Background
Methods
Cross-cultural adaptation
Arabic version of the CPQ11–14 questionnaire
Data collection
Study population
Completion of the questionnaires
Clinical data
Aesthetic Index Components | Regression coefficients (Rounded weights) |
---|---|
Missing visible teeth (incisor, canine, or premolar teeth in maxillary and mandibular arches) | 6 |
Crowding in the incisal segments (0 = no segment crowded; 1 = 1 segment crowded; 2 = 2 segments crowded) | 1 |
Spacing in the incisal segments (0 = no spacing; 1 = 1 segment spaced; 2 = 2 segments spaced) | 1 |
Midline diastema in mm | 3 |
Largest anterior irregularity in mm (maxillary) | 1 |
Largest anterior irregularity in mm (mandibular) | 1 |
Anterior maxillary over-jet in mm | 2 |
Anterior mandibular over-jet in mm | 4 |
Vertical anterior open-bite in mm | 4 |
Anterior-posterior molar relation (0 = Normal; 1 = 1/2cusp; 2 = Fullcusp) | 3 |
Constant | 13 |
Statistical analyses
Results
Description sample
In the past 3 months | Never N (%) | Once or twice N (%) | Sometimes N (%) | Often N (%) | Everyday or almost every day N (%) |
---|---|---|---|---|---|
Dimension 1: Oral symptoms | |||||
CPQ1 Pain in your teeth or mouth | 353 (50.9%) | 159 (22.9%) | 138 (19.9%) | 30 (4.3%) | 13 (1.9%) |
CPQ2. Bleeding gums | 400 (57.7%) | 128 (18.5%) | 103 (14.9%) | 30 (4.3%) | 32 (4.6%) |
CPQ3. Sore spots | 374 (54.0%) | 182 (26.3%) | 103 (14.9%) | 29 (4.2%) | 5 (.7%) |
CPQ4. Bad breath | 436 (62.9%) | 111 (16.0%) | 95 (13.7%) | 34 (4.9%) | 17 (2.5%) |
CPQ5. Food stuck in or between your teeth | 251 (36.2%) | 184 (26.6%) | 166 (24.0%) | 45 (6.5%) | 47 (6.8%) |
CPQ6. Food stuck in the top of your mouth | 549 (79.2%) | 88 (12.7%) | 32 (4.6%) | 16 (2.3%) | 8 (1.2%) |
Dimension 2: Functional limitations | |||||
CPQ7. Breathed through your mouth | 256 (36.9%) | 145 (20.9%) | 160 (23.1%) | 59 (8.5%) | 73 (10.5%) |
CPQ8. Took longer than others to eat a meal | 535 (77.2%) | 89 (12.8%) | 38 (5.5%) | 14 (2.0%) | 17 (2.5%) |
CPQ9. Had Have trouble sleeping | 552 (79.7%) | 82 (11.8%) | 41 (5.9%) | 14 (2.0%) | 4 (.6%) |
CPQ10. Difficult to bite or chew food like apples, corn on the cob or steak | 472 (68.1%) | 94 (13.6%) | 79 (11.4%) | 36 (5.2%) | 12 (1.7%) |
CPQ11. Difficult to open your mouth wide | 576 (83.1%) | 59 (8.5%) | 34 (4.9%) | 12 (1.7%) | 12 (1.7%) |
CPQ12. Difficult to say any words | 595 (85.9%) | 44 (6.3%) | 27 (3.9%) | 17 (2.5%) | 10 (1.4%) |
