Oral health-related quality of life and oral hygiene status among special need school students in amhara region, Ethiopia

Background
Oral conditions remain a substantial population health challenge worldwide. Poor oral health affects the quality of life as a result of pain or discomfort, tooth loss, impaired oral functioning, disfigurement, missing school time, loss of work hours, and sometimes even death. This study assessed the magnitude of Oral Health-Related Quality of Life (OHRQoL) and oral hygiene status and associated factors among special needs school students in the Amhara region.

Methods
An institution-based cross-sectional study was conducted from November 2020 to April 2021 in the Amhara Region, Ethiopia. A total of 443 randomly selected special needs students were included. A structured pretested interview-administered questionnaire was used for data collection. Bivariable and multivariable ordinal logistic regression models were fitted to identify the factors associated with oral hygiene status. The statistical significance of differences in mean OHIP-14 scores was assessed using the Kruskal-Wallis equality-of-populations rank and Wilcoxon rank-sum tests. Variables with a p-value less than 0.05 were considered statistically significant.

Results
Almost half 46.6% (95% CI: 42.1%, 51.4%) of the study participant had poor oral hygiene status. The median OHIP-14 score was 16 with an interquartile range from 14 to 20. The highest score was for functional limitation (mean: 1.45 (SD ± 0.70)) and the lowest score was for psychological disability (mean: 1.08 (SD ± 0.45)). Mother education, frequency of taking sugared foods, and the types of disabilities were significant predictors of the poor oral hygiene status of special needs students in the Amhara region. The students living in Dessie had higher OHIP-14 scores compared to those living in other places (Gondar, Bahir Dar, and Debre Markos). The students who never brush their teeth had lower OHIP-14 scores than those who brush sometime and once a day. Whereas, students affiliated with the orthodox religion had lower OHIP-14 scores compared to those affiliated with all other religions (Catholic, Muslim, and Protestant).

Conclusion
A substantial amount of students with a disability had poor oral hygiene. The OHIP-14 scores indicated poor oral health-related quality of life. The study found that maternal education, frequency of taking sugared foods, and the types of disabilities were statistically significant factors associated with oral hygiene status.