Association between perceived oral and general health

Predicting oral hygiene practices through health behavior, perceived stress and self-efficacy in undergraduate dental students of Pakistan: a national survey

BACKGROUND

Dental students face the rigorous demands of coursework, which can lead to feelings of inadequacy and stress. These pressures can negatively influence self-efficacy and cause neglect in practicing healthy behaviors that encompass oral health. Identifying the associations of these variables with oral hygiene practices can help in the formulation of interventions tailored toward supporting young students. Therefore, this study aimed to investigate the impact of health behaviors, perceived stress and self-efficacy on oral hygiene practices among undergraduate dental students in Pakistan.

METHODS

A national online survey was carried out among 904 students across the dental colleges of Pakistan. The survey assessed general health behaviors such as tobacco use, sleep, and exercise, among other demographic variables. Perceived stress was evaluated via the Perceived Stress Scale (PSS-10), and self-efficacy was evaluated via the General Self-Efficacy Scale (GSES). Twice daily brushing, brushing for 2 min, and changing toothbrushes after 3 months informed oral hygiene practice of the participants.

RESULTS

The students experienced moderate perceived stress (20.82 ± 5.92) and high self-efficacy (29.19 ± 5.43). The majority of participants were in their third year (31.9%), were female (65.9%), and resided in home during their studies (64.4%). Perceived stress was observed to have no significant effect on the oral practice of participants. Female gender, non tobacco user, regular exercise, frequent dental visits and higher self-efficacy were associated with good oral hygiene practices.

CONCLUSIONS

The results highlight the importance of addressing stress, enhancing self-efficacy and encouraging healthy behaviors among dental students to improve their oral health, which could be reflected in their professional practice and personal well-being. This study contributes to the understanding of behavioral determinants and emphasizes the need for supportive measures to foster better health behaviors in future dental professionals.

Evaluation of the effects of periodontal status according to 2017 classifications on oral health-related quality of life and quality of life-related to general health: A cross-sectional study

BACKGROUND

In patients with periodontal disease, various symptoms are observed along with inflammation. The impact of local and systemic inflammation on periodontal tissue is well-known; however, the impact of periodontal disease on the individual's quality of life is unclear. This study aimed to assess oral health-related and general health-related quality of life in patients undergoing maintenance treatment following treatment for periodontitis (RP-CPH), patients with gingivitis (G) and patients with Stage I periodontitis (SI-P) and to compare this with individuals with clinical periodontal health (IP-CPH).

METHOD

This study was comprised of cross-sectional periodontal assessment along with questionnaires. Oral health-related quality of life and general health-related quality of life were assessed using, respectively, the Oral Health Impact Profile-14 (OHIP-14) and Short-Form-36 (SF-36) questionnaires. Study participants were classified according to the classification of periodontal and peri-implant diseases and conditions established by the 2017 World Workshop.

RESULTS

The OHIP-14 total scores for the 166 study participants (age range: 22-57) of the G (11.61 ± 3.21) and SI-P (13.03 ± 3.47) groups were significantly higher than the OHIP-14 total scores of the IP-CPH (1.09 ± 1.58) and RP-CPH (2.95 ± 2.58) groups. SF-36 scores were found to be significantly lower in the SI-P group in all subgroups compared to the G and IP-CPH groups.

CONCLUSIONS

A correlation was found between early-stage periodontal disease and low levels of OHRQoL and GHRQoL. The health of periodontal tissues may have a positive effect on the quality of life.

Evaluating the harmonization potential of oral health-related questionnaires in national longitudinal birth and child cohort surveys

BACKGROUND/OBJECTIVES

Effective use of longitudinal study data is challenging because of divergences in the construct definitions and measurement approaches over time, between studies and across disciplines. One approach to overcome these challenges is data harmonization. Data harmonization is a practice used to improve variable comparability and reduce heterogeneity across studies. This study describes the process used to evaluate the harmonization potential of oral health-related variables across each survey wave.

METHODS

National child cohort surveys with similar themes/objectives conducted in the last two decades were selected. The Maelstrom Research Guidelines were followed for harmonization potential evaluation.

RESULTS

Seven nationally representative child cohort surveys were included and questionnaires examined from 50 survey waves. Questionnaires were classified into three domains and fifteen constructs and summarized by age groups. A DataSchema (a list of core variables representing the suitable version of the oral health outcomes and risk factors) was compiled comprising 42 variables. For each study wave, the potential (or not) to generate each DataSchema variable was evaluated. Of the 2100 harmonization status assessments, 543 (26%) were complete. Approximately 50% of the DataSchema variables can be generated across at least four cohort surveys while only 10% (n = 4) variables can be generated across all surveys. For each survey, the DataSchema variables that can be generated ranged between 26% and 76%.

CONCLUSION

Data harmonization can improve the comparability of variables both within and across surveys. For future cohort surveys, the authors advocate more consistency and standardization in survey questionnaires within and between surveys.

Linking patient-reported oral and general health-related quality of life

Background

The relationship between oral and overall health is of interest to health care professionals and patients alike. This study investigated the correlation between oral health-related quality of life (OHRQoL) and health-related quality of life (HRQoL) in a general adult population.

Methods

This cross-sectional study used a convenience sample of adult participants (N = 607) attending the 2022 Minnesota County and State fairs in USA, the 5-item Oral Health Impact Profile (OHIP-5) assessed OHRQoL, and the 10-item PROMIS v.1.2 Global Health Instrument assessed HRQoL. Spearman and Pearson correlations were used to summarize the bivariable relationship between OHRQoL and HRQoL (both physical and mental health dimensions). A structural equation model determined OHRQoL-HRQoL correlations (r). Correlations' magnitude was interpreted according to Cohen's guidelines (r = 0.10, 0.30, and 0.50 to demarcate "small," "medium," and "large" effects, respectively).

Results

OHRQoL and HRQoL correlated with r = 0.52 (95% confidence interval, CI: [0.50-0.55]), indicating that the two constructs shared 27% of their information. According to Cohen, this was a "large" effect. OHRQoL, and the physical and mental HRQoL dimensions correlated with r = 0.55 (95% CI: [0.50-0.59]) and r = 0.43 (95% CI: [0.40-0.46]), respectively, indicating a "large" and a "medium" effect. OHRQoL and HRQoL were substantially correlated in an adult population.

