口腔健康相关生活质量调查在正畸学中的应用

口腔健康相关生活质量是反映口腔疾病及其防治对患者的身体功能、心理功能和社会功能等方面影响的综合评估.口腔正畸治疗对患者的生活质量有着显著影响,正畸患者在疗程中感受到功能限制、生理疼痛、心理不适、社会功能障碍和治疗后整体生活质量的改善.本文就口腔健康相关生活质量量表及正畸学相关的口腔健康相关生活质量研究方面作一综述.     

固定矫治中青少年及成人患者口腔健康生活质量的比较

目的:比较青少年及成人患者在固定矫治过程中口腔健康生活质量的不同变化特点。方法:选择81例于2013年9月—2015年8月就诊于山东大学口腔医院正畸科的患者,年龄15~25岁,分为青少年组（43例）和成人组（38例）。在矫治前及矫治中3个阶段完成填写口腔健康影响程度量表（OHIP-14）。采用SPSS 20.0软件包对数据进行Friedman双向方差分析、Wilcoxon秩和检验和Bonferroni校正检验。结果:矫治过程中,青少年及成人患者的总得分及除社交障碍、社会功能障碍外5个维度得分均呈下降趋势,差异具有显著性。社交障碍维度仅成人患者得分差异显著。社会功能障碍维度2组得分无显著差异。结论:口腔正畸医师应重视青少年及成人患者矫治中生活质量的变化特点,并根据其特点加强与患者的交流。     

口腔修复治疗效果主观评价—250 例调查分析

目的：研究口腔修复患者修复前后口腔健康相关生活质量（OHRQoL）状况,并结合其他主观指标探讨治疗效果。方法：以口腔健康影响程度量表（OHIP-14中文版）对修复治疗患者治疗前后的OHRQoL进行问卷调查,比较治疗前后患者生活质量变化。结果：量表各领域中”生理性疼痛”得分最高,该领域OHRQoL最差,其次为”生理障碍”。”吃什么东西都不舒服”是出现负面影响最多的条目（42．4％）,治疗后总体OHRQoL比治疗前提高,差异有统计学意义（P〈0．05）。结论：口腔健康状况对修复患者的影响主体现在生理性疼痛和生理障碍两个领域,修复治疗能改善患者口腔健康,提高患者口腔健康相关的生活质量。     

微创拔牙对老年患者口腔健康生存质量的影响

目的评价老年患者微创拔牙术前、术后生存质量的差别。方法选取2013年5月—2015年5月在我院就诊的老年患者63例,使用微创方法拔除其161颗残根残冠,于术前、术后发放口腔健康影响程度量表中文版(OHIP-14),根据量表具体条目进行打分,量表总分越高,表明口腔健康生存质量状况越差,以此来评价术前及术后1周患者生存质量的变化。结果老年患者微创拔牙手术后,OHIP-14总分低于拔牙治疗前(P<0.05)。"功能限制"、"生理性疼痛"、"心理不适"、"生理障碍"、"心理障碍"五个领域的得分均较术前有所下降(P<0.05)。其中,"生理性疼痛"领域负面影响百分比术前为50.8%,术后为9.5%,有明显改善(P<0.05)。结论老年患者的残根残冠使用微创拔牙方法拔除,准备充分,效果良好,值得推广。     

成人固定正畸治疗前后的口腔健康相关生活质量

目的 探讨错(牙合)畸形及正畸治疗对患者口腔健康相关生活质量(OH-QoL)的影响趋势和程度,分析可能影响患者生活质量的因素.方法 用口腔健康研究量表(OHIP-14中文版)测量不同类型错(牙合)畸形人群治疗前后的口腔健康生活质量.运用统计分析方法比较162例成人患者正畸治疗开始后1个月(T1)、3个月(T2)、6个月(T3)、12个月(T4)、治疗结束拆除矫正器(T5)、治疗结束后6个月(T6)的口腔健康生活质量变化,分析患者OH-QoL的变化趋势和可能的影响因素.结果 量表各领域中Angle Ⅰ类错殆组及Angle Ⅱ类错(牙合)组在心理不适(领域3)得分最高,而Angle Ⅲ类错(牙合)组在功能限制(领域1)得分最高,患者正畸治疗开始后1个月(T1)OHIP-14平均总得分最高(P＜0.05);同时T0与T1 、T1与T2、T2与T3、T4与T5、T5与T6比较差异均有统计学意义(P＜0.05).正畸治疗后(T6)得分低于治疗前(T0)(P＜0.05),即患者治疗后总体OH-QoL比治疗前提高.各条目中,正畸治疗前(T0)“其他人面前觉得不自在”最常给错(牙合)畸形患者带来负面影响,T1“出现过明显疼痛”、“吃什么东西都不舒服”、“在其他人面前觉得不自在”、“感到紧张不安”、“对自己的饮食不满意”给固定正畸患者带来负面影响最大,与正畸治疗前(T0)比较差异均有统计学意义(P＜0.05).结论 口腔健康状况对本研究患者OH-QoL的影响主要体现在心理不适领域,而对于AngleⅢ类错(牙合)畸形患者的负面影响主要体现在功能障碍方面;错(牙合)畸形的固定正畸矫治过程会对患者产生一定的消极影响,治疗后能改善患者口腔健康,提高患者的口腔健康相关生活质量.     

