Development and Validation of the Greek version of the Early Childhood Oral Health Impact Scale (ECOHIS)

The Open Dentistry Journal 20 Mar 2020 RESEARCH ARTICLE DOI: 10.2174/1874210602014010088



The oral health of preschool-age children can affect their quality of life (QoL) as well their families. The Early Childhood Oral Health Impact Scale (ECOHIS) is a reliable instrument that has been used to assess the impact of oral health problems and their treatment on the QoL of preschool-age children and their families’.


To report the development, evaluation and psychometric properties of the Greek version of ECOHIS (Gr-ECOHIS).


Participants of this cross-sectional study were 176 mothers and their young (aged 25-71 months) children, patients of a private pediatric dental practice. During a structured interview, they completed a questionnaire, including a translated, Greek language version of the ECOHIS. Data on children’s oral health were obtained via clinical examinations. The psychometric properties of Gr-ECOHIS evaluated were reliability (internal and test-retest) and construct (convergent and discriminant) validity. Test-retest reliability was determined in an independent sample of 20 mother-child dyads, who completed the Gr-ECOHIS twice within a two-week interval.


The scale showed excellent internal consistency (Cronbach’s alpha=0.85) and test-retest reliability (Intraclass Correlation Coefficient= 0.97). Gr-ECOHIS showed a strong correlation with dental caries (Spearman’s rho=0.62, p<0.0005) and dental treatment needs. Gr-ECOHIS was also positively associated with dental knowledge, health literacy and parental oral health-related QoL.


The Gr-ECOHIS is a psychometrically reliable and valid Greek language QoL instrument, which demonstrated significant associations with clinical and parent-reported measures of early childhood oral health. As such, it can be used to measure oral health-related QoL among preschool-age children in clinical and public health settings.

Keywords: Early Childhood Oral Health Impact Scale, ECOHIS, Validity, Psychometric properties, Oral health, Preschool age children.
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