Parental support programs for preventing early childhood caries

Background/Objectives: Early childhood caries (ECC) and severe early childhood caries (S-ECC) are oral health problems that affect many preschool children worldwide. ECC and S-ECC negatively impact the quality of life of preschool children, including functional, psychological, and social well-being, as well as their families. There is no updated data regarding the prevalence of ECC and S-ECC in Jeddah, Saudi Arabia. Additionally, no study has been conducted on oral health-related quality of life (OHRQoL) with regard to ECC and S-ECC among preschool children in Jeddah. Thus, this investigation aimed to determine the prevalence of ECC and S-ECC in children 3 to 5 years old in Jeddah and its relation to OHRQoL. Methods: A cross-sectional survey was carried out on 322 children randomly selected from different preschools in Jeddah. The early childhood oral health impact scale (ECOHIS) questionnaires were distributed and completed by the parents followed by clinical examination. The dmft and dmfs index scores were determined by WHO diagnostic criteria. Results: A total of 322 preschool children were included in the final sample. The results indicated a caries prevalence rate of 74.2% with ECC and S-ECC prevalence rates of 34.2% and 40.1%, respectively. The mean ± SD dmft and dmfs scores were 4.6 ± 0.4 and 10.8 ± 0.9, respectively. The mean ± SD total score of the early childhood oral health impact scale (ECOHIS) was 6.1 ± 7.3. S-ECC was significantly associated with higher ECOHIS scores (p < 0.001) after controlling for age. Conclusions: ECC and S-ECC are highly prevalent in Jeddah, Saudi Arabia, and negatively impact OHRQoL.

Stunting, a form of chronic malnutrition, is associated with impaired growth and potential changes in salivary function that may increase susceptibility to early childhood caries (ECC). These oral conditions may further influence a child's oral health-related quality of life (OHRQoL). However, the extent to which stunting modifies the impact of salivary factors and ECC on OHRQoL remains unclear. This analytical cross-sectional study included 210 preschool children aged 24-59 months in Bandung, Indonesia, equally divided into stunted and non-stunted groups based on height-for-age z-scores (HAZ <-2 SD for stunted). Dental caries was assessed using the deft index, while salivary pH and buffering capacity were measured using the GC Saliva Check Buffer Test. OHRQoL was evaluated using a modified Early Childhood Oral Health Impact Scale (ECOHIS) with a dichotomous response format (never = 0, ever = 1) validated through pilot testing (Cronbach's α = 0.870). Statistical analyses included Mann-Whitney U, Chi-square, and t-tests, followed by logistic regression with interaction terms to examine effect modification by stunting. Non-stunted children had higher mean deft scores (6.50 ± 4.43) compared to stunted children (5.12 ± 4.38, p = 0.020). Acidic Saliva was more frequent among stunted children (11.4%) than non-stunted children (3.8%, p = 0.037). However, no significant differences were observed in ECOHIS total scores or in the impact of OHRQoL between groups (p > 0.05). Logistic regression revealed no significant interactions between stunting, ECC, salivary pH, or buffering capacity (all p > 0.05). Stunting did not affect the association between salivary factors, early childhood caries, and oral health-related quality of life in preschool children. Although children with stunted had slightly higher salivary acidity, these differences did not result in measurable differences in quality of life. Prevention should combine oral health education and nutritional interventions to comprehensively address the risk of stunting and dental caries.

