Impact of masticatory performance on oral health-related quality of life for elderly Japanese

PURPOSE: This study aimed to investigate the association of masticatory performance with oral health-related quality of life in independently living elderly Japanese subjects. MATERIALS AND METHODS: The study sample consisted of 1028 independently living people over the age of 60 years. Masticatory performance was determined by the concentration of dissolved glucose obtained from test gummy jellies, which are the standardized food developed for measuring masticatory performance. The short-form Oral Health Impact Profile (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI) were used to measure the impact of oral conditions on oral health-related quality of life. RESULTS: Subjects with lower masticatory performance had significantly higher total OHIP-14 and GOHAI scores (15.0 +/- 9.0 and 14.5 +/- 9.2, respectively) than their counterparts (10.0 +/- 7.5 and 11.3 +/- 7.1, respectively) (P < .01). Logistic regression analyses showed that after controlling for age, gender, self-perceived general health, satisfaction with financial status, and number of teeth, a higher GOHAI score was significantly related to lower masticatory performance (P = .001; odds ratio: 0.56; 95% CI: 0.40 to 0.79). A higher OHIP-14 score was associated with lower masticatory performance but at a level below statistical significance (P = .096; odds ratio: 0.75; 95% CI: 0.53 to 1.05). CONCLUSION: It is suggested that masticatory performance is an important factor influencing the quality of life in independently living, relatively healthy elderly Japanese subjects.     

Evaluation of a Swedish version of the OHIP-14 among patients in general and specialist dental care

The aim of this study was to investigate the Swedish version of an oral health-related quality of life (OHRQL) instrument, the short form of the Oral Health Impact Profile (OHIP-14), and to assess OHRQL among patients in general dental care and specialist clinics (periodontics, TMD and implant dentistry) in G?teborg, Sweden. Consecutively selected patients were asked to answer the OHIP-14, the General Oral Health Assessment Index (GOHAI) and a questionnaire including socio-demographic, general health and oral health questions. 153 patients (50-89 years old) out of 237 (65%) returned the questionnaires. Cronbach's Alpha among the OHIP items was high (0.93) and the corrected item-scale correlation varied between 0.51 and 0.79. The correlation between the OHIP-14 score and the GOHAI was high (-0.83) indicating good criterion validity. The mean additive OHIP-14 score was 22.6 (SD = 10.5). Implant patients scored significantly higher than other patient groups with respect to missing teeth, dentures and mobile teeth. High scores were also associated with perceived poor general health and dissatisfaction with life-situation. The test-retest reliability was assessed in a separate sample (n = 47) and the correlation coefficient was 0.85. The Swedish version of OHIP-14 demonstrated good reliability and validity. The poorer OHRQL reported by the implant patients reflects the strong association found between OHIP score and dentures and missing teeth, while OHIP-14 did not show similar sensitivity to other impacts of oral disorders.     

Reliability and validity of two oral health related quality of life measures in Myanmar adolescents

OBJECTIVE: To assess two Oral Health Related Quality of Life (OHQoL) measures and the levels of oral impacts among 14-year-old students in Yangon Division, Myanmar. DESIGN: Cross-sectional validation study. Setting High schools in Yangon Division. PARTICIPANTS: A multi-stage stratified random cluster sample of 543 students. OUTCOME MEASURES: Prevalence, extent (number of impacts) and total score as recorded using the Oral Impacts on Daily Performance (OIDP) and the short form of the Oral Heath Impact Profile (OHIP-14). Psychometric measures of validity and reliability. RESULTS: 15.8% and 53.0% of participants had an impact using OIDP and OHIP-14 respectively. The extents and total scores were low among those with impacts. Both measures had good reliability (Cronbach's alpha 0.72 for OIDP and 0.86 for OHIP-14). The presence of dental caries was associated with summary measures of OHIP-14 but not with OIDP. The most frequent cause of impact was dental caries. CONCLUSIONS: Both OIDP and OHIP-14 had reasonable reliability but OHIP-14 had superior construct validity. OHIP-14 appears to be more useful as an instrument to discriminate between groups with and without impacts in population surveys.     

