study was to investigate the difference and correlation between the ratings given by children and their parents or caregivers on their oral health-related quality of life (OHRQoL) before, during and after orthodontic treatment.

Methods: In this ongoing observational prospective cohort study, 498 children aged 11 to 16 years-old and one of their parents/caregivers completed questionnaires before (T0), 1 year after start (T1) and 1 month after the end of orthodontic treatment (T2). OHRQoL was scored by using the Child Perception Questionnaire (CPQ_11-14) and the Parental-Caregiver Perception questionnaire (P-CPQ). The self-perception of oral aesthetics was evaluated with the Oral Aesthetic Subjective Impact Scale (OASIS) in addition to the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). Spearman correlations, Mann-Whitney U-tests and linear models were used to analyze the longitudinal data.

Results: At T0, the ratings of parents/caregivers were significantly lower for the total CPQ as well as for the subdomains of oral symptoms, functional limitations and emotional well-being. Parents/caregivers also scored significantly lower at T2 for the total CPQ and the subdomain of oral symptoms. The relations between the scores of children and their parents/caregivers were significant at all three time points, as were the changes in scores, but all of them were at most moderate in size. Parents/caregivers scored significantly lower for OASIS than their children at all time points and only at baseline a significant, weak correlation was found.

Conclusion: The reports of parents/caregivers should be seen as important complementary information in OHRQoL research.

Trial registration: This study was approved by the Medical Ethical Commitee of the University Hospitals Leuven and the Katholieke Universiteit Leuven (ML5739), Leuven, Belgium, on the 12th of May of 2009, with the registration number S51642. All procedures performed are in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Keywords: Adolescents; Oral health-related quality of life; Orthodontics; Parent-child agreement; Prospective cohort study.

Fig. 1

Results of the Child Perception Questionnaire and the Parental-Caregiver Perception Questionnaire. (a) Results for the total CPQ. For parents/caregivers (red line): difference between all timepoints with P < 0.0001. (b) Results for the subdomain of oral symptoms. For parents/caregivers (red line): difference between all timepoints with P < 0.0001. (c) Results for the subdomain of functional limitations. For parents/caregivers (red line): difference between all timepoints with P < 0.0001. (d) Results for the subdomain of emotional well-being. For parents/caregivers (red line): difference between all timepoints with P < 0.0001 (e) Results for the subdomain of social well-being. For parents/caregivers (red line): difference between all timepoints with P < 0.0001, except for T1-T2 P = 0.99