Aims and backgroundNeonatal factors like gestational age have a major impact on the general and oral growth and development of the child. To compensate for the low birth weight and enhance weight gain, preterm children are often exposed to more frequent cariogenic food intakes between meals and during the night, and these are well-known risk factors for early childhood caries (ECC). ECC in preterm children might also impact the quality of life of the child and parent. This study evaluates the oral health status and quality of life among children born preterm.Materials and methodsA clinical examination of 150 preterm children was done to evaluate their oral health status. The Oral Health-related Early Childhood Quality of Life (OH-ECQoL) tool was used to assess the quality of life.ResultsThe mean age of children in years was 4.99. A total of 72% of the children were introduced to oral hygiene after the age of 24 months, 52% of children had moderate caries, and 8% had severe caries. Children born at 32–36 weeks had a reduced likelihood of ECC as compared to those born before 32 weeks.ConclusionFrom this study, it may be concluded that children born preterm had higher caries prevalence and poorer quality of life. Early guidance on oral health is needed to combat the health disparity among these children. Longitudinal studies to understand the long-term impact of preterm on oral health are needed.Clinical significancePreterm children are at higher risk of having dental diseases. Identification of disparities and challenges faced by preterm children related to oral health needs to be focused on, as the prevalence of preterm children is high among the Indian population.How to cite this articleDevraj IM, Girish MS, Sushma K, et al. Oral Health Status and Oral Health-related Quality of Life among Children Born Preterm: A Cross-sectional Study. Int J Clin Pediatr Dent 2025;18(12):1454–1460.

Both oral and global health-related quality of life (HRQoL) are markedly impaired in SSc. In this study we aimed to determine the degree of association between oral HRQoL and global HRQoL in SSc. Subjects were recruited from the Canadian Scleroderma Research Group registry. Global HRQoL was measured using the Medical Outcomes Trust 36-item Short Form Health Survey (SF-36) and oral HRQoL with the Oral Health Impact Profile (OHIP). The Medsger Disease Severity Score was used to determine organ involvement. Multivariate regression models determined the independent association of the OHIP with the SF-36 after adjusting for confounders. This study included 156 SSc subjects. The majority (90%) were women, with a mean age of 56 years, mean disease duration 13.8 years (s.d. 8.5) and 29% of the subjects had dcSSc. Mean total OHIP score was 40.8 (s.d. 32.4). Mean SF-36 mental component summary (MCS) score was 49.7 (s.d. 11.1) and physical component summary (PCS) score was 37.0 (s.d. 10.7). In adjusted analyses, the total OHIP score was significantly associated with the SF-36 MCS and PCS, accounting for 9.7% and 5.6% of their respective variances. Measures of disease severity were not related to OHIP score. Oral HRQoL in SSc is independently associated with global HRQoL. Oral HRQoL, however, is not related to physician-assessed disease severity. This suggests that physicians may be disregarding issues related to oral health. HRQoL is an additional dimension of HRQoL not captured by generic instruments such as the SF-36.

The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well-being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors. Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children's OHRQoL and socioeconomic conditions. Two calibrated dentists (κ>0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0=caries free; 1-5=low severity; ≥6=high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome. In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (P<0.001). TDI and AMT did not show a negative impact on OHRQoL nor in each domain (P>0.05). The increase in the child's age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (P<0.05). The multivariate adjusted model showed that the high severity of ECC (RR=3.81; 95% CI=2.66, 5.46; P<0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR=0.93; 95% CI=0.87, 0.99; P<0.001). The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents.

ObjectiveAchieving good oral health-related quality of life (OHRQOL) is of particular concern in children. The inter-relations among oral health knowledge, self-efficacy, behaviours and OHRQOL in children groups remain unclear. This...

Oral health-related quality of life among reproductive-aged women with HIV in the southern United States.

ABSTRACTObjectives:This study aimed at evaluating the relationships among oral health practices, early childhood caries (ECC), and oral health-related quality of life (OHRQoL) in five-year-old children in Indonesia.Materials and Methods:Overall, 266 parent–child pairs (PCPs) from preschools in Jakarta participated in a cross-sectional study. The ECC was clinically assessed by two calibrated screeners using the decayed, missing, and filled teeth (dmft) and the pufa index, which records the presence of severely decayed teeth with visible pulpal involvement (p), ulceration caused by dislocated tooth fragments (u), fistula (f), and abscess (a). The parents of the participating children completed the self-administered questionnaire comprising SOHO-5p and their oral health practices. The SOHO-5c questionnaire was used to interview the children.Results:The prevalence of ECC was 88.7%, with 35% having pufa index scores greater than 0. There were significant relationships among oral health practices, ECC, and the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) scores. There was also a significant relationship between cariogenic food consumption and the dmft and SOHO-5p scores. There was a significant relationship between ECC and the SOHO-5 scores. All the SOHO-5p variables except smile avoidance because of appearance had a significant relationship with the dmft and pufa variables. Eating and sleeping difficulties were significantly related to the dmft and pufa scores.Conclusion:OHRQoL was found to be related to the dmft and pufa scores, and the parents’ perceptions were more strongly correlated than the children’s. No significant difference was found in the perceptions indicated by the SOHO-5p and SOHO-5c scores. This suggests that parents can be used as proxies regarding their children’s OHRQoL.

