Dental caries trajectories and oral health-related quality of life

Background: Distinctive trajectories, or patterns over time, of dental caries experience from childhood through to adulthood have recently been described, however no research has yet been produced to show how these trajectory groups may affect oral health-related quality of life. Objective: To examine differences in oral health-related quality of life by caries trajectory groupings. Methods: In a longstanding prospective cohort study of 1037 individuals born in 1972/73 in Dunedin (NZ), dental health data were recorded at ages 5, 9, 15, 18, 26 and 32 years, including Oral Health Impact data at age 32 years (collected using OHIP-14). Analyses were based upon 955 individuals for whom complete data were available. Within the cohort, three distinct trajectories of caries experience from age 5 to 32 years were identified ( previously described). These trajectories were: Low (N = 384; DMFS = 0.215[age] - 1.486), Moderate (N = 427; DMFS = -0.001[age]3 + 0.073[age]2 - 0.502[age] + 0.684), and High (N = 144; DMFS = -0.004[age]3 + 0.230[age]2 - 2.082[age] + 4.869). Results: Overall, one or more oral health impacts were experienced fairly often or very often by 23.6% of Study participants. By trajectory group, 17.7%, 23.7%, and 38.9% of those in the low, medium, and high caries trajectories experienced oral health impacts, respectively (c2=26.1, P<0.001), while impacts within the OHIP ‘pain' subscale were experienced by 3.9%, 6.3%, and 16.7%, respectively (c2=26.9, P<0.001). Average OHIP scores differed within trajectory groups according to socioeconomic status (SES), with those of higher SES experiencing lower OHIP scores. For example, given a high caries trajectory, the mean number of impacts experienced fairly often or very often was 0.5, 1.0, and 1.3 for those of high, medium, and low SES at age 32 years. Conclusion: Dental caries trajectories appear to be important determinants of individuals' oral health-related quality of life, and this effect may be moderated by an individual's SES.