Child and family impact of dental caries in Welsh year 1 schoolchildren

Abstract

Background: National surveys across the UK report that tooth decay remains prevalent in children. Poor oral health can negatively impact children’s physical, social, and educational development. Negative effects may also extend to emotional, occupational, and financial impact on the parents/guardians of children with poor oral health.

Objectives: To explore the impact that dental caries has on school year 1 children (5-year-olds) and their families in Wales.

Methods: During the 2022/23 academic year, children in year 1 in a sample of state-maintained schools in Wales were selected to undergo a clinical examination. Their parents/guardians completed the Early Childhood Oral Health Impact Scale (ECOHIS). BASCD diagnostic criteria were used to calculate the decayed, missing and filled teeth (dmft) and pulpal involvement, ulceration, fistula, and abscess (PUFA) scores for each child.

Results: ECOHIS questionnaires were completed for 8463 children from 612 schools (90.3% of all children examined). The children had a mean age of 5.95 years, 28.6% had evidence of decay experience with a mean dmft of 1.07 (3.39 in those with decay experience), and PUFA was present in 2.0%. Negative impact was reported by 18.4% of respondents, this raised to 35.1% if dmft>0. 15.4% reported negative impact(s) affecting the child (29.8% if dmft >0) and 8.8% reported negative family impact(s) (20.4% dmft>0). Pain was the most frequently reported impact on children at 11.6% (23.6% if dmft>0) and feelings of guilt had the most impact on parents/guardians (6.7%, 16.5% if dmft>0).

Conclusion: Children in year 1 are starting their educational career. This study found that in a class of 30 children around nine would have decay experience. Just over five children would be experiencing some form of symptomatic, functional, and/or psychological impact and/or parental distress. These findings reinforce the need for measures to tackle early childhood caries alongside other efforts to minimise childhood disadvantage.