It is generally thought that early childhood caries (ECC) is a public health problem associated with impaired oral health-related quality of life and high costs for families and the society in general. There are numerous epidemiological studies available from various European countries and current ECC inequalities, not only across Europe but also within countries, are obvious. The burden of caries from different countries and regions can however not directly be compared with each other due to design, methodological and reporting issues. For example, there is no consensus on the definition of ECC, which age group(s) that should be examined, sample selection techniques, calibration and number of examiners, inclusion of non-cavitated early lesions, with or without bitewing radiographs, etc. On top of that, small children are not always cooperative, allowing proper cleaning and drying before the examinations. Consequently, it is not surprising to find that prevalence of ECC, assessed with the WHO-criteria, can vary from 86% in Kosovo to 15% in Italy. Likewise, the prevalence of severe ECC seems to range between 3 and 12% across Europe. The mean dmft is reported to vary 0.9 from 10.9. In spite of the abovementioned limitations, it is possible to trace an increasing tendency in the prevalence of ECC from the north-western to the south-eastern countries of Europe. Within all European countries however, there is a clear relationship between socio-economic inequalities and caries; children to low-income and low-educated parents with and without immigrant background display a higher risk of having caries lesions early in life. Poor and near poor 2-5 year-olds have on average 3 times higher dft than non-poor children and this association can be even stronger in the most developed countries. A further problem is that the majority of the disadvantaged children remain untreated. As a first step to combat existing caries inequalities in preschool children, it is important to better map and understand the disease as well as main socio-economic and behavioral determinants. The reporting of ECC (prevalence and severity) in epidemiologic studies must be standardized and the importance of including 3 and 5-year-old children in periodical examinations should be underlined. The adoption of a validated scoring system that allows proper staging of caries lesions is another key factor that should be adopted.

BackgroundThe life expectancy of patients with Human Immunodeficiency Virus (HIV) has increased, but its oral manifestations can affect the Oral Health-Related Quality of Life (OHRQoL) of these patients. This study aimed to evaluate OHRQoL in HIV-infected patients and determine its related factors.MethodsIn this cross-sectional study, 250 HIV-infected patients were randomly selected from Shiraz Voluntary Counseling and Testing center in 2019. OHRQoL was measured using the revised Geriatric Oral Health Assessment Index for HIV patients. The associations between patients’ OHRQoL and demographic characteristics were examined.ResultsThe mean score of the patients' OHRQoL was 24.55 ± 6.27. The lowest and highest scores belonged to the psychosocial and pain categories, respectively. In the univariate analysis, the OHRQoL was significantly associated with patients' age (p = 0.012), duration of the disease (p = 0.009), job (p = 0.006), edentulous status (p = 0.003), and wearing denture (p < 0.001). However, in the multiple linear regression analysis, a significant difference was found only between denture wearing and non-denture wearing patients (p ≤ 0.001).ConclusionsThe OHRQoL of HIV-infected patients was not optimal since most of the patients were worried about their oral and dental health problems. The OHRQoL was significantly better in denture-wearing patients. This finding highlights the impact of unmet dental needs on OHRQoL in HIV-infected patients. Therefore, dental services coverage for patients with HIV is essential, so that they can have timely access to oral health care. Furthermore, dentures should be considered as an unmet healthcare need among HIV patients in public health policies.

