Children’s oral health-related quality of life five to seven years after comprehensive care under general anaesthesia for early childhood caries

Early childhood caries (ECC) is one of the most common childhood diseases in preschool children. Untreated ECC can lead to pain, sepsis, periapical infection, malnutrition and may result in poor Oral Health Related Quality of Life (OHRQoL) and general health. Many children are treated successfully in the dental clinic with local anaesthesia. Children with ECC who cannot cooperate well for traditional restorative care require comprehensive dental care under general anaesthesia (GA). Many early studies suggest an improved OHRQoL immediately after the dental care under GA. However, none of these studies have looked at the OHRQoL in the mixed dentition period. While it has been reported that caries in preschool years is a significant indicator of caries risk in adolescence, it is unknown whether this risk is also evident in the mixed dentition. The significance of the current research is that this is the first study to investigate the OHRQoL during mixed dentition of the children five to seven years after they received comprehensive dental care under general anaesthesia for ECC. Furthermore, this study has compared the OHRQoL of children who had dental care under GA with children who had dental care without GA, and children who did not have caries. The aim of the study was to compare the OHRQoL in children in the mixed dentition period following comprehensive dental treatment and/or extractions for early childhood caries under GA with that of children who had received dental restorations in the chair or children of the same age who were caries-free. This was done by using the 16-item Short-Form Child Perceptions Questionnaire (CPQ11-14). The findings of this research will help with development of appropriate preventive strategies and recommendations to improve quality of life and dental outcomes. Following ethics approval, 346 children were invited to participate in the study. Children who had comprehensive dental care or extractions only for ECC under GA, before five years of age in 2009-2011, were age-matched with a group of children who had treatment for caries in the dental chair and a group of children who had been diagnosed as caries-free. Following consent from both the participants and parents, participants were recruited into one of the four groups, depending on the type of dental care they had received. Participants completed the Impact 16-item Short-Form Child Perceptions Questionnaire (CPQ11-14), to evaluate their current OHRQoL. Children who had comprehensive care under GA reported poorer OHRQoL mainly in the oral symptoms/functional limitation domains, whereas children who reported poorer OHRQoL also reported that their overall health was affected by their oral condition. There were no statistically significant differences in OHRQoL reported between children who had comprehensive dental care under GA and children who had teeth extractions only under GA. While all the children who had high caries in the primary dentition reported poorer OHRQoL, children who had dental care under GA had more caries currently than children in the other groups. Approximately 45% of these children had two or more carious lesions in the permanent dentition at the time of the study. The present study determined that the children who had dental care under general anaesthesia have a poorer OHRQoL in the mixed dentition period. Further research is needed to understand the factors that are contributing to the ongoing poorer OHRQoL