Open Access Research article

The potential of the Child Health Utility 9D Index as an outcome measure for child dental health

Lyndie A Foster Page1*, W Murray Thomson1, Zoe Marshman2 and Katherine J Stevens3

Author Affiliations

1 Faculty of Dentistry, University of Otago, Dunedin, New Zealand

2 Academic Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK

3 School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK

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BMC Oral Health 2014, 14:90  doi:10.1186/1472-6831-14-90

Published: 16 July 2014



The Child Health Utility 9D (CHU9D) is a relatively new generic child health-related quality of life measure (HRQoL)—designed to be completed by children—which enables the calculation of utility values.

The aim is to investigate the use of the CHU9D Index as an outcome measure for child dental health in New Zealand.


A survey was conducted of children aged between 6 and 9 years attending for routine dental examinations in community clinics in Dunedin (New Zealand) in 2012. The CHU9D, a HRQoL, was used, along with the Child Perceptions Questionnaire (CPQ), a validated oral health-related quality of life (OHRQoL) measure. Socio-demographic characteristics (sex, age, ethnicity and household deprivation) were recorded. Dental therapists undertook routine clinical examinations, with charting recorded for each child for decayed, missing and filled deciduous teeth (dmft) at the d3 level.


One hundred and forty 6-to-9-year-olds (50.7% female) took part in the study (93.3% participation rate). The mean d3mft was 2.4 (SD = 2.6; range 0 to 9). Both CHU9D and CPQ detected differences in the impact of dental caries, with scores in the expected direction: children who presented with caries had higher scores (indicating poorer OHRQoL) than those who were free of apparent caries. Children with no apparent caries had a higher mean CHU9D score than those with caries (indicating better HRQoL). The difference for the CPQ was statistically significant, but for CHU9D the difference was not significant. When the two indices were compared, there was a significant difference in mean CHU9D scores by the prevalence of CPQ and subscale impacts with children experiencing no impacts having mean CHU9D scores closer to 1.0 (representing perfect health).


The CHU9D may be useful in dental research. Further exploration in samples with different caries experience is required. The use of the CHU9D in child oral health studies will enable the calculation of quality-adjusted life years (QALYs) for use in economic evaluation.

Quality of life; Health utility; Dental caries; Children