Is oral health–related quality of life of preschool children affected by the severity of early childhood caries?

Objectives This national cross-sectional study investigated the severity of early childhood caries (ECC) and its impact on the oral health–related quality of life (OHRQoL) of preschool children and their families, providing large-scale population-based evidence. Methods Kindergarten children (levels I and II) from randomly selected schools across all six governorates were examined. Caries experience was recorded using dmft/dmfs and merged ICDAS criteria, and caries severity was assessed using the pufa index. Demographic data and OHRQoL were obtained from caregivers using the validated Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS). Results Of 1,783 examined children, 892 caregivers completed the questionnaire. ECC prevalence was 88.6%, with a mean dmft of 6.45 ± 4.5 and dmfs 13.0 ± 14.1. Extensive lesions (ICDAS 5–6) were observed in 63.4%, and 9.3% showed clinical consequences of untreated caries (PUFA > 0). Caries experience was significantly associated with higher child- and family-level A-ECOHIS scores ( p < 0.001). Clinical consequences of untreated caries (pufa) were associated with poorer child-level OHRQoL, but not family-level OHRQoL. Lower paternal education and higher birth order were associated with greater caries experience ( p < 0.05). Conclusions Early childhood caries experience was strongly associated with poorer oral health–related quality of life among preschool children and their families. ECC severity was associated with poorer child-level OHRQoL but showed no additional impact at the family level. Early, family-centered preventive strategies are essential to reduce the burden of ECC and enhance child well-being.