Conclusion

Using OHIP-5 to assess their dental patients' oral health impact allows dental professionals to gain insights into patients' overall health-related wellbeing.

DIGITAL DENTISTRY AND ITS IMPACT ON ORAL HEALTH-RELATED QUALITY OF LIFE

Over the past 50 years, digitization has gradually taken root in dentistry, starting with computer tomography in the 1970s. The most disruptive events in digital dentistry were the introduction of digital workflow and computer-aided manufacturing, which made new procedures and materials available for dental use. While the conventional lab-based workflow requires light or chemical curing under inconsistent and suboptimal conditions, computer-aided manufacturing allows for industrial-grade material, ensuring consistently high material quality. In addition, many other innovative, less disruptive, but relevant approaches have been developed in digital dentistry. These will have or already impact prevention, diagnosis, and therapy, thus impacting patients' oral health and, consequently, their oral health-related quality of life. Both software and hardware approaches attempt to maintain, restore, or optimize a patient's perceived oral health. This article outlines innovations in dentistry and their potential impact on patients' oral health-related quality of life in prevention and therapy. Furthermore, possible future developments and their potential implications are characterized.

Effects of oral health-related quality of life on total mortality: a prospective cohort study

BACKGROUND

The effects of oral health on mortality have been reported; however, the association between mortality and Oral Health-Related Quality of Life (OHQOL) is unknown. We investigated the effect of OHQOL on total mortality in a cohort consisting of dentists.

METHODS

In this cohort study, we analyzed data from the Longitudinal Evaluation of Multi-phasic, Odonatological and Nutritional Associations in Dentists study. We conducted a baseline survey of general and oral health factors. We called for 31,178 participants and collected responses from 10,256 participants. We followed up with 10,114 participants (mean age ± standard deviation, 52.4 ± 12.1 years; females, 8.9%) for 7.7 years, until March 2014, to determine the average total mortality. OHQOL was assessed using the General Oral Health Assessment Index (GOHAI). The total score was divided into quartiles (Q1 ≤ 51.6, Q2 = 51.7-56.7, Q3 = 56.8-59.9, and Q4 = 60.0), with higher GOHAI scores indicating better OHQOL (score range, 12-60). The association between OHQOL and total mortality was analyzed using the Cox proportional hazards model.

RESULTS

We documented 460 deaths. Males with low GOHAI scores possessed a remarkably high risk of total mortality. The multivariate adjusted-hazard ratios (aHRs), were 1.93 (95% confidence interval [CI], 1.07 - 3.48) for Q1, 1.69 (95% CI, 0.90 - 3.17) for Q2, and 0.65 (95% CI, 0.29 - 1.46) for Q3, relative to Q4 (trend p = 0.001). The aHRs in the multivariate model with all background variables were 1.69 (95% CI, 1.15-2.46) for Q1, 1.53 (95% CI, 1.04-2.27) for Q2, and 1.09 (95% CI, 0.71-1.70) for Q3, relative to Q4 (trend p = 0.001). In females, there was no significant association between the quartiles, in both the multivariate-adjusted model (trend p = 0.52) and multivariate-adjusted model with all background variables (trend p = 0.79).

CONCLUSIONS

A lower OHQOL indicated an increased risk of total mortality in dentists. OHQOL may be used as an indicator for selecting treatment plans and personalized care interventions, thus contributing to increased healthy life expectancy.

TRIAL REGISTRATION

Aichi Cancer Center, Nagoya University Graduate School of Medicine, and Hiroshima University (Approval numbers: 33, 632-3, 8-21, and E2019-1603).

Association between oral and general health related quality of life among Norwegian patients with substance use disorders in opioid agonist therapy

OBJECTIVE

Assess the association between oral and general health related quality of life using oral impacts on daily performances (OIDP) and the quality of life tool EQ-5D-5L from EuroQoL among patients with substance use disorder (SUD) who receive opioid agonist therapy.

METHOD

609 patients with SUD completed the EQ-5D-5L. A dental sub-study of 167 patients completed OIDP and an oral examination when attending outpatient clinics in Western Norway for their opioid agonist therapy. The merged analytical sample consisted of 165 patients. The association between OIDP and EQ-5D-5L was assessed by Spearman's rho and a linear multiple variable regression analysis. A line graph and a Pen's parade displayed the distributions of OIDP sum scores and EQ-5D-5L index values.

RESULTS

Overall mean summary- and index EQ-5D-5L scores were 9.97 (sd 3.25) and 0.69 (sd 0.22). Mean score for OIDP was 9.75 (sd 9.59). Spearman's rho was 0.34 (p < .01) between OIDP and EQ-5D-5L summary scores. Linear regression revealed an association adjusted for sex and age of 0.12 (95% CI 0.07-0.17) and a coefficient of determination of 0.1460.

CONCLUSION

This study reveals a strong association between OIDP and EQ-5D-5L reflecting the importance of oral health to general health for patients with SUD. Health care professionals should pay attention to oral health. Effective interventions might improve patients' oral and health related quality of life.

APPLICABILITY of DENTAL PATIENT REPORTED OUTCOMES in LOW RESOURCE SETTINGS -A CALL to BRIDGE the GAP in CLINICAL and COMMUNITY DENTISTRY

Low resource settings (LRSs) are typically regions where inadequate healthcare resources exist and the healthcare system does not meet the acceptable global standards. The problems encountered in LRS in oral and dental medicine could be related to lack of human personnel, e.g., insufficient numbers of dentists and other dental professionals, poor infrastructure, limited or remote treatment/care facilities, lack of dental materials and supplies as well as inadequate monitoring and evaluation of public health programs. Despite the limited human resources in LRS, such settings are currently experiencing a brain drain, a situation where there is massive emigration of highly trained and qualified healthcare professionals including dentists to other countries for better living conditions. To allocate health resources judiciously, exploration of alternatives to traditional oral health assessments, which are cheap, easily available, and patient-oriented, becomes pertinent. Thus, there is a need to consider the applicability of oral assessment tools such as dental patient-reported outcomes (dPROs) in general, and oral health-related quality of life (OHRQoL) in particular. Therefore, the aim of this narrative review was to describe opportunities for the applicability of dPROs in LRSs with a focus on Nigeria, based on empirical data. The applicability of dPROs and OHRQoL in LRS includes prevention, screening, diagnosis, assessment of oral health impact, application of the first step of targeted treatment, treatment evaluation, planning, and monitoring of public health programs, as well as research needs. dPROs could be very useful in LRS because their practical advantages may be utilized to improve patient and population health.

