Impact of Caries and Enamel Opacities on Irish Schoolchildren's OHRQoL
Objectives: Estimate the impact of dentinal caries and enamel opacities on 12-year-olds reported OHRQoL in Dublin and Cork Kerry in the Republic of Ireland.
Methods: Within the Fluoride and Caring for Children's Teeth (FACCT) Study, 12-year-old schoolchildren (n = 1,582) completed the Child Perceptions Questionnaire (CPQ11–14-ISF-16) and two global OHRQoL questions. These data were combined with their gender, responses to Davies et al's (2012) self-perception of enamel opacities tool, parent reported socio-demographic variables and clinical outcomes; caries (WHO criteria, closed dentinal lesions were included) and fluorosis (Dean's index: 'normal/questionnable' vs 'very mild/mild/moderate', no severe fluorosis was present). Participants were categorised as having always lived in areas with fluoridated water supplies 'Full-Fl'; Dublin and Cork Kerry, and 'Non-Fl'; Cork Kerry, participants never had fluoridated water supplies.
The relationship between overall CPQ11–14-ISF-16 scores and dentinal caries, dental fluorosis, self-perception of enamel opacities and global OHRQoL questions were assessed using multivariate linear regressions, adjusted for behavioural and socio-demographic factors.
Results: Dentinal caries prevalence ranged from 33% in Dublin ‘Full-Fl’ to 53% in Cork Kerry ‘Non-Fl’. Fluorosis prevalence ranged from 4% in Cork Kerry ‘Non-Fl’ to 14% in Dublin ‘Full-Fl’. Among all groups self-perception of oral health as excellent/very good (vs good/fair/poor) was associated with lower CPQ11–14-ISF-16 scores (better OHRQoL). In Dublin ‘Full-Fl’, participants with dentinal caries (vs no caries) had poorer OHRQoL (CPQ11–14-ISF-16 score 1.3 times greater). Female gender and economic disadvantage were also associated with poorer OHRQoL (CPQ11–14-ISF-16 scores; 1.3 and 1.7 times greater respectively), holding all other variables constant (p<0.05). In 'Full-Fl' Cork and Kerry, those who had noticed white marks on their front teeth (vs not noticed) had higher CPQ11–14-ISF-16 scores (poorer OHRQoL), holding all other variables constant (p<0.01).
Conclusions: The self-perception of enamel opacities by schoolchildren in Cork Kerry 'Full-Fl' and dentinal caries in Dublin 'Full-Fl' were associated with poorer OHRQoL. More nuanced exploration of subgroups and subscales will further our understanding of children's perceptions.