Enrollment in early head start and oral health-related quality of life.

Abstract

Dental problems in young children are widespread and can negatively impact quality of life. We examined the effect of enrollment in North Carolina Early Head Start (EHS)-a federally funded early education program for children under three years of age and their families-on oral health-related quality of life (OHRQoL). In this quasi-experimental study, we interviewed 479 EHS and 699 Medicaid matched parent-child dyads at baseline (children's average age 10months) and 24months later. Parents reported OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS), a 0-52 point scale with higher scores representing more negative impacts. We used a marginalized semicontinuous two-part model to estimate: (1) the effect of EHS on the probability of reporting any follow-up impacts (ECOHIS≥1), and (2) the difference in overall mean ECOHIS follow-up scores. We controlled for baseline ECOHIS, language, and EHS and non-EHS group imbalances using a propensity score. At follow-up, negative OHRQoL impacts were more often reported by parents of non-EHS than EHS children (45 versus 37%, P<.01). In the adjusted model, EHS parents reported a lower odds of negative OHRQoL impacts (OR 0.70; 95% CI 0.52, 0.94). Mean adjusted ECOHIS scores were not significantly different (EHS: 1.59±3.34 versus non-EHS: 2.11±3.85, P>0.05). This study is the first to demonstrate that families of young children enrolled in EHS report improved OHRQoL compared to their non-enrolled peers. These results highlight the potential effectiveness of improving the quality of life of low-resource families through early childhood education.