Association between oral health and oral health-related quality of life in patients before hip and knee endoprosthesis surgery: a cross-sectional study

Objectives

Aim of this cross-sectional study was the assessment of oral health-related quality of life (OHRQoL) health-related quality of life (HRQoL), oral health behaviour and oral health status in patients before hip and knee endoprosthesis (EP) surgery. Moreover, associations between OHRQoL, HRQoL and oral health should be examined.

Methods

Consecutive patients before hip and/or knee EP implantation were recruited and referred to the dental clinic for oral examination including: number of remaining teeth, dental findings (DMF-T-Index), periodontal condition (periodontal treatment need, Staging/Grading) and temporomandibular joint screening. OHRQoL was assessed by the German short form of oral health impact profile (OHIP G14), HRQoL by short-form 36 survey.

Results

Hundred and sixty two patients with a mean age of 66.80 ± 11.10 years were included, which had on average 18.22 ± 8.57 remaining teeth and a periodontal treatment need of 84.5%. The OHIP G14 sum score revealed a median of 1 (mean: 2.7 ± 4.4, 25–75th percentile: 0–4) and its dimension oral function of 0 (mean: 0.8 ± 1.8, 25–75th percentile: 0–1), what was also found for psychosocial impact (median: 0, mean: 1.4 ± 2.6, 25–75th percentile: 0–2). The OHIP G14 sum score and both dimensions were significantly associated with mental component summary (p < 0.01). A higher number of remaining teeth as well as remaining molars/premolars were associated with lower OHIP G14 sum score (p = 0.02). This was also found for the dimension oral function (p < 0.01).

Conclusion

Patients prior to hip and knee EP had an unaffected OHRQoL, although they had an insufficient oral health. Individuals before EP implantation need increased attention in dental care, fostering information, sensibilization and motivation of the patients.

Oral health-related quality of life in patients with osteoarthritis of the temporomandibular joint-Results of a systematic review

OBJECTIVES

The aim of this systematic review was to assess the oral health-related quality of life (OHRQoL) of patients with osteoarthritis (OA) of the temporomandibular joint (TMJ).

METHODS

This systematic literature search applied the search terms "oral health-related quality of life AND osteoarthritis of jaw OR arthritis of temporomandibular joint AND oral health-related quality of life" in PubMed, Medline, Web of Science and Scopus. Eligibility criteria were publication until 31 August 2021, examination of children or adults with OA of TMJ, reporting of any OHRQoL measurement and a full text in English language. Two different, independent and experienced reviewers performed this systematic literature search. The analysis of respective data was qualitative. For quality appraisal, the available checklist from the Agency for Healthcare Research and Quality (AHRQ) was applied.

RESULTS

Out of 102 findings, eight studies were included in qualitative analysis. Seven clinical investigations were performed in adults aged between 34 and 43 years. The other included study was performed on children. The quality of two studies was moderate, and six studies were evaluated as of high quality. Most studies applied the 14-item short form of the oral health impact profile (OHIP 14) for assessment of OHRQoL. OHIP 14 ranged between 9.24 and 38.86 points in means of sum score. Comparison with healthy individuals revealed worse OHRQoL of OA patients in two studies. Associations between OHRQoL with either oral health, general quality of life or disease-related parameters were rarely reported and heterogeneous. Five of the included studies reported subscales of OHIP 14, showing an impairment in all subscales.

CONCLUSIONS

There are hints that patients with OA of the TMJ show a reduced OHRQoL. More studies are needed, especially regarding oral health, disease-related parameters and pain intensity and its potential influence on OHRQoL.

Oral health knowledge, attitudes, and practices and oral health-related quality of life among stroke inpatients: a cross-sectional study

BACKGROUND

Stroke patients have poor oral hygiene, experience oral dysfunction due to disease factors, and have impaired oral health-related quality of life (OHRQoL). This study aimed to determine the oral health knowledge, attitudes, and practices of stroke inpatients, assess the OHRQoL of these patients, and identify their correlates.

METHODS

In this cross-sectional study, 281 stroke inpatients aged between 22 and 88 years (57.94 ± 10.94) were conveniently selected from three hospitals in Guangzhou, China. OHRQoL was measured among these stroke patients using a Chinese version of the Oral Health Impact Profile-14 (OHIP-14). SPSS 26.0 was used for statistical analysis. Mean scores, standard deviations, and frequency distributions were obtained. The Mann-Whitney U test, Kruskal‒Wallis H test, Spearman's correlation, and multiple linear regression were used in the analysis.

RESULTS

The mean score of the patients' OHRQoL was 8.37 ± 6.67, with the highest score in the pain or discomfort of the mouth dimension (3.11 ± 2.13) and pain being the most common negative effect (13.5%). In multiple linear regression analysis, significant differences were found between patients only in age (P = 0.008), toothache (P < 0.001), self-rated oral health (P < 0.001), time since last dentist visit (P = 0.037) and reason for not having visited a dentist in the past year (P < 0.001).

CONCLUSION

The OHRQoL of patients hospitalised with stroke was moderate, and oral conditions still need to be improved. Increasing age, toothache, a longer time since the last dental visit and the reason for not visiting a dentist in the past year had a negative effect on OHRQoL, and better self-rated oral health had a positive effect. Therefore, in clinical work, greater attention should be given to elderly stroke patients, patients with poor oral status and poor oral health behaviours, timely assessment of patients' swallowing function, nutritional function, and self-care ability, and early and targeted oral health interventions and guidance.

Oral Health-Related Quality of Life in Patients after Stroke-A Systematic Review

OBJECTIVES

Aim of this systematic review was to assess oral health-related quality of life (OHRQoL) of patients after stroke.

METHODS

The systematic literature search was performed on December 2021 based on PubMed, Medline, Web of Science, and Scopus, with the search terms: "oral health-related quality of life" AND stroke OR apoplexy OR ischemic stroke OR apoplectic insult. Articles exclusively examining patients after stroke and reporting a well-documented and valid OHRQoL measurement were included.

