Longitudinal evaluation of the impact of dental caries treatment on oral health-related quality of life among schoolchildren

The relationship of children's dental clinical status with school performance and school attendance in the Kingdom of Bahrain: A life-course approach

OBJECTIVES

To examine the association between dental clinical status and school performance and school attendance in the Kingdom of Bahrain (KoB) using a life-course framework.

METHODS

This time-ordered cross-sectional study included 466 school children in Grade 2 (aged 7-8 years) and their parents in the KoB. Data were collected through parents' self-administered questionnaires, children's face-to-face interviews and dental clinical examinations. Data on children's school performance and school attendance were gathered from parents and school records. Structural equation modelling (SEM) examined the direct and indirect pathways between variables.

RESULTS

Children born in families with high socio-economic status (SES) were less likely to have dental caries and more likely to have better school performance at 7-8 years of age. Dentine caries was directly linked with poor school performance. Treated teeth directly predicted high school performance. The presence of dentine caries mediated the relationship of SES with school performance.

CONCLUSIONS

Birth and current socio-economic factors were significant predictors of dental clinical conditions and school performance. Dental caries and fewer treated teeth directly predicted poor school performance.

The impact on the quality of life caused by the early loss of primary molars

INTRODUCTION

Evidence regarding the impact of early loss of primary molars (ELPM) on Oral Health-Related Quality of Life (OHRQoL) is lacking. The aim of the present study was evaluating the impact of ELPM on OHRQoL of Brazilian schoolchildren aged 6-10 years.

METHODS

This observational prospective cohort study was conducted with 163 schoolchildren, assigned in the primary tooth loss group (PTLG), in which all tooth loss was caused by carious lesions, and in a control group without tooth loss (CG). Two calibrated examiners conducted the clinical oral assessments to determine caries experience and tooth loss. OHRQoL was assessed using the Child Perception Questionnaire 8-10 years (CPQ8-10) instrument administered at baseline and at 10-12 months of follow-up.

RESULTS

Children in PTLG exhibited significantly more negative impact on OHRQoL at baseline (p < 0.01) than CG, and also after the follow-up period (p < 0.01). It was also possible to observe a significant reduction in the negative impact on OHRQoL in both CG and PTLG in the longitudinal analysis (p < 0.01). Nevertheless, there was an even more substantial reduction in the negative impact on OHRQoL in children in PTLG.

CONCLUSIONS

This study provides evidence that early tooth loss is associated with negative impact on OHRQoL. Moreover, it indicates that access to dental treatment can have a positive impact on the OHRQoL of children with dental caries and ELPM.

Impact of dental treatment on the oral health-related quality of life of Brazilian schoolchildren

This before-after experimental study evaluated the impact of dental treatment on the oral health-related quality of life (OHRQoL) in children aged 6-8 years from Paranoá, DF, considering the presence or absence of cavitated dentin carious lesions pre- and post-treatment. The responsiveness and sensitivity of the questionnaires were also investigated. Caries was detected by using the Caries Assessment Spectrum and Treatment (CAST) instrument, while the impact of oral health on the children's health-related quality of life was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which was completed by the children and the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), which was completed by their parents. Sociodemographic characteristics were also assessed. After the examinations, the children were categorized into two groups according to the presence (treatment/n = 34) or absence (control/n = 34) of cavitated dentin carious lesions. Restorative/curative care was provided to the treatment group, while the control group received preventive measures. OHRQoL was assessed at baseline and at four weeks post-treatment. No significant sociodemographic differences were observed between the groups. In the treatment group, the children and their families reported a greater impact of oral health on their OHRQoL in both questionnaires (p < 0.05). However, there was a significant reduction in the impact of oral health, with differences between the pre-treatment and post-treatment phases (p = 0.001). Good sensitivity and responsiveness were observed for both questionnaires. Dental treatment was found to reduce the negative impact of dental caries on OHRQoL in 6-8-year-old children, which was detected by both questionnaires (B-ECOHIS and CPQ8-10).

The effect of caries increment on oral health-related quality of life among adolescents in Brazil: a 3-year longitudinal study

This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ11-14 instrument demonstrated acceptable responsiveness properties.

Dental treatment improves the oral health-related quality of life of adolescents: A mixed-methods approach

AIM

To evaluate and understand the impact of dental treatment on oral health-related quality of life (OHRQoL) of adolescents.

