title: The influence of normative and subjective oral health status on schoolchildren's happiness.
abstract: BACKGROUND
  Traditional methods to measure oral health based on clinical standards are limited because they do not consider psychosocial and functional aspects of oral health. It has been recommended that these measures need to be supplemented by data obtained from patients regarding their individual perceptions on oral health-related quality of life (OHRQoL). Happiness is a multidimensional construct comprising both emotional and cognitive domains, and has been defined as "the degree to which an individual judges the overall quality of his or her life as a whole favorably". It has been associated with several health outcomes, including oral health. The aim of this study was to assess the impact of oral health conditions, oral health-related quality of life (OHRQoL), and socioeconomic factors on the subjective happiness of Brazilian adolescents.
  
  
  METHODS
  A cross-sectional study was conducted in 2012 on a representative sample of 12-year-old schoolchildren in Santa Maria-RS, Brazil. The data were collected through dental examinations and structured interviews. The participants underwent an evaluation aimed at detecting dental caries, traumatic dental injuries, malocclusion, and gingival bleeding. They also completed the Brazilian versions of the Child Perceptions Questionnaire-short form (CPQ11-14-ISF: 16) and the Subjective Happiness Scale (SHS), which was our outcome variable. Socioeconomic conditions were evaluated through a questionnaire that was completed by the participants' parents. Poisson regression analysis was used to determine the association between the explanatory variables and the outcome. Moreover, a correlation analysis was performed to determine the relationship between the SHS scores and the overall and domain scores of the CPQ11-14-ISF: 16.
  
  
  RESULTS
  A total of 1,134 children were evaluated. Unadjusted analyses showed that happiness was associated with socioeconomic indicators, the use of dental services, clinical status, and scores on the OHRQoL measure. After adjustment, household overcrowding (RR: 0.96; 95% CI: 0.93-0.98), dental caries (RR: 0.98; 95% CI: 0.97-0.99), malocclusion (RR: 0.98; 95% CI: 0.96-0.99), and the severity associated with the CPQ11-14 (RR: 0.95; 95% CI: 0.93-0.97) still showed a significant association with lower levels of the mean SHS score.
  
  
  CONCLUSIONS
  Happiness is influenced by oral conditions, socioeconomic status, and OHRQoL.
authors.forename: Simone
authors.initials: S
authors.lastname: Tuchtenhagen
authors.forename: Carmela Rampazzo
authors.initials: CR
authors.lastname: Bresolin
authors.forename: Fernanda
authors.initials: F
authors.lastname: Tomazoni
authors.forename: Guilherme Nascimento
authors.initials: GN
authors.lastname: da Rosa
authors.forename: Joana Possamai
authors.initials: JP
authors.lastname: Del Fabro
authors.forename: Fausto Medeiros
authors.initials: FM
authors.lastname: Mendes
authors.forename: José Leopoldo Ferreira
authors.initials: JL
authors.lastname: Antunes
authors.affiliation: Department of Stomatology, Federal University of Santa Maria, UFSM, Rua Cel,Niederauer 917/208, Santa Maria, RS, Brazil. thiardenghi@hotmail.com.
authors.forename: Thiago Machado
authors.initials: TM
authors.lastname: Ardenghi
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D003441:Crowding / Q000523:psychology; D003729:Dental Care / Q000706:statistics & numerical data; D003731:Dental Caries / Q000523:psychology; D004522:Educational Status; D005260:Female; D005884:Gingival Hemorrhage / Q000523:psychology; D006240:Happiness; D006304:Health Status; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008310:Malocclusion / Q000523:psychology; D009909:Oral Health; D010290:Parents / Q000193:education; D011788:Quality of Life; D012923:Social Class; D018677:Tooth Injuries / Q000523:psychology; D044465:White People / Q000706:statistics & numerical data