Oral Health-Related Quality of Life in Children with Orofacial Clefts Who Are Treated at a University Hospital

Abstract

Background: Orofacial cleft is a congenital malformation of the palate, lip, or both lip and palate that affects the quality of life in children. Objectives: To evaluate the oral health-related quality of life (OHRQoL) of children with orofacial clefts treated at a university hospital. Materials and Methods: A qualitative study using a structured oral health-related quality of life (OHRQoL) questionnaire was conducted. The subscale scores were summarised to obtain the overall OHRQoL score. Concordance between parents and children was examined using a paired sample t-test by comparing the overall and subscale scores. Pearson’s correlation coefficients and complementary regression analysis also examined the predictive value of OHRQoL for general health. Cronbach’s alpha was used to determine internal consistency, and the subscale score data were statistically analysed. All the tests were at a 5% level of significance. Results: A total of 39 patients with orofacial clefts participated in this study. Most of the participants were male (22/39; 56%). Most participants were younger than 18 years (28/39;71.8%), presented with cleft lip and palate (24/39; 61.5%) and have not received orthodontic braces (30/39;76.9%). Cronbach’s alpha reliability for each subscale ranged from 0.661 to 0.908, with an overall reliability of 0.898, showing that the instrument was consistent in its measurement. On average, the overall OHRQoL score was 198.12 (standard deviation: ±0.57), ranging from 38 to 228. The presence of braces had a significant correlation (p = 0.029) with general health, and the presence of a cleft had a significant correlation (p = 0.026) with oral problems. Participants’ ages were shown to significantly correlate with emotion (p = 0.003), schooling (p = 0.012), the impact on their families (p = 0.037), and general health (p = 0.022). Most participants had a cleft lip with or without a palate (61.5%), followed by a cleft lip (23.1%), and a cleft palate (15.4%). Cleft lip prevalence was higher in males (77.8%) than in females (22.2%). Overall, 79.5% of adults in the study reported good or great health. A smaller percentage of adults reported average health (10.3%) or were unsure of their health status (10.3%). Conclusion: Cleft lip and palate were reported in 39 patients, while 30 of them did not wear braces due to which their OHRQoL was not satisfactory. Some of the underlying causes are iv the severity of the cleft condition, lack of access to proper and advanced medical services, and socioeconomic factors. These patients reported attributes such as severe pain, eating and speaking difficulties, embarrassment and social isolation that affected their everyday lives. The patients as well as the caregivers recorded high levels of stress and anxiety emphasizing the need to embrace orthodontic treatment and the need to address the general well-being of the patients through socio-psychosocial support to enhance their OHRQoL.