CPQ13. Difficult to eat foods you would like to eat | 535 (77.2%) | 74 (10.7%) | 49 (7.1%) | 28 (4.0%) | 7 (1.0%) |
CPQ14. Difficult to drink with a straw | 630 (90.9%) | 29 (4.2%) | 19 (2.7%) | 10 (1.4%) | 5 (.7%) |
CPQ15. Difficult to drink or eat hot or cold foods | 390 (56.3%) | 143 (20.6%) | 90 (13.0%) | 42 (6.1%) | 28 (4.0%) |
Dimension 3: Emotional well-being | |||||
CPQ16. Felt irritable or frustrated | 563 (81.2%) | 70 (10.1%) | 29 (4.2%) | 19 (2.7%) | 12 (1.7%) |
CPQ17. Felt unsure of yourself | 570 (82.3%) | 56 (8.1%) | 36 (5.2%) | 18 (2.6%) | 13 (1.9%) |
CPQ18. Felt shy or embarrassed | 507 (73.2%) | 96 (13.9%) | 49 (7.1%) | 22 (3.2%) | 19 (2.7%) |
CPQ19. Concerned about what other people think about your teeth or mouth | 490 (70.7%) | 104 (15.0%) | 59 (8.5%) | 25 (3.6%) | 15 (2.2%) |
CPQ20. Worried that you are not as good-looking as others | 521 (75.2%) | 83 (12.0%) | 57 (8.2%) | 17 (2.5%) | 15 (2.2%) |
CPQ21. Felt upset | 457 (65.9%) | 120 (17.3%) | 73 (10.5%) | 27 (3.9%) | 16 (2.3%) |
CPQ22. Felt nervous or afraid | 568 (82.0%) | 69 (10.0%) | 33 (4.8%) | 16 (2.3%) | 7 (1.0%) |
CPQ23. Worried that you are not as healthy as others | 564 (81.4%) | 70 (10.1%) | 37 (5.3%) | 11 (1.6%) | 11 (1.6%) |
CPQ24. Worried that you are different from others | 548 (79.0%) | 83 (12.0%) | 37 (5.3%) | 10 (1.4%) | 15 (2.2%) |
Dimension 4: Social well-being | |||||
CPQ25. Missed school because of your teeth or mouth | 586 (84.6%) | 75 (10.8%) | 23 (3.3%) | 9 (1.3%) | 0 (0.0%) |
CPQ26. Had problems paying attention in school | 549 (79.2%) | 86 (12.4%) | 40 (5.8%) | 14 (2.0%) | 4 (.6%) |
CPQ27. Had difficulty doing your homework | 589 (85.0%) | 58 (8.4%) | 28 (4.0%) | 14 (2.0%) | 4 (.6%) |
CPQ28. Did not want to speak or read out loud in class | 566 (81.7%) | 80 (11.5%) | 33 (4.8%) | 11 (1.6%) | 3 (.4%) |
CPQ29. Stayed away from sports and club activities | 641 (92.5%) | 34 (4.9%) | 10 (1.4%) | 5 (.7%) | 3 (.4%) |
CPQ30. Did not want to talk to other children | 620 (89.5%) | 50 (7.2%) | 16 (2.3%) | 6 (.9%) | 1 (.1%) |
CPQ31. Avoid smiling or laughing with other children | 524 (75.6%) | 95 (13.7%) | 46 (6.6%) | 18 (2.6%) | 10 (1.4%) |
CPQ33. Did not want to spend time with other children | 642 (92.6%) | 22 (3.2%) | 18 (2.6%) | 8 (1.2%) | 3 (.4%) |
CPQ34. Argued with other children or your family | 613 (88.5%) | 46 (6.6%) | 17 (2.5%) | 12 (1.7%) | 5 (.7%) |
CPQ35. Other children teased you or called you names | 605 (87.3%) | 47 (6.8%) | 24 (3.5%) | 12 (1.7%) | 5 (.7%) |
