Determinants of children's oral health-related quality of life following aesthetic treatment of enamel opacities

Abstract

Objectives: To identify clinical and psychosocial predictors of oral health-related quality of life (OHRQoL) in children with molar incisor hypomineralisation (MIH) following aesthetic treatment of incisor opacities.

Methods: Participants were 7- to 16-year-old children referred to a UK Dental Hospital for management of incisor opacities. Prior to treatment (T_o), participants completed validated questionnaires to assess OHRQoL and overall health status (C-OHIP-SF19), and self-concept (Harter's Self-Perception Profile for Children [SPPC]). Interventions for MIH included microabrasion, resin infiltration, tooth whitening or composite resin restoration. Children were reviewed after six months (T₁) when they re-completed the C-OHIP-SF19 and SPPC questionnaires. The relationships of predictors with improvement of children's OHRQoL (T₁-T_o) and children's overall health status at T₁ were assessed using linear and ordinal logistic regression respectively, guided by the Wilson and Cleary's theoretical model.

Results: Of 103 participants, 86 were reviewed at T₁ (83.5 % completion rate). Their mean age was 11-years (range = 7-16) and 60 % were female. Total and domain OHRQoL scores significantly increased (improved OHRQoL) following MIH treatment. There was a significant positive change in SPPC physical appearance subscale score between T_o and T₁. A higher number of anterior teeth requiring aesthetic treatment were associated with poor improvement of socio-emotional wellbeing at T₁ (Coef =-0.43). Higher self-concept at T_o was associated with greater improvement of socio-emotional wellbeing at T₁ (ß = 3.44). Greater orthodontic treatment need (i.e. higher IOTN-AC score) at T₀ was linked to worse overall oral health at T₁ (OR = 0.43).

Conclusions: Psychosocial factors and dental clinical characteristics were associated with change in children's OHRQoL following minimal interventions for incisor opacities.

Clinical significance: MIH is a common condition and clinicians should be aware of the negative impacts some children experience, particularly those with multiple anterior opacities, poor tooth alignment and low self-concept. However, simple, minimally invasive treatments can provide good clinical and psychosocial outcomes and should be offered to children reporting negative effects.

Keywords: Aesthetic treatment; Children; Enamel opacities; Molar incisor hypomineralisation; Oral health-related quality of life.