Abstract
Background
The recognition of oral health as a subjective state has led to a significant body of research into oral health-related quality of life (OHRQoL). OHRQoL is a dynamic construct, susceptible to change according to age and different life stages, and so it is important to understand how OHRQoL changes throughout the life course. To date, there are no studies that have investigated OHRQoL throughout the transition from adolescence to young adulthood, which is partly due to the fact that no OHRQoL index has been validated in both adult and child populations. This presents a significant challenge when measuring OHRQoL changes from adolescence to young adulthood, as scores between different measures cannot be compared directly.
The Child Perceptions Questionnaire (CPQ11-14) is one of the most commonly used OHRQoL measures for children, validated for use from 6 to 14 years. It has been widely used in OHRQoL research in New Zealand and internationally, with New Zealand researchers playing a key role in the measure’s epidemiological validation. While originally developed alongside two other age-specific questionnaires (CPQ6-7 and CPQ8-10), subsequent validation studies demonstrated that CPQ11-14 was valid in younger children, removing the need for the three age-specific questionnaires. With its sound theoretical basis and history of field use, it is possible to consider that the age range of the CPQ11-14 could be extended in the other direction, making it the first OHRQoL measure to be validated in both the child and adult population. This would be an important step towards longitudinal research across the transition from adolescence to young adulthood, bringing with it valuable information to oral health researchers, policy makers and clinicians.
With this in mind, the current study aimed to investigate whether the Child Perceptions Questionnaire was a valid measure for OHRQoL in a young adult population by comparing it to the Oral Health Impact Profile (OHIP-14).
Objectives
The objectives of this study were:
1. To determine whether the CPQ11-14 is a valid and reliable measure for OHRQoL in young adults aged 18-30 years;
ii
2. To compare the performance of the CPQ11-14 and the OHIP-14 as measures of self-reported OHRQoL in a sample of New Zealand young adults aged 18-30 years;
3. To describe self-reported OHRQoL, and its influences in a sample of New Zealand young adults aged 18-30 years; and
4. To examine the ability of self-rated general health measures to identify differences in self-reported oral health.
Methods
A cross-sectional study of young adults in New Zealand aged 18 to 30 years was undertaken. The questionnaire was advertised using social media, where participants were invited to complete the questionnaire through the online platform RedCap. Data were collected on sociodemographic characteristics, oral hygiene habits and dental service usage, dental anxiety, personality, and three separate measures of OHRQoL (CPQ11-14, OHIP-14, and global items). A total of 968 participants completed the survey.
Results
The overall prevalence of 1+ impacts was 62.7% for the CPQ11-14, and 68.7% for the OHIP-14. The mean score was 15.8 (SD=9.7) for the CPQ11-14, and 24.1 (SD=10.1) for the OHIP-14. Both the CPQ11-14 and the OHIP-14 demonstrated acceptable construct validity as assessed by Locker’s global oral health item. The internal consistency reliability was high for both the CPQ11-14 and the OHIP-14, with Cronbach’s alpha scores of 0.87 and 0.92 respectively.
The Pearson correlation coefficient between the CPQ11-14 and the OHIP-14 measures was 0.8, representing a strong correlation. Ordinal logistics regression modelling demonstrated that the CPQ11-14 had a slightly better fit, and explained more variance than the OHIP-14.
Individuals who identified as being dentally anxious reported poorer OHRQoL. Associations were also noted between aspects of personality (positive and negative affect) and OHRQoL. The self-rated general health item was not as discriminative for differing oral health states as the other oral-specific global items.
Conclusion
This study provided evidence of validity and reliability of the CPQ11-14 in a young adult population. Further epidemiological validation studies should be completed to confirm the findings in a representative sample.