CPQ36. Other children made you feel left out | 640 (92.3%) | 34 (4.9%) | 12 (1.7%) | 5 (.7%) | 2 (.3%) |
CPQ37. Other children asked you questions about your teeth or mouth | 551(79.5%) | 87(12.6%) | 34(4.9%) | 15(2.2%) | 6(.9%) |
Reliability
Reproducibility
Concurrent validity
Dimension 1- Oral Symptoms | Dimension 2- Functional limitations | Dimension 3- Emotional well being | Dimension 4- Social well being | Global score | ||
---|---|---|---|---|---|---|
Self perception of general health | Poor/very poor (n = 40) | 6.40 ± 3.79 | 7.55 ± 5.34 | 7.18 ± 8.41 | 5.35 ± 7.21 | 26.48 ± 18.90 |
Moderate (n = 118) | 6.44 ± 3.58 | 7.23 ± 5.19 | 6.99 ± 8.08 | 5.69 ± 7.20 | 26.36 ± 19.85 | |
Good/Very good (n = 533) | 4.01 ± 3.05 | 3.82 ± 3.92 | 2.70 ± 4.02 | 1.87 ± 3.10 | 12.40 ± 10.85 | |
Sig
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
| |
Self perception of oral health | Poor/very poor (n = 84) | 7.02 ± 3.86 | 8.21 ± 5.80 | 9.73 ± 8.69 | 7.36 ± 8.05 | 32.32 ± 20.68 |
Moderate (n = 219) | 5.11 ± 3.07 | 5.22 ± 4.56 | 4.23 ± 4.99 | 3.06 ± 3.93 | 17.62 ± 12.68 | |
Good/Very good (n = 388) | 3.72 ± 3.05 | 3.50 ± 3.57 | 2.08 ± 3.76 | 1.53 ± 3.12 | 10.83 ± 10.51 | |
Sig
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
| |
Satisfaction with oral health | Not satisfied (n = 112) | 6.01 ± 3.70 | 7.12 ± 5.80 | 7.71 ± 7.86 | 5.94 ± 7.32 | 26.77 ± 19.73 |
Moderately (n = 160) | 5.38 ± 3.12 | 5.02 ± 4.54 | 5.12 ± 5.88 | 3.44 ± 4.61 | 18.96 ± 14.47 | |
Very satisfied (n = 419) | 3.87 ± 3.14 | 3.80 ± 3.75 | 2.07 ± 3.69 | 1.59 ± 3.02 | 11.32 ± 10.56 | |
Sig
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
| |
Self reported need for dental treatment | Yes (n = 419) | 5.23 ± 3.41 | 5.29 ± 4.77 | 4.92 ± 6.42 | 3.62 ± 5.44 | 19.06 ± 16.12 |
No (n = 272) | 3.54 ± 2.97 | 3.58 ± 3.79 | 1.80 ± 3.02 | 1.34 ± 2.49 | 10.26 ± 9.64 | |
Sig
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
Dimension 1- Oral Symptoms | Dimension 2- Functional limitations | Dimension 3- Emotional well being | Dimension 4- Social well being | Global score | ||
---|---|---|---|---|---|---|
How much do you like the look of your teeth | Never (n = 100) | 6.01 ± 3.82 | 6.95 ± 5.50 | 8.64 ± 7.97 | 6.07 ± 7.41 | 27.67 ± 19.94 |
Moderately (n = 349) | 4.73 ± 3.28 | 4.78 ± 4.57 | 3.81 ± 5.18 | 2.92 ± 4.38 | 16.24 ± 13.87 | |
Very much (n = 242) | 3.74 ± 2.99 | 3.42 ± 3.37 | 1.46 ± 2.90 | 1.06 ± 2.02 | 9.67 ± 8.41 | |
