Caries Severity Affects Quality of Life in 3-4 Year Olds

Objectives: Despite an increase in preventive measures, disparities remain in dental caries rates across America. We are developing a Pediatric Oral Health Quality of Life (POHQOL) questionnaire to examine the impact of dental caries on parent reports of their children's quality of life. This study examined the use of our parent-report on child questionnaire in a pre-school age population and examines if there are differences in quality of life among young children based on caries status, as well as sociodemographic and behavioral factors. Methods: Parents/guardians of 396 children aged 6 months to 4 years were interviewed at the Floating Hospital for Children in Boston, Massachusetts between August 2003 and January 2008. The interviews asked sociodemographic, behavioral, and quality of life questions; these data were paired with those from non-invasive dental examinations of the children. Analyses examined the relationship of caries status defined three ways: white lesions (WL), early childhood caries (ECC), and untreated caries (UC), on parent-reported oral health-related quality of life. Results: Untreated caries and ECC were related to age group, with 3-4 year olds having significantly higher caries rates than 1-2 year olds. Lower income and lack of insurance coverage were related to caries presence; using fluoridated toothpaste and visiting a dentist were more common in children with ECC and UC. Selected POHQOL items (pain, fear, trouble eating) were more frequent in 3-4 year olds with ECC and UC. Impact scores were higher in older children with ECC and UC, but not WL, compared to those without caries; POHQOL findings in 1-2 year olds appeared unrelated to caries. Conclusion: Untreated caries and ECC were associated with selected POQOL items in 3-4 year olds but not 1-2 year olds; however, the presence or absence of white lesions was not associated with quality of life.

This study was supported by NIDCR U54 DE014264, K24 DE000419, and K24 DE018211.