Associations between orthodontic treatment need and oral health‐related quality of life among young adults: does it depend on how you assess them?

Liu Z, McGrath C, Hägg U. Associations between orthodontic treatment need and oral health‐related quality of life among young adults: does it depend on how you assess them? Community Dent Oral Epidemiol 2011; 39: 137–144. © 2011 John Wiley & Sons A/S Abstract – Objective: To determine the association between orthodontic treatment need (OTN) and oral health‐related quality of life (OHRQoL). Methods: A cross‐sectional study involving 273 young adults seeking orthodontic care. OHRQoL was assessed by the short‐form Oral Health Impact Profile (OHIP‐14) and United Kingdom oral health‐related quality of life measure (OHQoL‐UK). Study casts were assessed for OTN by: Dental Aesthetic Index (DAI), Index of Orthodontic Treatment Need (IOTN)‐Aesthetic Component (IOTN‐AC) and Dental Health Component (IOTN‐DHC) and Index of Complexity, Outcome and Need (ICON). Variations in OHIP‐14 and OHQoL‐UK were determined with respect to OTN, and the magnitude of differences was calculated (effect size: ES). Results: There were significant but weak correlations between occlusal indices scores and OHIP‐14 scores (P < 0.05, r < 0.3) and between occlusal indices scores and OHQoL‐UK scores (P < 0.05, r < 0.4). The magnitude of the statistical difference in OHQoL‐UK scores was moderate to large with respect to OTN (ES: 0.36–0.87) and largest when DHC (ES = 0.87) and ICON (ES = 0.74) were used. The magnitude of the statistical difference in OHIP‐14 scores was relatively lower (ES: 0.21–0.69), but also greatest when DHC and ICON were used to determine OTN (ES 0.69 and 0.50, respectively). Conclusion: Orthodontic treatment need was associated with OHRQoL. The magnitude of the statistical difference between those with and without an orthodontic treatment need was larger when OHRQoL was assessed using OHQoL‐UK compared to OHIP‐14. DHC and ICON were more useful indices in identifying greater differences in OHRQoL with respect to orthodontic treatment need.     

A community study on the relationship of dental anxiety with oral health status and oral health-related quality of life

Abstract – Objective: To investigate the relationship of dental anxiety with oral health status and oral health‐related quality of life (OHQoL) among dentate subjects living in Hong Kong. Methods: One thousand Hong Kong residents who were aged 25–64 years and predominantly Chinese were asked to complete the Chinese short‐forms of the Dental Anxiety Inventory (SDAxI) and Oral Health Impact Profile (OHIP‐14S). Dental (DMFT index) and periodontal statuses [full‐mouth clinical attachment level (CAL)] were also assessed. Results: Ninety‐six (9.6%; mean SDAxI, 9.6), 799 (79.9%; mean SDAxI, 15.0), and 105 (10.5%; mean SDAxI, 27.4) participants had low, average, and high dental anxiety, respectively. The mean DMFT/CAL scores of each SDAxI subgroup were 8.5/1.4, 9.3/1.9, and 9.8/3.6, respectively. The corresponding mean OHIP‐14S scores for each SDAxI subgroup were 4.0, 8.1, and 13.2, respectively. Post hoc analysis, adjusted for possible confounding factors, revealed statistically significant differences in DMFT and CAL scores in subjects with low versus high level of SDAxI, and significant differences in OHIP‐14S scores between all 3 SDAxI categories. Conclusion: The trait disposition of dental anxiety may be a significant risk indicator of poor dental and periodontal status and is associated with a worse OHQoL.     

