What do children's global ratings of oral health and well-being measure?

Objectives: To explore the constructs children incorporate in the responses to global ratings of their oral health (OH) and OH-related overall well-being (OWB). Methods: Data were collected as part of a project to validate the Child Perceptions Questionnaire for ages 11-14 (CPQ(11-14)), a self-report measure of OH-related quality of life. Its 37 questions are organized in the symptoms, functional limitations, emotional and social well-being domains. Children were recruited from paediatric dentistry, orthodontic and orofacial dental clinics. To identify the CPQ(11-14) domain scores and questions predicting the global ratings, correlation and multiple regression analyses were used. Results: Of the 123 children, 22.8% rated their OH as 'Fair/Poor' and 30.1% reported that their OWB was affected by their oral/orofacial condition. Positive significant correlations were observed between the OH ratings and the CPQ(11-14) oral symptoms and emotional well-being domains, and between the OWB ratings and all four CPQ(11-14) domains. The number of the CPQ(11-14) questions significantly correlated with the OH and OWB ratings were 8 and 19, respectively. Only the symptoms domain entered the model for the OH (R-2=0.05), while age, functional limitations and emotional well-being domains predicted the OWB (R-2=0.18). The OH model included three questions (R-2=0.13) and the OWB model included age and six questions (R-2=0.25). In both models all but one of the questions came from the emotional and social well-being domains. Conclusions: These findings suggest that children view OH and its impact on well-being as multidimensional concepts. Further research, including qualitative studies, is needed to better understand the referents children use when responding to global ratings and the factors that determine their responses.