口腔癌患者健康相关生活质量及其影响因素调查

目的:调查口腔恶性肿瘤患者手术后生活质量状况及其影响因素。方法:选择郑州大学第一附属医院口腔颌面外科2011年5月~2013年1月收治的85例口腔恶性肿瘤患者,使用中文版口腔健康影响程度量表(oral health impact profile,OHIP-49)及华盛顿大学头颈肿瘤生活质量量表(University of Washington Quality of Life Scale,UW-QOL),在患者术后至少12个月后进行生活质量评测。结果:发出问卷85份,回收76份,完成问卷调查89.4%。UW-QOL调查问卷得分最高的项目是疼痛(77.3±6.3)分,其次是焦虑(76.4±7.8)分,第三是活力(74.3±8.2)分;得分最低的3项依次是:咀嚼(34.5±8.3)分、唾液(46.4±4.8)分、味觉(49.9±3.9)分。OHIP-14量表得分最好的项目是残障(38.5±7.4)分,其次是生理性疼痛(46.8±10.2)分,第三是心理障碍(50.9±5.8);得分差的3项依次是:功能限制(62.4±12.3)分、心理不适(57.8±9.2)分、社交障碍(55.8±12.8)分。结论:口腔癌根治性治疗对患者生活质量有显著的影响。对口腔恶性肿瘤应切实做好疾病护理,同时加强营养支持和心理疏导,并加强社会支持。     

复发性阿弗他溃疡患者口腔健康相关生活质量的初步研究

目的:通过口腔健康影响程度量表了解复发性阿弗他溃疡患者口腔健康相关生活质量。方法:采用OHIP-14中文版对复发性阿弗他溃疡患者进行问卷调查,同时记录其总间歇时间和VAS分值,并与普通人群OHQOL进行比较。结果:RAU患者量表得分中位数为22.00,明显高于普通人群中位数7.50(P<0.01),经历负面影响比例占前3位的依次是生理性疼痛、生理障碍和心理不适3个领域,量表得分与总间歇时间呈负相关关系(P<0.01),量表得分与VAS分值间呈正相关关系(P<0.01)。结论:RAU患者OHQOL明显低于普通人群,可为RAU病情评估提供参考。     

中文版口腔健康影响程度量表（OHIP-49）的研制

目的：中文版口腔健康影响程度量表（OHIP-49）的翻译及验证研究。方法：按国际标准程序,对英文原版口腔健康影响程度量表（OHIP-49）进行翻译、回译及跨文化适应过程,形成中文版OHIP-49。使用该量表和自评口腔健康状况调查表,对随机抽取的患有不同口腔疾病的患者和社区居民进行口腔健康相关生活质量调查,考评量表的信度和效度。结果：发放问卷360分,回收有效量表333份。OHIP-49各维度及量表总得分的内部一致性Cronbach＇sα系数为0.79～0.96,重测系数为0.83～0.97;量表得分与自评口腔健康呈显著正相关（P〈0.001）;量表各维度及总得分在不同自我评价治疗需要的人群中有显著差异。结论：OHIP-49中文版具有良好的信度、效度,适合在中国人群中应用。     

正畸对儿童及青少年口腔健康相关生活质量影响的研究进展

近年来,对口腔健康相关生活质量的研究发展迅速,大量相关量表得到深入研究与临床应用。研究证实,正畸治疗对患者口腔相关生活质量的影响是多方面的,包括口腔健康与功能、行为与社会心理学等等。为了深入了解正畸治疗对儿童及青少年患者口腔健康相关生活质量可能产生的影响及其评估手段,笔者对相关领域最新研究进展作一综述。     