Oral health related quality of life is affected by disease activity in Behçet's disease

Objectives: This study aimed to investigate oral and general health related quality of life (QoL) in patients with Behçet's Disease (BD) and to assess the performance of Turkish versions of oral health related quality questionnaires. Subjects and methods: Ninety‐four BD patients, 24 patients with recurrent aphthous stomatitis (RAS), 113 healthy controls (HC) and 44 dental patients were investigated. QoL was assessed by oral health impact profile‐14 (OHIP‐14), oral health related quality of life (OHQoL) and short form‐36 (SF‐36) questionnaires. Results: OHQoL, OHIP‐14 and SF‐36 subscale scores were significantly worse in patients with BD compared with those in HC (P < 0.05). Both OHIP‐14 and OHQoL scores were significantly worse in active patients compared with inactives in BD and RAS (P < 0.05). Scores of SF‐36 Role physical, Role emotional and Vitality were also lower in active patients than in inactives in BD (P < 0.05). Scores of OHIP‐14 and OHQoL were significantly worse in patients treated with colchicine compared with those treated with immunosuppressives (P < 0.05). Conclusions: Both oral and general QoL was impaired in BD and associated with disease activity and treatment modalities. Translated Turkish versions of OHIP‐14 and OHQoL were also observed to be valid and reliable questionnaires for further studies.     

Neutral zone or conventional mandibular complete dentures: a randomised crossover trial comparing oral health‐related quality of life

There is widespread consensus that the neutral zone (NZ) concept contributes to improved stability for mandibular complete dentures (CDs). However, little is known about its impact on oral health‐related quality of life (OHRQoL) of edentulous patients compared to conventionally (CV) manufactured dentures. In this prospective crossover trial, performed at the Oral Health Centre of the University of the Western Cape, CV and NZ mandibular dentures were made for each patient. Scores from the 20‐item oral health impact profile (OHIP‐20) for both types of dentures were compared with pre‐treatment scores using paired t‐tests. Treatment effect size (ES) was established. Associations of OHIP‐20 scores and several patient variables (age, gender, period of edentulousness, quality of the denture‐bearing tissue, denture dimensions, preference) were performed using the generalised linear model. Significance was set at P = 0·05. Records of thirty‐five participants were included in the study (mean age of 62·3 years, range 47–85 years). There were highly significant differences between pre‐treatment and both post‐treatment OHIP‐20 scores with t = 6·470 for CV and t = 6·713 for NZ. Treatment ES was large for both types of dentures (>0·8). Difference of ES between NZ and CV dentures was small (ES < 0·2). None of the patient variables showed significant associations with OHIP‐20 scores of the two types of dentures, except for preference and NZ OHIP‐20 scores. For this group of patients, both treatment methods improved OHRQoL significantly and patient‐related factors did not influence impact on OHRQoL differently for both interventions.     

Comparison of perceptions of oral health‐related quality of life in adolescents affected with ectodermal dysplasias relative to caregivers

The objective of this study was to assess the perceived oral health‐related quality of life (OHQoL) of adolescents affected with one of the ectodermal dysplasias (EDs). Data were collected from 2003 to 2007 in a cross‐sectional study of a convenience sample of individuals affected by ED (n = 35) using the Child Perceptions Questionnaire (CPQ11–14) for children and the Parent‐Caregiver Perceptions Questionnaire for their caregivers. The main findings of this study were that individuals who were affected with ED in the older age group (15‐ to 19‐year‐olds) perceived more functional problems than younger individuals (11‐ to 14‐year‐olds) (p= .04). Females with ED (n = 13) perceived more emotional problems than males (n = 22; p= .01). Although caregivers tended to report slightly higher OHQoL scores (indicating worse OHQoL), no significant differences were observed between children’s and parents’ total OHQoL and individual domains’ median scores (p > .05). Thus, the perceptions of oral health and well‐being may vary by age and gender for children who have ED. Caution is warranted concerning using parents as proxies for their children when assessing the child’s OHQoL.     

Oral health‐related quality of life and its relationship with health locus of control among Indian dental university students

Objectives: The objectives of this study were to assess the relationship between Oral Health‐Related Quality of Life (OHRQoL) and Health Locus of Control (HLC) among students in an Indian dental school. Materials and methods: A cross sectional study design was used. Three hundred and twenty‐five dental students returned completed forms containing the 14 item Oral Health Impact Profile (OHIP‐14) and the 18 item Multidimensional Health Locus of Control Scale (MHLC). Results: The results showed that the perceived OHRQoL differed among students studying in different stages of the dental course. The OHRQoL dimensions of ‘Social Handicap’ and ‘Handicap’ were significantly (P < 0.01) lower among the later years of the course than the freshman year students. There was a sharp increase in Self‐reported dental problems, in particular, Malocclusion, Tooth decay, Calculus among the third year and final year students respectively. The OHIP‐14 scores were significantly higher among those with self‐reported oral problems. Correlation analysis between the OHIP‐14 and the MHLC scores also showed a statistically significant (P < 0.01) correlation between the ‘Chance’ dimension of the MHLC and OHIP‐14 scores. Conclusions: The results of this study underscored the relationship between the OHRQoL and HLC and of importance of assessing health attitudes and their impact on OHRQoL among the dental student community.     