DESIGN

A sequential explanatory mixed-methods design was performed. A sample of 182 adolescents, aged 10 and 15 years old who had finished their dental treatment at adolescent dental clinic of Federal University of Santa Maria from 2010 to 2016, were included. Participants answered the short form of Child Perceptions Questionnaire (CPQ_11-14) prior to their dental treatment and 1 month after concluding the treatment. The effect size was calculated to assess magnitude of change. In qualitative phase, semi-structured interviews took place at the end of the dental treatment. Interviews were audio-recorded and analyzed according to thematic analysis following Braun and Clarke.

RESULTS

The effect sizes ranged from 0.35 to 1.00, and the oral symptom domain presented the greatest effect. Sixteen interviews were conducted and five themes emerged: concept of quality of life, oral health influenced by oral conditions, oral health symptoms influencing seeking care behavior, personal and subjective experiences, and dental educational environment.

CONCLUSION

Dental treatment has an uncountable meaning for adolescents because it has a psychosocial meaning in this phase of life and it is able to improve their OHRQoL.

Changes in Adolescents' Oral Health Status: Responsiveness of the Child Perception Questionnaire11-14

Changes in oral health status following treatment should be assessed clinically as well as by patients' reported outcomes. This study investigated changes on oral-health-related quality of life (OHRQoL) of adolescents enrolled in a comprehensive oral health care program for caries and gingival conditions. The sensitivity of the Child Perception Questionnaire11-14 (CPQ11-14) to detect clinical changes, that is, its responsiveness, was assessed. A total of 618 10-15-year adolescents answered the questionnaire before treatment and 560 at follow-up after 1 year. In the follow-up, 2 additional global transition judgment questions were asked. The adolescents were clinically and radiographically examined. At the baseline, 374 adolescents needed only nonoperative treatment, whereas 274 needed non- and operative treatments. After 1 year, the adolescents were regrouped according to the fulfillment of their treatment needs in Group 1 (n = 363) needing/receiving nonoperative treatment only; Group 2 (n = 98) needing/receiving both non- and operative treatments; Group 3 (n = 99) receiving nonoperative treatment only, while needing also operative treatment. The CPQ11-14 total mean change scores by the global transition judgment on self-perceived oral health status indicated significant differences (p < 0.001, ANOVA; internal responsiveness). The effect of the program for the treatment groups was significant (p = 0.014, ANCOVA; external responsiveness). The effect size for the change scores was of moderate magnitude. In conclusion, an overall improvement of adolescents' OHRQoL was observed following 1-year oral health care program for caries and gingival conditions. The CPQ11-14 was internally and externally sensitive to detect substantial clinical changes. The CPQ11-14 seems appropriate for measuring long-term changes on adolescents' OHRQoL.

Responsiveness of Oral Health-Related Quality of Life Questionnaires to Dental Caries Interventions: Systematic Review and Meta-Analysis

This systematic review and meta-analysis were undertaken to assess the responsiveness of validated oral health-related quality of life (OHRQoL) questionnaires to dental caries interventions in children, adolescents, and young adults. Studies eligible were randomized clinical trials (RCTs), controlled clinical trials (CCTs), and prospective case series (PCS), which had OHRQoL questionnaires answered before and after caries intervention(s). The main outcome was improvement in OHRQoL mean scores following caries intervention. Twenty-six studies were selected for the quality assessment and 14 were selected for the meta-analysis. Most of the studies were PCS with a single group pretest and posttest study design (n = 19). Five studies were CCT and only 2 were RCT. The numbers of participants were 3,522 in the control group (baseline = 2,002; final = 1,520) and 5,917 in the test group (baseline = 3,102; final = 2,815). The age of the subjects ranged from 3 to 19 years. All studies showed significant improvement in OHRQoL following caries intervention. Most of nonrandomized studies (n = 15) had low or moderate risk of bias. The meta-analysis showed the effect of caries interventions (standardized weighted mean differences = -1.24; 95% CI: -1.68 to -0.81; p < 0.001). However, high heterogeneity between the studies was found. The Grading of Recommendations Assessment, Development and Evaluation approach classified the quality of evidence as very low and its strength weak. In conclusion, there is evidence that the OHRQoL of children and adolescents improved following caries intervention procedures, but the quality of the evidence was very low. In spite of that, caries interventions are highly recommended as abstaining from treatment is likely to result in a deterioration of OHRQoL.

