Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings.

Abstract

This paper evaluated the impact of cleft-related surgery on the oral health-related quality of life (OHRQoL) of youth with cleft over time. Data were derived from a 5-year, multi-center, prospective, longitudinal study of 1196 youth with cleft lip and/or palate and their caregivers. Eligible youth were between 7.5 and 18.5years old, spoke English or Spanish, and were non-syndromic. During each observational period, which included baseline, and 1- and 2-year post-baseline follow-up visits, youths and their caregivers completed the Child Oral Health Impact Profile, a validated measure of OHRQoL. Multilevel mixed-effects models were used to analyze the effects of receipt of craniofacial surgery on OHRQoL over time. During the course of this study a total of 516 patients (43%) received at least one surgery. Youth in the surgery recommendation group had lower self- (β=-2.18, p<0.05) and proxy-rated (β=-2.92, p<0.02) OHRQoL when compared to non-surgical self- and proxy-rated OHRQoL at baseline. Both surgical and non-surgical youth (β=3.73, p<0.001) and caregiver (β=1.91, p<0.05) ratings of OHRQoL improved over time. There was significant incremental improvement (time×surgery interaction) in self-reported OHRQoL for youth postsurgery (β=1.04, p<0.05), but this postsurgery increment was not seen in the caregiver proxy ratings. Surgical intervention impacts OHRQoL among youth with cleft. Youth who were surgical candidates had lower baseline self- and caregiver-rated OHRQoL when compared to non-surgical youth. Youth who underwent cleft-related surgery had significant incremental improvements in self-rated but not caregiver (proxy)-rated OHRQoL after surgery.