Oral Health Related Quality of Life of Canadian Indigenous Children

Objectives: To assess the oral health status and oral-health related quality of life (OHRQoL) of young First Nations and Metis children.
Methods: This cross-sectional study assessed the oral health status of First Nations and Metis children <72 months of age while their parents/caregivers completed a questionnaire, including the Early Childhood Oral Health Impact Scale (ECOHIS) to assess OHRQoL. Participants were from three rural Indigenous communities and one urban centre in Manitoba, Canada participating in a scale up the Healthy Smile Happy Child (HSHC) initiative. Analysis included descriptive statistics and bivariate analyses. A p-value ≤ 0.05 was significant.
Results: Altogether, 138 children were recruited with a mean age of 40.4±20.5 (SD) months and 49% were male. Overall, 60% had early childhood caries (ECC) while 56% had severe ECC (S-ECC). The mean dmft score was 5.0±5.3 (range 0-20) and the mean dmfs score was 14.6±20.5 (range 0-80). The total mean ECOHIS score was 4.4±5.8 (range 0-25), while the mean Child Impact Section (CIS) and Family Impact section (FIS) scores were 2.7±1.5 (range 0-10) and 1.7±1.8 (range 0-8), respectively. In total, 12.5% of children frequently experienced oral pain. Higher mean total mean ECOHIS scores (which indicate poorer OHRQoL) were observed in children with ECC compared to those caries-free (5.6 vs. 2.6, p=0.001). Statistically significant correlations were found between increased ECOHIS scores and dmft and dmfs scores (both p<0.0001).
Conclusions: Oral health disparities such as ECC and reduced OHRQoL exist among many First Nations and Metis children. This is the first Canadian study exploring the OHRQoL of Indigenous children in addition to their oral health status. These findings help inform community-based oral health promotion and ECC prevention activities. It also establishes baseline findings that will be compared with assessments at the end of the study to determine the overall effectiveness of the “Scaling up the HSHC initiative”.