Severe Caries Associated With Lower Oral Health Quality of Life in Underserved Populations

Objectives: To assess if oral health-related quality of life (OHQL) is associated with caries status in children from an underserved population.
Methods: Parents of children ages 3-7 presenting for initial exams at the pediatric dental clinics at Franciscan Hospital for Children in Brighton, MA and East Boston Neighborhood Health Center in East Boston, MA were asked to complete a survey. The survey consisted of sociodemographic and dental behavior questions and the Pediatric Oral Health-related Quality of Life (POQL) instrument. Only children from underserved populations, identified as children who are from minority racial and ethnic groups, have a medical condition, and/or have Medicaid for insurance, participated in the study. Caries severity was calculated using the definition of severe early childhood caries (S-ECC) by the American Academy of Pediatric Dentistry.
Results: 106 parent-child pairs participated in the study. The sample of children had a mean age of 4.6 years and 56% were male. The child subjects were from diverse racial and ethnic backgrounds (34% Caucasian, 29% Hispanic, 13% Asian, 11% African-American, and 12% other/mixed), with the majority of children (78%) being covered by Medicaid for dental care. One-third of the children had a medical condition (asthma, ADHD, and autism being the most frequent). The majority of the children were classified as having S-ECC (72.6%), with 10.4% having childhood caries and 17% being caries free. Children with S-ECC reported significantly worse OHQL as measured by the POQL than caries free children in multiple POQL categories (p<0.01)--total score, parental burden and distress, and child emotional and physical domains.
Conclusions: Young children with S-ECC from underserved populations have significantly lower OHQL compared to their caries free peers. An emphasis should be made on seeing children from this population at a young age to prevent the initiation of dental caries.