Figure 1.
Figure 2.
Distribution of responses to individual questions of the ECOHIS-SVN questionnaire_
| Never | Hardly ever | Occasionally | Often | Very often | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| (n) | (%) | (n) | (%) | (n) | (%) | (n) | (%) | (n) | (%) | |
| Child impact | ||||||||||
| Oral/dental pain | 180 | 70.6 | 49 | 19.2 | 21 | 8.2 | 5 | 2.0 | 0 | 0.0 |
| Difficulty drinking | 229 | 89.8 | 20 | 7.8 | 4 | 1.6 | 1 | 0.4 | 1 | 0.4 |
| Difficulty eating | 220 | 86.3 | 26 | 10.2 | 6 | 2.4 | 2 | 0.8 | 1 | 0.4 |
| Difficulty pronouncing words | 230 | 90.2 | 14 | 5.5 | 4 | 1.6 | 5 | 2.0 | 2 | 0.8 |
| Missed kindergarten, day care, school | 233 | 91.4 | 17 | 6.7 | 5 | 2.0 | 0 | 0.0 | 0 | 0.0 |
| Trouble sleeping | 239 | 93.7 | 10 | 3.9 | 6 | 2.4 | 0 | 0.0 | 0 | 0.0 |
| Irritable, frustrated | 220 | 86.3 | 30 | 11.8 | 4 | 1.6 | 1 | 0.4 | 0 | 0.0 |
| Avoided smiling, laughing | 246 | 96.5 | 8 | 3.1 | 1 | 0.4 | 0 | 0.0 | 0 | 0.0 |
| Avoided talking | 251 | 98.4 | 3 | 1.2 | 1 | 0.4 | 0 | 0.0 | 0 | 0.0 |
| Family impact | ||||||||||
| Been upset | 181 | 71.0 | 49 | 19.2 | 16 | 6.3 | 6 | 2.4 | 3 | 1.2 |
| Felt guilty | 196 | 76.9 | 33 | 12.9 | 20 | 7.8 | 5 | 2.0 | 1 | 0.4 |
| Time off from work | 225 | 88.2 | 29 | 11.4 | 0 | 0.0 | 1 | 0.4 | 0 | 0.0 |
| Financial impact | 244 | 95.7 | 6 | 2.4 | 1 | 0.4 | 1 | 0.4 | 3 | 1.2 |
Ranges and floor effect of ECOHIS-SVN items (child, family and total)_
| Domain | Number of items | Possible range | Range | Floor effect (% of minimum score) |
|---|---|---|---|---|
| Child impact | 9 | 9-45 | 9-31 | 58.0 |
| Family impact | 4 | 4-20 | 4-16 | 63.5 |
| Total score | 13 | 13-65 | 13-40 | 50.2 |
In the subgroup of children with dmft=0, associations between ECOHIS-SVN (child, family and total) and the parent’s age, level of oral health status education, self-reported and OHIP-SVN14 score_
| B | SE | 95 % CI | Std. B | p-value | |
|---|---|---|---|---|---|
| ECOHIS-SVN child score | |||||
| Parent’s age | 0.03 | 0.02 | -0.005-0.066 | 0.132 | 0.097 |
| Parent’s education | |||||
| Primary | Ref. | ||||
| Secondary | 0.119 | 0.73 | -0.416-0.635 | 0.119 | 0.684 |
| University | 0.199 | 0.723 | -0.195-0.579 | 0.199 | 0.332 |
| Self-reported oral health | -0.203 | 0.111 | -0.432-0.045 | -0.165 | 0.112 |
| OHIP-SVN14 | 0.047 | 0.017 | 0.003-0.089 | 0.234 | 0.038 |
| R2=0.040, F=2.168 (p=0.061) | |||||
| ECOHIS-SVN family score | |||||
| Parent’s age | 0.023 | 0.025 | -0.018-0.063 | 0.079 | 0.275 |
| Parent’s education | |||||
| Primary | Ref. | ||||
| Secondary | -0.296 | 0.9 | -1.427-0.867 | -0.235 | 0.633 |
| University | -0.215 | 0.891 | -1.308-0.927 | -0.171 | 0.739 |
| Self-reported oral health | -0.205 | 0.137 | -0.486-0.082 | -0.132 | 0.163 |
| OHIP-SVN14 | 0.086 | 0.021 | 0.008-0.167 | 0.343 | 0.032 |
| R2=0.082, F=3.494 (p=0.005) | |||||
| ECOHIS-SVN total score | |||||
| Parent’s age | 0.052 | 0.039 | -0.009-0.115 | 0.116 | 0.093 |
| Parent’s education | |||||
| Primary | Ref. | ||||
| Secondary | -0.177 | 1.421 | -1.533-1.150 | -0.089 | 0.780 |
| University | -0.017 | 1.408 | -1.328-1.315 | -0.008 | 0.993 |
| Self-reported oral health | -0.408 | 0.217 | -0.870-0.075 | -0.166 | 0.099 |
| OHIP-SVN14 | 0.132 | 0.034 | 0.014-0.250 | 0.334 | 0.028 |
| R2=0.086, F=3.629 (p=0.004) | |||||
ECOHIS-SVN score validity: correlations with parental-reported oral and general health as well as caries and plaque accumulation_
| (n) | Child impact (9 items) | Family impact (4 items) | Total score (13 items) | ||||