Validation of the Geriatric Oral Health Assessment Index (GOHAI) in the Malay language

OBJECTIVE: To translate and validate the Geriatric Oral Health Assessment Index (GOHAI into the Malay language for use in Malaysia. METHODOLOGY: The 6-Likert scale GOHAI was translated into the Malay language and self-administered on 189 subjects aged 60+. All subjects underwent oral status assessment. The measure was assessed for construct and discriminant validity, for test-retest reliability and principal component factor. FINDINGS: Mean GOHAI score was 46.2 (SD 9.7, range 17-60). The Cronbach's alpha was 0.79. Mean GOHAI scores increased with more positive self-rated oral health and general health. The elderly with no perceived dental treatment need had higher mean GOHAI scores than those with perceived needs. There were slightly stronger inverse correlations between GOHAI scores and caries experience, number of teeth present, and number of pathologically mobile teeth. The measure demonstrated strong test-retest reliability. Eight of the 12 items had Spearman's r3 0.7. Only one principal factor was found at eigenvalue > 1. Using ANCOVA, self-rated perception of oral health and perceived need for dental treatment had the most significant impact on the GOHAI score. CONCLUSION: AND RECOMMENDATIONS: The Malay language version of the GOHAI demonstrated acceptable validity and reliability and will be an important instrument to measure oral health-related quality of life among Malay-speaking Malaysians. Use of the Malay language version GOHAI should also be pursued among diverse adult age groups.     

Comparison of a generic and a specific measure of oral health related quality of life

OBJECTIVES: The aims of the study were to compare the discriminant validity of a generic health state measure, the EuroQol, and a specific oral health measure, the Oral Health Impact Profile. PARTICIPANTS: Patients treated by a random sample of South Australian dentists. BASIC RESEARCH DESIGN: Data were collected in 2001-02 using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental conditions and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol (EQ-5D+) and 14-item version of the Oral Health Impact Profile (OHIP-14) instruments. Data were available from 375 patients (response rate = 72%). MAIN OUTCOME MEASURES: Three measures (simple counts, additive scores and scale scores) were used for each instrument and compared by oral health, patient demographic and visit factors, and main presenting dental condition. RESULTS: Across all three measures the OHIP-14 was associated with the oral health factors of dentate status, number of teeth, denture wearing and number of decayed teeth while the EuroQol was associated with decayed teeth. For patient demographics both the EuroQol and OHIP-14 were associated with age of patient. For visit factors both the EuroQol and OHIP-14 were associated with visit type and insurance status, while only the EuroQol was associated with time since last visit. Both the EuroQol and OHIP-14 were associated with main dental condition. CONCLUSIONS: There was little difference in the number of associations of either EuroQol or OHIP-14 scores regardless of whether simple counts, additive scores or scale score measures were used. In bivariate analyses the OHIP-14 was more sensitive to oral health factors, but the EuroQol performed as well or better than the OHIP-14 for patient demographics, visit factors and main dental condition, and was associated with the oral health factor of number of decayed teeth. Both measures performed similarly in multivariate analysis.     

Validation of the Korean version of the oral health impact profile among the Korean elderly

OBJECTIVES: This study aimed to validate a Korean version of the oral health impact profile (OHIP) and to develop a short-form of OHIP for the Korean elderly. METHODS: The original English version of OHIP was translated into Korean using a forward-backward method. Internal consistency was measured by Cronbach's alpha among 1098 subjects aged 56 or more. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) with a 3-month interval among 155 subjects aged 57 or more. The validity of the Korean version of OHIP (OHIP-K) was assessed by comparing OHIP scores with the perceived dental treatment needs and by identifying associations between OHIP scores and the number of natural teeth among 128 subjects aged 54 or more. The short-form of OHIP for the Korean elderly (OHIP-14K) was developed using linear regression models and was also validated and compared with the short-form of OHIP by Slade (OHIP-14S). RESULTS: The Cronbach's alpha value for OHIP-K was 0.97. The ICC for OHIP-K was 0.64. Adults with perceived dental treatment needs had a higher OHIP score than adults without any such needs (P < 0.001). The number of natural teeth was negatively associated with the OHIP score (r = -0.44, P < 0.001). OHIP-14K and OHIP-14S shared seven identical items out of a total of 14 items. OHIP-14K results correlated with OHIP-K almost exactly (r(2) = 0.96), as did OHIP-14S (r(2) = 0.95). CONCLUSIONS: OHIP-K showed excellent reliability and validity. OHIP-14S may be a better choice for the evaluation of oral health-related quality of life among the Korean elderly for an international comparison.     

