Objectives:
To assess the impact of dental caries and treatment under general anaesthetic (GA) on the everyday lives of children and their families, using measures of quality of life (QoL) and oral health-related quality of life (OHRQoL).
Methods:
Participants, aged 5-16 years old requiring treatment for caries under GA, were recruited. OHRQoL was measured
before and three months after treatment using the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC). Overall QoL was measured using the Child Health Utility 9D (CHU9D). Parents/caregivers completed the Family Impact Scale (FIS). Change in scores after treatment were analysed using Wilcoxontests. Path analysis was conducted to investigate the relationships between clinical, individual and environmental factors and QoL outcomes, guided by a theoretical model.
Results:
In total, 85 parent-child dyads completed the study. Three-quarters (76%) of children were living in the most deprived areas of England. There was a statistically significant improvement in OHRQoL (mean interval score difference in CARIES-QC=4.43, p<0.001) and QoL (mean score difference in CHU9D=2.48, p<0.001) following treatment, with moderate to large effect sizes. Path analyses revealed that 47% of the variance in OHRQoL scores was accounted for by the variables in the model. There were significant
relationships between change in OHRQoL score and treatment type [extraction only vs. comprehensive care (β=1.41, p=0.07)] and number of extractions (β=0.46, p<0.001). There
was statistically significant improvement in FIS scores following treatment (mean score difference= 5.48, p=0.03). Overall, 95% of parents felt their child’s dental health had improved, and 74% reported improvement in their child’s QoL.
Conclusion:
Treatment under GA was associated with significant improvement in QoL and OHRQoL as reported by both children
and their parents. Path analysis suggests that treatment type, via number of extractions, may impact on child OHRQoL and QoL following treatment under GA. Increased number of extractions was associated with worse OHRQoL and QoL. The results could have implications for treatment planning and the provision and commissioning of services.
