Impact of early childhood caries on oral health-related quality of life among 5-year-old children in Mandalay, Myanmar
Authors:   , Min Saw 
Published: September 2023

Purpose: The study aimed to develop the cross-cultural adaptation and psychometric properties of the Myanmar Version of SOHO-5 and assess the impact of ECC on oral health quality of life among 5-year-old children in Mandalay using the Myanmar version of the SOHO-5 questionnaire. Materials and methods: The Myanmar SOHO-5 version was conducted with the forward-backward translation method and investigated the content validity, internal consistency, test-retest reliability, construct validity, and discriminant validity on 5-year-old children and their parents in phase I. A cross-sectional study was conducted using a self-administered questionnaire to investigate the impact of ECC and relative factors on the oral health related quality of life of children in phase II. A total of 509 child–parent pairs in seven districts of Mandalay city, Myanmar were recruited to collect data related to the child’s demographic, oral health behavior, and children's OHRQoL using parental and child versions of SOHO-5 questionnaire.  Clinical examinations were performed to determine the dmfs caries. Chi-squared analysis and multiple logistic regression were used to analyze the data. Results: In Phase I, the questionnaires were tested on 173 five years old children and their parents for reliability and validity. Cronbach's alpha coefficient values for internal consistency were 0.82 for the children's report and 0.79 for the parental report. The ICCs were 0.90 and 0.89 for the total scores of the children and parental versions in the test-retest reliability analysis. The total SOHO-5 scores for both reports were significantly associated with the global rating questions except for the 'impact on children's general health' question in the parental report. Furthermore, the Myanmar version discriminated between the children with and without caries experiences (p < 0.001). The result in phase II showed that 64.4 % of children reported an impact on OHRQoL (SOHO-5 score > 0), and 67.8% of the parent reported an impact on their children’s OHRQoL. The mean (standard deviation) total score of the SOHO-5 was 1.8 (2.2) and 2.6 (3.2), for child self-report and parental version, respectively. In multivariate logistic regression analysis, children with a higher dmft score had a significantly higher chance of having a poorer OHRQoL (OR: 1.23 (95% CI 1.16 - 1.31, p < 0.001) for children’s report and (OR:  1.24, 95% CI 1.17 - 1.33, p < 0.001) for parent’s report. Moreover, the debris score (OR: 2.12, 95% CI 1.39 – 3.23, p < 0.001) and the starting age for tooth brushing (OR: 1.61, 95% CI 1.03 – 2.51, p = 0.037) were the significant factors affecting children’s OHRQoL based on children’s report. Similarly in parent’s report, the debris score (OR: 2.08, 95% CI 1.35 – 3.21, p = 0.001), starting age for tooth brushing (OR: 1.89, 95% CI 1.21 – 2.98, p = 0.006) and brushing day per week (OR: 1.98, 95% CI 1.00 – 3.92), p < 0.049) had a greater probability of exerting an impact on children’s OHRQoL. Conclusion: This study provides evidence that the Myanmar SOHO-5 version’s children and parental reports have good reliability and validity and can be used to assess the OHRQoL of 5-year-old children in a Burmese-speaking population. In phase II, there was a significant relationship between ECC and OHRQoL of 5-year-old children in terms of the perceptions of both children and their parents. Furthermore, the study showed that the children’s OHRQoL was significantly associated with caries experiences, oral hygiene status, and starting age for tooth brushing in both reports, and brushing days per week in the parent report.