An assessment of the validity and reliability of dental self-report items used in a National Child Nutrition Survey

Abstract

Objectives: To examine the clinical validity and reliability of dental self-report items used in a national child nutrition survey. Methods: The study involved completion of dental self-report questionnaires by 6–9-year-old children who attended one of the three schools with ethnic distributions, similar to schools in the national survey, and their care-givers. Children were then dentally examined. Results: Two hundred and four children (response rate 74.2%) returned questionnaires and were dentally examined. The highest degree of child and care-giver concordance for the self-reported dental items was for the ‘has had an extraction due to dental caries’ item (kappa = 0.92), while the lowest was for the ‘brushes twice or more per day’ item (kappa = 0.61). The prevalence of dental caries in the deciduous dentition was 67.6%. The mean dfs, mean DFS and mean number of missing primary teeth because of caries were 6.15 (SD 6.51), 0.83 (SD 1.28) and 0.30 (SD 0.82), respectively. Caries severity was higher in children who reported brushing infrequently, having received a filling, having had an extraction because of caries, having been kept awake at night because of dental pain or having had a general anaesthetic for dental treatment. Values for self-report and clinical reliability were above 0.80 in all instances. Conclusions: The dental self-report items showed a high level of concordance between child and care-giver, and appeared to be clinically valid. The findings suggest that using dental self-report measures for children may be valuable in dental epidemiological investigations.