老年患者口腔健康生命质量的相关因素分析

目的：初步研究老年口腔疾病患者的口腔健康生命质量及其影响因素。方法：选择在中山大学光华口腔医学院门诊就诊的250名55岁以上（含55岁）的老年人，应用老年口腔健康评价指数（geriatric oral healthassessment index，GOHAI）量表中文版、一般项目表及自我口腔健康评价表对其口腔健康生命质量进行调查，通过多元回归分析得出影响口腔健康生命质量的相关因素。结果：GOHAI中文版平均得分为12．26±7．67。多元回归方程为：GOHAI中文版得分=-6．477＋0．309×自我评价的口腔健康＋0．164×缺失牙数＋0．237×对口腔状况的满意度＋0．127×对生活的满意度，方程的决定系数为0．423。结论：自我评价的口腔健康、缺失牙数、对口腔状况的满意度及对生活的满意度是影响老年患者口腔健康生命质量的主要因素。     

A Swedish version of the GOHAI index. Psychometric properties and validation

This study investigated a Swedish version of the 12 item General Oral Health Assessment Index (GOHAI). The aim was to validate the translated instrument, and to investigate factors that may influence the GOHAI score. Consecutive samples at eight dental clinics in G?teborg, Sweden were asked to answer the GOHAI, the short form of Oral Health Impact Profile (OHIP-14) and a questionnaire including socio-demographic, general health and oral health questions. 153 patients (50-89 yrs old) out of 237 (65%) returned the questionnaires. The most commonly reported problem (GOHAI) was 'worried or concerned' due to problems related to oral health (48%), followed by 'unhappy with the appearance of teeth, gums, or dentures' (36%) and 'teeth sensitive to hot, cold, or sweets' (33%). The Cronbach's Alpha (0.86) indicated a high degree of internal consistency and homogeneity between items. Item-scale correlations varied between 0.50 and 0.83. Strong relations were found between depressed GOHAI-scores and dental problems (mobile teeth, number of teeth, dentures). The correlation between the GOHAI score and the OHIP-14 was high (-0.83) indicating good construct validity. Also 'perceived general health' and 'satisfaction with life-situation' and dental status were significantly, but less strongly, correlated with the patient's GOHAI score. In a linear regression analysis, age,'perceived general health' and dental status (number of teeth in lower jaw and mobile teeth) were found to have a significant effect on the GOHAI score. Factor analysis of GOHAI indicated a two-factor solution and did not support the theoretical construction reported of the index. The test-re-test reliability was assessed in a separate sample (members of a physical handicap organization, n = 47) and the correlation coefficient for the GOHAI was 0.64. For individual items, the weighted kappa coefficient varied between 0.25 and 0.80. In conclusion, the Swedish version of the GOHAI showed acceptable reliability and validity.     

《口腔健康影响程度量表（OHIP—14中文版）》与《老年口腔健康评价指数（GOHAI中文版）》的比较研究

目的：了解《口腔健康影响程度量表（OHIP～14中文版）》与《老年口腔健康评价指数（GOHAI中文版）》各自特点及应用范围,指导口腔健康相关生存质量临床研究开展。方法：使用两种量表选取60岁以上、无认知障碍及视力疾患的老年人进行调查及口腔检查。通过对老年人口腔健康相关生存质量的测评,比较两份量表的维度、条目内部一致性及区分效度。结果：共250位老年人参与此次研究,收回有效量表221份,无效量表29份,数据缺失量表12份。比较两种量表平均得分GOHAI中文版比OHIP-14中文版高（P〈0．01）。两份量表都可由缺失牙数区分有牙颌人群的生存质量,同时能够区分出戴用活动义齿的人群与不戴用活动义齿的人群的生存质量,以及能通过自我评价口腔状况和满意程度方面来区分不同人群的生存质量。通过比较可认为这两份量表都具有一定的区分效度。结论：《老年口腔健康评价指数（GOHAI中文版）》和《口腔健康影响程度量表（OHIP-14中文版）》在信度、效度方面存在的差异并不明显,维度的分布方面则各有所侧重。     

