Validity of mother-child self-perceived oral health for the assessment of 5 years old children’s oral health in Indonesia

Abstract

Background: Early childhood caries (ECC) is a serious condition that has a negative impact on young children’s quality of life. Mothers’ perceived need for oral health care plays an important role in their children’s oral health behavior. This study aimed to compare mother and child self-perceived and dentist-evaluated needs for oral health care. Methods: This cross-sectional study included 266 preschool children aged 5 years old and their mothers. A self-administered questionnaire to the mothers and interviews with the children were used to assess the perceived needs of oral health care. The mothers were asked to rate their children’s oral health and determine if they needed dental treatment. The children were also asked how they felt about their oral health and whether they had any tooth decay. Agreement between mother and child regarding the child’s oral health was assessed. The evaluated needs were assessed clinically using the dmft (decayed, missing, and filled teeth [primary dentition]) and pufa (pulpal involvement, ulceration, fistula, and abscess [primary dentition]) indices. The perceived and evaluated needs were compared using spearman analysis to determine their correlations and the validity of the perceived needs compared to the clinical examination was assessed using the area under the curve (AUC), sensitivity (Sn), specificity (Sp), and likelihood ratio (LR). Results: The prevalence rate of ECC was 89.4%, with 35% having at least one condition from untreated caries (pufa > 0). Mothers and children have a fair agreement regarding the child’s oral health (ICC = 0.335). When comparisons were conducted between perceived and evaluated conditions, Mother’s rating about their child’s oral health showed the strongest correlation to dmft index (r = 0.372; p < 0.001). Several accuracy parameters done in this study (AUC, Sn, and Sp) did not meet the acceptable threshold. The sensitivity and specificity were the highest when comparing mothers’ perceived need for their child’s dental treatment to the dmft index (Sn = 96.7%) and pufa index (Sp = 88.1%), respectively. Conclusion: Compared to the dentist’s assessment, the mother and child self-reported oral health statuses showed lower accuracy in assessing the child’s condition. But, the mothers in this study were better than their 5-year-old children at perceiving their child’s oral health care needs. As a result, these subjective assessments can be used as a complement, but not as a substitute, to the actual clinical evaluation.