Systematic review of factors influencing oral health-related quality of life in children in Africa.

BACKGROUND: Oral health-related quality of life (OHRQoL) is influenced by cultural and societal context. Existing OHRQoL children measurement tools have been conceptualised in high-income countries. Probing whether the factors influencing OHRQoL are context-reliant in the African setting is necessary and is the purpose of the current review. AIM: To investigate if the factors influencing OHRQoL are context-reliant. METHODS: Seven databases were searched using search terms ('oral health'; and 'quality of life', 'health-related quality of life', 'patient-reported outcomes', 'well-being'; and 'child*', 'adolescents', 'teen*', 'youth'; and 'determinants', 'factors', 'predictors'; and 'oral health quality of life tools/instruments/scales'; and 'Africa*'). Abstracts identified were exported to a reference software manager. Three of the authors used specific selection criteria to review, firstly, 307 abstracts and, secondly, 30 full papers. Data were extracted from these papers using a pre-designed data extraction form, after which quantitative synthesis of data was performed. RESULTS: Key factors influencing OHRQoL followed an existing conceptual framework where environmental and individual factors in the form of socio-economic status (SES), area of residence and children psyche status, and the presence of any oral condition other than dental caries were reported among child populations in Africa. CONCLUSION: There is preliminary evidence to suggest an association between individual factors such as children's psyche and oral problems, excluding dental caries, and environmental determinants such as area of residence and SES in children's OHRQoL in African children. The finding that dental caries was not a key factor in child-oral health is unexpected. There seemed to be a contextual viewpoint underpinning the current OHRQoL frameworks and OHRQoL was context-reliant.

Prevalence of Early Childhood Caries Among Preschool Children in Johannesburg, South Africa.

PURPOSES: (1) To determine the prevalence of dental caries among preschool children in the metropolitan area of Johannesburg; (2) to determine the dental caries status and unmet treatment needs of four- to six-year-old children; (3) to compare their dmft/DMFT scores with the significant caries index (SiC) for similar age cohorts; and (4) to compare their dental caries prevalence with those of similar age cohorts, as reported in the National Children's Oral Health Survey (NCOHS). METHODS: This cross-sectional study included 10 preschools. Stratified randomized sampling of the participating children was done and schools were stratified by regions. RESULTS: A total of 459 children, with a mean age of 4.8 years, were examined. The overall caries prevalence (CP) was 44 percent, with a mean dmft score of 2.3±3.4 (standard deviation [SD]). Among four- to five-year-old children, the CP was 49 percent (dmft 2.4 ±3.4 SD versus 2.38 NCOHS, SiC=6.41; P<0.00001). The CP for six-year-old children was 51 percent (dmft 2.38, ±3.4 SD versus 2.9 NCOHS, SiC = 5.35; P<0.00001). Ninety-seven percent of the children did not have their dental needs met. CONCLUSION: There is high caries prevalence among preschool children in Johannesburg.