Causal effect of molar incisor hypomineralisation on oral health-related quality-of-life of Australian children 7 to 16 years-of-age

 

Purpose: Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel characterised by demarcated opacities. Aesthetic and functional sequelae of MIH may manifest as reduced oral health related quality of life (OHRQoL). This study aims to investigate the impact of the presence and severity of MIH on children’s OHRQoL.

Methods: This cross-sectional study recruited children aged 7 to 16 years-of-age attending specialist paediatric dental clinics in Melbourne, Australia. Clinical examination utilised the modified European Academy of Paediatric Dentistry index to quantify the presence and severity of MIH. OHRQoL data was collected via the Child Perception Questionnaire, Parent-Caregiver Perception Questionnaire and Family Impact Statement. Causal analysis used quantile regression and included poor medical health as a confounding variable. Sensitivity analysis used the same model and different strata of MIH lesion location and severity.

Results: 131 participants with complete self-reported OHRQoL data were included in the causal analysis. The estimated average causal effect after adjusting for poor medical health showed the estimated difference in medians of child-reported OHRQoL was 6 (CI = 2.62, 12.25, p = 0.02) in the MIH group compared to the unaffected group. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 7 (CI = 1.87, 11.99, p = 0.01) for severe MIH group and -1 (CI = -5.16, 3.62, p = 0.63) for the mild group compared to those unaffected. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 5.16 (CI = -2.42, 10.99, p = 0.15) for participants with MIH-affected incisors compared to the rest of the cohort.

Conclusions: MIH impacts children’s OHRQoL as reported by self and parent/caregiver.