种植覆盖义齿修复牙列缺失的生活质量研究

目的研究下颌牙列缺失患者采用全口义齿（CD）和种植覆盖义齿（IOD）修复后的患者满意度以及口腔健康相关生活质量（OHRQoL）,探讨种植覆盖全口义齿修复对老年下颌牙缺失患者的心理及社会行为是否存在积极的影响。 方法收集2016至2018年在中山大学附属口腔医院门诊就诊,50 ~ 80岁下颌牙列缺失,曾采用传统全口义齿修复且因义齿稳定性差而自愿行种植覆盖全口义齿修复的受试者19例,其中男8例,平均69.25岁;女11例,平均72.45岁。通过自身对照研究,每位受试者均先后佩戴在相同标准下制作的新传统全口义齿（CD）以及种植覆盖义齿（IOD）,并于戴用义齿3个月后完成口腔健康影响程度量表（OHIP-20）、老年口腔健康评价指数量表（GOHAI）和日常生活牙科影响量表（DIDL）调查,分析传统全口义齿和种植覆盖全口义齿修复对患者心理状态和生活质量的影响。数据采用Wilcoxon符号秩检验进行统计分析,P<0.05为差异有统计学意义,并计算CD组和IOD组OHRQoL得分的效应量（ES值）以评价其影响程度。 结果OHIP-20、GOHAI、DIDL量表均显示,IOD组在量表的功能限制、疼痛、心理不适、生理能力受限、心理能力受限、社交能力丧失、身心缺陷、美观、口腔舒适的各领域得分及总体得分上均明显优于CD组,差异具有统计学意义（P<0.05）。此外,根据DIDL量表评价标准得知,IOD修复可有效提提升患者满意度,并减少不满意人数的比例。3个量表在各领域及总得分的ES值均大于0.8,代表每个领域均受到高度影响,并以咀嚼能力（ES = 3.74）、生理能力受限（ES = 3.12）和功能限制（ES = 2.94）等生理功能改善最为显著。说明,IOD组比CD组对患者的生活质量改善较好,且对各方面的改善程度较高。 结论OHIP-20、GOHAI、DIDL量表调查结果反映种植覆盖全口义齿修复对老年下颌牙缺失患者的心理及社会行为有积极的影响。     

Assessing the responsiveness of measures of oral health-related quality of life

OBJECTIVES: This paper illustrates ways of assessing the responsiveness of measures of oral health-related quality of life (OHRQoL) by examining the sensitivity of the oral health impact profile (OHIP)-14 to change when used to evaluate a dental care program for the elderly. METHODS: One hundred and sixteen elderly patients attending four municipally funded dental clinics completed a copy of the OHIP-14 prior to treatment and 1 month after the completion of treatment. The post-treatment questionnaire also included a global transition judgement that assessed subjects' perceptions of change in their oral health following treatment at the clinics. Change scores were calculated by subtracting post-treatment OHIP-14 scores from pre-treatment scores. The longitudinal construct validity of these change scores were assessed by means of their association with the global transition judgements. Measures of responsiveness included effect sizes for the change scores, the minimal important difference, and Guyatt's responsiveness index. An receiver operating characteristic (ROC) curve was constructed to determine the accuracy of the change scores in predicting whether patients had improved or not as a result of the treatment. RESULTS: Based on the global transition judgements, 60.2% of subjects reported improved oral health, 33.6% reported no change, and only 6.2% reported that it was a little worse. These changes are reflected in mean pre- and post-treatment OHIP-14 scores that declined from 15.8 to 11.5 (P < 0.001). Mean change scores showed a consistent gradient in the expected direction across categories of the global transition judgement, but differences between the groups were not significant. However, paired t-tests showed no significant differences in the pre- and post-treatment scores of stable subjects, but showed significant declines for subjects who reported improvement. Analysis of data from stable subjects indicated that OHIP-14 had excellent test-retest reliability with an intraclass correlation coefficient (ICC) of 0.84. Effect size based on change scores for all subjects and subgroups of subjects were small to moderate. The ROC analysis indicated that OHIP-14 change scores were not good "diagnostic tests" of improvement. The minimal important difference for the OHIP-14 was of 5-scale points, but detecting this difference would require relatively large sample sizes. CONCLUSIONS: OHIP-14 appeared to be responsive to change. However, the magnitude of change that it detected in the context described here was modest, probably because it was designed primarily as a discriminative measure. The psychometric properties of the global transition judgements that often provide the "gold standard" for responsiveness studies need to be established.     