心理干预对口腔扁平苔藓治疗效果的影响

目的 探讨心理干预对口腔扁平苔藓缓解的影响.方法 将210例口腔扁平苔藓患者随机分为2组,其中105例患者在药物治疗的基础上辅以心理治疗,作为心理治疗组;另105例单纯药物治疗,作为对照组.分别在首诊,治疗后2周、1个月、3个月、6个月和9个月后复诊时记录2组患者的心理量表得分和黏膜病损情况得分(包括体征得分和症状得分)以及治疗疗效情况.结果 心理治疗组口腔黏膜扁平苔藓病损体征和症状计分明显降低,并且口腔黏膜病损愈合时间缩短,疼痛减轻,缓解期延长.两组比较的差异有统计学意义(P＜0.01).结论 在药物治疗的基础上辅以心理治疗口腔扁平苔藓,效果明显,方法简便,疗效确切.     

固定矫治对错(牙合)患者口腔健康相关生活质量的影响

目的 探讨固定矫治对错胎患者口腔健康相关生活质量的影响,以期为临床提供参考.方法 使用口腔健康影响程度量表,选择2006年9月-2007年9月于中山大学光华口腔医学院正畸科行固定矫治的错(牙合)畸形患者进行生活质量调查,调查时间为矫治前和矫治1、4、12、24周,根据人口统计学资料(性别、年龄、学历)及正畸临床资料(安氏错(牙合)分类、骨面型分类、牙列拥挤程度、拔牙与否)分组,分析患者生活质量随矫治而发生的变化.结果 共发放问卷1250份,回收问卷1110份,问卷回收率为88.8%;其中有效问卷1110份,即完整回收222例患者5个时间点的问卷.矫治开始后4周内固定矫治对患者的负面影响明显,集中于生理疼痛[55/222(27.8%)]、心理不适[40/222(18.0%)].矫治前和矫治1、4、12、24周量表总分分别为3、10、7、5、4分,矫治前与矫治24周时、矫治4周与12周时量表总分的差异无统计学意义(P>0.05),其他任何两个时间点量表总分的差异均有统计学意义(P<0.001).不同性别和临床情况组间量表总分差异无统计学意义(P>0.05),不同年龄(成年组各时间点分别为9、13、8、4、3分,青少年组各时间点分别为6、9、5、3、4分)和学历组(高学历组各时间点分别为9、12、8、3、3分,低学历组各时间点分别为6、9、5、3、4分)量表总分差异均有统计学意义(P<0.001).结论 固定矫治可影响患者口腔健康相关生活质量.矫治1周时患者生活质量最差,而后逐步回升,至矫治24周时患者生活质量基本与矫治前无差别.     

Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents

OBJECTIVE: To assess whether Brazilian adolescents who had completed orthodontic treatment had lower levels of impacts on their oral health-related quality of life. DESIGN: A cross-sectional study. SETTING: The study was conducted in public and private secondary schools in Bauru-SP, Brazil. PARTICIPANTS: 1675 randomly selected adolescents aged between 15 and 16 years. METHODS: Adolescents were clinically examined using the Index of Orthodontic Treatment Need (IOTN). Two oral health-related quality of life measures, namely the Oral Impacts on Daily Performance (OIDP) and the shortened version of the Oral Health Impacts Profile (OHIP-14) were used to assess adolescents' oral health-related impacts. Multiple logistic regression was used in the data analysis. RESULTS: A response rate of 100% was obtained. Adolescents who had completed orthodontic treatment had fewer oral health-related impacts compared to the other two groups. They were 1.85 times (95% CI 1.30 to 2.62) less likely to have an oral health impact on their daily life activities than adolescents currently under treatment or 1.43 (1.01 to 2.02) times than those who never had treatment. CONCLUSIONS: Adolescents who had completed orthodontic treatment had a better oral health-related quality of life than those currently under treatment or those who never had treatment.     

The relationship between normative orthodontic treatment need and oral health-related quality of life

OBJECTIVES: The first objective was to assess whether having had orthodontic treatment affected the levels of oral health-related quality of life impacts in Brazilian adolescents. A second objective was to assess the relationship between a normative clinical measure of orthodontic treatment need and two measures of oral health-related quality of life. METHODS: A cross-sectional study was conducted in Bauru, SP, Brazil, on 1675 randomly selected adolescents aged between 15 and 16 years. Adolescents were clinically examined using the Index of Orthodontic Treatment Need (IOTN). Two oral health-related quality of life measures, namely the Oral Impacts on Daily Performance (OIDP) and the shortened version of the Oral Health Impacts Profile (OHIP-14) were used to assess the adolescents' oral health-related impacts. Multiple logistic regression was used in the data analysis. RESULTS: Adolescents who had completed orthodontic treatment reported less oral health impacts on their daily life activities than those currently under treatment or those who never had any treatment. Combining the IOTN index with either of the two oral health-related quality of life measures used in this study provided more information about the adolescents' perceived satisfaction with their appearance than the IOTN on its own. CONCLUSION: Current methods of assessing orthodontic need should be complemented by oral health-related quality of life measures with valid psychometric properties, and measures of perceived need.     

