To determine the extent to which history of dental pain explains the impact of dental caries on oral health-related quality of life (OHRQoL) among pre-schoolers.
A population-based study was conducted with a random sample of 769 five-year-old children. Preschoolers self-completed the Brazilian version of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5), and caregivers completed a questionnaire addressing sociodemographic characteristics. Children had a dental/oral examination done by dentists. The effect of cavitated caries lesions on OHRQoL explained by pain was estimated by the percentage variation of the prevalence ratio (PR) for the impact of cavitated lesions on OHRQoL (PRc), and this measure was adjusted by dental pain (PRct). PR was determined through multiple Poisson regression ( <0.05).
The prevalence of cavitated lesions was 58.8 percent; among this cohort, 23.8 percent reported dental pain. The PRc was 1.063 and PRct was 1.039. Thirty-eight percent of the impact of dental caries on OHRQoL was due to dental pain.
History of dental pain explains 38 percent of the impact of dental caries on the OHRQoL of preschoolers.

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