Changes in psychological health,subjective food intake ability and oral health‐related quality of life during orthodontic treatment

Assessing changes in patient's psychological health and oral health‐related quality of life (OHRQoL) over time during orthodontic treatment may help clinicians to treat patients more carefully. To evaluate changes in mental health, self‐reported masticatory ability and OHRQoL during orthodontic treatment in adults, this prospective study included 66 adults (30 men, 36 women; mean age, 24·2 ± 5·2 years). Each patient completed the Korean versions of the State–Trait Anxiety Inventory, Zung Self‐Rating Depression Scale, Rosenberg self‐esteem scale, key subjective food intake ability (KFIA) test for five key foods and Oral Health Impact Profile‐14 (OHIP‐14K) at baseline (T0), 12 months after treatment initiation (T1) and debonding (T2). All variables changed with time. Self‐esteem and the total OHIP‐14K score significantly decreased and increased, respectively, at T1, with a particular increase in the psychological and social disabilities scores. There were no significant differences in any questionnaire scores before and after treatment. The total OHIP‐14K score was positively correlated with trait anxiety and depression, and negatively correlated with self‐esteem and KFIA at T0, regardless of the treatment duration. Older patients showed a significant increase in the total OHIP‐14K score at T1 and T2. OHRQoL worsened with an increase in the treatment duration. Our results suggest that OHRQoL temporarily deteriorates, with the development of psychological and social disabilities, during orthodontic treatment. This is related to the baseline age, psychological health and self‐reported masticatory function. However, patients recover once the treatment is complete.     

A comparison of two questionnaires measuring oral health-related quality of life before and after dental hygiene treatment in patients with periodontal disease

To cite this article:
Int J Dent Hygiene 10 , 2012; 9–14
DOI: 10.1111/j.1601‐5037.2011.00511.x
Öhrn K, Jönsson B. A comparison of two questionnaires measuring oral health‐related quality of life before and after dental hygiene treatment in patients with periodontal disease. Abstract: Aim: The aim of this study was to compare the usefulness of two different questionnaires assessing oral health‐related quality of life (OHRQoL) at the basic examination and after initial dental hygiene treatment (DHtx). Methods: A total of 42 patients referred for periodontal treatment completed the Oral Health Impact Profile (OHIP‐14) and the General Oral Health Assessment Index (GOHAI) at the basic periodontal examination. They underwent DHtx and completed the questionnaires once again after the treatment. Results: No statistically significant differences could be found between the two assessments, neither for the total scores nor for any of the separate items of the OHIP‐14 or the GOHAI. However, the GOHAI questionnaire seems to result in a greater variety in the responses indicating that the floor effect is not as pronounced as for the OHIP‐14. Those who had rated their oral health as good reported significantly better OHRQoL on both questionnaires. The same pattern was found for patients who reported that they were satisfied with their teeth. After DHtx and necessary extractions, there was a statistically significant correlation between the number of teeth and the total scores on both questionnaires. No other statistically significant correlations with periodontal variables could be found. Conclusion: No statistically significant difference could be found after DHtx compared to before in regard to OHRQoL assessed with OHIP‐14 and GOHAI. However, there was a greater variety in the responses with the GOHAI questionnaire; it may hereby be more useful for patients with periodontal disease.     