Factors Influencing Quality of Life after Surgical and Nonsurgical Interventions of Persistent Endodontic Disease

IntroductionNonsurgical endodontic retreatment and apical surgery are predictable procedures for the management of endodontically treated teeth with persistent disease. However, there is no information available that compares these treatment modalities based on patients’ oral health–related quality of life (OHRQOL). The aims of this study were to compare the OHRQOL of patients who received nonsurgical endodontic retreatment versus those who received apical surgery and to identify correlations between OHRQOL, clinician-assessed healing outcome, and other factors.MethodsPatients who received treatment at 2 dental hospitals with a recall period of 6–24 months were invited to participate. They underwent follow-up examination and were surveyed with the Oral Health Impact Profile (OHIP-14). Healing outcomes were determined by clinical and radiographic evaluation. Potential influencing factors for OHIP-14 scores were investigated.ResultsOne hundred fifty patients (75 patients from each group) participated in the study. There were no differences in OHIP-14 scores between both groups at the follow-up. The overall adverse impact on OHRQOL was low, with patients experiencing greater impact in the domains of “physical pain” and “psychological discomfort.” Women and patients who had preoperative pain reported a greater impact. There was an overall high healed and healing rate for both groups. No correlation was found between OHIP-14 scores and healing outcome.ConclusionsPatients who received nonsurgical endodontic retreatment and apical surgery reported comparable OHRQOL, with women and patients with preoperative pain reporting greater impact. Both treatments are viable options for the management of persistent endodontic disease based on clinician- and patient-reported outcome assessments.     

Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents

Abstract

Objective: To assess whether Brazilian adolescents who had completed orthodontic treatment had lower levels of impacts on their oral health-related quality of life.

Design: A cross-sectional study.

Setting: The study was conducted in public and private secondary schools in Bauru-SP, Brazil.

Participants: 1675 randomly selected adolescents aged between 15 and 16 years.

Methods: Adolescents were clinically examined using the Index of Orthodontic Treatment Need (IOTN). Two oral health-related quality of life measures, namely the Oral Impacts on Daily Performance (OIDP) and the shortened version of the Oral Health Impacts Profile (OHIP-14) were used to assess adolescents’ oral health-related impacts. Multiple logistic regression was used in the data analysis.

Results: A response rate of 100% was obtained. Adolescents who had completed orthodontic treatment had fewer oral health-related impacts compared to the other two groups. They were 1.85 times (95% CI 1.30 to 2.62) less likely to have an oral health impact on their daily life activities than adolescents currently under treatment or 1.43 (1.01 to 2.02) times than those who never had treatment.

Conclusions: Adolescents who had completed orthodontic treatment had a better oral health-related quality of life than those currently under treatment or those who never had treatment.     

Oral Health-Related Quality of Life (OHQoL) among Adolescents Seeking Orthodontic Treatment

Aim: The aim of this study was to assess the effect of different orthodontic treatment needs on the OHQoL of adolescents. Materials and methods: 200 subjects (100 males and 100 females), 11 to 15 years of age were recruited for the study. OHQoL was assessed with the short form of the oral health impact profile (OHIP-14), and malocclusion severity was assessed with the index of orthodontic treatment need (IOTN). The Chi-square test was used to analyse the qualitative data. The level of significance was 0.05. Results: The more severe the malocclusion the worse was the impact on the OHQoL. Orthodontic treatment need had almost similar impact on the daily activities of both males and females. Pronunciation and taste was not significantly affected by the need for orthodontic treatment in either males or females. The proportions of orthodontic patients who found it uncomfortable to eat any food and had to interrupt their meals were significantly correlated with orthodontic treatment needs in both males and females. Conclusion: Orthodontic treatment need had an impact on OHQoL of adolescents with no significant difference between males and females. Clinical significance: Orthodontists should be aware of the impact caused by malocclusion and orthodontic treatment on the quality of life of the patients and should provide regular positive reinforcements to them. Keywords: Oral health-related qualtiy of life, Orthodontic treatment need, Malocclusion. How to cite this article: Manjith CM, Karnam SK, Manglam S, Praveen MN, Mathur A. Oral Health-Related Quality of Life (OHQoL) among Adolescents Seeking Orthodontic Treatment. J Contemp Dent Pract 2012;13(3):294-298. Source of support: Nil Conflict of interest: None declared.     