Sig
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
| |
Your teeth are | Less beautiful than others (n = 90) | 6.74 ± 4.11 | 6.74 ± 5.45 | 8.83 ± 8.17 | 6.12 ± 7.06 | 28.44 ± 19.52 |
Like others (n = 504) | 4.28 ± 2.96 | 4.29 ± 4.10 | 2.94 ± 4.48 | 2.11 ± 3.63 | 13.62 ± 11.98 | |
More beautiful than others (n = 96) | 4.06 ± 3.70 | 4.41 ± 4.94 | 2.81 ± 5.11 | 2.81 ± 5.24 | 14.09 ± 15.63 | |
Sig
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
| |
You think your teeth are | Less aligned than others (n = 186) | 5.47 ± 3.32 | 5.88 ± 4.81 | 5.97 ± 6.98 | 4.20 ± 6.17 | 21.52 ± 17.37 |
Aligned as others (n = 431) | 4.13 ± 3.19 | 4.00 ± 4.19 | 2.80 ± 4.55 | 2.07 ± 3.51 | 12.99 ± 12.19 | |
More aligned than others (n = 73) | 4.92 ± 3.79 | 5.12 ± 4.69 | 3.16 ± 5.31 | 2.86 ± 5.21 | 16.07 ± 15.44 | |
Sig
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
< 0.001
|
Discriminant validity
Dimension 1- Oral Symptoms | Dimension 2- Functional limitations | Dimension 3- Emotional well being | Dimension 4- Social well being | Global score | ||
---|---|---|---|---|---|---|
Gender | Boy (n = 377) | 4.67 ± 3.44 | 4.59 ± 4.22 | 3.62 ± 5.35 | 2.75 ± 4.63 | 15.64 ± 14.02 |
Girl (n = 316) | 4.45 ± 3.23 | 4.65 ± 4.79 | 3.77 ± 5.78 | 2.69 ± 4.66 | 15.56 ± 15.18 | |
Sig
|
0.390
|
0.860
|
0.725
|
0.851
|
0.945
| |
Age categories | 11–12 years (n = 160) | 4.74 ± 3.64 | 5.06 ± 4.71 | 4.11 ± 5.23 | 2.62 ± 4.18 | 16.52 ± 14.50 |
13–14 years (n = 533) | 4.52 ± 3.25 | 4.49 ± 4.41 | 3.57 ± 5.64 | 2.75 ± 4.77 | 15.32 ± 14.57 | |
Sig
|
0.450
|
0.160
|
0.281
|
0.746
|
0.361
| |
Recruitment level | Public (n = 307) | 4.60 ± 3.60 | 5.21 ± 5.08 | 4.68 ± 6.44 | 3.05 ± 4.81 | 17.55 ± 16.24 |
Private (n = 386) | 4.54 ± 3.13 | 4.15 ± 3.90 | 2.90 ± 4.58 | 2.46 ± 4.50 | 14.05 ± 12.87 | |
Sig
|
0.811
|
0.002
|
< 0.001
|
0.099
|
0.002
| |
Malocclusion category | None/Minor (n = 387) | 4.26 ± 3.08 | 4.13 ± 3.84 | 2.72 ± 3.95 | 1.88 ± 3.12 | 12.99 ± 10.58 |
Definite (n = 141) | 4.82 ± 3.69 | 4.78 ± 4.61 | 4.13 ± 5.49 | 3.06 ± 4.88 | 16.79 ± 15.37 | |
Severe/handicapping (n = 110) | 5.06 ± 3.52 | 5.73 ± 6.15 | 6.80 ± 8.73 | 4.72 ± 7.41 | 22.31 ± 22.17 | |
Sig
|
0.037
|
0.004
|
< 0.001
|
< 0.001
|
< 0.001
| |
Number of decayed teeth | ≤4 (n = 570) | 4.41 ± 3.30 | 4.48 ± 4.36 | 3.34 ± 5.26 | 2.47 ± 4.03 | 14.70 ± 13.42 |
> 4 (n = 119) | 5.20 ± 3.35 | 5.16 ± 4.99 | 5.24 ± 6.47 | 3.88 ± 6.77 | 19.49 ± 18.47 | |
Sig.
