Four-dimensional oral health-related quality of life impact in children: A systematic review.

Oral health-related quality of life (OHRQoL) is an important dental patient-reported outcome which is commonly based on 4 dimensions, namely Oral Function, Orofacial Pain, Orofacial Appearance and Psychosocial Impact. The Oral Health Impact Profile (OHIP) is the most used OHRQoL instrument designed for adults; nevertheless, it is used off-label for children as well. Our aim was to describe the OHRQoL impact on children measured by OHIP and map the information to the 4-dimensions framework of OHRQoL. A systematic literature review following the PRISMA statement was conducted to include studies assessing OHRQoL of children ≤ 18 years using OHIP. The OHIP seven-domain information was converted to the OHRQoL 4-dimension scores accompanied by their means and 95% confidence interval. Risk of bias was assessed using a six-item modified version of quality assessment tool for prevalence studies. We identified 647 articles, after abstracts screening, 111 articles were reviewed in full text. Twelve articles were included, and their information was mapped to the 4-dimensional OHRQoL. Most included studies had low risk of bias. OHRQoL highest impact was observed for Oral Function, Orofacial Pain, and Orofacial Appearance for children with: Decayed-Missing-Filled-Surface (DMFS) of ≥10, anterior tooth extraction without replacement and untreated fractured anterior teeth, respectively. Across all oral health conditions, Psychosocial Impact was less affected than the other three dimensions. OHIP has been applied to a considerable number of children and adolescents within the literature. One instrument and a standardised set of 4-OHRQoL dimensions across the entire lifespan seem to be a promising measurement approach in dental and oral medicine.