Oral health-related quality of life (OHRQOL) is the perceived impact of one's own oral health on daily life. Oral diseases influence children's OHRQOL directly, but OHRQOL might also be related to oral health experiences from the past. We investigate the relation between dental caries at the age of 6 with OHRQOL assessed at the age of 10. This study was conducted within the Generation R Study, a population-based prospective cohort study. Caries experience was assessed with the decayed, missing, and filled teeth index (dmft) at a median age of 6.09 years (90% range: 5.73-6.80). OHRQOL was assessed with a short form of the Child Oral Health Impact Profile at the children's age of 9.79 years (9.49-10.44). In total, 2,833 children participated in this study, of whom 472 (16.6%) had mild caries (dmft 1-3) and 228 (8.0%) had severe caries (dmft >3). The higher the dmft score at the age of 6, the lower the OHRQOL at the age of 10 (p < 0.001). The children with severe caries at the age of 6 had significantly higher odds of being in the lowest OHRQOL quartile at the age of 10 (OR = 1.69; 95% CI: 1.17-2.45). Our study highlights the importance of oral health during childhood, because those who get a compromised start to oral health are much more likely to follow a trajectory which will lead to poor oral health (-related QOL) later. OHRQOL is not only related to current oral health experiences but also to oral health experiences from the past.

Purpose:To evaluate the relationship between self-rated oral health, subjective oral conditions, oral health behaviours, and oral health-related quality of life (OHRQoL) in Chinese college students.Materials and Methods:An online cross-sectional survey was conducted, inviting college students from eastern China to participate. A total of 1708 participants were included. A structural equation model was constructed to explain and assess the associations among self-rated oral health, subjective oral conditions, oral health behaviours, and OHRQoL.Results:Self-rated oral health had a direct positive effect on subjective oral conditions and OHRQoL. Oral health behaviours had direct negative impacts on subjective oral conditions and OHRQoL as well as on tooth condition perception and oral health interventions. Subjective oral conditions had a direct positive effect on OHRQoL. There was a positive correlation between oral health behaviours and self-rated oral health. In addition, subjective oral conditions partially mediated both the effect of oral health behaviours on OHRQoL and the effect of self-rated oral health on OHRQoL.Conclusion:There were influential associations between self-rated oral health, subjective oral conditions, oral health behaviours, and OHRQoL among college students in eastern China. Making the most of their association can be a guide to radically improving the oral health of college students.

Children and adolescents living with HIV (CALHIV) have a higher risk of hard and soft oral tissue diseases as compared with their healthy peers. It is important to increase awareness regarding the need to integrate oral health within medical care among pediatric HIV populations. Studies on associations of oral diseases with oral health-related quality of life (OHRQoL) in CALHIV are lacking. This study examined the association between oral diseases and OHRQoL in Kenyan CALHIV. This cross-sectional analysis was nested in a longitudinal cohort study of CALHIV in Nairobi. CALHIV received oral examinations, and the World Health Organization's Oral Health Surveys and Record Form was administered. OHRQoL was measured with the Parental-Caregiver Perceptions Questionnaire, with the subdomains of global, oral symptoms, function limitations, and emotional and social well-being, with higher scores indicating poorer OHRQoL. Linear regression was used to model associations between OHRQoL and oral diseases, adjusting for age at the time of oral examination, CD4 counts, and caregiver's education. Among 71 CALHIV, the mean age was 12.6 y (SD, 2.9; range, 10 to <21), and the mean composite OHRQoL score was 12.6 (SD, 11.2). Ulcers (not herpes simplex virus or aphthous) were associated with the worst overall OHRQoL (mean, 21.8; SD, 11.1; P = 0.055) and oral symptoms subdomain (mean, 7.0, SD, 2.5; P = 0.003). Children with dry mouth and untreated caries had significantly higher mean global OHRQoL scores than those without disease (P < 0.0001). In the multivariate analysis, the OHRQoL composite score was 6.3 units (95% CI, -0.3 to 12.9) higher for those who had dry mouth and untreated dental caries; dry mouth accounted for the highest percentage of variability of OHRQoL (9.6%) and the global subdomain (31.9%). Ulcers accounted for the highest percentage of variability of the oral symptoms domain (15.4%). Oral ulcers, dry mouth, and untreated caries were associated with poorer OHRQoL in CALHIV. Integrating oral health into the primary care of CALHIV may improve their OHRQoL. This study aimed to determine the association of oral diseases with the oral health-related quality of life of children and adolescents living with HIV (CALHIV). The findings will form part of the evidence to incorporate oral health protocols into care programs for CALHIV. Oral health monitoring has the potential to increase the surveillance of HIV clinical status, monitor the effectiveness of antiretroviral therapy, and improve the oral health-related quality of life of CALHIV.