Subjective food intake ability related to oral health‐related quality of life and psychological health

Reduced food intake ability can restrict an individual's choice of foods and might have a significant impact on the individual's quality of life and mental health. The aim of this study was to evaluate the correlations between self‐reported masticatory ability and oral health‐related quality of life (OHRQOL) and psychological health. The study included 72 (26 men, 46 women) adults with a mean age of 26·4 ± 8·6 years. Each participant completed the key subjective food intake ability (KFIA) test for five key foods, the Korean version of the Oral Health Impact Profile‐14 (OHIP‐14K) and three questionnaires for measuring anxiety, depression and self‐esteem. The participants were distributed into two groups by sex (a mean age of 23·9 ± 5·2 for men and 27·9 ± 9·8 for women) and by the median KFIA score. There were no significant differences in any of the variables according to sex. Thirty‐two participants (12 men, 20 women) in the lower KFIA group had a higher total OHIP‐14K (P < 0·001) and depression level (P < 0·05) than the 40 participants (14 men, 26 women) in the higher KFIA group. As the KFIA decreased, OHRQOL worsened (P < 0·001) and depression increased (P < 0·05). Participants with lower KFIA scores were more than 4·3 times as likely as to have a poor OHRQOL than the reference group (odds ratio, 4·348; 95% confidence interval, 1·554–12·170, P < 0·01). Lower subjective food intake ability is associated with a poor oral health‐related quality of life and higher depression level.     

Oral health‐related quality of life among rural‐dwelling Indigenous Australians

Background: There is limited information on the impact of poor oral health on Indigenous Australian quality of life. This study aimed to determine the prevalence, extent and severity of, and to calculate risk indicators for, poor oral health‐related quality of life among a convenience sample of rural‐dwelling Indigenous Australians. Methods: Participants (n = 468) completed a questionnaire that included socio‐demographic, lifestyle, dental service utilization, dental self‐care and oral health‐related quality of life (OHIP‐14) factors. Results: The prevalence of having experienced one or more of OHIP‐14 items ‘fairly often’ or ‘very often’ was 34.8%. The extent of OHIP‐14 scores was 1.88, while the severity was 15.0. Risk indicators for having experienced one or more of OHIP‐14 items ‘fairly often’ or ‘very often’ included problem‐based dental attendance, avoiding dental care because of cost, difficulty paying a $100 dental bill and non‐ownership of a toothbrush. An additional risk indicator for OHIP‐14 extent was healthcare card ownership, while additional indicators for OHIP‐14 severity were healthcare card ownership and having had 5+ teeth extracted. Conclusions: Risk indicators for poor oral health‐related quality of life among this marginalized population included socio‐economic factors, dentate status factors, dental service utilization patterns, financial factors and dental self‐care factors.     

Association between oral health‐related and general health‐related quality of life in subjects attending dental offices in Germany

Objectives: To evaluate the GHRQoL and OHRQoL of patients attending dental offices in Germany and to determine correlation coefficients between SF (Short Form)‐12 and OHIP (Oral Health Impact Profile)‐14 scores. Methods: A total of 10,342 dental offices were randomly selected. Each of the 1,113 that consented to participate received 20 questionnaires to be filled in by a convenience sample of the patients. The questionnaire included the OHIP‐14‐form for OHRQoL as well as the SF‐12‐form for GHRQoL. Results: A total of 12,392 completed questionnaires were analyzed. The mean age of the participants (64.9 percent female, 35.1 percent male) was 44.25 years. The mean summary score of OHIP‐14 was 6.30 (SD 7.46). The mean physical component summary scale (PCS) of the SF‐12 was 51.15 (SD 7.23) and the mental component summary scale (MCS) was 50.17 (SD 8.55). The variance of PCS and MCS could be explained to 10 percent each by oral health‐related quality of life (r² = 0.095 and 0.101, P < 0.001). Conclusion: OHRQoL is considerably related to GHRQoL.     

