Does oral health affect self perceptions, parental ratings and video-based assessments of children's smiles?

Objectives: To explore whether there is a relationship between children's objectively determined oral health status and their oral health-related quality of life, specifically the evaluations of their smiles as assessed by the children, their parents, and through measurements of the children's videotaped smiles. Methods: Chart review data were collected from 99 children (56 boys, 43 girls; average age: 7.06 years; range: 4-12 years) to determine their oral health status. The children responded to the Michigan Oral Health-Related Quality of Life Scale - Child Version (MOHRQOL-C), and the parents responded to the Michigan Oral Health-Related Quality of Life Scale - Parent Version (MOHRQOL-P) to assess the smiling-related aspect of the children's oral health-related quality of life. Parents also responded to questions concerning their own evaluations of their child's smile. The children were videotaped while they watched a funny cartoon. Two independent raters measured the width and openness of the children's mouth plus the number of teeth shown at 25 predetermined time points during these taped sessions to assess the children's video-based smiling patterns. Results: The children's self evaluated smile scores correlated with the video-based ratings of the children's smiles, and with the number of positive adjectives parents chose to describe their children's smiles. There were significant relationships between several indicators of oral health status and all smile assessment scores. Children without caries evaluated their own smiles more positively, showed more teeth when smiling, and received more positive parent evaluations for their smiles than children with decay. Conclusion: Poor oral health is significantly related to children's smiling patterns and the way others perceived their smiles. Poor oral health may prevent children from expressing positive emotions, which can impact their social interactions and the way they feel about themselves.