The Impact of Early Childhood Caries on the Quality of Life of 3-6 year Old Children and Their Parents Visiting Teacher Dental Hospital in Peshawar

Abstract

Background: Dental caries is a worldwide challenge to the public health, predominantly effecting young children. Early childhood caries (ECC) can begin soon after tooth eruption starting on the smooth surface, progressing rapidly and require filling or leading to extraction of the involved tooth. Children experiencing caries in the earliest ages of their lives are at a greater risk of developing caries in permanent dentition as well. It can have a drastic impact on the permanent dentition and hence adds up to the increasing burden of oral diseases. Unlike other infectious diseases, dental caries is not self-limiting, and untreated early childhood caries will affect both oral and general health as well as quality of life.

Aims & Objectives: The objectives were to assess the impact on quality of life of early childhood caries (ECC) on the quality of life of children at teaching dental hospital in Peshawar and to determine the impact of ECC on quality of life of their parents. Using the claimed methods for the assessment of the severity of the dmft-index and the severity of their impact on QoL through the use of ECOHIS questionnaire.

 Method: The study comprises of 400 children (3 to 6year) attending tertiary care dental hospitals in Peshawar. A consecutive non-probability sampling technique was used. Data related to the severity of ECC and the QoL of the child and parent were collected through clinical examinations and ECOHIS questionnaires (Pahel et al. 2007). ECC and its severity of each child was recorded as nil, mild, moderate and severe using dmft index. Urdu version of the ECOHIS was derived though a forward-backward translation without modifications. Primary caregivers completed an Urdu version of the ECOHIS. Data analysis was done using SPSS version 22.0. The impact levels for QoL of the child and the parent were recorded as weak/mild, moderate, high.

Result: The mean age of the children was 2.58 ± 1.13 with a male to female ratio of 1:0.8. More than half of the families in the study (64%) had a low socioeconomic status. About 41.5% children included in the study had high dmft scores indicative of severe ECC (S-ECC). The ECOHIS scores and children’s caries experience (dmft) were related to each other (r =0.59, P < 0.01). In addition, the variations in ECOHIS scores were apparent with respect to caries severity (P < 0.001), supporting the ability to distinguish between patient groups. About 38.5% of the children showed greater total ECOHIS scores (range 36 to 52) suggesting high impact on QoL. In the CIS 55% of the children reported high impact (range 25 to 36), whereas in the FIS majority of the parents (40.2%) showed weak impact levels. In the child section the functional domain was the most reported item (73.2%), whereas the financial impact item (54.4%) was the frequently reported in the parent section. Cronbach’s alpha values (internal consistency) for total ECOHIS score were 0.86, and 0.78 and 0.82 for both the child and family impact sections respectively.

Conclusions: Severe ECC in children adversely affected their quality of life. The use of an oral health specific instrument such as the ECOHIS proved useful in assessing the impact of dental caries on functional and psychosocial well-being of children. And it is also able to evaluate the functional and financial impact on QoL of parents of children having ECC.

Keywords:  oral health, preschool children, Quality of lifeearly, childhood caries.