RESULTS

Out of 68 findings, 8 studies were included. The number of patients ranged between 31 and 549 individuals, mean age between 55.7 and 73.9 years, and 49-72% of individuals were male. Two studies included a healthy control group. Oral health parameters were rarely reported across studies. Five studies reported on the Oral Health Impact Profile (OHIP) 14 for OHRQoL, showing means between 2.87 and 33.0 in sum score. Three studies applied Geriatric Oral Assessment Index (GOHAI), with sum scores between 45.6 and 55.0. Only one study found worse OHRQoL in stroke patients compared to healthy controls. Two studies reported on an association between OHRQoL and general quality of life. Three studies found OHRQoL to be associated with different oral health parameters. Only one study found OHRQoL to be associated with stroke-related parameters.

CONCLUSIONS

Patients after stroke show a reduced OHRQoL. Medical staff and caregivers should support oral hygiene and dental visits, to foster patients' oral health and OHRQoL.

Oral Health-Related Quality of Life in Patients With Chronic Respiratory Diseases-Results of a Systematic Review

Background: This systematic review evaluates the oral health-related quality of life (OHRQoL) of patients with chronic respiratory diseases.

Methods: A systematic literature search was performed based on the PubMed, Medline, Web of Science, and Scopus, using the search terms: “oral health-related quality of life” and “respiratory disease” or “lung” and “oral health-related quality of life.” Full-text articles published until June 30, 2021 and reporting any OHRQoL measurement in children or adults with a chronic respiratory disease or condition were included and analyzed qualitatively.

Results: A total of seven out of 44 studies were included, of which four studies examined adults and three studies investigated children. The respective diseases were chronic obstructive pulmonary disease (COPD) (n = 2), sleep apnea (n = 2), severe asthma (n = 1), cystic fibrosis (n = 1), and lung transplantation (n = 1). Four studies confirmed a worse OHRQoL in the respiratory diseased group compared to healthy controls. The overall OHRQoL was reduced in the included studies. Oral health, health-related quality of life, and disease-related parameters were rarely examined with regard to OHRQoL.

Conclusion: Patients with chronic respiratory diseases show a reduced OHRQoL. Oral health should be fostered in these individuals to support their OHRQoL.

Measuring oral health: the Physical Oral Health Index: Physical Oral Health Index (PhOX)

OBJECTIVES

Oral health is an important component of a person's general health. Studies focusing on this issue need valid and reliable tools to assess oral health. Aim was to develop a comprehensive measure for physical oral health and to establish its measurement properties.

METHODS

The construct physical oral health was defined based on a systematic literature review and a modified Delphi technique in an expert panel (n=31). The preliminary tool was applied in a multicenter study (n=609) to gain empirical data on acceptance, item characteristics, reliability, and responsiveness. Validity was assessed as correlation of sores with patients' and experts' global oral health ratings and Oral Health Impact Profile (OHIP) summary score. Based on findings of field testing, the tool was modified to derive the final version of the Physical Oral Health Index (PhOX). Finally, measurement properties of the PhOX were determined.

RESULTS

The PhOX consists of 14 items covering all relevant oral health structures and conditions. For repeated measures, reliability of the summary score was high (ICC=0.87). The summary score was correlated in the expected direction to patients' (r=0.43) and examiners' (r=0.55) global oral health ratings and to OHIP summary scores (r=-0.41). Among patients receiving dental treatments between two assessments, PhOX summary scores increased from baseline to follow-up statistically significantly (p=0.002).

CONCLUSIONS

The newly developed PhOX is a methodologically sound and easy to apply tool for the comprehensive assessment of physical oral health.

Validation of self-reported oral health among Indonesian adolescents

Background and aim

With the recognition of health as a subjective state, self-reported oral health has been applied in many epidemiological studies. However, the validity of self-reports may vary across different age groups and socio-cultural backgrounds and by using different tools. This study aimed to assess the validity of self-reported oral health of 15-year-old Indonesian adolescents.

Materials and methods

This study used data from the Indonesian National Oral Health Survey, a part of the Indonesian Basic Health Survey 2018. The study included 572 15-year-old Indonesian adolescents. We compared the presence of clinically assessed dental caries, tooth loss, and fillings following the World Health Organization Basic Health Survey method and questionnaire-based self-reported oral conditions using McNemar test. The sensitivity (Sn), specificity (Sp), and likelihood ratios (LRs) of self-reports were calculated using clinical assessment as the reference standard. The overall accuracy of self-reports in identifying the clinical condition was assessed using the area under the curve (AUC) of a receiver operating characteristic curve.

Results

Self-reports significantly underestimated the clinical presence of caries (39.3% and 67.1%) and overestimated the clinical presence of tooth loss (9.3% and 4.2%) and filling (4.7% and 2.4%, p < 0.05). All self-reported conditions had higher Sp (at least 70.3%) than Sn (max 54.2%) and the AUC for all self-reported conditions were < 0.7. Self-reporting the presence of fillings had the highest LR+  = 11.

Conclusions

Self-reporting oral health in Indonesian adolescents had low accuracy. Further studies of other methods of self-reporting are needed before they can be used to assess adolescents’ oral health in epidemiological surveys.

Design, implementation, and evaluation of a PRECEDE-PROCEED model-based intervention for oral and dental health among primary school students of Rafsanjan city: a mixed method study

Background

Oral and dental health has a significant impact on public health as well as the quality of life among individuals and families. This study aims to design, implement, and evaluate an intervention based on the PRECEDE-PROCEED model for oral and dental health among primary school students in Rafsanjan city, Southern Iran.

Methods

According to the nature of the model and with the focus group discussion and interview methods, in phases 1 to 4 (PRECEDE), predisposing, enabling, and reinforcing factors related to oral health were identified. The training program was designed and consisted of six sessions for students (250 students) with a brushing session, three sessions for parents, and two sessions for teachers. Process evaluation and the effect of the program on behavioral and factors affecting oral health were evaluated (PROCEED).

Results

In the qualitative section, seven predisposing factors, five enabling factors, and two reinforcing factors were identified. A training program based on the PRECEDE-PROCEED model was found to be effective in increasing the mean scores of the above constructs and the students’ brushing behavior (P < 0.001).

Conclusion

Based on the model planning phases, the factors affecting the brushing behavior of children aged 6–12 years were identified. The educational program has had a significant effect on improving the scores of predisposing, enabling and reinforcing factors and children’s brushing behavior.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11585-z.

