Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families.

Research from JAMA Pediatrics — Cost-effectiveness of Preventive Oral Health Care in Medical Offices for Young Medicaid Enrollees

The objectives of this study were to determine the impact of enamel fluorosis and dental caries on oral health–related quality of life (OHRQoL) in North Carolina schoolchildren and their families. Students ( n = 7,686) enrolled in 398 classrooms in grades K-12 were recruited for a onetime survey. Parents of students in grades K-3 and 4-12 completed the Early Childhood Oral Health Impact Scale (ECOHIS) and Family Impact Scale (FIS), respectively. Students in grades 4-12 completed the Child Perceptions Questionnaire (CPQ_8-10 in grades 4-5; CPQ_11-14 in grades 6-12). All students were examined for fluorosis (Dean’s index) and caries experience (d_2-3fs or D_2-3MFS indices). OHRQoL scores (sum response codes) were analyzed for their association with fluorosis categories and sum of d_2-3fs and D_2-3MFS according to ordinary least squares regression with SAS procedures for multiple imputation and analysis of complex survey data. Differences in OHRQoL scores were evaluated against statistical and minimal important difference (MID) thresholds. Of 5,484 examined students, 71.8% had no fluorosis; 24.4%, questionable to very mild fluorosis; and 3.7%, mild, moderate, or severe fluorosis. Caries categories were as follows: none (43.1%), low (28.6%), and moderate to high (28.2%). No associations between fluorosis and any OHRQoL scales met statistical or MID thresholds. The difference (5.8 points) in unadjusted mean ECOHIS scores for the no-caries and moderate-to-high caries groups exceeded the MID estimate (2.7 points) for that scale. The difference in mean FIS scores (1.5 points) for the no-caries and moderate-to-high groups exceeded the MID value (1.2 points). The sum of d_2-3fs and D_2-3MFS scores was positively associated with CPQ_11-14 ( B = 0.240, p < .001), ECOHIS ( B = 0.252, p ≤ .001), and FIS ( B = 0.096, p ≤ .01) scores in ordinary least squares regression models. A child’s caries experience negatively affects OHRQoL, while fluorosis has little impact.