Using associations between oral diseases and oral health-related quality of life in a nationally representative sample to propose oral health goals for 12-year-old children in Thailand

Abstract

This study was carried out to assess the associations between oral diseases and specifically oral health-related quality of life (OHRQoL) in a nationally representative sample of 12-year-old children in Thailand in order to classify children according to their levels of risk for adverse OHRQoL and to apply findings to formulate proposals for oral health goals. Oral examinations and OHRQoL interviews using the Child-Oral Impacts on Daily Performances (Child-OIDP) schedule were conducted in 1,100 children as part of the Thailand National Oral Health Survey. The severity of oral impacts was categorised according to their 'intensity'. Associations of oral diseases and condition-specific (CS) OHRQoL impacts were investigated. Oral impacts were prevalent. Most were of low intensity; these were excluded from the analysis used to develop goals. At the threshold of moderate/high intensity, CS impacts attributable to dental caries, edentulous areas, periodontal disease and discolouration were reported by 18.5%, 0.2%, 8.7% and 2.6% of participants, respectively. Missing teeth was significantly related to CS impacts. Condition-specific impacts were 1.6 times and three to four times more likely to affect children with one decayed tooth and two or more decayed teeth, respectively. Children with gingivitis or calculus in three or more sextants were twice as likely and children with calculus and gingivitis in three or more sextants were 3.5 times more likely to report CS impacts. Based on these findings, these recommendations are proposed: all 12-year-old children should have fewer than two untreated decayed teeth; 60% of 12-year-old children should not have periodontal disease in any form in more than two sextants, and the proportion of 12-year-old children with calculus with gingivitis in three or more sextants should not exceed 5%. Measures of oral health and goals for oral health in children should include measures of OHRQoL.