Impact of Dental Status on Oral Health-related Quality of Life in Children with Missing or Multiple Teeth in Saudi Arabia: A Cross-sectional Analysis.

OBJECTIVES

This study assessed associations between dental health status and oral health-related quality of life (OHRQoL) in 11-14-year-old children at a Saudi university pediatric dental clinic, identifying clinical and psychosocial predictors of OHRQoL.

METHODS

A cross-sectional study recruited 385 children (71.7% Saudi, 28.3% non-Saudi) via convenience sampling. Clinical measures included dental caries [decayed, missing, and filled teeth (DMFT) index], Plaque index, and Dental Aesthetic Index (DAI) per World Health Organization/International caries detection and assessment system criteria. OHRQoL was assessed using the validated Arabic Child Perceptions Questionnaire 11-14. Self-reported perceptions of general/oral health and dental aesthetics were collected. Non-parametric tests (Kruskal-Wallis, Mann-Whitney with Bonferroni correction), Spearman correlations, and multiple linear regression were performed (α = 0.05).

RESULTS

The sample comprised 68.8% older adolescents (13-14 years) with a balanced gender distribution (51.9% male). Contrary to expectations, objective clinical measures showed no significant associations with OHRQoL. Neither DMFT [B = 0.001, 95% confidence interval (CI): -0.019, 0.020, P = 0.951] nor DAI (B = 0.003, 95% CI: -0.003, 0.009, P = 0.308) predicted overall OHRQoL, with negligible correlations across all domains (r = -0.055 to 0.050, P > 0.05). Instead, age was a strong negative predictor, most pronounced for emotional well-being (B = -0.848, 95% CI: -0.993, -0.703, P < 0.001) and overall OHRQoL (B = -0.720, 95% CI: -0.847, -0.594, P < 0.001), with older adolescents reporting significantly poorer OHRQoL. Participant background (Saudi vs. non-Saudi) significantly predicted higher OHRQoL among Saudi participants (B = 0.907, 95% CI: 0.805, 1.009, P < 0.001). Self-reported perceptions-including satisfaction with oral health, perceived dental aesthetics, and treatment needs-demonstrated stronger associations with OHRQoL than clinical indicators (P < 0.001 across domains after Bonferroni correction).

CONCLUSION

In this convenience sample, objective clinical measures (DMFT, DAI) did not predict OHRQoL. Quality of life was predominantly influenced by age, participant background, and self-perceptions of oral health and aesthetics, reflecting the psychosocial significance of this developmental stage. Convenience sampling from a single clinic limits generalizability. Future interventions should integrate psychosocial support with clinical care and address health care access disparities. Population-based studies are needed for validation.