Quality Appraisal of Child Oral Health-Related Quality of Life Measures: A Scoping Review

BACKGROUND

Children's oral health-related quality of life (COHQoL) measures are well known and widely used. However, rigorous systematic reviews of these measures and analyses of their quality are in absence.

OBJECTIVES

To systematically review and quantitatively assess the quality of COHQoL measures through a scoping review.

DATA SOURCES

Systematic literature search of PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE (Excerpta Medica database), HaPI (Health and Psychosocial Instruments), and DOSS (Dentistry and Oral Sciences Source).

STUDY ELIGIBILITY

The measure's focus was COHQoL; the child age ranged from 5 to 14 years; the publication was either a research article or a systematic review and related to caries; and it was written in English or had an English abstract. Two authors independently selected the studies. Disagreements were reconciled by group discussions with a third author.

APPRAISAL

The International Society for Quality of Life Research minimum standards for patient-reported outcome measures were used for quality appraisal.

SYNTHESIS

Descriptive analysis.

RESULTS

We identified 18 measures. Their quality scores ranged from 9.5 to 15.0 on a scale of 16. The quality appeared to bear no relationship to the citation and use of these measures. However, elements of these measures might be more useful than others, depending on the age-specific use and primary quality concerns.

LIMITATIONS

Some of the information on the minimum standards of the 18 measures cannot be found in the existing literature. Measures published without English abstract were not searched.

CONCLUSIONS

The quality of these measures is suboptimal. Researchers and practitioners in this field should exercise caution when choosing and using these measures. Efforts at improving the quality of the COHQoL measures, such as refining existing ones or developing new measures, are warranted.

KNOWLEDGE TRANSFER STATEMENT

Researchers, clinician scientists, and clinicians can use the results of this study when deciding which oral health-related quality of life measure they wish to use in children.

Comparison of Canine Overlap in Pediatric Patients Requiring Stainless Steel Crown Placement under General Anesthesia before and after the Procedure

Objectives

Despite the increasing popularity of pediatric dental treatments under general anesthesia, information is scarce regarding occlusal changes in patients receiving stainless steel crowns (SSCs) under general anesthesia. This study sought to compare canine overlap before and after general anesthesia in children receiving SSCs. In case of a change, the possibility of returning to the preoperative state and the time required for this process were also evaluated.

Materials and Methods

This interventional, before-and-after study was performed on 60 children between 2 to 7 years of age requiring dental treatment under general anesthesia. The contact point of the most prominent area of the maxillary primary canine and mandibular primary canine was marked before and immediately after general anesthesia and at one and two weeks postoperatively. The change in canine overlap was analyzed using repeated measures analysis of variance (ANOVA) and linear regression test.

Results

Canine overlap significantly decreased immediately after general anesthesia (P<0.05). The mean bite opening was 0.51±0.22 mm at the site of the right canine and 0.50±0.185 mm at the site of the left canine. These values returned to their normal preoperative state after one week (P<0.05). Repeated measures ANOVA showed significant differences in this respect between the time points (P=0.002).

Conclusion

The occlusion and vertical dimension of pediatric patients may change following dental treatment under general anesthesia; the magnitude of change in canine overlap may vary depending on the class of occlusion and number of SSCs placed. These changes are temporary and often resolve within a week.

Development and evaluation of CARIES-QC: a caries-specific measure of quality of life for children

BACKGROUND

Existing paediatric oral health-related quality of life (OHRQoL) measures are generic instruments designed to evaluate a range of oral conditions. It has been found that disease-specific measures may be more adept at detecting subtle changes which occur following treatment of the condition in question. Furthermore, existing self-report OHRQoL measures have not involved children at all stages of development of the measure. The aim of this study was to develop a caries-specific measure of quality of life for children.

METHODS

The first stage of the study involved a qualitative enquiry with children, aged 5-16 years, to inform the development of the measure. Children generated the potential items, contributed to item reduction and questionnaire design and participated in the testing of face and content validity. The resulting measure was evaluated in a cross-sectional validation study. Ethical approval was granted for the study.

