The impact of dental caries and local-area deprivation on 5-year-olds’ oral health-related quality of life (OHRQoL)

Abstract

Objective: To explore the impact of area-level deprivation on 5-year-olds’ (school year 1) oral health-related quality of life (OHRQoL) in Wales. Basic research design: During the 2022/23 academic year, a sample of 5-year-old children in state-maintained schools in Wales were selected to undergo a clinical examination. A random stratified sample of 15,625 children were invited to participate. The British Association for the Study of Community Dentistry diagnostic criteria was used to calculate d3mft (decayed, missing, and filled teeth) and PUFA (pulpal involvement, ulceration, fistula, and abscess) scores for each child. Main outcome measures: Before the examination, parents/guardians completed the Early Childhood Oral Health Impact Scale (ECOHIS), a validated measure of OHRQoL. Results and Conclusion: Data were gathered from 8,463 children from 612 schools, with a mean age of 5.95 years. 28.6% had experienced dental caries. Mean d3mft was 1.07 (3.39 in those with caries experience) and PUFA was present in 2.0%. 18.4% of parents/guardians reported a negative impact on the ECOHIS and this increased to 35.1% amongst children with caries experience (d3mft>0). The most common impacts reported were pain (11.6%, 23.6% if d3mft>0) and feelings of guilt in parents/guardians (6.7%, 16.5% if d3mft>0). The highest levels of impact were recorded amongst children from deprived communities, and this persisted after controlling for caries experience or untreated decay (p < 0.05). These data reinforce the need for measures to tackle early childhood caries alongside other efforts to minimise childhood disadvantage.