Oral health and oral health-related quality of life in patients with oral dystonia indicates their need for dental special care

BACKGROUND

This retrospective study aimed in the evaluation of oral health and oral health-related quality of life (OHRQoL) of patients with oral dystonia (OD).

MATERIAL AND METHODS

Seventeen patients with OD (Meige Syndrome: n=11, Oromandibular Dystonia: n=6) were included, of which seven were examined again at three months after botulinum toxin injection. OHRQoL was assessed by the German short form of oral health impact profile (OHIP G14). Within oral examination, dental parameters, remaining teeth and periodontitis severity were assessed. A matched healthy control (HC) was composed for comparison.

RESULTS

The OD patients had significantly more carious teeth (0.94 ± 1.75 vs. 0; p<0.01), less remaining teeth (15.65 ± 9.89 vs. 22.22 ± 5.91; p=0.01) and higher dental treatment need than the HC (42.9% vs. 0%; p<0.01). The OHIP G14 sum score of 9.47± 9.82 vs. 1.58 ± 2.79 (p<0.01) as well its dimensions psychosocial impact (4.47 ± 6.45 vs. 0.53 ± 1.16; p=0.03) and oral function (4.35 ± 2.98 vs. 0.47 ± 1.34; p<0.01) were clinically relevant and statistically significant higher in OD compared to HC group. No significant differences could be detected at three months after botulinum toxin injection.

CONCLUSIONS

Patients with OD suffer from more dental diseases and have a worse OHRQoL than HC. Dental special care appears recommendable and should be fostered by everyone, who is involved in the treatment of patients with OD.

Oral health-related quality of life in patients with heart failure and left ventricular assist devices-results of a cross-sectional study

Objectives

The aim of this cross-sectional study was to compare oral health-related quality of life (OHRQoL) of patients with left ventricular assist device (LVAD) and heart failure (HF).

Material and methods

Seventy-four patients with LVAD were recruited from University Department for Cardiac Surgery, Leipzig Heart Center, Germany. A group of 72 patients with HF was composed by matching (age, gender, smoking). The German short form of oral health impact profile (OHIP G14) was applied. Health-related quality of life (HRQoL) was measured by short form 36 survey (SF-36). Dental conditions (decayed-, missing- and filled-teeth [DMF-T]), remaining teeth and periodontal findings were assessed. Statistics: t-test, Mann-Whitney U test, Kruskal-Wallis test, chi-square or Fisher test, linear regression.

Results

Age, gender, smoking, underlying disease, co-morbidities and oral findings were comparable between groups (p > 0.05). OHIP G14 sum score was 3.53 ± 6.82 (LVAD) and 2.92 ± 5.35 (HF; p = 0.70), respectively. The scales SF-36 physical functioning (p = 0.05) and SF-36 social functioning (p < 0.01) were worse in LVAD. In the LVAD group, the DMF-T and remaining teeth negatively correlated with OHIP G14 sum score (p < 0.01). In HF patients, positive correlations were found between OHIP G14 and D-T (p < 0.01) and remaining teeth (p = 0.04). Moreover, DMF-T (p = 0.03) and remaining molars/premolars (p = 0.02) were negatively correlated with SF-36 scales in HF.

Conclusions

Oral health and OHRQoL was comparable between LVAD and HF; thereby, OHRQoL reflected the clinical oral status.

Clinical relevance

Dental care, with beginning in early stage of HF, should be fostered to preserve teeth and support quality of life before and after LVAD implantation.

Determinants of self-perceived oral health in adolescents: A cross-sectional study

BACKGROUND

Self-perceived oral health (SPOH) is a summary of multiple determinants related to oral health and has been suggested for use in clinical practice as a health assessment tool.

AIM

To analyse determinants of SPOH among adolescents.

DESIGN

In 2018, we selected 1742 participants from eight high schools in Olinda/PE, Brazil, using a multistage stratified cluster sample. The main survey item of SPOH was 'How would you rate your oral health'. Determinants of were queried with a questionnaire and a clinical examination: socio-demographic variables, exposure to family violence, somatic symptoms, and orofacial and general health factors. Pearson's chi-square test and logistic regressions evaluated associations between determinants and SPOH.

RESULTS

Very poor SPOH had a prevalence of 8.7%. Nearly half (43.5%) rated their oral health as 'fair'. Very poor SPOH was associated with poor self-perceived general health (OR = 2.60), anterior open bite (OR = 2.24), not cohabiting with one or both parents (OR = 2.40), caries experience (OR = 1.93), dental pain (OR = 1.91), and temporomandibular disorders (OR = 1.77).

CONCLUSION

Very poor self-perceived oral health indicates life stress and associates with poor oral conditions. Assessments should be used to explore individual treatment needs and abilities to comply with recommendations.

Does oral health-related quality of life of patients after solid organ transplantation indicate a response shift? Results of a systematic review

BACKGROUND

The physical oral health and dental behaviour of patients after solid organ transplantation (SOT) has repeatedly been reported as insufficient. The objective of this systematic review was to detect whether the oral health-related quality of life (OHRQoL) of patients after SOT is reduced compared to that of healthy individuals.

METHODS

A systematic literature search was performed by two independent individuals based on the PubMed, Web of Science and Scopus databases by using the following search terms: "transplantation" AND "oral health-related quality of life". The findings were checked to determine eligibility, whereby publication prior to 31 October 2020, examination of adult patients (age at least 18 years) with SOT, reporting of an OHRQoL outcome and full text in English language were the prerequisites for inclusion in the qualitative analysis. Quality appraisal of the included studies was performed using the Agency for Healthcare Research and Quality methodology checklist.

RESULTS

Seven of 25 studies that examined patients after kidney (3), heart (2), liver (1) and lung transplantation (1) were included. Four studies included healthy controls, and five studies included a cohort of patients before transplantation for comparison. Clinical oral health examinations were heterogeneous between groups. The majority of studies (5/7) applied the short form of the "Oral Health Impact Profile" (OHIP 14) to assess OHRQoL. The OHIP 14 values ranged between 1.7 and 8.9 across studies, indicating an unaffected or just slightly reduced OHRQoL. Only one study found better OHRQoL in patients after SOT compared to a group before SOT, and one study confirmed worse OHRQoL of SOT recipients compared to a healthy control. Only two studies revealed an association between OHRQoL and oral health parameters. Furthermore, two studies each found a relationship between OHRQoL and general health-related quality of life or disease-related parameters.

