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Aust Dent J. 2015 Sep;60(3):375-81. doi: 10.1111/adj.12236.

Evaluation of the Early Childhood Oral Health Impact Scale in an Australian preschool child population.

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Dental Health Services, Health Department of Western Australia.
Australian Research Centre for Population Oral Health, The University of Adelaide, South Australia.



Early childhood caries has significant impacts on children and their families. The Early Childhood Oral Health Impact Scale (ECOHIS) is an instrument for capturing the complex dimensions of preschool children's oral health. This study aimed to evaluate the reliability and validity of the instrument among Australian preschool children.


Parents/children dyads (n = 286) participating in a treatment trial on early childhood caries completed the scale at baseline, and 33 parents repeated the questionnaire 2-3 weeks later. The validity and reliability of the ECOHIS was determined using tests for convergent and discriminant validity, internal reliability of the instrument and test-retest reliability.


Scale impacts were strongly correlated with global oral health ratings (Spearman's correlations; r = 0.51, total score; r = 0.43, child impact; and r = 0.49, family impact; p < 0.001). The scale was significantly associated with children's caries experience, p < 0.001. Cronbach's alpha values were 0.87, 0.89 and 0.74 for the total, the child and the family domains, respectively. Test-retest reliability was 0.92, 0.89 and 0.78 for the total, child and family domains, respectively.


The scale demonstrated acceptable validity and reliability for assessing the impact of early childhood caries among Australian preschool children.


Child oral health-related quality of life; early childhood caries; early childhood oral health impacts

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