title: Oral health-related quality-of-life scores differ by socioeconomic status and caries experience.
abstract: (i) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience.
  
  
  
  This study was a cross-sectional analysis of children in southern Brazil (n=456, mean age: 38 months) participating in an existing health centre-based intervention study. OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1-4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modelling, overall and within socioeconomic strata defined by maternal education, social class and household income.
  
  
  
  Caries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 vs dmft=0, a pattern that persisted regardless of family socioeconomic status (P for interaction: all >0.3). However, adjusted for dental status and sociodemographic characteristics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0) or in lower income households (ratio: 0.8; 95% CI: 0.6, 1.3).
  
  
  
  Dental caries was associated with negative child and family experiences and lower OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality-of-life impact at the same level of disease experience. Thus, subjective quality-of-life measures may differ under varying social contexts, with possible implications for service utilization, evaluating oral health interventions, or quantifying disease morbidity in low-SES groups.
authors.affiliation: Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Chaffee
authors.affiliation: Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Priscila Humbert
authors.initials: PH
authors.lastname: Rodrigues
authors.affiliation: Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Paulo Floriani
authors.initials: PF
authors.lastname: Kramer
authors.affiliation: Department of Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Márcia Regina
authors.initials: MR
authors.lastname: Vítolo
authors.affiliation: Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Feldens
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008423:Maternal Age; D009035:Mothers / Q000706:statistics & numerical data; D009909:Oral Health / Q000191:economics / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012923:Social Class
keywords: early childhood caries; epidemiology; health disparities; health perceptions; quality of life