Oral health-related quality of life of children by dental caries and fluorosis experience

Abstract

Objective: To evaluate the oral health-related quality of life (OHRQoL) of children by dental caries and fluorosis status. Methods: A random sample of South Australian 8- to 13-year-old children was selected. Caries data were collected from school dental service records to group children by combined deciduous and permanent tooth caries experience. Children were examined for fluorosis using the Thylstrup and Fejerskov (TF) Index to form groups by fluorosis scores on maxillary central incisors. Occlusal traits were recorded using the Dental Aesthetic Index. Children and their parents completed the Child Perception Questionnaire (CPQ) and the Parental Perception Questionnaire (PPQ) and a global rating of oral health (OH). OHRQoL indicators, rating OH as Excellent/Very good, and mean overall CPQ/PPQ scores were compared between groups by fluorosis scores and caries experience. Multivariate models were generated for both OH and CPQ/PPQ indicators. Results: Two hundred forty-two children (43.0 percent) had 0 decayed, missing, and filled primary and permanent tooth surface (dmfs/DMFS), while 170 (23.9 percent) had 5+ dmfs/DMFS. The prevalence of TF scores 1, 2, and 3 were 14.5, 9.5, and 1.9 percent, respectively. The proportion of children/parents rating OH as Excellent/Very good was significantly associated with children's caries experience. That proportion increased when fluorosis severity increased from a TF score of 0 to 2, but decreased with a TF of 3. Having low caries experience and better dental appearance were associated with parents’ perception of good OH. Having mild fluorosis and more acceptable appearance were significant factors for children's perception of good OH. Caries and malocclusion were associated with lower OHRQoL, while having a TF score of 2 was associated with better OHRQoL in multivariate models for overall CPQ/PPQ scores. Conclusion: Caries and less acceptable appearance showed a negative impact, while mild fluorosis had a positive impact on child and parental OHRQoL.