Development of a questionnaire to measure perceptions of, and concerns derived from, dental fluorosis.
ABSTRACT To develop a questionnaire in English and Spanish to measure concerns caused by children's (and their parents') perceptions of dental appearance.
The questionnaire addressed concerns in the physical, mental, and social domains, perceptions about discolourations and other oral conditions including tooth colour. Test-retest and internal reliability, and construct and criterion validity, were assessed as part of the development process. Children in Mexico City, Mexico and Indianapolis, Indiana answered the questionnaire and were examined for fluorosis using the TSIF index. Data were analysed using Cronbach's alpha, Pearson's, Spearman's and intraclass correlations, and percentage agreement tests.
Ninety-five children and 28 parents participated in Mexico City; fluorosis was diagnosed in 66% of children. Seventy-one children and 65 parents participated in Indianapolis; fluorosis was diagnosed in 63% of children. English and Spanish questionnaires had acceptable test-retest performance, and moderate internal reliability. Criterion validity was acceptable, and the translated versions retained acceptable construct validity. Perceptions of discolourations were associated with concerns of the participants. Level of concern was higher in Indianapolis than in Mexico City, generally. Many participants reported that they were at least occasionally distressed or worried over the appearance of the children's teeth, that it hindered children from smiling freely, and that it was an unsatisfactory appearance.
The developed questionnaire allowed children and parents to report perceived dental appearance problems and concerns.
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ABSTRACT: To compare dental esthetic perceptions of adolescents at age 13 with those of parents and to assess associations with dental fluorosis. Adolescents aged 13 underwent dental examinations for fluorosis on maxillary anterior teeth using the Fluorosis Risk Index. Adolescents and parents completed questionnaires concerning satisfaction with adolescents' dental appearance. McNemar and Bowker tests of symmetry were used for comparisons of esthetics ratings between parents and adolescents. Comparison of satisfaction between subjects with fluorosis and subjects with no fluorosis was made using Cochran-Armitage Trend and Fisher's Exact tests. From 376 adolescents included in the study, 26 percent had definitive fluorosis, mostly at a mild level. Fifteen percent of adolescents were dissatisfied with dental appearance, and concerns were mainly about color (45 percent) and alignment (35 percent). Adolescents were less satisfied with overall dental appearance (P < 0.001) and color (P = 0.048) and more concerned about tooth shape (P = 0.002) than were their parents. Fluorosis status (yes/no) was not significantly associated with adolescents' perceptions (P > 0.05). Parents of subjects with fluorosis were more dissatisfied with dental appearance (P = 0.014) and color (P < 0.001) than other parents. The number of maxillary anterior zones exhibiting fluorosis was negatively associated with adolescent (P = 0.03) and parent (P = 0.002) satisfaction. Adolescents generally had less satisfaction with dental appearance and color, and were more concerned with tooth shape than were parents. For both parents and adolescents, decreased satisfaction was associated with the number of zones with definitive fluorosis.Journal of Public Health Dentistry 02/2012; 72(2):164-71. · 1.21 Impact Factor
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ABSTRACT: To assess dental fluorosis, dental caries and quality of life factors associated with dental fluorosis among schoolchildren living in a Colombian endemic dental fluorosis area. 110 12-year olds were visually examined for dental caries (ICDAS) and dental fluorosis (TF) and a self-administered quality of life and fluorosis questionnaire was applied. The prevalence of dental fluorosis reached 100% in this sample with most children falling within the TF 3 severity category. Varying degrees of severity were observed as follows for TF 1 to 6: 1%, 16%, 62%, 16%, 4%, 2%. The prevalence of caries experience (DF-S2) was 54%. The DF-S2 mean was 4.4 (sd 4.3). The principal contributor to the DF-S2 outcome was the decayed component. When initial caries lesions were included (ICDAS-scores 1-3) the mean DF-S1,2 increased to 10 (sd 5.1). The association between fluorosis and dental caries was not statistically significant (p > 0.05). Children not only detected the presence of something abnormal in their teeth but also reported feeling embarrassed, and worried due to their dental appearance. Almost 60% of the children reported avoiding smiling because of their teeth's appearance. The high prevalence of dental fluorosis and dental caries combined with the schoolchildren's negative perception about their dental health reflects the need to propose effective dental public health policies to regulate multiple exposures to fluoride at an early age, and to improve health outcomes in a highly vulnerable population.Community dental health 03/2012; 29(1):95-9. · 0.93 Impact Factor
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ABSTRACT: Mild-to-moderately severe enamel fluorosis (EF) is an unsightly maturation-phase dental disorder. Despite extensive epidemiological studies on EF, little is known about individual treatment options. This study was carried out to determine whether a simple microabrasion technique is effective in improving the esthetics of EF. Patients with a variety of severities were treated using a water-cooled fine diamond polishing bur at high speed to remove the surface enamel layers. Photographs of the affected teeth before and after treatment were shown by computer to a panel of three judges (two lay and one experienced), who rated the appearance of the teeth using a newly developed visual analog scale. The severity of EF was rated randomly and blind for 52 individual teeth (26 before and 26 after treatment). Reteated-measures analysis of variance was used to analyze the results. The lay judges rated the appearance of the teeth with EF as significantly more objectionable before treatment. All judges found a significant improvement in the severity of EF after treatment. Using a newly developed visual analog scale, our study indicates that EF of an objectionable nature can be significantly improved with a simple microabrasion technique, thus conserving tooth structure and minimizing the cost of treating EF.European Journal Of Oral Sciences 06/2006; 114 Suppl 1:123-6; discussion 127-9, 380. · 1.42 Impact Factor