Translation and validation of the Chinese version of GOHAI

OBJECTIVE: To translate and validate the Chinese version of General Oral Health Assessment Index (GOHAI) for elderly in Hong Kong and to investigate factors that possibly may influence the GOHAI scores. METHODS: The English version of GOHAI was translated into Chinese. Persons aged 60-80 years were interviewed by two trained interviewers and clinically examined by a dentist. Information on subjects' demographic background and oral health conditions was collected. RESULTS: Altogether 1,023 elderly were interviewed and clinically examined. The mean GOHAI score was 48.9 (SD = 7.2). Cronbach's alpha of the translated GOHAI was 0.81; item-scale correlation ranged from 0.28-0.61. It was found that the mean GOHAI scores were lower for subjects with poorer perceived oral health (rs = 0.57, P < .001). Elderly who had perceived dental treatment need had a lower mean GOHAI score than those who did not (P < .001). It was also found that elderly who lived in elderly homes, those who received social welfare assistance, those who had recent dental visits, and those with higher DMFT scores had higher mean GOHAI scores. CONCLUSION: The translated Chinese version of GOHAI demonstrated acceptable reliability and validity. It is available for use by researchers in oral health-related quality of life studies on Chinese elderly population.     

Patient-centred outcome measures in oral medicine: are they valid and reliable?

The present study evaluates the performance of patient-centred outcome measures in the oral medicine setting in patients with oral lichen planus. The study included 48 patients with a histologically confirmed diagnosis of oral lichen planus who completed a questionnaire incorporating two patient-centred outcome measures: the 16-item UK Oral Health Related Quality Of Life Measure (OHQOL-UK) and 14-item Oral Health Impact Profile (OHIP-14). They subsequently underwent an oral examination and rated the pain they experienced on a visual analogue scale (VAS). The impact of oral health on their life quality was considerable with physical, social and psychological consequences. Both OHQOL-UK (P<0.01) and OHIP-14 scores (P<0.01) were associated with clinical findings; demonstrating criterion validity. Patient rating of pain experienced (on a VAS) correlated with OHQOL-UK scores (P<0.01) and OHIP-14 (P<0.01); demonstrating construct validity. The mean inter-item correlation for OHQOL-UK was 0.93 and was 0.90 for OHIP-14; demonstrating high internal consistency reliability. Our results suggest both OHQOL-UK and OHIP-14, patient-centred outcome measures perform well in patients with oral lichen planus, demonstrating validity and reliability. This implies patient-centred outcome measures may be utilized in both oral medicine and oral and maxillofacial surgery to assess patient needs and opinions.     

Oral health and its impact on the life quality of homeless people in Hong Kong

OBJECTIVES: To report on the oral health status and its impact on the life quality of homeless people in Hong Kong. DESIGN: A cross sectional epidemiological survey involving clinical oral examinations and face-to-face interviews with 147 homeless participants. Clinical examinations were carried out following WHO criteria. The impact of oral health on quality of life was assessed with the short form of Oral Health Impact Profile, OHIP-14. RESULTS: Over 90% had caries experience and most related to untreated decay. The mean DMFT score for dentate subjects was 8.1 (DT = 3.4, MT = 4.0, FT = 0.7). Periodontal disease was highly prevalent, 96% having periodontal pockets. The burden of oral health on their daily lives was common, 88% reporting an oral health impact within the past year. A multiple regression analysis indicated that the OHIP-14 score had significant associations with self-rated oral health, dental pain, employment status and length of time being homeless (p < 0.05). Those who assessed rated oral health as 'poor/very poor', reported dental pain in the past year, were unemployed, and homeless for more than one year had poorer oral health related quality of life (significantly higher OHIP scores) than their counterparts. CONCLUSION: Among the homeless population studied, oral health status was poor and its impact on their life quality was substantial. The oral health impact was associated with socio-demographics and perceived dental problems.     