CONCLUSIONS

Patients after SOT show an unaffected or only slightly reduced OHRQoL, which was mainly independent of the insufficient oral status. This might indicate a shift in the perception threshold for oral diseases and conditions caused by the general health burden related to the SOT.

Oral health-related quality of life in different rheumatic diseases

OBJECTIVES

Aim of this cross-sectional study was to investigate oral health-related quality of life (OHRQoL) of patients with different rheumatic diseases.

SUBJECTS AND METHODS

Patients with rheumatic disease, including rheumatoid arthritis (RA), systemic lupus erythematodes (SLE), systemic sclerosis (SSc), ankylosing spondylitis (AS), psoriatic arthritis (PsA) and vasculitis were included. OHRQoL was assessed with the German short form of oral health impact profile (OHIP G14). Age, disease duration, leukocytes, c-reactive protein (CRP) and haemoglobin counts were considered as disease related parameters.

RESULTS

A total of 356 patients, assigned to the groups RA (n = 218), SLE (n = 36), AS (n = 36), PsA (n = 33), vasculitis (n = 19) and SSc (n = 14) were included. The OHIP G14 sub-scale psychosocial impact differed significantly between groups (p = .02). The OHIP G14 sum score was also significantly different between groups (p < .01). A medium-sized correlation was found for CRP with OHIP G14 sum score within SLE group (r = .344, p = .04). A large correlation was detected for leukocytes within PsA group (r = .525, p < .01). The reliability of the applied OHIP G14 was high.

CONCLUSION

Patients with rheumatic disease show a reduced OHRQoL, with several differences between the entities. Psychosocial aspects appear to be of relevance and should be considered in multidisciplinary dental care of these patients.

Patient-reported outcome measures of edentulous patients restored with single-implant mandibular overdentures: A systematic review

AIM

To review the literatures concerning the effect of the single-implant mandibular overdenture (SIMO) on patient-reported outcome measures (PROMs) and masticatory function in the fully edentulous patients.

MATERIALS AND METHODS

Electronic databases (PubMed, Cochrane Library, EMBASE and Web of Science) were searched, complemented with manual resources. Prospective studies published in English up to February 2020 reporting the effect of SIMO on PROMs and masticatory function in the edentulous patients were included. This review focused on oral health-related quality of life (OHRQoL), satisfaction and masticatory function outcomes.

RESULTS

Of 1157 initially screened articles, 9 randomised controlled trials (RCTs) and 8 prospective studies involving 551 subjects fulfilled the inclusion criteria. Two RCTs were graded as high risk of bias or some concern, while others were low risk. All prospective studies had adequate representativeness and assessment, but only one study had a controlled cohort. In general, the edentulous patients restored with SIMOs had improved OHRQoL and general satisfaction compared to those with conventional complete dentures (CCDs), but the outcome of masticatory function was controversial. Compared with two-implant mandibular overdenture (TIMO), SIMO showed no significant differences regarding general satisfaction and satisfaction with speech, comfort, chewing ability, aesthetics and social life. Conflicting results were observed in OHRQoL and satisfaction with retention and stability. Better masticatory performance was observed in TIMO group than SIMO group.

CONCLUSION

Within the limitation of this review, SIMO is featured with better OHRQoL and satisfaction than CCD. SIMO and TIMO rendered similar patient satisfaction, but TIMO had better masticatory performance.

Perception of orofacial appearance among laypersons with diverse social and demographic status

BACKGROUND

The perception of dentofacial esthetics differs considerably between patients and dentists. Patient's expectations regarding his/her esthetics are important and should be assessed ahead of any planning of esthetic treatment. The aim of this study was to explore the differences in perception of orofacial appearance by laypersons with different social and demographic status.

MATERIALS AND METHODS

Self-administered questionnaires were distributed to 400 subjects. The questionnaire comprised three parts; the first part addressed the demographic variables. The second part queried about dental prosthesis, orthognathic or plastic surgery, and/or ongoing or previous orthodontic treatment. The third part included the Arabic version of the-8-item Orofacial Esthetic Scale (OES-Ar) whose responses were scored in the 5-point Likert scale. These scores were compared by different grouping factors (age, gender, marital status, and education) using non-parametric Mann-Whitney U and Kruskal Willis tests with 95% confidence interval (α > 0.05).

RESULTS

A total of 268 questionnaires were eligible for analysis, representing 67% response rate. The satisfaction with facial profile appearance was the highest (4.0±1.1) followed by facial appearance (3.9±1.1), while the color of teeth was the least satisfying item (3.1±1.3). No significant differences were found between age groups for the mean summary score as well as for each item independently. No significant difference was found between both sexes except for the last item "overall impression". Married subjects rated one item (alignment of teeth) better than their counterparts. Positive perception of orofacial appearance increased significantly with the increase of education level, the perception of the oral health status, and the perception of the general health status.

CONCLUSION

Good oral health and/or high education level are significant determinants of more positive perception of orofacial esthetic appearance. Patients with these characteristics might be more concerned about their orofacial appearance, and this should be taken into consideration before planning any esthetic restorative dental treatment.

Methodological considerations when measuring oral health-related quality of life

BACKGROUND

Dental patient-reported outcomes (dPROs) and their measures, dPROMs, are fundamental for evidence-based dentistry. However when selecting, applying and evaluating an instrument with a focus on OHRQoL assessment for adults, several methodological considerations are essential to derive valid and meaningful results.

METHODS

In this review article, criteria for selecting the appropriate OHRQoL instrument, aspects of administering the instrument and how to evaluate resulting scores of single and multiple assessments are presented and critically assessed.

RESULTS

Oral disease-generic and dimension-generic instruments capturing the entire construct OHRQoL allow for best comparability of findings across different diseases, settings and populations, with the Oral Health Impact Profile (OHIP) being the most often used and methodologically best investigated one. It is available in several versions with the 5-item version being the one with the lowest burden for the patient. Responses are given on a 5-point ordinal rating scale, the recommended response scale for dPROMs. A 7-day recall period allows for assessment of short-term effects. Clinically relevant effects of item or instrument order or administration method on OHIP scores do not seem to be likely. OHIP summary and dimension scores can be compared to norms from general population or different patient populations. Change scores should be set into context with the minimal important difference of the instrument.