RESULTS

The qualitative study found that children discussed a number of caries-related impacts which affected their daily lives. These were incorporated into a draft measure which was further refined following testing of face and content validity. This resulted in the production of the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), comprising 16 items and one global question. Two hundred participants with a mean (range) age of 8.1 (5-16) years took part in the further evaluation of CARIES-QC. Four items, which did not fit the Rasch model, were removed from further analysis. The remaining 12 items demonstrated good internal consistency (alpha = 0.9) and the total score showed significant correlations with the number of decayed teeth, presence of pain, pulpal involvement, the Child Perceptions Questionnaire (16-item short form) and the global score (p < 0.01, Spearman's rho).

CONCLUSION

In conclusion, children's input allowed the development of a valid and reliable child-centred caries-specific quality of life measure. CARIES-QC can now be used to evaluate which interventions for dental caries are most effective in reducing impacts from the child's perspective.

Responsiveness of the Brazilian versions of CPQ11-14 and Child-OIDP

AIM

The aim of this study was to investigate the responsiveness of the Brazilian versions of Child Perceptions Questionnaire (CPQ_11-14 ) and Child-Oral Impacts on Daily Performances (Child-OIDP).

DESIGN

The data were collected from a convenience sample of 209 patients aged 10-15 years, who visited the adolescent dental clinic of Federal University of Santa Maria, Brazil. The subjects answered the CPQ_11-14 and the Child-OIDP prior to their dental treatment and 1 month after concluding the treatment. The responsiveness of CPQ_11-14 and Child-OIDP was analysed through (a) the mean change observed in scores before and after treatment, (b) an investigation of the effect size, (c) an assessment of the statistical significance of changes within the groups over time, as per the global transition judgement, and (d) the receiver operating characteristic (ROC) curve.

RESULTS

Positive changes were observed for both questionnaires. According to global transition judgement, 82.30% of the participants reported an improvement following treatment, 16.75% reported no change, and 0.96% reported deterioration. The effect size was 0.8% and 0.5% for the overall CPQ_11-14 and Child-OIDP, respectively. The area under the curve was 0.38 for CPQ_11-14 and 0.43 for Child-OIDP.

CONCLUSION

The Brazilian versions of CPQ_11-14 and Child-OIDP demonstrated limited responsiveness following dental treatment.

Does oral health influence school performance and school attendance? A systematic review and meta-analysis

AIM

To examine the evidence on the influence of oral health status on school performance and school attendance in children and adolescents.

DESIGN

A systematic review was performed in accordance with PRISMA included epidemiological studies that assessed concomitantly oral health measures, participants' school performance and/or school attendance. Electronic search was conducted on MEDLINE, SCOPUS, Web of Science, ScienceDirect, and LILACS. Studies published up to May 2018 in any language were eligible. The risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was used to obtain pooled estimates between oral health measures and school performance and school attendance.

RESULTS

Eighteen studies were included. Of them, fifteen studies were used for the meta-analyses. Most studies were assessed as moderate quality. Children with one or more decayed teeth had higher probability of poor school performance (OR = 1.44 95%CI: 1.24-1.64) and poor school attendance (OR = 1.57 95%CI: 1.08-2.05) than caries-free children. Poor parent's perception of child's oral health increased the odds of worse school performance (OR = 1.51 95%CI: 1.10-1.92) and poor school attendance (OR = 1.35 95%CI: 1.14-1.57).

CONCLUSIONS

Children and adolescents with dental caries and those reporting worse oral health experience poor school performance and poor school attendance.

Silver diamine fluoride versus therapeutic sealants for the arrest and prevention of dental caries in low-income minority children: study protocol for a cluster randomized controlled trial

BACKGROUND

Dental caries is the most prominent childhood disease in the world. In the United States, more than 50% of children have experienced caries. Untreated caries can have negative impacts on quality of life, academic performance, and school attendance. To reduce oral health disparities, multiple organizations recommend school-based caries prevention.