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.     

牙周炎对老年糖尿病患者口腔健康相关生活质量的影响

目的:探索牙周炎对老年糖尿病患者口腔健康相关生活质量的影响,为提高老年糖尿病患者口腔健康相关生活质量提供理论依据。方法:采用OHIP-14中文版对第四军医大学口腔医院老年病科149名60岁以上2型老年糖尿病患者进行问卷调查,并采用CPI牙周探针进行牙周健康检查,利用FoxPro6.0软件建立数据库,SPSS19.0软件进行统计分析。结果:糖尿病牙周炎组老年人OHIP量表总得分的中位数和四分位数为P₂₅=13,P₅₀=16,P₇₅=18;糖尿病非牙周炎组老年人分别为P₂₅=7,P₅₀=9,P₇₅=11;糖尿病牙周炎组高于糖尿病非牙周炎组,差异有统计学意义(P<0.05)。两组老年人在功能限制、生理性疼痛领域得分最高。除生理障碍领域外,在其他领域糖尿病牙周炎组得分均高于糖尿病非牙周炎组(P<0.05)。结论:牙周炎影响老年糖尿病患者口腔健康相关生活质量,尤其在功能限制和生理性疼痛领域。医生应当重视老年糖尿病患者的牙周状况,改善其口腔健康相关生活质量。     

Validity and reliability of OIDP and OHIP-14: a survey of Chinese high school students

Background

To determine the impact of oral diseases on everyday life, measures of oral quality of life are needed. In complementing traditional disease-based measures, they assess the need for oral care to evaluate oral health care programs and management of treatment. To assess the reliability and validity of the Oral Impact of Daily Performance (OIDP) and the short-form Oral Health Impact Profile (OHIP-14) among high school students in Xi’an, the capital of Shanxi province, China.

Methods

Cross-sectional one-stage stratified random cluster sample using high schools as the primary sampling unit. Students completed self-administered questionnaires at school. The survey included the OHIP-14 and OIDP inventories, translated and culturally adapted for China, and global oral health and socio-behavioral measures.

Results

A total of 5,608 students participated in the study, with a 93% response rate (mean age 17.2, SD 0.8, 52% females, 45.3% urban residents).The proportion experiencing at least one impact (at any frequency) during the previous six months was 62.9% for the OHIP-14 and 45.8% for the OIDP. Cronbach’s alpha measured internal consistency at 0.85 for OHIP-14 and 0.75 for OIDP while Cohen’s kappa varied between 0.27 and 0.58 for OHIP-14 items and between 0.23 and 0.65 for OIDP items. Kappa scores for the OHIP-14 and OIDP additive scores were 0.52 and 0.66, respectively. Both measures varied systematically and in the expected direction, with global oral health measures showing criterion validity. The correlation between OIDP and OHIP-14 was r_s +0.65. That both measures varied systematically with socio-behavioral factors indicates construct validity.

Conclusion

Both the OIDP and OHIP-14 inventories had reasonable reliability and construct validity in relation to subjective global oral health indicators among adolescents attending high schools in China and thus appear to be useful oral health –related quality of life measures in this context. Overall, the OHIP-14 and OIDP performed equally well, although OHIP-14 had superior content validity due to its sensitivity towards less severe impacts.

     

Dental status, xerostomia and the oral health-related quality of life of an elderly institutionalized population

The author examined the relative effects of tooth loss and xerostomia on the oral health-related quality of life of an elderly, medically compromised population, living in a long-term care setting. Data were collected from 225 subjects (mean age: 83 years) via a questionnaire and review of dental charts. Oral health-related quality of life was assessed using self-ratings, satisfaction ratings, an index of chewing capacity, the GOHAI, and OH1P-14. Almost all participants had one or more chronic medical conditions and were taking prescribed medications. Two-thirds of the study group was dentulous with a mean number of 16 remaining teeth. One-third of the participants had scores on a xerostomia index indicating marked oral dryness. In bivariate and multivariate analyses, xerostomia index scores were significantly associated with all oral health-related quality of life outcomes. Dental status was associated with chewing capacity only. The results suggest that xerostomia has an important influence on the well-being and quality of life of this population.     

