Introduction:
The study focuses on early childhood caries (ECC) and its impact on a child’s quality of life, specifically revolving around daily activities such as comfort, eating, and sleeping. The researchers focused on oral health-related quality of life (OHRQoL), measuring how oral health problems affect everyday well-being. In this study, researchers aimed to discover the correlation between dental decay and a worse quality of life in preschool children from a birth cohort in Isfahan, Iran.
Methods:
During the study, a cross-sectional design was conducted, where researchers examined the children at one point in time rather than tracking them for many years. Dating from April to October 2023, using 347 children from the PERSIAN birth cohort in Isfahan aged 2 to 6 years, the study observed the behavior and asked questions to the children. The researchers specifically did clinical dental exams and recorded each child’s DMFT score. Parents also completed the Early Childhood Oral Health Impact Scale (ECOHIS), a questionnaire that measures how oral health affects both the child and the family. The researchers used statistical tests and multivariate logistic regression to study the relationship between tooth decay and quality of life while adjusting for other factors that could affect the results.
Results:
A DMFT score index ranges from 0-32, where a score of 4.5 to 6.5 is considered high, while 6.6 or higher is extremely high. It was found that children with higher DMFT scores were associated with worse oral health-related quality of life, which is directly linked to both the child-related and parent-related parts of the questionnaire. In addition, another prominent factor, income, was assessed, where families with higher income correlated with less DMFT; however, external factors such as parents’ attentiveness to the child’s oral hygiene or regular doctor visits may have also impacted the findings. Regardless, the relationship was statistically significant, indicating that the pattern was unlikely to be due to chance alone. For every 1-point increase in DMFT, the likelihood of worse child quality-of-life outcomes increased by about 23%, worse parent-reported outcomes increased by about 32%, and lower parental satisfaction increased by about 35%. This means that as dental decay increased, the negative impact on daily life and family experience also increased in a stepwise way, not just in the most severe cases.
Limitations:
The study presents a general overview of how dental caries affects children’s quality of life. For example, the study’s environment is a limitation to assess the findings globally, as the study was only focused on a birth cohort in Isfahan, Iran. The results are biased to Iran’s conditions, such as health care access, the country's development, environmental issues, and doctors, where it does not account for results in other international countries. In addition, the data can be skewed due to a small population size, which affects the credibility of whether a high DMFT causes poorer quality of life, rather than if the patients were outliers in the study, having extreme cases, and an external chance that may have affected the results.
Conclusion:
Overall, the study found a clear association between more dental caries and poorer quality of life in preschool children and their families. The findings suggest that tooth decay in early childhood should be seen as more than a simple dental problem, as it directly affects external factors of the children’s lives: speaking, playing, concentration, and eating. However, despite the cross-sectional design, an association was found, but it cannot be interpreted as a positive direct cause-and-effect relationship. The authors of the article note that its findings cannot be completely credible due to the limited sample size, especially in the moderate-income group (a socioeconomic factor evaluated). Regardless, the study’s attention is to support the value of early detection, prevention, oral health education, and attention to children experiencing ECC.
