USE OF THE CHILD HEALTH UTILITY 9D INDEX IN AUSTRALIAN ADOLESCENTS WITH DENTAL CARIES

Purpose:

To investigate the use of Child Health Utility 9D (CHU9D) as quality of life (QoL) measure in adolescents participating in a Minimal Intervention Dentistry (MID) trial. 

Method:

The CHU9D, the International Caries Detection and Assessment System (ICDASII), oral health perception and knowledge and socio-demographic baseline data were collected from public dental patients aged 11-16 participating in the MID trial. QoL scores were derived from the CHU9D tariff of Australian adolescents. ICDASII was translated to a dental caries (D₃MFT) index that represented the number of teeth that were cavitated or missing or filled due to decay.  

   Descriptive analysis was performed followed by Chi-square and Mann-Whitney test where appropriate. Correlation was assessed between QoL scores and dental caries index, oral health perception and knowledge and socio-demographic factors. 

Result:

85% of the 239 participants provided complete data on CHU9D and 79 % socio-demographic questions compared to 83% on oral health perception and knowledge questions and 100% with observed ICDASII. Mean QoL score was 0.86 (SD=0.12), ranging from 0.44 to 1 with negatively-skewed distribution (median 0.88).

   Most participants (83%) experienced dental caries (D₃MFT >1), with a mean 3.1 (SD 2.5) decayed teeth (range 0 to 12). Mean QoL scores changed only slightly across quartiles of the D₃MFT index (0.85, 0.86, 0.87 and 0.85) with no evidence of significant association between dental caries index score and QoL (p=0.37).

  Lower self-reported oral health (pain in teeth while eating or drinking; frequency of gum bleeding; perceived plaque on teeth) had lower QoL score. Participants reporting poor oral health had a significant lower QoL score than those reporting better oral health (0.76, 0.83, 0.86, 0.88, 0.92, p=0.02). Similar significant differences were seen in participants who reported placing a greater importance on having a healthy mouth (0.90, 0.81, 0.75, 0.85, 0.87, p=0.04). However, the latter two factors explained only a small proportion of total variance (R²=0.32 and 0.23). QoL did not vary significantly across socio-demographic factors within this population.

Conclusion:

QoL was not associated with the extent of clinically-diagnosed dental caries, but was related to the individual’s self-perceived oral health and importance of oral health. The use of CHU9D as a measure of oral health-related QoL for cost-utility analysis study in adolescents requires further exploration.