METHODS/DESIGN

A longitudinal, cluster randomized, non-inferiority trial will be conducted in low-income children from primarily Hispanic/Latino backgrounds currently enrolled in public elementary schools in New York City, New York, United States, from 2018 to 2023. The primary objective is to compare the non-inferiority of silver diamine fluoride and fluoride varnish versus glass ionomer therapeutic sealants and fluoride varnish in the arrest and prevention of dental caries. Secondary objectives are to evaluate differences in effectiveness when care is provided by nurses versus dental hygienists and assess the impact of prevention on oral health-related quality of life and educational outcomes. Caries arrest will be evaluated after 2 years, and caries prevention and secondary outcomes will be assessed at the completion of the study. Data analysis will follow intent-to-treat, and statistical analyses will be conducted using a two-sided significance level of 0.05.

DISCUSSION

The comparative effectiveness of alternative caries prevention delivery models is considered to be one of the highest research priorities in the United States. Many treatments are currently available to prevent and arrest dental caries. The simplicity and affordability of silver diamine fluoride may be a viable alternative for the prevention of dental caries in high-risk children.

TRIAL REGISTRATION

U.S. National Library of Medicine, www.clinicaltrials.gov , ID: NCT03442309 . Registered on 22 February 2018.

Effects of dental treatment and systemic disease on oral health-related quality of life in Korean pediatric patients

Background

The findings that not only dental caries but also systemic disease can exert a negative effect on oral health-related quality of life (OHRQoL), and that dental treatment can improve OHRQoL have been confirmed in multiple studies. The purpose of this study is to investigate the impact of dental treatment on OHRQoL of Korean pediatric patients and the differences in OHRQoL between patients with and without systemic disease.

Methods

All the primary caregivers of pediatric patients who underwent dental treatments under either general anesthesia or intravenous deep sedation at Seoul National University Dental Hospital completed abbreviated versions of the Child Oral Health Impact Profile (COHIP-14) and Family Impact Scale (FIS-12) surveys on OHRQOL pre- and post-treatment (average: 2.4 ± 1.7 months after dental treatment). This is a case control study with patients divided into two groups according to the presence or absence of systemic disease.

Results

Data from 93 pediatric patients (46 male and 47 female, average patient age: 5.0 ± 3.4 years) were analyzed to compare OHRQoL before and after treatment with the Wilcoxon signed-rank test and to calculate the effect size using Cohen’s d. All of the patients exhibited an improvement in OHRQoL (COHIP-14: p <  0.001, effect size = 1.0; FIS-12: p <  0.001, effect size = 0.7). Patients with systemic diseases demonstrated lower OHRQoL in both pre- and post-treatment surveys than patients without systemic diseases (Wilcoxon Rank-sum test, both COHIP-14 and FIS-12: p <  0.05). The COHIP-14 appears to have a greater impact on the FIS-12 in patients with systemic disease than those without (explanatory power of 65.3 and 44.6%, respectively).

Conclusions

Based on the primary caregivers’ perceptions, dental treatment can improve the OHRQoL in Korean pediatric patients. Systemic disease results in a reduced OHRQoL, and the awareness of patients’ oral health appeared to have a greater impact on OHRQoL for family members of patients with a systemic disease.

Trial registration

KCT0002473 (Clinical Research Information Service, Republic of Korea) and 22 Sep 2017, retrospectively registered.

Dental health between self-perception, clinical evaluation and body image dissatisfaction - a cross-sectional study in mixed dentition pre-pubertal children

Background

Self-perception of oral health status is a multidimensional construct that includes psychological, psychosocial and functional aspects of oral health. Contemporary concepts suggest that the evaluation of health needs should focus on clinical standards and socio-dental indicators that measure the impact of health/disease on the individual quality of life. Oral health cannot be dissociated from general health. This study evaluates a possible association between oral health status, body size, self-perception of oral health, self-perception of body size and dissatisfaction with body image in prepubertal children with mixed dentition, targeting the completion of children’s health status assessment which will further allow the identification of individuals at risk and could be further used as an evaluation of the need for specific interventions.

Methods

The present study is cross-sectional in design and uses data from 710 pre-pubertal children with mixed dentition. The outcome variables comprised one item self-perception of oral health: dmft/DMFT Index and Dental Aesthetic Index, body size, self-assessed body size and desired body size. Multiple logistic regression analyses were performed. The level of significance was set at 5%.

Results

More than a half (53.1%) of the participants with mixed dentition reported that their oral health was excellent or very good. In the unadjusted model, untreated decayed teeth, dmft score and body dissatisfaction levels had a significant contribution to poor self-perception of oral health, but after adjustment for gender, BMI status, dmft score, DMFT score and DAI score, only untreated decayed teeth OR = 1.293, 95%CI (1.120–1.492) and higher body dissatisfaction levels had a significant contribution.