Impact of Periodontal Disease Experience on Oral Health–Related Quality of Life

Background: Periodontal research has traditionally focused on the site level, regarding etiology, pathogenesis, and treatment outcome. Recently, some studies have indicated that the presence of periodontal disease is associated with reduced quality of life. The aim of this study is to investigate the impact of periodontal disease experience on the quality of life. Methods: This cross‐sectional study includes 443 individuals. Clinical and radiographic examinations were performed; in conjunction, the oral health–related quality of life of all participants was assessed using the Swedish short‐form version of the Oral Health Impact Profile (OHIP‐14). Based on marginal bone loss, measured on radiographs, three different groups were identified: participants with loss of supporting bone tissue of less than one third of the root length (BL?), loss of supporting bone tissue of one third or more of the root length in <30% of teeth (BL), or loss of supporting bone tissue of one third or more of the root length in ≥30% of teeth (BL+). Results: The effect of periodontal disease experience on quality of life was considerable. For the BL? group, the mean OHIP‐14 score was 3.91 (SD: 5.39). The corresponding mean values were 3.81 (SD: 5.29) for the BL group and 8.47 (SD: 10.38) for the BL+ group. The difference among all groups was statistically significant (P ≤0.001). A comparison among the mean OHIP‐14 scores in the different groups (BL?, BL, and BL+) revealed significant differences in six of seven conceptual domains. Conclusions: The BL+ individuals experienced reduced quality of life, expressed as the OHIP‐14 score, compared with the BL and BL? participants.     

Scaling and Root Planing per Quadrant Versus One‐Stage Full‐Mouth Disinfection: Assessment of the Impact of Chronic Periodontitis Treatment on Quality of Life — A Clinical Randomized,Controlled Trial

Background: There are few randomized, controlled clinical trials about the effect of non‐surgical periodontal treatment on oral health–related quality of life (OHRQL). This study aims to compare the effects of two different forms of non‐surgical periodontal therapy, scaling and root planing (SRP) per quadrant and one‐stage full‐mouth disinfection (FMD), on periodontal clinical parameters and OHRQL of patients with chronic periodontitis. Methods: In this randomized, controlled clinical trial, the questionnaires Oral Impacts on Daily Performance (OIDP) and Oral Health and Quality of Life (OHQoL) were given to 90 patients divided into two groups: SRP (n = 45) and FMD (n = 45). Periodontal clinical parameters recorded included probing depth, clinical attachment level, plaque index, and gingival index. For statistical analysis, χ² test, Fisher exact test, Mann‐Whitney U test, and Wilcoxon test were used. Intention‐to‐treat analyses were performed at T0 (baseline) for periodontal clinical parameters, T1 (30 days after treatment) for questionnaires, and T2 (180 days after treatment) for both. Results: No significant differences were identified between the SRP and FMD groups in regard to OHQoL and OIDP scores when comparing the data of T1 and T2. Conclusion: Patients treated by both SRP and FMD showed improvement in all periodontal clinical parameters and OHRQL, with no significant differences between treatment groups.     

Oral health‐related quality of life in patients with non‐metal clasp dentures: a randomised cross‐over trial

We investigated the efficacy of non‐metal clasp dentures (NMCDs) with regard to the oral health‐related quality of life (OHRQoL) and compare the findings with those for conventional metal clasp‐retained dentures (MCDs). This single‐centre, randomised controlled, two‐phase, open label, cross‐over trial included 28 partially dentate individuals. The patients were randomised to receive MCDs followed by NMCDs, or the opposite sequence (n = 14 in each group); each denture was worn for 3 months. OHRQoL was evaluated using the Oral Health Impact Profile‐Japanese version (OHIP‐J) at entry (T‐entry; before treatment with the first denture) and at 3 months after treatment with each denture (T3). An examiner evaluated denture stability, oral appearance and surface roughness before denture delivery (T0) and at T3 and denture hygiene at T3. A total of 24 patients completed the trial. There were no complications related to the dentures, abutment teeth or denture‐bearing mucosa during the follow‐up periods for both dentures. The mean OHIP summary score was lower for NMCDs than for MCDs, and the difference (9 points) was greater than the minimal important difference (6 points), indicating the difference was clinically relevant. The effect size was medium (0·70). Statistical analyses with linear mixed models found a significant effect of the denture type on the OHIP summary score and scores for the Oro‐facial appearance, Oro‐facial pain and Psychological impact domains (NMCD < MCD; P < 0·05). The results of our study suggest that NMCDs allow for better OHRQoL compared with MCDs.     

