63 Caries and Fluorosis Impacts on Oral Health-Related Quality of Life

Thursday, March 22, 2012: 8 a.m. - 9:30 a.m.
Presentation Type: Oral Session
U. ONORIOBE, NC DHHS Oral Health Section, Raleigh, NC, R.G. ROZIER, University of North Carolina, Chapel Hill, NC, R.S. KING, North Carolina Oral Health Section, NC Department of Health and Human Services, Raleigh, NC, and J. CANTRELL, Health Policy & Management, University of North Carolina, Chapel Hill, NC
Objective: To determine the impacts of dental caries and enamel fluorosis on oral health-related quality of life (OHRQoL) in North Carolina Schoolchildren and their families.

Method: All students (n=7,686) enrolled in a probability sample of 398 classrooms in grades K-12 in North Carolina public schools and their parents were recruited for a one-time survey in 2003-04.  Parents of children in grades K-3 and 4-12 completed the Early Childhood Oral Health Impact Scale (ECOHIS) and the Family Impact Scale (FIS), respectively.  Students in grades 4-5 (CPQ8-10) and 6-12 (CPQ11-14) completed a Child Perception Questionnaire.  All students received a clinical examination for enamel fluorosis in anterior teeth (Dean’s Index) and caries experience (d2-3fs, D2-3MFS) by one of 6 trained dentists.  OHRQoL (sum of impact frequency Likert scores) were analyzed by fluorosis categories (unaffected; questionable-very mild; mild-moderate-severe) and caries scores (sum of d2-3fs, D2-3MFS) descriptively and using OLS regression, while controlling for covariates (child ever had dental injury, treatment needed, unmet demand, dental home, age, race-ethnicity, percent poverty level, county urbanicity and parental education).

Result: Clinical or OHRQoL information was available for 6,088 children (Response Rate=79.2%).  72.4% of children were unaffected by fluorosis, 24.0% had questionable or very mild fluorosis, and 3.4% had mild, moderate or severe fluorosis.  Mean d2-3fs and D2-3MFS scores per child were 2.1 and 1.7, respectively.  CPQ8-10, CPQ11-14, ECOHIS and FIS mean scores were 13.3, 21.4, 4.9 and 2.4, respectively.  No associations were found between fluorosis categories and any OHRQoL scales in the multivariate analysis (all P-values > 0.1).  The sum of d2-3fs and D2-3MFS scores was positively and strongly associated with ECOHIS (B=0.220; P=<.001), FIS (B=0.063; P=.001), and CPQ11-14 (B=0.239; P<.001) scores.

Conclusion: The child’s caries experience had a negative impact on OHRQoL of the child and parent, while fluorosis prevalence or severity had no impact.

This abstract is based on research that was funded entirely or partially by an outside source: CDC : U48/CCU415769 HRSA: D13H P15295

Keywords: Caries, Children, Fluorosis and Quality of life