Early childhood caries (ECC) has a multifactorial nature. This study aimed to develop a structural model to identify the association between possible sleep problems, ECC, and oral health-related quality of life (OHRQoL). A cross-sectional study was conducted with 575 children aged 3-5 years. ECC was assessed using the ICDAS-II by calibrated dentists. Possible sleep problems were determined using the Children's Sleep Habits Questionnaire. OHRQoL was measured using the ECOHIS. Data were analyzed using structural equation modeling through Mplus, version 8.6. Children with more severe stages of ECC experienced dental pain (β = 0.712; p < 0.001), and the presence of dental pain was associated with more disturbed sleep (β = 0.723; p < 0.001). ECC and dental pain negatively impacted the child's (β = 0.208; p < 0.001; β = 0.750; p < 0.001) and the family's (β = 0.347; p < 0.001; β = 0.612; p < 0.001) OHRQoL, respectively. An indirect association was found between ECC and children's sleep, mediated by the variable dental pain. ECC and dental pain were associated with higher OHRQoL scores.

BackgroundThis study assessed the prevalence and severity of early childhood caries (ECC) and identified socioeconomic and behavioral correlates of the disease in preschool children living in Xinjiang.MethodsFor this cross-sectional survey, 1727 children aged 3–5 years in Xinjiang were randomly recruited using a three-stage cluster sampling procedure. The “dmft” index according to the WHO 1997 criteria was used to assess ECC and severe ECC (S-ECC). A questionnaire was completed by caregivers. Variables included sociodemographic characteristics, dietary and oral hygiene behaviors, and access to dental services. The statistical associations of variables with ECC, S-ECC, and dmft were evaluated by univariate and multiple logistic regression analyses.ResultsThe prevalence of ECC was 78.2% and that of S-ECC was 41.2%; mean dmft scores were 5.61 ± 3.56 and 8.17 ± 2.94, respectively. The prevalence of ECC was significantly higher in children from Ining (OR 2.747; 95% CI 2.033–3.713), those whose caregivers had caries (OR 1.78; 95% CI 1.245–2.547), those with a dental visit in the past (OR 2.023; 95% CI 1.429–2.865), and those whose parents had received instructions on oral health care (OR 2.171; 95% CI 1.44–3.272), and increased significantly at age 4 years (OR 2.09; 95% CI 1.506–2.901) and 5 years (OR 2.666; 95% CI 1.855–3.833) and in children who starting tooth brushing at a young age (OR 1.363; 95% CI 1.171–1.587), and decreased significantly in children with a more educated mother (OR 0.817; 95% CI 0.688–1), those from high-income families (OR 0.667; 95% CI 0.582–0.765), those with low consumption of sweets (OR 0.66; 95% CI 0.57–0.763), and those who seldom ate before sleep (OR 0.557; 95% CI 0.437–0.712).ConclusionsECC and S-ECC remain a serious problem among preschool children in Xinjiang. Caries rates were associated with sociodemographic and behavioral factors, which could be modified by public health strategies, including protection of primary dentition, extension of insurance to cover oral preventive services, improvement of the oral health care system, and public health education.