Oral Health and Quality of Life of Pediatric Patients with Complex Chronic Conditions

Objective: To analyze the correlation between clinical and subjective oral health indicators and quality of life in pediatric patients with Complex Chronic Conditions (CCC). Methods: A cross-sectional study was conducted with 63 pediatric patients with CCC. Data collection in a hospital setting involved oral clinical examinations using the Simplified Oral Hygiene Index, caries experience (DMFT/dmft), gingival bleeding, and Dental Aesthetic Index. Oral health-related quality of life (OHRQoL) was measured using the Parental-Caregivers Perceptions Questionnaire (P-CPQ), completed by caregivers. Correlations between indicators and quality of life scores were analyzed using Spearman's correlation coefficient (ρ), with a significance level of p < 0.05. Results: Poor oral hygiene was observed in 34.9% of participants (mean OHI = 2.03) and a dmft index of 1.67. Gingival bleeding was present in more than 30% of sites in 47.6% of children, and severe or very severe malocclusion was observed in 47.6%. Overall oral health-related quality of life (OHRQoL) had a mean score of 26.38, with the functional limitation domain being the most affected. There were no correlations between objective clinical indicators and quality of life domains. However, the subjective perception of "difficulty biting or chewing" showed a strong and significant correlation with the functional limitation domain (ρ = 0.823; p < 0.001) and with overall quality of life (ρ = 0.812; p < 0.001). Conclusion: Functional perception (chewing difficulty) proved to be a more sensitive indicator of the impact on OHRQoL in children with chronic heart disease (CHD) than traditional clinical indices. These findings underscore the importance of incorporating subjective and functional assessments into oral health care strategies for this vulnerable population.