Anyone who has experienced toothache knows how debilitating it can be. For young children, it can have a devastating effect on both them and their families. But just how much the oral health of youngsters affects lives has been hard to quantify - until now.
Professor Murray Thomson, of the Department of Oral Sciences at the School of Dentistry, has been investigating how children's quality of life is changed after treatment for extensive dental problems.
The research has also validated a new questionnaire designed to measure those changes.
It's part of master's thesis research by Wellington hospital dentist Penny Malden and also involves collaborators from the University of Toronto.
"We have ways of measuring the impact of adults' oral-health conditions on their day-to-day lives," says Thomson. "We needed to do the same thing for children.
"The Toronto team had developed a measure that looked very promising and we were lucky enough to be able to do some of the epidemiological validation for it here in New Zealand. We did some work with 12-year-olds in Taranaki and it looked to have all the right elements for such a measure.
"The next stage was to find out whether it was good enough to measure improvements or deteriorations in people's oral health as they are treated or not treated."
Malden's study involved more than 200 children undergoing dental treatment under general anaesthetic in the greater Wellington area. The new measure showed that after treatment they had substantial improvements in their quality of life, with a reduction in pain and problems with sleeping, eating or behaviour.
"The findings are pretty stunning. They are as good as I had hoped for," says Thomson. "This is a very important piece of work from the point of view of the validation of the measure itself because it's the first time it's been done to show that it is useful as a measure in health-services research."
Thomson hopes that the work will give ammunition to those campaigning for better oral health programmes for young children.
"In this country we have inequalities in oral health. Most kids have pretty good teeth, but there are others who have so much disease we can't treat them conventionally. You have to treat them in theatre under general anaesthetic."
A recent national child nutrition survey showed that about one-in-20 New Zealand children had had dental treatment under general anaesthetic.
"That's higher than I would have expected and it seems to be on the increase," says Thomson. "Theatre treatment is highly resource-intensive and relatively expensive, so every now and then someone suggests the service should be cut. Their thinking is that these are only baby teeth, so they don't matter. The problem should go away."
That couldn't be more wrong, says Thomson.
"What we have shown is that the oral health of pre-schoolers and young children does matter, and matters a lot. You treat these kids, take away their problems and you get big improvements in the quality of life of the whole family - and now we can support that with data.
"This is the first time this better scale has been used and validated for this sort of work. Its international importance in its field can't be overstated."
It also supports local initiatives, says Thomson. "The New Zealand Society of Hospital and Community Dentistry has just put out a code of practice for the dental treatment of children under general anaesthetic. The timing of our study could not be better for that, because it outlines the procedures and we can show how much they will improve lives."
FUNDING
New Zealand Dental Association
esearch Foundation
Monday, 8 December 2008