|
0.019
|
0.131
|
0.001
|
0.003
|
0.001
| |
Number of filled teeth | ≤ 2 (n = 542) | 4.63 ± 3.37 | 4.70 ± 4.50 | 3.86 ± 5.67 | 2.81 ± 4.54 | 16.00 ± 14.54 |
> 2 (n = 147) | 4.26 ± 3.15 | 4.22 ± 4.40 | 2.95 ± 4.93 | 2.38 ± 5.01 | 13.80 ± 14.37 | |
Sig.
|
0.230
|
0.250
|
0.074
|
0.325
|
0.104
| |
Missing teeth | ≤0 (n = 666) | 4.54 ± 3.33 | 4.53 ± 4.46 | 3.48 ± 5.28 | 2.58 ± 4.43 | 15.13 ± 14.17 |
> 0 (n = 23) | 4.78 ± 3.16 | 6.43 ± 4.87 | 9.17 ± 8.94 | 6.61 ± 7.99 | 27.00 ± 19.38 | |
Sig.
|
0.733
|
0.045
|
< 0.001
|
< 0.001
|
< 0.001
| |
DMFT | ≤6 (n = 608) | 4.44 ± 3.29 | 4.47 ± 4.41 | 3.47 ± 5.38 | 2.52 ± 4.14 | 14.91 ± 13.77 |
> 6 (n = 81) | 5.36 ± 3.44 | 5.51 ± 4.88 | 5.12 ± 6.39 | 4.16 ± 7.28 | 20.15 ± 18.67 | |
Sig.
|
0.020
|
0.051
|
0.012
|
0.003
|
0.002
|
Unstandardized Coefficients | Standardized Coefficients | t | Sig. | Correlations | ||
---|---|---|---|---|---|---|
B | Std. Error | Beta | Part | |||
Global score | ||||||
Age | −0.214 | 1.380 | −0.006 | −0.155 | 0.877 | −0.006 |
Recruitment level | −3.409 | 1.177 | − 0.116 | −2.897 | 0.004 | −0.111 |
DMFT | 5.089 | 1.721 | 0.114 | 2.957 | 0.003 | 0.113 |
DAI index | 4.316 | 0.734 | 0.226 | 5.880 | 0.000 | 0.224 |
Oral symptoms | ||||||
Age | −0.201 | 0.321 | −0.026 | − 0.626 | 0.531 | − 0.025 |
Recruitment level | −0.005 | 0.274 | 0.000 | −0.018 | 0.985 | 0.000 |
DMFT | 0.992 | 0.400 | 0.098 | 2.479 | 0.013 | 0.098 |
DAI index | 0.442 | 0.171 | 0.103 | 2.594 | 0.010 | 0.102 |
Functional limitation | ||||||
Age | −0.224 | 0.434 | −0.021 | −0.517 | 0.605 | −0.020 |
Recruitment level | −1.192 | 0.370 | −0.131 | −3.224 | 0.001 | −0.126 |
DMFT | 0.952 | 0.541 | 0.069 | 1.761 | 0.079 | 0.069 |
DAI index | 0.704 | 0.231 | 0.120 | 3.052 | 0.002 | 0.119 |
Emotional well-being | ||||||
Age | −0.060 | 0.521 | −0.005 | −0.114 | 0.909 | −0.004 |
Recruitment level | −1.582 | 0.445 | −0.141 | −3.558 | 0.000 | −0.135 |
DMFT | 1.540 | 0.650 | 0.090 | 2.369 | 0.018 | 0.090 |
DAI index | 1.832 | 0.277 | 0.251 | 6.608 | 0.000 | 0.250 |
Social well-being | ||||||
Age | 0.271 | 0.440 | 0.025 | 0.615 | 0.539 | 0.024 |
Recruitment level | −0.631 | 0.376 | −0.068 | −1.680 | 0.094 | −0.065 |
DMFT | 1.605 | 0.549 | 0.113 | 2.922 | 0.004 | 0.112 |
DAI index | 1.338 | 0.234 | 0.221 | 5.712 | 0.000 | 0.220 |