Complete dentures and oral health‐related quality of life – do coping styles matter?

Oral health-related quality of life (OHRQOL) in edentulous patients with complete dentures is often impaired. This paper investigates the effect of different coping styles on OHRQOL. PURPOSE: (a) To assess OHRQOL of edentulous patients with conventional complete dentures, and (b) to investigate if individual differences in these patients' styles of coping with stress affect their OHRQOL. MATERIALS AND METHODS: Data were collected from 249 fully edentulous patients with complete dentures (mean age: 66.0 years) who responded to a mailed survey (adjusted response rate: 48.8%). OHRQOL was measured with the 14-item short form of the oral health impact profile (OHIP). Ratings of coping strategies were obtained using the 28-item Brief COPE, an instrument measuring various styles of coping with stress. Linear regression analyses were used to explore the relationships between coping styles, background variables such as age, gender, income, and age of prosthesis, and the patients' OHRQOL. RESULTS: About 35% of the respondents reported impacts from their oral conditions on their overall OHRQOL (OHIP-14 total score) occasionally, fairly often, or often. Physical pain was even more prevalent, with 53.3% of the respondents reporting pain impacts. The linear regression model (P < 0.0001) explained 31.1% of the variation in the OHIP-14 total score. The coping variables instrumental support, behavioral disengagement, substance abuse, denial, and religion were significant negative predictors of OHRQOL. Only emotional support was a significant positive predictor of OHRQOL. CONCLUSION: Wearing conventional complete dentures has a significant impact on OHRQOL. This impact is moderated by the styles a patient uses to cope with stress. Using emotional support has a positive effect on OHRQOL, while other coping styles, namely instrumental support, behavioral disengagement, substance abuse, denial, and religion are significant negative predictors of OHRQOL.     

Perceptions of Dutch Orthodontic Patients and Their Parents on Oral Health-Related Quality of Life

Objective:To test the hypotheses that 1) there is no difference between orthodontic patients'' and their parents'' reports of patients'' oral health-related quality of life, and 2) there are no gender differences.Materials and Methods:The sample consisted of 182 orthodontic patients (age range, 8–15) and their parents. Respondents were required to complete the Child Oral Health Impact Profile (COHIP). Items were divided into five different subscales, and scores on all subscales were compared between and within groups. Also, scores on six additional items regarding treatment expectations and global health perception were compared. Two hypotheses were tested: first, that no differences between parents and patients would be detected, and second, that no differences between boys and girls would be found.Results:The first hypothesis could not be rejected. Only a few minor differences between parents and patients were found. The second hypothesis was rejected. Differences between boys and girls were found on the subscales Emotional Well-Being and Peer Interaction, indicating that girls experience more effects of oral health on their quality of life than do boys.Conclusions:Parents'' reports on their children''s oral health-related qualities of life were in agreement with reports of the orthodontic patients. This suggests that parents are suitable alternatives to their children in surveys measuring oral health-related quality of life.     

Impact of malocclusion on oral health–related quality of life in young adults

Objective:To assess oral health–related quality of life (OHRQoL) in young adult patients with malocclusion and to measure the association between orthodontic treatment need and OHRQoL.Materials and Methods:The study sample comprised 190 young adults aged 18 to 25 years who were attending orthodontic clinics at the Faculty of Dentistry. The Index of Orthodontic Treatment Need-Dental Health Component was used to measure orthodontic treatment need. Each participant was assessed for OHRQoL before and after treatment by using the Oral Health Impact Profile, Chinese version (OHIP-14).Results:Patients who had little or no, borderline, and actual need for orthodontic treatment represented 21.6%, 50.5%, and 27.9% of the total sample, respectively. OHRQoL (total OHIP-14 score and score for each domain) improved after treatment (P < .05). Significant differences in summary OHIP-14 scores were apparent with respect to orthodontic treatment need. Participants with high treatment need reported a significantly greater negative impact on the overall OHRQoL score. The greatest impact was seen in the psychological discomfort domain and the psychological disability domain.Conclusion:Malocclusion has a significant negative impact on OHRQoL. This is greatest for the psychological discomfort and psychological disability domains. The orthodontic treatment of malocclusion improves OHRQoL of patients.