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Background: Dental caries is the most common infectious disease of childhood, It affects 60% to 90% of school-aged children (Petersen, 2008). ECC remains a significant public health problem and may have a harmful impact on oral health-related quality of life (OHRQoL) of young children and their parents. Aims of the Study: This study aims at assessing the prevalence of dental caries among preschool children aged 4 and 5 years in Amman, as well as evaluating the impact of dental caries on the quality of life of these children and their families in Amman. Methods: A cross-sectional survey targeting preschool children of both genders aged 4 and 5 years regularly attending private and public preschools in Amman was carried out. A stratified, two-stage random cluster sample design was adopted, using preschool children as the primary sampling unit with a final sample size of 1557 children. ECC was assessed using dmft index according to standardized criteria of the WHO (WHO, 1997). ECOHIS questionnaire was used to assess OHRQoL of the children and their families. AMT, TDI, gender, and socioeconomic indicators were considered as confounding variables. Descriptive statistics, ANOVA, ANCOVA and stepwise logestic regression analysis were used for statistical analysis. The level of significance for all tests was set as 0.05. Results: The prevalence of ECC was 76% where 41% of children had dmft 1-4 and 35% had dmft> 4. The prevalence of dental caries in 5 years old was 77.2% which was significantly higher than that recorded in 4 years old (72.5%). There was a statistically significant difference between caries groups and caries free group in most items of ECOHIS There was a statistically significant difference between caries free and dmft > 4 group in all items of the ECOHIS. Regarding caries free and dmft 1-4, most items showed a significant difference. A statistically significant difference in the overall ECOHIS score was found between caries free and both dmft 1-4 and dmft> 4, as well as between dmft 1-4 and dmft> 4. Conclusions: The prevalence of early childhood caries was 76% which is higher than the figures reported in previous studies conducted in Jordan. The prevalence of ECC in 5-year-old children was higher than that in 4-year-old children. Dental caries and the level of severity are associated with worse OHRQoL of 4 and 5 years old children and their families. The child function domain and the parental distress domain were the mostly affected in the child section and the family section of ECOHIS, respectively. Oral/ dental pain had the most negative impact on QoL
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