Assessing Oral Health Quality of Life in Sudanese Children

Oral health-related quality of life was measured using an Arabic version of the eight item Child-OIDP questionnaire. The questionnaire, originally constructed in English, was translated into Arabic and back translated by different translators and subsequently the two English versions were compared. They were proclaimed acceptable by the first author. The questionnaire was translated to classical Arabic, but read out to each student individually in a Sudanese dialect to ease the comprehension. Initially, the participating children were first presented with a list of 16 impairments; toothache, sensitive teeth, tooth decay (hole in teeth), exfoliating primary teeth, tooth space (due to a non-erupted permanent tooth), fractured permanent tooth, colour of tooth, shape or size of tooth, position of tooth, bleeding gum, swollen gum, calculus, oral ulcers, bad breath, deformity of mouth or face, erupting permanent tooth and missing permanent tooth. From that list, the schoolchildren selected the impairments they experienced in the past 3 months. Then, they were asked about the frequency and severity of each of the 8 Child-OIDP items, e.g. 'Has your oral health affected your eating habits, speaking, mouth cleaning, relaxing, maintaining your emotional state, smiling, schoolwork and contact with people in the past three months?' If the schoolchild responded positively, he/she was asked about the frequency and severity of each impact, e.g. "How often did this happen? How severe was it?' A single impact frequency scale for individuals affected on a regular basis was used. The frequency and severity of impacts were scored on a 3 point Likert scale (1-3) as follows: Frequency scores (1) being once or twice a month, (2) three or more times a month, or once or twice a week (3) three or more times a week. Severity scores; 1 = little effect, 2 = moderate effect and 3 = severe effect. Lastly, the children were asked to mention the impairments they thought caused the impact on each performance. A maximum of 3 impairments per impact were recorded.
From the frequency scores (range between 1-3) of each of the 8 items, the following variables were constructed as described by Gherunpong et al. [20 (link)] and Mtaya et al. [9 (link)]:
Child-OIDP simple count score (Child-OIDP-SC) or Extent (range between 0-8) refers to the number of performances with impacts (PWI) affecting a child's quality of life in the past 3 months. This score was grouped into those with impact (frequency score 1 to 3) and those without impact (score 0).
Child-OIDP ADD Score (range between 0-24) is the sum of the reported frequencies (range between 0-3) of the 8 items.
The Impact Score (range between 0-72) is the sum of the 8 Performance Scores (PS) (range between 0-9). PS is the product of the severity (range between 0-3) and frequency (range between 0-3) scores. The Overall Impact is the impact score divided by 72 and multiplied by 100.
Each performance score (range between 0-9) was classified into 6 levels of intensity following the alternative scoring method described by Gherungpong et al [20 (link)]; non, very little, little, moderate, severe and very severe impact.