Socioeconomic and Dental Factors Associated with Oral Health-Related Quality of Life in Brazilian Preschoolers: Structural Modeling Analysis.

Purpose: To assess the direct and indirect effects of oral conditions, family income, child's sex, history of toothache and dental visits on oral health-related quality of life (OHRQoL) of children, according to parents. Methods: A cross-sectional study was conducted with 843 pairs of parents and children aged three to five years of age, in Campina Grande, Paraíba, Brazil. Parents answered a questionnaire with sociodemographic and socioeconomic questions, and their children's use of services and experience of toothache, as well as the Brazilian Scale of Impact on Oral Health in Early Childhood. Three researchers examined for the presence of dental caries, dental trauma and malocclusion. Descriptive and confirmatory factor analyses were conducted to validate the measurement models and constructs. The analysis accounted for confounding factors to ensure precise estimates of the relationships among variables. Structural equation modeling was employed to examine both direct and indirect associations between variables. Results: Absence of dental visits (β =-0.332; 95 percent confidence interval [95% CI]:- 0.471 to -0.193; P <0.001) and toothache (β =-0.748; 95% CI:0.588 to 0.883; P <0.001) directly impacted OHRQoL negatively. Family income (β =0.689; 95% CI: 0.518 to 0.859; P <0.001) and anterior open bite (β =-0.339; 95% CI:-0.613 to -0.184; P <0.001) had indirect effects mediated by dental caries (β =0.748; 95% CI: 0.748 to 0.883; P <0.001). Conclusion: Both direct and indirect factors affect the OHRQoL of preschoolers, emphasizing the importance of considering oral health conditions and socioeconomic factors to evaluate and improve their quality of life.