|---|---|---|---|---|---|---|---|
| Mean (SD) | r (95% CI) | Mean (SD) | r (95% CI) | Mean (SD) | r (95% CI) | ||
| General health rating | |||||||
| Excellent | 108 | 9.3 (1.3) | 0.56 | 4.1 (0.6) | 0.52 | 13.5 (1.9) | 0.60 |
| Very good | 116 | 10.6 (2.4) | (0.46-0.64)* | 5.5 (2.3) | (0.41-0.61)* | 16.1 (4.0) | (0.50-0.68)* |
| Good | 25 | 13.2 (4.9) | 6.4 (2.2) | 19.6 (6.4) | |||
| Fair | 5 | 10.0 (1.2) | 5.0 (1.0) | 15.0 (2.1) | |||
| Poor | 1 | 15.0 (/) | 7.0 (/) | 22.0 (/) | |||
| Dental health rating | |||||||
| Excellent | 93 | 9.1 (0.3) | 0.69 | 4.1 (0.3) | 0.65 | 13.2 (0.5) | 0.75 |
| Very good | 89 | 9.6 (1.0) | (0.61-0.76)* | 4.7 (1.3) | (0.56-0.72)* | 14.3 (1.8) | (0.68-0.80)* |
| Good | 43 | 11.6 (2.0) | 5.7 (2.1) | 17.3 (3.2) | |||
| Fair | 22 | 14.1 (5.6) | 7.8 (3.0) | 22.0 (7.2) | |||
| Poor | 8 | 15.0 (4.1) | 8.4 (2.3) | 23.4 (4.7) | |||
| Mean (SD) | Median (IQR) | Mean (SD) | Median (IQR) | Mean (SD) | Median (IQR) | ||
| Dmft | |||||||
| dmft=0 | 140 | 9.5 (1.0) | 9 (9-9) | 4.6 (1.3) | 4 (4-4) | 14.0 (2.0) | 13 (13-14) |
| dmft>0 | 115 | 11.4 (3.5) | 10 (9-12)* | 5.6 (2.4) | 5 (4-6)* | 17.0 (5.2) | 15 (13-19)* |
| Dental plaque | |||||||
| no | 131 | 9.7 (1.5) | 9 (9-10) | 4.8 (1.9) | 4 (4-5) | 14.6 (3.0) | 13 (13-15) |
| yes | 124 | 11.0 (3.4) | 10 (9-11)* | 5.2 (1.9) | 4 (4-6) | 16.2 (4.8) | 14 (13-17)* |
Associations between ECOHIS-SVN (total, child and family) and the parent’s age, education level, self-reported oral health status and OHIP-SVN14 score_
| B | SE | 95 % CI | Std. B | p-value | |
|---|---|---|---|---|---|
| ECOHIS-SVN child score | |||||
| Parent’s age | -0.068 | 0.036 | -0.140-0.005 | -0.118 | 0.068 |
| Parent’s education | |||||
| Primary | Ref. | ||||
| Secondary | 0.278 | 1.003 | -2.592-3.182 | 0.105 | 0.842 |
| University | -0.578 | 0.993 | -3.337-2.210 | -0.218 | 0.691 |
| Self-reported oral health | 0.330 | 0.197 | -0.149-0.812 | 0.109 | 0.177 |
| OHIP-SVN14 | 0.076 | 0.034 | -0.013-0.168 | 0.146 | 0.096 |
| R2=0.072, F=4.916 (p<0.001) | |||||
| ECOHIS-SVN family score | |||||
| Parent’s age | -0.043 | 0.026 | -0.088-0.001 | -0.103 | 0.044 |
| Parent’s education | |||||
| Primary | Ref. | ||||
| Secondary | -0.341 | 0.748 | -2.497-1.934 | -0.177 | 0.804 |
| University | -0.374 | 0.740 | -2.536-1.912 | -0.194 | 0.784 |
| Self-reported oral health | 0.02 | 0.147 | -0.244-0.308 | 0.009 | 0.822 |
| OHIP-SVN14 | 0.065 | 0.025 | -0.004-0.133 | 0.171 | 0.065 |
| R2=0.022, F=2.156 (p=0.059) | |||||
| ECOHIS-SVN total score | |||||
| Parent’s age | -0.111 | 0.055 | -0.213-0.015 | -0.126 | 0.025 |
| Parent’s education | |||||
| Primary | Ref. | ||||
| Secondary | -0.063 | 1.540 | -5.267-4.878 | -0.016 | 0.941 |
| University | -0.952 | 1.524 | -6.091-3.927 | -0.236 | 0.673 |
| Self-reported oral health | 0.350 | 0.303 | -0.298-1.034 | 0.076 | 0.279 |
| OHIP-SVN14 | 0.141 | 0.052 | -0.002-0.279 | 0.177 | 0.054 |
| R2=0.06, F=4.259 (p<0.001) | |||||
ECOHIS-SVN score reliability of the study sample_
| Number of items | Internal consistency (n=255) | Test-retest reliability (n=71) | |||
|---|---|---|---|---|---|
| Cronbach’s alpha (lower limit of 95% CI) | Average inter-item correlation | ICC (95% CI) | Mean ECOHIS score difference examination time 1-time 2 (95% CI) | ||
| Child impact | 9 | 0.81 (0.77) | 0.38 | 0.85 (0.76-0.91) | 0.13 (-0.28-0.54) |
| Family impact | 4 | 0.76 (0.71) | 0.46 | 0.79 (0.65-0.87) | 0.25 (0.06-0.44) |
| Total score | 13 | 0.85 (0.82) | 0.34 | 0.85 (0.76-0.91) | 0.38 (-0.14-0.90) |