Oral health‐related quality‐of‐life scores differ by socioeconomic status and caries experience

Abstract

Objectives 1) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); 2) Examine whether that association differed according to family socioeconomic status (SES); and 3) Explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience. Methods Among children in Southern Brazil (N=456, mean age: 38 months), OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1–4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modeling, overall and within socioeconomic strata defined by maternal education, social class, and household income. Results Caries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 versus dmft=0, a pattern that persisted regardless of family socioeconomic status (P-for-interaction: all >0.3). However, adjusted for dental status and socio-demographics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7 ; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0), or in lower income households (ratio: 0.8; 95% CI: 0.4, 1.2). Conclusion Dental caries was associated with negative child and family experiences, contributing to diminished OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality of life impact at the same level of disease experience. Thus, subjective quality of life measures may differ under varying social contexts, with possible implications for service utilization, evaluating oral health interventions, or quantifying disease morbidity in low SES groups.

Conceptual modelling of the factors affecting oral health‐related quality of life in children: A path analysis

“…This finding may show that families with high income levels pay more attention to oral and dental health; therefore, we may consider there to be a link between more time and budget allocations. Many studies involving children of different age groups have found associations of higher levels of parental education with better OHRQoL in children, which our findings support . This is understandable because the knowledge and skills acquired through education can affect one's cognitive functions, make parents more sensitive to their children's oral and dental health, or lead them to be more likely to communicate with and access more appropriate health services.…”

“…Children's oral health is often associated with socio-economic dimensions such as parental income and education. 10,12 In this study, it was determined that family income, health insurance, and parental education level had a direct effect on children's OHRQoL as well as indirectly affecting children's oral health behaviour. Many studies in addition to this study have reported a significant relationship between higher family income and better OHRQoL.…”

“…Many studies involving children of different age groups have found associations of higher levels of parental education with better OHRQoL in children, which our findings support. 12,21,35 This is understandable because the knowledge and skills acquired through education can affect one's cognitive functions, make parents more sensitive to their children's oral and dental health, or lead them to be more likely to communicate with and access more appropriate health services. Contrary to these findings, Abonto et al 10 reported that the level of education of either parent was not related to OHRQoL.…”

Evidence-Based Dentistry Update on Silver Diamine Fluoride

“…5 In lower income groups, much of the caries goes untreated, resulting in severe disease levels that leads to pain, expense, and a decreased quality of life for the affected children and their families. 6 …”

Dental treatment improves the oral health‐related quality of life of adolescents: A mixed‐methods approach

“…3,4 The OHRQoL is a multidimensional construct that is related to the self-perception of an individual's oral health condition and that has also been widely used as an outcome evaluation of clinical treatments. [2][3][4][5] These measures of OHRQoL, however, have been criticized because they use mostly negative questions from theories and models to elicit responses to the presence of disease without considering the individual's ability to adapt or resist to such diseases. 6,7 Also, they are limited for not including psychosocial characteristics (like the sense of coherence, self-esteem, psychological well-being) that seem to be important predictors of quality of life to all age groups including adolescents.…”