Conclusion

It was concluded that the need for dental treatment influenced self-perception of oral health in prepubertal children with mixed dentition, especially with relation to untreated decayed teeth. Since only body dissatisfaction levels, but not BMI, were related to poor self-perception of oral health, which involves a psychological component, further studies should evaluate the risk factors of body dissatisfaction, in order to plan health care directed to this age group, and with the purpose to positive parenting strategies.

Caries progression as a risk factor for increase in the negative impact on OHRQOL-a longitudinal study

OBJECTIVES

The aim of this study is to evaluate the association between caries lesions progression and oral health-related quality of life (OHRQoL) among Brazilian preschools, after 2 years.

MATERIALS AND METHODS

At baseline, 163 children (3-4 years old) enrolled in 12 public primary care services in Porto Alegre/RS-Brazil were evaluated. After 2 years, 119 children were re-evaluated. Calibrated examiners employing the ICDAS criteria conducted clinical examinations. A socio-demographic questionnaire and the Brazilian version of the Early Childhood Oral Health Impact Scale were applied to the parents of the children at baseline and 2-year follow-up. Data analysis was performed using a hierarchical approach based in a conceptual framework testing by Poisson regression.

RESULTS

The number of surfaces that progressed from baseline to 2-year follow-up was associated with an increased negative impact on OHRQoL.

CONCLUSIONS

Caries progression increased the negative impact on OHRQoL.

CLINICAL RELEVANCE

The progression of caries lesions could negative impact on OHRQoL in Brazilian preschoolers.

Impact of a dental care program on the quality of life of children with and without caries

The aim of the present study was to evaluate the long-term effects of the caries treatment provided by a dental care program on changes in schoolchildren's OHRQoL. A one-year follow-up was conducted with a sample of 372 children aged 8 to 10 years which were clinically examined and divided into two matched groups according to their caries experience: dental treatment group (DTG) and group without caries (GWC). Both groups were assessed three times (at baseline, at 4 weeks, and at 1 year) using the Child Perceptions Questionnaire (CPQ8-10). The normality test was performed for the statistical analyses; the Friedman test was used for the dependent variables (longitudinal assessment repeated three times for the same group); and the Mann-Whitney test was used for the independent variables (test and control groups in each time period). There was improvement in all domains and in overall CPQ8-10 (p < 0.0001) in the DTG over time, but no significant changes (p > 0.05) were observed at baseline for overall CPQ8-10 and for the emotional well-being domain in the GWC. The comparison between groups demonstrated that OHRQoL was persistently better for the GWC (p < 0.05) over time. In conclusion, dental caries treatment has a long-term positive impact on schoolchildren's OHRQoL, highlighting the importance of health policies that promote access to dental care for this population.

Early Caries Predicts Low Oral Health-Related Quality of Life at a Later Age

Oral health-related quality of life (OHRQOL) is the perceived impact of one's own oral health on daily life. Oral diseases influence children's OHRQOL directly, but OHRQOL might also be related to oral health experiences from the past. We investigate the relation between dental caries at the age of 6 with OHRQOL assessed at the age of 10. This study was conducted within the Generation R Study, a population-based prospective cohort study. Caries experience was assessed with the decayed, missing, and filled teeth index (dmft) at a median age of 6.09 years (90% range: 5.73-6.80). OHRQOL was assessed with a short form of the Child Oral Health Impact Profile at the children's age of 9.79 years (9.49-10.44). In total, 2,833 children participated in this study, of whom 472 (16.6%) had mild caries (dmft 1-3) and 228 (8.0%) had severe caries (dmft >3). The higher the dmft score at the age of 6, the lower the OHRQOL at the age of 10 (p < 0.001). The children with severe caries at the age of 6 had significantly higher odds of being in the lowest OHRQOL quartile at the age of 10 (OR = 1.69; 95% CI: 1.17-2.45). Our study highlights the importance of oral health during childhood, because those who get a compromised start to oral health are much more likely to follow a trajectory which will lead to poor oral health (-related QOL) later. OHRQOL is not only related to current oral health experiences but also to oral health experiences from the past.