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.     

The impact of the National Denture Service on oral health-related quality of life among poor elders

The objective of this study was to assess the effects of the Korean National Denture Service (NDS) for poor elderly people requiring dentures on oral health-related quality of life (OHRQOL). Data from follow-up studies were collected from 439 subjects at eight public health centres who answered every question of a questionnaire, and the OHRQOL was measured at the baseline and at 3-month follow-up after receiving the NDS according to the type of denture provision. The multivariate linear mixed model with a public health centre as a random effect for the score change of Oral Health Impact Profile (OHIP)-14K was carried out to confirm the factors related to the improvement in OHRQOL. The mean OHIP-14K was 28.60 at the baseline time points, and there was a decrease in the OHIP-14 scores to 21.14 ± 12.52 at the 3-month follow-up of the removable partial denture beneficiaries. The changes in OHIP-14K among complete denture beneficiaries were 21.53 ± 12.01 for previously dentate subjects and 22.54 ± 11.12 for edentate subjects. The multivariate linear mixed model of dentate subjects demonstrated that the improvement in the OHRQOL was associated with the number of remaining teeth, satisfaction with denture and self-reported oral health status after 3 months. In the case of the edentate model, satisfaction with denture was the only factor related to the improvement in OHRQOL. This study revealed considerable improvement in OHRQOL among poor elderly people after NDS. Satisfaction with provision of dentures was associated with improvement in the OHRQOL.     

Impact of dental treatment under general anesthesia on the oral health‐related quality of life of adolescents and adults with special needs

This study aimed to assess the perception of the family's primary caregiver on the oral health‐related quality of life (OHRQoL), and the impact on family dynamics, of dental treatment under general anesthesia (GA) in adolescent and adult patients with intellectual and developmental disabilities (IDD) and neurocognitive disorders. Self‐administered questionnaires were completed, before dental treatment, by 116 primary family caregivers of patients who received dental treatment under GA, and 102 (88%) of these caregivers completed the same questionnaires within 4 wk after treatment. The Child Oral Health Impact Profile (COHIP) and the Family Impact Scale (FIS) were shortened to a 14‐item COHIP (COHIP‐14) and a 12‐item FIS (FIS‐12) based on the limitations of patients’ communication. The COHIP‐14 and FIS‐12 scores and each subscale improved after treatment. The baseline scores varied based on certain characteristics of the patients, such as age, disabilities, medications, caregivers, meal types, cooperation levels, and treatment needs. The postoperative improvement in OHRQoL was significant in the patients who were older than 30 yr of age, originally eating soft meals, displaying no or very low levels of cooperation, or receiving endodontic treatment. Based on the primary caregiver perceptions, the OHRQoL of adolescents and adults with IDD and neurocognitive disorders was improved by dental treatment under GA.     

Oral health‐related quality of life of 12‐ and 15‐year‐old Thai children: findings from a national survey

Abstract – Objective: To assess the prevalence and characteristics of oral impacts on daily life, and the relationship between certain dental conditions and impacts attributed to them, in a nationally representative population of Thai school children aged 12 and 15 years. Methods: A cross‐sectional study on a representative sample of children in Sixth Thailand National Oral Health Survey. Sample included half the children aged 12‐ and 15‐year‐old selected in Bangkok and all participants in 8 of 16 provinces included in national survey. Children were individually interviewed using the Child‐OIDP (12‐year‐old) and OIDP indices (15‐year‐old), and two questions for overall subjective assessments. Results: A total of 1066 12‐year‐olds and 815 15‐year‐olds were interviewed. Some 85.2% of 12‐year‐olds reported experiencing oral impacts during the past 3 months. Child‐OIDP scores ranged from 0 to 68.0 (mean = 7.83, SD = 7.8). Eating was the most commonly affected performance (64.4%), followed by cleaning teeth (51.7%) and maintaining emotional state (49.1%). Among 15‐year‐old children, 83.3% had oral impacts during the past 6 months. OIDP scores ranged from 0 to 39.5 (mean = 5.47, SD = 6.0). The three most commonly affected performances were eating (64.0%), cleaning teeth (55.3%) and maintaining emotional state (53.1%). Toothache and oral ulcers were the two most important perceived causes in 12‐year‐olds. Impacts from toothache were the most prevalent (39.2%) and had a condition‐specific (CS) Child‐OIDP score of 7.0, while oral ulcers affected 24.7% of children; mean CS‐score of 8.0. Among 15‐year‐olds, oral ulcers ranked first in terms of both prevalence (36.2%) and CS‐score (6.0), followed by toothache (prevalence 33.9% and CS‐score 5.0). For both age groups, problems with gums were of less concern. Conclusions: Oral impacts were common but not severe in Thai children and adolescents. For both age groups, impacts were mostly on eating performance; toothache and oral ulcers were the two important perceived causes reflecting needs for oral health promotion and treatment of dental caries and oral ulcers.     

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.     

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.     

Need of minimal important difference for oral health‐related quality of life measures

Demand and use for oral health‐related quality of life (OHRQoL) instruments have increased in recent years in both research and clinical settings. These instruments can be used to measure patient's health status or detect changes in a patient's health status in response to an intervention or changes in disease trajectory. Ensuring universal acceptance of these measures requires easy interpretation of its scores for clinicians, researchers, and patients. The most important way of describing and interpreting this significance of changes in OHRQoL is through the establishment of minimal important difference (MID). The minimally important difference represents the smallest improvement considered worthwhile by a patient. A comprehensive search of published literature identified only 12 published articles on establishment of MID for OHRQoL measures. This scarcity of published studies on MID encourages the need of appropriate interpretation and describing patient satisfaction in reference to that treatment using MID. Anchor‐ and distribution‐based methods are the two general approaches that have been proposed and recommended to interpret differences or changes in OHRQoL. Both of these methods of determining the MID have specific shortcomings; therefore, it is proposed to adopt triangulation approaches in which the methods are combined. The objective of this review is to summarize the need for, importance of, and recommendations for methods of establishing MID for OHRQoL measures.     

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.