Patterns of impaired oral health‐related quality of life dimensions

How dental patients are affected by oral conditions can be described with the concept of oral health‐related quality of life (OHRQoL). This concept intends to make the patient experience measurable. OHRQoL is multidimensional, and Oral Function, Oro‐facial Pain, Oro‐facial Appearance and Psychosocial Impact were suggested as its four dimensions and consequently four scores are needed for comprehensive OHRQoL assessment. When only the presence of dimensional impact is measured, a pattern of affected OHRQoL dimensions would describe in a simple way how oral conditions influence the individual. By determining which patterns of impact on OHRQoL dimensions exist in prosthodontic patients and general population subjects, we aimed to identify in which combinations oral conditions’ functional, painful, aesthetical and psychosocial impact occurs. Data came from the Dimensions of OHRQoL Project with Oral Health Impact Profile (OHIP)‐49 data from 6349 general population subjects and 2999 prosthodontic patients in the Learning Sample (N = 5173) and the Validation Sample (N = 5022). We hypothesised that all 16 patterns of OHRQoL dimensions should occur in these individuals who suffered mainly from tooth loss, its causes and consequences. A dimension was considered impaired when at least one item in the dimension was affected frequently. The 16 possible patterns of impaired OHRQoL dimensions were found in patients and general population subjects in both Learning and Validation Samples. In a four‐dimensional OHRQoL model consisting Oral Function, Oro‐facial Pain, Oro‐facial Appearance and Psychosocial Impact, oral conditions’ impact can occur in any combination of the OHRQoL dimensions.     

Childhood bruxism: Related factors and impact on oral health‐related quality of life

This study aimed to assess childhood bruxism relating associated factors and the bruxism's impact on oral health‐related quality of life (OHRQoL). A case‐control study was performed with 3‐ to 6‐year‐old children obtained from public preschools in Brazil. The case and control groups had 21 and 40 children, respectively. Associations between bruxism and respiratory problems (p = 0.04, OR: 0.33, CI: 0.09 to 1.14), dental wear (p < 0.01, OR: 0.01, CI: 0.00 to 0.05), malocclusion (p < 0.01, OR: 0.06, CI: 0.01 to 0.35), and dental caries (p = 0.02, OR: 0.22, CI: 0.04 to 1.04) were observed. The OHRQoL overall mean score and subscales were relatively low independent of the evaluated group (p > 0.05). The association between presence and absence of impact with bruxism or other variables showed no statistical relationship (p > 0.05). It could be concluded that childhood bruxism is related to respiratory problems, dental wear, dental caries, and malocclusion. Despite being a topic that demands special care in dentistry, bruxism does not significantly affect the OHRQoL.     

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口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、隐匿性、具有癌变倾向的炎性疾病.患者进食刺激性食物时口内疼痛,口腔黏膜苍白僵硬,触摸有条索感,舌运动、张口受限,以致咀嚼、吞咽困难,有的甚至发生癌变,严重影响患者的生存质量和身心健康.复杂的发病机制导致该病至今尚无满意的治疗方法.本文介绍了目前主要的治疗方法,包括药物治疗、物理治疗和手术治疗等,主张根据病变发展的阶段,采用多种方法联合治疗.     