Psychosocial impact of periodontal disease and its treatment with 24-h root surface debridement

Aim: To assess the impact of periodontal disease and treatment with 24-h root surface debridement on the oral health-related quality of life of patients (OHQoL).
Methods: Two cohorts were recruited: 20 patients with moderate to advanced periodontal disease and 16 dentally healthy patients. Patients with periodontal disease were treated with 24-h root surface debridement. OHQoL was assessed, using Oral Health Impact Profile-14, during the initial assessment and by a telephonic interview daily for 7 days for both groups. OHQoL was also assessed at review for the treated cohort. The number of impacts each patient experienced "occasionally" or more often was analysed by non-parametric tests.
Results: Patients with periodontal disease reported significantly more impacts on their quality of life than dentally healthy patients ( p <0.05). After root surface debridement the impact was significantly reduced ( p <0.05) and sustained at review ( p <0.05); however, the impact on quality of life was still greater than that experienced by the dentally healthy cohort ( p <0.05).
Conclusions: Patients with periodontal disease have worse OHQoL than healthy patients, but this impact can be partly ameliorated by periodontal treatment. This implies that periodontal disease is not "silent" and that conventional non-surgical treatment provided in a secondary referral centre can be effective from patients' perspectives.     

A case-control study assessing oral-health-related quality of life after immediately loaded single implants in healed alveolar ridges or extraction sockets

Introduction: Tooth loss reduces oral‐health‐related quality of life (OHRQoL) as assessed with the 14‐item Oral Health Impact Profile questionnaire (OHIP‐14). Objectives: This prospective multicenter case‐control study sought to (i) establish OHRQoL in patients requiring a single implant in the anterior maxilla and to (ii) compare these changes following implant placement and immediate provisionalization in extraction sockets with healed alveolar ridges up to 1 year. Material and methods: Ninety‐six patients were enrolled in the study with 102 single implants (OsseoSpeed^? AstraTech) provisionalized immediately after placement in sockets or after placement in healed ridges. A final crown was cemented after 12 weeks. OHIP‐14 was registered before surgery (baseline), after 1 (provisional crown), 6 and 12 months (final crown). Repeated measures ANOVA was performed for the seven conceptual OHIP Domains, the treatment group (extraction site socket vs. healed alveolar ridge) and time as within subjects variables. Results: Two implants failed, 1/48 (2.1%) in the extraction group (n=46 patients) and 1/54 (1.8%) in the healed ridge group (n=50 patients). From 82 patients (87.5%), OHIP‐14 was available at all time points. The overall OHIP‐14 based on the mean of the seven domains increases between baseline and 6 months and remained stable afterward for the total study group and both treatment groups. Comparison between extraction and healed groups revealed no significant difference at baseline but the healed group showed a significantly higher improvement for functional limitation, physical disability, physical pain and psychological discomfort (P<0.05). Between baseline and 1 year in the healed bone group, all seven domains improved significantly compared with only three domains in the extraction group. However, the overall OHIP‐14 score between groups was not substantially different. Hence, both treatment modalities lead to similar OHRQoL improvement. Conclusion: Patients in need of a single‐tooth replacement have limited OHRQoL problems as reflected by the OHIP‐14 score but improvements in several domains related to oral health were evaluated when implants were placed and provisionalized in healed bone and extraction sites.     

Burning mouth syndrome and oral health‐related quality of life: is there a change over time?

Oral Diseases (2010) 16 , 643–647 Background: The symptoms associated with burning mouth syndrome can be quite varied and can interfere with the every day lives of patients. Management of the condition can be challenging for clinicians. Aims: To determine the oral health‐related quality of life (OHRQOL) implications of BMS on patients over a period of time whilst undergoing treatment and to evaluate whether treatment interventions had a positive effect on OHRQOL. Materials and methods: Thirty‐two individuals (26 females, 6 males, mean age 61 years, range 38–83 years) were enrolled in this study. Individuals were interviewed using Short‐Form McGill Pain Questionnaire (SFMPQ), Visual Analogue Scale (VAS), the Hospital Anxiety and Depression Scale (HADS) and the Oral Health Impact Profile (OHIP‐14), at weeks 0, 8 and 16. Results: Scores from all outcome measures used decreased over the 16 weeks of the study. Statistically significant differences were found between time points for VAS pain scores (P < 0.001), HADS depression scores (P = 0.029), SFMPQ sensory pain scores (P < 0.01) and total scores for OHIP‐14 (P < 0.05). Conclusion: Burning mouth syndrome has a negative impact on OHRQOL; however, individually tailored management of the condition can result in an improvement in patient‐reported outcome measures including quality of life.     

