Impact of Dental Caries on the Quality of Life of Preschool Children: A Cross-Sectional Study Within a Birth Cohort Publisher Pubmed



Raji SAH ; Baninajarian H ; Tarrahi MS ; Daniali SS ; Yazdi M ; Kelishadi R ; Faghihian R
Source: BMC Oral Health Published:2026

Abstract

Background: Early Childhood Caries (ECC) is a common oral health problem that negatively affects their quality of life and everyday function. The Early Childhood Oral Health Impact Scale (ECOHIS) is a validated tool for measuring Oral Health-Related Quality of Life (OHRQoL) in preschoolers. Although the Persian version of ECOHIS exists, the relationship between dental caries and OHRQoL has not been sufficiently investigated in Iranian preschool populations. This study aimed to examine the association between ECC and OHRQoL in children aged 2 to 6 years within the PERSIAN birth cohort in Isfahan, Iran. Methods: A cross-sectional study was conducted between April and October 2023 on a subset of the PERSIAN birth cohort-Isfahan. A total of 350 children aged 2–6 years were initially recruited, of whom 347 were included in the final analysis. Clinical examinations were performed to record decayed, missing, and filled primary teeth (dmft) and parents completed the ECOHIS questionnaire. Children received oral health education and fluoride varnish. The association between dmft and OHRQoL was analyzed using chi-square tests, independent t-tests, and multivariate logistic regression, with adjustments made for confounding variables. Results: Higher dmft scores were significantly associated with lower OHRQoL in both child and parent sections of the ECOHIS questionnaire (p <.001). According to multivariate logistic regression, each unit increase in dmft was associated with greater odds of low child OHRQoL (OR = 1.23, 95% CI: 1.16–1.31), low parent OHRQoL (OR = 1.32, 95% CI: 1.23–1.41), and lower parental satisfaction (OR = 1.35, 95% CI: 1.26–1.45). Household income was significantly associated with parent-reported OHRQoL (OR = 0.27, 95% CI: 0.12–0.61). Conclusions: Dental caries were associated with lower OHRQoL of preschool children and their families. These findings emphasize the need for early detection, preventive strategies, and targeted oral health education, especially among low-income households. However, the results should be interpreted with caution due to the limited sample size, particularly within the moderate-income subgroup. Enhancement of public health initiatives and considering oral health in early childhood care programs may help reduce the burden of ECC and improve quality of life in this vulnerable population. © The Author(s) 2025.