Body mass index, oral health status and OHRQoL among special health care needs children and parenting stress: a case-control study in Southern Saudi Arabia

The appropriateness for determining Oral Health Related Quality of Life (OHRQoL) of special children by their caregivers must be thoroughly assessed. The present study was conducted to assess the Oral health related quality of life of children with disability and the stress levels of their parents. Moreover, the study also evaluated the plaque, DMFT (Decayed, missing, filled teeth) and BMI (Body Mass Index) of disabled children (cases) and healthy children (controls). The present case-control study was carried out on 150 parents of disabled children and 30 parents of healthy children (control group) at King Khalid University, Abha, KSA. The Arabic version of the 36-item parenting stress index-short format (PSI-SF) instrument was used for the assessment of parental stress, and the WHOQOL-BREF (World Health Organization Quality of Life Brief Version) Arabic version questionnaire was used for the assessment of quality of life of children. The parents or the caregivers who would be mainly occupied in assisting and rendering care to their children with different disabilities (certified by a pediatrician, aged between 4–14 years), were included in the study. Data were analyzed using statistical software. The total mean value score of the PSI scale of parents of cases was statistically found to be significantly higher compared to the mean scores among parents of controls (p = 0.004). The correlation between BMI and plaque & BMI and DMFT+df of cases indicated no statistically significant correlation while a statistically significant correlation between plaque and DMFT+df values in cases was observed. The mean score of the social relationship domain was statistically significantly different across the four levels of parents’ educational status. The severity of dental caries, plaque accumulation and education-level of caregivers had a significant impact on the OHRQoL, however, BMI did not show a significant relation with DMFT and plaque scores. The parenting stress was found to be statistically higher among the parents of cases compared to the parents of controls.

Body mass index; Dental caries; Quality of life; Disabled children

[1] American academy of pediatric dentistry definition of special health care needs. Pediatric Dentistry. 2018; 40: 16.

[2] Nelson LP, Getzin A, Graham D, Zhou J, Wagle EM, McQuiston J, et al. Unmet dental needs and barriers to care for children with significant special health care needs. Pediatric Dentistry. 2011; 33: 29–36.

[3] Schmidt J, Vogel M, Poulain T, Kiess W, Hirsch C, Ziebolz D, et al. Association of oral health conditions in adolescents with social factors and obesity. International Journal of Environmental Research and Public Health. 2022; 19: 2905.

[4] Baxevanos K, Menexes G, Lazaridou A, Coolidge T, Topitsoglou V, Kalfas S. Dental caries and psychosocial factors: testing a conceptual model in adolescents. Community Dentistry and Oral Epidemiology. 2021; 49: 314–321.

[5] Stangvaltaite-Mouhat L, Furberg A, Drachev SN, Trovik TA. Common social determinants for overweight and obesity, and dental caries among adolescents in Northern Norway: a cross-sectional study from the Tromsøstudy fit futures cohort. BMC Oral Health. 2021; 21: 53.

[6] Alwattban RR, Alkhudhayr LS, Al-Haj Ali SN, Farah RI. Oral health-related quality-of-life according to dental caries severity, body mass index and sociodemographic indicators in children with special health care needs. Journal of Clinical Medicine. 2021; 10: 4811.

[7] Brown A. Caries prevalence and treatment needs of healthy and medically compromised children at a tertiary care institution in Saudi Arabia. Eastern Mediterranean Health Journal. 2009; 15: 378–386.

[8] Alzahrani AAH. Parent perspectives on perceived dental pain and dental caries in Saudi schoolchildren with intellectual disability. Special Care in Dentistry. 2019; 39: 310–318.

[9] Pani SC, Badea L, Mirza S, Elbaage N. Differences in perceptions of early childhood oral health-related quality of life between fathers and mothers in Saudi Arabia. International Journal of Paediatric Dentistry. 2012; 22: 244–249.

[10] Al-Ogayyel S, Al-Haj Ali S. Comparison of dental treatment performed under general anesthesia between healthy children and children with special health care needs in a hospital setting, Saudi Arabia. Journal of Clinical and Experimental Dentistry. 2018; 10: e963–e969.

[11] Pani SC, Mubaraki SA, Ahmed YT, AlTurki RY, Almahfouz SF. Parental perceptions of the oral health-related quality of life of autistic children in Saudi Arabia. Special Care in Dentistry. 2013; 33: 8–12.

[12] Lee JY, Lim KC, Kim SY, Paik HR, Kim YJ, Jin BH. Oral health status of the disabled compared with that of the non-disabled in Korea: a propensity score matching analysis. PLOS ONE. 2019; 14: e0208246.

[13] Akhter R, Hassan NMM, Martin EF, Muhit M, Smithers-sheedy H, Badawi N, et al. Caries experience and oral health-related quality of life (OHRQoL) of children and adolescents with cerebral palsy in a low-resource setting. BMC Oral Health. 2019; 19: 15.

[14] Ashour NA, Ashour AA, Basha S. Association between body mass index and dental caries among special care female children in Makkah city. Annals of Saudi Medicine. 2018; 38: 28–35.

[15] Rivas GR, Arruabarrena I, Paúl JD. Parenting stress index-short form: psychometric properties of the Spanish version in mothers of children aged 0 to 8 years. Psychosocial Intervention. 2020; 30: 27–34.

[16] Shahrum Vahedi. World health organization quality-of-life scale (WHOQOL-BREF): analyses of their item response theory properties based on the graded responses model. Iranian Journal of Psychiatry. 2010; 5: 140–153.

[17] Lu H, Wong MCM, Lo ECM, McGrath C. Risk indicators of oral health status among young adults aged 18 years analyzed by negative binomial regression. BMC Oral Health. 2013; 13: 40.

[18] Silness J, Loe H. Periodontal disease in pregnancy. II. correlation between oral hygiene and periodontal condtion. Acta Odontologica Scandinavica. 1964; 22: 121–135.

[19] Kang H. Sample size determination and power analysis using the G*Power software. Journal of Educational Evaluation for Health Professions. 2021;18: 17.

[20] Alshehri YFA, Park JS, Kruger E, Tennant M. Association between body mass index and dental caries in the Kingdom of Saudi Arabia: systematic review. The Saudi Dental Journal. 2020; 32: 171–180.

[21] D’Alessandro G, Cremonesi I, Alkhamis N, Piana G. Correlation between oral health in disabled children and depressive symptoms in their mothers. European Journal of Paediatric Dentistry. 2014; 15: 303–308.

[22] Aracena M, Gómez E, Undurraga C, Leiva L, Marinkovic K, Molina Y. Validity and reliability of the parenting stress index short form (PSI-SF) applied to a Chilean sample. Journal of Child and Family Studies. 2016; 25: 3554–3564.

[23] Du RY, Yiu CKY, King NM. Health- and oral health-related quality of life among preschool children with autism spectrum disorders. European Archives of Paediatric Dentistry. 2020; 21: 363–371.

[24] 765Mo H. Neurodevelopmental Disorders & Oral Health-Related Quality of Life for Children and Their Caregivers [Master’s thesis]. University of California, San Fransisco. 2019.

[25] Chaffee BW, Rodrigues PH, Kramer PF, Vítolo MR, Feldens CA. Oral health-related quality-of-life scores differ by socioeconomic status and caries experience. Community Dentistry and Oral Epidemiology. 2017; 45: 216–224.