This study aimed to describe different approaches for the evaluation of the Oral 
health-related quality of life (OHRQoL) of preschool children and to discuss 
perspectives for future instruments. The OHRQoL is a concept that surpasses an 
exclusively clinical perception and includes functional, social, emotional, and 
environmental issues. The measure of OHRQoL represents a holistic approach for 
researchers and clinicians extending their visions beyond the mouth and 
understanding the entire context of the patient. Negative impacts of oral 
conditions on OHRQoL in childhood can reflect on health development, especially 
in a life stage marked by social and cognitive maturation. Instruments have been 
developed and cross-culturally adapted to evaluate the impact of oral conditions 
on the OHRQoL of preschool children and their families. Some features 
distinguish these instruments and influence their selection, such as: self- or 
proxy-report; generic- or specific-condition; long- or short-form, and less or 
more established used in literature. Moreover, theoretical framework, construct 
validation and availability should also be considered. Nine OHRQoL instruments 
for preschool children were included in the present literature review. They were 
created between 2003 and 2017 by developed countries in most cases. The shorter 
instrument has five items, and the larger has 31 items. Most of them are 
proxy-reported, generic-condition, and have been relatively well established in 
the literature. The diversity of instruments indicates the evolution of OHRQoL 
studies, but there are methodological issues still in need to be improved in 
future developments or cross-cultural adaptations, according to current 
psychometric evidence.