Discrepancies between self-ratings of and satisfaction with oral health in two older adult populations

OBJECTIVES: General health perceptions, usually measured by means of single-item indicators, are commonly included in health and oral health surveys. The aim of the study reported here was to assess the relationship between self-rated oral health and satisfaction with oral health in two studies of older adult populations. METHODS: Participants in Study 1 were aged 50 years and over, the majority of whom had multiple chronic medical conditions and disabilities and lived within a multi-level geriatric care setting. They were recruited when attending a clinic in that setting for their annual dental screening. Participants in Study 2 were somewhat healthier community dwelling individuals, also aged 50 years and older, who took part. They were originally recruited by means of a telephone survey based on random-digit dialing. For Study 1, data were collected by means of personal interviews and a review of dental clinic charts, while for Study 2 personal interviews, clinical examination and self-completed questionnaires were used. Measures included self-rated oral health, satisfaction with oral health, oral health-related quality of life (OHRQoL) and tooth loss. RESULTS: Data were obtained from 225 persons in Study 1 and 541 in Study 2. In both studies there was a significant association between self-ratings of oral health and satisfaction with oral health. However, also in both studies there was a discrepancy between the measures: approximately 10% of those with favourable oral health ratings were dissatisfied while approximately half of those with unfavourable ratings were satisfied. Those with apparently discordant responses had significantly higher scores on OHRQoL measures such as the GOHAI and the OHIP-14 than those with concordant responses. In Study 2, a similar discrepancy between self-rated general health and satisfaction with general health was also observed. CONCLUSIONS: There is degree of discordance between self-ratings of and satisfaction with both oral and general health status in the older adult populations studied here. This may be because of the expectations concerning health in later life. More needs to be known about the frames of reference people use in constructing their responses to questions designed to assess health perceptions.     

Oral Health–Related Quality of Life and Periodontal Health Status in Patients Undergoing Hemodialysis

BackgroundHealth-related quality of life (HRQOL) is a multidimensional concept regarding quality of life (QOL) as it relates specifically to health and disease. The effect of ongoing hemodialysis on a person's oral health can be determined by clinical variables, but these do not reflect the person's perception of health versus illness. The authors conducted a study to determine the periodontal status, attitude toward oral health and self-perceived oral health in patients undergoing hemodialysis, as well as to evaluate the effect of oral health on QOL within this group.MethodsPatients undergoing hemodialysis were evaluated for socio-demographic and periodontal variables. The authors evaluated oral health–related quality of life (OHRQOL) by means of the short-form Oral Health Impact Profile (OHIP-14) and the General Oral Health Assessment Index (GOHAI). They measured perceived oral health by asking a single question.ResultsThe study involved 47 patients undergoing hemodialysis. Plaque index score, gingival index score, probing depth and bleeding-on-probing status were 2.21 ± 0.66, 1.24 ± 0.77, 2.17 millimeters ± 0.53 mm and 33.51 percent ± 24.58 percent, respectively. Participants reported being uncomfortable when eating or swallowing. Participants reported being sensitive to hot or cold (69.8 percent), having a worse sense of taste (90.8 percent) and having painful aching in the mouth (72.1 percent). The mean OHIP-14 and GOHAI scores were 19.40 ± 7.74 and 15.72 ± 8.68, respectively.ConclusionsThe self-perceived health of 72.7 percent of participants undergoing hemodialysis was fair or poor, and the impact of OHRQOL was moderate, which means that oral health was not a major concern. These results underscore the importance of using subjective and self-reported oral assessments to determine more convenient and satisfying treatment approaches for each patient.Clinical ImplicationsClinicians should use oral health assessment tools to determine individual treatment and approaches to promote the oral health of patients undergoing hemodialysis and improve their QOL.