Effects of low‐level laser therapy on burning mouth syndrome

To investigate low‐level laser therapy (LLLT) applied to treat burning mouth syndrome (BMS). This prospective, comparative, partially blinded, single‐centre, clinical trial of GaAlAs Laser, with 815 nm wavelength, included 44 BMS patients divided randomly into three groups: Group I (n = 16): GaAlAs laser 815 nm wavelength, 1 W output power, continuous emissions, 4 s, 4 J and fluence rate 133·3 J cm^?2; Group II (n = 16): GaAlAs infrared laser, 815 nm wavelength, 1 W output power, continuous emissions, 6 s, 6 J and fluence rate 200 J cm^?2; Group III (n = 12) placebo group, sham laser. All groups received a weekly dose for 4 weeks. Pain intensity was recorded using a 10‐cm visual analogue scale; patients responded to the oral health impact profile (OHIP‐14), xerostomia severity test and the hospital anxiety–depression scale (HAD). These assessments were performed at baseline, 2 and 4 weeks. LLLT decreased pain intensity and improved OHIP‐14 scores significantly from baseline to 2 weeks in groups I and II compared with the placebo group. No statistically significant differences were found from 2 to 4 weeks. Overall improvements in visual analogue scale (VAS) scores from baseline to the end of treatment were as follows: Group I 15·7%; Group II 15·6%; Group III placebo 7·3%. LLLT application reduces symptoms slightly in BMS patients.     

When and how do endodontic specialists use cone‐beam computed tomography?

This study investigated the use of cone‐beam computed tomography (CBCT) by endodontists in Germany and Switzerland. Sixty‐eight German endodontic specialists (G‐ES), 22 Swiss endodontic specialists (CH‐ES) and 95 dentists with a German Master of Science in endodontics (MSc) were invited to participate. Data on the timing of diagnostic assessments, endodontic case difficulty and indications for CBCT use were collected by questionnaire. The frequencies of pre‐, intra‐ and postoperative use of periapical radiography and CBCT were analysed by case difficulty level. In high difficulty cases, access to a CBCT device was significantly associated with the frequency of both pre‐ and intraoperative CBCT use. The type of endodontic qualification had a significant impact on the rate of preoperative CBCT use in high difficulty cases. German endodontic specialists used preoperative CBCT more frequently than CH‐ES and MSc. Our findings show that CBCT is a valuable imaging tool for endodontists, particularly in high difficulty cases.     

Shortened dental arch and prosthetic effect on oral health‐related quality of life: a systematic review and meta‐analysis

This systematic review aimed to compare oral health‐related quality of life (OHRQoL) between two tooth replacement strategies – the shortened dental arch (SDA) concept and conventional treatment with removable partial dental prosthesis (RPDP) or implant‐supported fixed partial dental prosthesis (IFPDP) – for distal extension of edentulous space in the posterior area. We retrieved eligible randomised controlled trials (RCTs) and non‐RCTs published between 1980 and November 2016 retrieved from MEDLINE and the Cochrane Central Register of Controlled Trials. The primary outcome was OHRQoL evaluated using validated questionnaires. Two reviewers independently screened and selected the articles, evaluated the risk of bias and determined the standardised weighted mean difference (SWMD) in OHRQoL scores between the two strategies using a random effects model. Two RCTs and one non‐RCT involving 516 participants were included in this review. All studies employed the oral health impact profile (OHIP) for evaluation of OHRQoL. There was no statistically significant difference in OHIP summary scores between SDA and RPDP at 6 (SWMD = 0·24) or 12 (SWMD = 0·40) months post‐treatment. Only one non‐RCT had reported higher OHRQoL with IFPDP than with SDA; however, because of the small sample size, there was no significant difference in OHIP summary scores between the two strategies at 6 (SWMD = ?0·59) or 12 (SWMD = ?0·67) months post‐treatment. In terms of OHRQoL in partially dentate patients, the SDA concept appears to be as feasible as RPDP restoration. Further clinical trials are required to clarify the effect of IFPDP restoration on OHRQoL.