Impact of shortened dental arches on oral health‐related quality of life

This study described the prevalence of adults with shortened dental arches (SDA) in Brazil, specifically assessing the differences of oral health‐related quality of life [the prevalence and severity of oral impacts on daily performance (OIDP)] by dentition status. We analysed data from the 2010 National Survey of Oral Health in Brazil, including home interviews and oral examinations. The assessment of SDA used two alternative definitions: having 3–5 natural occlusal units (OUs) in posterior teeth or having 4 OUs in posterior teeth. Both definitions included having intact anterior region and no dental prosthesis. The analysis was weighted, and a complex sampling design was used. Negative binomial regression models assessed associations as adjusted for socio‐demographic conditions and dental outcomes. A total of 9779 adults (35–44 years old) participated in the study. A non‐negligible proportion had SDA: 9·9% and 3·8% for the first and second definition, respectively. Individuals with SDA (first definition) ranked higher in OIDP prevalence [count ratio (CR) 1·22; 1·09–1·36, 95% confidence interval (CI)] and severity (CR = 1·43; 1·19–1·72, 95% CI) than those with more natural teeth. This difference was not statistically significant when adjusted for socio‐demographic and dental covariates: OIDP prevalence (CR = 1·04; 0·92–1·17, 95% CI) and severity (CR = 1·09; 0·91–1·30, 95% CI). Analogous results were obtained when the second definition of SDA was adopted. These findings suggest that a considerable contingent of adults may function well without dental prostheses, despite having several missing teeth. This conclusion challenges the traditional approach of replacing any missing tooth and instructs the allocation of more dental resources to preventive, diagnostic and restorative services.     

Oral health care needs and oral health‐related quality of life (OHIP‐14) in homeless people

Daly B, Newton T, Batchelor P, Jones K. Oral health care needs and oral health‐related quality of life (OHIP‐14) in homeless people. Community Dent Oral Epidemiol 2010. © 2009 John Wiley & Sons A/S Abstract – Objectives: The aim of this study was (i) to determine the oral health status and oral health care needs of this population, (ii) to assess oral health‐related quality of life using OHIP‐14 and (iii) to explore whether there is a relationship between oral health status and oral health‐related quality of life. Methods: A convenience sample was drawn from eight facilities catering for homeless people in south east London. Participants were invited to attend an outreach dental clinic and receive a clinical oral health and treatment needs assessment. The impact of oral disease was assessed using OHIP‐14. Results: There were 102 people from a range of vulnerable housing situations invited to participate in the study. The mean age was 39.5 (SD ± 12.3) and 92% (n = 92) were men. The mean DMFT of dentate participants (n = 94) was 15.5 (SD ± 7.6), mean DT was 4.2 (SD ± 5.2), mean MT was 6.8 (SD ± 6.0) and mean FT was 4.6 (SD ± 4.8). Normative needs were extensive with 76% having a restorative need, 80% having a need for oral hygiene measures and periodontal treatment and 38% having a prosthetic treatment need. Ninety one per cent of homeless people experienced at least one impact and the mean number of impacts (n = 90) was 5.9 (SD ± 4.8).The most commonly experienced oral health‐related quality of life impacts were in the dimension of pain, with aching in the mouth having a prevalence of 65% and discomfort while eating foods having a prevalence of 62%. Forty‐four per cent felt handicapped by their oral condition. The experience of oral impact had only a slight relationship with clinical status and there were no differences in clinical status or oral impact by vulnerability of housing situation. Conclusions: Oral health care needs were extensive and greater than that of the general population in the UK, although disease levels were similar. While homeless people experienced many more oral impacts (as measured with OHIP‐14) compared with adults of the same age in the general population in the UK, there was only a slight relationship with clinical status and oral health‐related quality of life.     

口腔黏膜下纤维性变的病因、致病机理、诊断与治疗

口腔黏膜下纤维性变是一种能形成瘢痕、组织纤维化的慢性疾病。流行病学研究显示,咀嚼槟榔是导致口腔黏膜下纤维性变的危险因素。在中国的口腔黏膜下纤维性变患者均有咀嚼槟榔的习惯。研究证实,嚼槟榔、吸烤烟和饮白酒可增加口腔黏膜下纤维性变的风险。口腔黏膜下纤维性变被广泛认为是一种口腔癌前病变,病理表现为慢性炎症、结缔组织内广泛的胶原纤维沉积、上皮固有层或其下结缔组织内的局部炎症改变。口腔黏膜下纤维性变的癌变发生率为7%~30%。口腔黏膜下纤维性变的治疗主要采用曲安奈德和丹参酮注射液行黏膜下局部注射,对改善患者的张口度及口腔黏膜的烧灼痛效果良好,其治疗总有效率可达93%。本文就口腔黏膜下纤维性变的病因、致病机理、诊断与治疗进行阐述,以供同道们临床参考之用。