Diagnostic accuracy of parents’ ratings of their child’s oral health-related quality of life

Purpose: Oral health-related quality of life (OHRQoL) in children and adolescents can be assessed with two different approaches: children can directly report their own perceptions or parents can serve as proxies and rate their child’s OHRQoL from their perspectives. It was the aim to investigate whether parents can accurately rate their children’s OHRQoL and to compare agreement between OHRQoL domains and between age groups. Methods: In this cross-sectional study, a sample of 140 children aged 7–17 years was consecutively recruited at a university-based orthodontic clinic and a public school. OHRQoL was assessed with the 19-item Child Oral Health Impact Profile (COHIP) with one version for the child and one for the parent. Correlation between child and parent ratings and diagnostic accuracy of the parental rating to assess children’s OHRQoL was calculated, and findings were compared between 7–11- and 12–17-year-old children. Results: COHIP summary score differed only slightly between parents (mean 60.7 ± 9.8 points) and children (mean 61.9 ± 8.9 points). Correlation of summary scores was r = 0.38, corresponding to a moderate agreement. Median of item prevalence of all 19 items was 29.5 % for children and 41.7 % for parents. Median of positive predictive values was 50.9 % and median of negative predictive values 76.7 %, with no substantial differences in age groups. Conclusions: Parents’ perception of their children’s OHRQoL is not accurate enough to detect oral health problems in an individual child aged between 7 and 17 years, and therefore, proxy OHRQoL assessment for individuals in this age group cannot be recommended.