CONCLUSION

OHIP-5 has greatest potential to be used across all settings for assessment and evaluation of OHRQoL in adults. It allows a comprehensive characterising of patients suffering from oral diseases and of this impact using OHRQoL dimensions.

Oral health-related quality of life of patients after heart transplantation and those with heart failure is associated with general health-related quality of life: a cross-sectional study

PURPOSE

The aim of this cross-sectional study was to examine the oral health-related quality of life (OHRQoL) in patients after heart transplantation (HTx) and those with heart failure (HF).

METHODS

In total, 186 participants (HTx: 104, HF: 82) were recruited from the University Department for Cardiac Surgery, Leipzig Heart Centre, Germany. OHRQoL was assessed with the German short form of the oral health impact profile (OHIP-G14). Health-related quality of life (HRQoL) was evaluated using the short form 36 survey (SF-36). Furthermore, the dental and periodontal treatment need was recorded.

RESULTS

With an OHIP-G14 sum score of 6.58 ± 6.40 [5; 2.5-8] in the HTx group and 5.54 ± 5.47 [5; 2-7] in the HF group, no clinically relevant or statistically significant difference was apparent (p = 0.39). The SF-36 scales for physical functioning, role-physical, general health and vitality were significantly worse in the HF group compared with the HTx group (pi < 0.01). A worse SF-36 physical component summary was significantly associated with a higher OHIP-G14 sum score (HTx: p < 0.01, HF: p = 0.04). In the HTx group, a significant association was also observed for the mental component summary (p < 0.01). Multiple regression analysis revealed physical component summary (p = 0.04) and mental component summary (p < 0.01) in HTx, and physical component summary (p = 0.02), mental component summary (p = 0.02) and smoking (p < 0.01) as significant predictors for OHIP G14 in HF.

CONCLUSION

The OHRQoL in HF and HTx patients appears to be mainly associated with general HRQoL. Therefore, multidisciplinary dental care concepts may be recommended to improve oral health conditions in these patients.

Association Between Oral Health-Related and Health-Related Quality of Life

OBJECTIVES

To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population.

METHODS

A cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients' data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile-version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL.

RESULTS

Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52-0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51-0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47-0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit.

CONCLUSIONS

OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients' general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients' OHRQoL as well as HRQoL.

Oral health-related quality of life in adult patients with end-stage kidney diseases undergoing renal replacement therapy - a systematic review

Background

The oral health of patients undergoing renal replacement therapy (RRT) is insufficient. Poor oral health and its components can affect the oral health-related quality of life (OHRQoL) of these patients. The aim of this systematic review was to assess the OHRQoL of adult patients under RRT.

Methods

A systematic literature search was performed using the terms: dialysis OR “renal disease” OR kidney OR “renal failure” OR “kidney transplantation” OR hemodialysis OR “peritoneal dialysis” OR “renal replacement therapy” AND “oral health-related quality of life”, complemented by manual search. Clinical studies including adults (age ≥ 18 years) that were published between 2009 and 2019 were included in qualitative analysis.

Results

Twelve out of 20 studies were included in the qualitative analysis. The majority (11/12 studies) included patients undergoing haemodialysis (HD), with a sample size between 47 and 512 participants. Two studies included patients after kidney transplantation. Only one-quarter of the investigations included a healthy control group. The overall OHRQoL was found to be reduced. The majority of studies found relationships between OHRQoL and different oral health parameters. Furthermore, several relationships between OHRQoL and general quality of life as well as disease related parameters including age, gender, diabetes, blood parameters and dialysis duration were found. OHRQoL subscales psychological/psychosocial impairment and pain were predominantly affected.

Conclusions

Patients under RRT suffer from a reduced OHRQoL, which is potentially influenced by oral health and disease related parameters. Interdisciplinary dental care is needed and should consider both physical and psychosocial issues.

Oral-Health-Related Quality of Life in Adult Patients with Rheumatic Diseases-A Systematic Review

OBJECTIVES

The aim of this systematic review was to assess the oral-health-related quality of life (OHRQoL) of adult patients with rheumatic diseases.

MATERIAL AND METHODS

A systematic literature search was performed, including clinical studies on adults (aged at least 18 years) with a verified diagnosis of rheumatic disease.

RESULTS

26 out of 41 clinical studies including rheumatoid arthritis (RA, seven studies), systemic sclerosis (SSc, five), Sjögren syndrome (SS, eight), Behcet disease (BD, four), systemic lupus erythematosus (SLE, one) and ankylosing spondylitis (AS, one) were found. In 15 studies, a healthy control group was recruited. The short form of the Oral Health Impact Profile (OHIP 14) was most frequently applied. The majority of studies (14/15) reported worse OHRQoL in patients with rheumatic disease compared to healthy individuals. In particular, patients with SS (salivary flow and composition) or BD (oral ulcers) showed a relation between OHRQoL and disease-specific oral manifestations. Most studies investigating subscales of OHRQoL (5/6) found the subscale physical disability to be predominantly affected in patients with rheumatic diseases. About half of the studies reported impaired psychosocial aspects.

CONCLUSION

Patients with rheumatic diseases exhibit reduced OHRQoL, especially in diseases with oral manifestations like SS and BD. Physical affections due to oral diseases and psychosocial impairments caused by disease-related parameters must be recognized within patient-centered dental care.

Disease activity, morning stiffness and missing teeth are associated with oral health-related quality of life in individuals with rheumatoid arthritis

OBJECTIVES

The aim of this cross-sectional study was to assess oral health-related quality of life (OHRQoL) in patients with rheumatoid arthritis (RA) and its relation to specific RA characteristics.

MATERIAL AND METHODS

Within the oral examination, the need for dental (carious teeth showing cavitation) and periodontal treatment (presence of a probing depth ≥ 3.5 mm) and the number of missing teeth (M-T) were recorded. OHRQoL was assessed with the German short version of the Oral Health Impact Profile (OHIP G14). The disease activity score (DAS28-ESR), disease duration, number of swollen/painful joints and duration of morning stiffness were retrieved from the patient records.

