Impact of psychosocial factors on oral health-related quality of life in Brazilian preschool children: structural equation modeling.

Objective: To investigate the pathways through which psychosocial factors, dental caries and dental visits impact the oral health-related quality of life (OHRQoL) of preschool children and their parents/guardians using structural equation modeling.

Methods: A cross-sectional study was conducted with 769 pairs of 5-year-old preschool children and their parents/guardians. The parents/guardians answered questionnaires addressing sociodemographic characteristics and oral hygiene factors, as well as the Sense of Coherence Scale (SoC) and Multidimensional Health Locus of Control Scale (MHLC). The children and parents/guardians also answered the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5). Dental caries lesions in children were classified using the International Caries Detection and Assessment System (ICDAS) by two calibrated examiners (Kappa > 0.80). Descriptive analysis and confirmatory factor analysis of the measurement models were performed, followed by structural equation modeling.

Results: Goodness-of-fit indices were considered adequate (root mean square error approximation = 0.03; comparative fit index = 0.96; standardized root mean square residual = 0.06; Tucker-Lewis index = 0.95). Weak sense of coherence (β: - 0.09; p < 0.03), external locus of control (β: - 0.14; p < 0.01), and cavitated teeth (β: 0.25; p < 0.01) exerted a direct impact on the OHRQoL of the children, and visit to the dentist (β: 0.16; p < 0.01) had an indirect effect.

Conclusion: Psychosocial factors and dental condition directly impact the OHRQoL of preschool children and their parents/guardians, while dental visits have an indirect effect. This highlights the need for integrated approaches that consider both clinical and psychological aspects to improve the OHRQoL of preschool children.