RESULTS

A total of 176 patients with a mean age of 62.5 ± 10.2 years were included. The overall OHIP G14 sum score was 5.4 ± 7.1. The M-T showed a significant correlation with the dimensions of oral function (r = 0.25, p = 0.001) and psychosocial impact (r = 0.20, p = 0.009) and the sum score (r = 0.26, p = 0.001). The DAS28-ESR showed a significant correlation with psychosocial impact (r = 0.19, p = 0.012) and the sum score (r = 0.16, p = 0.041). The duration of morning stiffness was correlated with oral function (r = 0.19, p = 0.019), psychosocial impact (r = 0.18, p = 0.024) and the sum score (r = 0.22, p = 0.006). The effect size of these correlations was interpreted as small.

CONCLUSION

Disease activity, morning stiffness and missing teeth are associated to OHRQoL of patients with RA. Accordingly, multidisciplinary dental care appears necessary for these patients.

CLINICAL RELEVANCE

The prevention of tooth loss as well as the consideration of psychosocial and disease-specific parameters in the multidisciplinary dental care of RA patients is necessary.

An Evidence-Based Approach to Outcome Measurement in Oral and Dental Health Services: Oral Health-Related Quality of Life and Oral Health Impact

PURPOSE

The purpose of this study was to examine the Oral Health-Related Quality of Life (OHRQOL) and Oral Health Impact Profile (OHIP) of oral and dental health patients in terms of gender, educational status, and the reason for coming to the oral health center. Also, we investigated the relationships between OHRQOL and OHIP.

METHODS

This cross-sectional study was conducted and planned for dental patients in Turkey. OHRQOL-United Kingdom (OHRQOL-UK) and OHIP-14 were used for data collection. Descriptive statistics, correlation analysis, student t-tests, and ANOVA were used for data analyses.

RESULTS

Of 527 respondents, 62.8% were female, and 37.2% were male. One-hundred-forty-one (26.8%) participants were illiterate. Three-hundred-fifty-four (67.20%) dental patients had an elementary school degree. Only 32 (6.10%) participants graduated from college and bachelor programs. For dimensions of the OHIP-14 and OHRQOL-UK, we detected statistically significant differences in personal characteristics. We found that gender, marital status, age, education status, and reasons for coming to the hospital have a significant impact on OHRQOL and OHIP.

LINKING EVIDENCE TO ACTION

These results are expected to provide important evidence-based information to health managers and decision-makers in health planning and reimbursement policies. Clinicians and health managers should use OHIP, quality of life (QOL), and evidence-based practice to determine individual treatments and approaches to improve oral health. QOL is an outcome indicator in healthcare services and evidence-based practice. Measurements of evidence-based health outcomes in national health systems can be made, and global comparisons and policies in oral and dental health can be developed.

Evolution of in vivo assessed retention forces in one-piece mini dental implant-retained mandibular overdentures: 5-Year follow-up of a prospective clinical trial

BACKGROUND

The evolution of retention forces in one-piece mini dental implants (MDIs) retaining implant overdentures (IODs) is of major importance, as the male parts cannot be exchanged, due to the implant design.

PURPOSE

To report the evolution of retention forces of one-piece MDIs, retaining mandibular IODs with ball/ O-ring attachments during 5 years assessed in vivo.

MATERIALS AND METHODS

Four MDIs were installed in the interforaminal region and immediately loaded using the existing mandibular complete denture. Directly post-op, at the 1-year and the 5-year follow-up, the retention forces were assessed with a validated strain gauge at each implant site separately.

RESULTS

At the male part, changes could only be observed at implant site 34: During the first year, there was a statistically significant increase, whereas the retention forces were decreased at the 5-year follow-up. At the female part, retention forces decreased significantly over time. Baseline values could be reestablished by exchanging the O-rings. The changes of the retention forces were more obvious in the posterior, compared to the anterior implants.

CONCLUSIONS

Retention forces at the female part decrease significantly over time, when retaining mandibular IODs by MDIs with ball/ O-ring attachments. Baseline values can be reestablished by exchanging the O-rings. At the male part, changes of retention forces depend on the implant location.

Link between perceived oral and general health status among Yemeni adult dental patients

BACKGROUND

Self-perceived health is an essential measure of health status and even a paramount predictor of mortality. So long as it is said that oral health (OH) and general health (GH) are mirrors to each other. This study sought to determine how Yemeni adults rate their OH and GH, whether such a self-rating influenced by some potential risk factors, and whether both ratings (OH and GH) are correlated.

METHODS

A sample of 587 Yemeni dental patients aged 20 years and over were consecutively recruited. A structured interview form was used covering the following variables: age, gender, marital status, educational level, presence of dental prosthesis (DP), smoking and Qat chewing habits as independent variables, along with questions on "perceived oral health (POH)" and "perceived general health (PGH)" as dependent variables. The bivariate and multiple ordinal regression analyses were applied at P-value < 0.05.

RESULTS

Most of participants were women (73.6%), and married (71.4%), and more than half of them were young adults (58.2%), with high educational levels (53.3%), and not having DP. Only 310 participants responded to the questions on smoking and Qat chewing habits. Of these, 88.5% were non-smokers and 62.1% were Qat non-chewers. Up to 50% of the participants reported their POH as poor or fair, while lower proportions of participants (17%) reported their PGH as such. Younger age (compared to elders), high education levels (compared to primary education) and being single (compared to married) significantly revealed better levels of POH, while high education levels and being females significantly revealed better levels of PGH. Smoking and Qat chewing habits were found to have no effect on the perception of POH or PGH. POH and PGH were found to be significantly correlated (r = 0.486; P < 0.001).

CONCLUSION

Higher levels of oral health problems can be anticipated among patients who perceive poor general health, and vice versa. The age, marital status and education were independent determinants of POH, while the gender and education were independent determinants of PGH.

Translation and validation of the Arabic version of the 5-item Oral health impact profile: OHIP5-Ar

Purpose

The aim of this study was to translate and validate an Arabic version of the 5-item Oral Health Impact Profile (OHIP).

Methods

A total of 320 subjects (aged 18 years and above) were consecutively recruited from dental clinics. The self-administered OHIP5-Ar was distributed and the data were collected and analyzed. The dimensionality of the instrument was investigated using confirmatory factor analyses (CFA). Reliability was assessed as the instruments internal consistency using Cronbach’s alpha and test-retest-reliability using intraclass correlation coefficient (ICC). Convergent validity was tested by correlation between perceived global oral and general health questions with the latent factor (OHRQoL) using structural equation modelling analysis and with OHIP5-Ar total score using spearman’s correlation coefficient. Known-groups validity was tested among groups with known differences and sensitivity to change was also investigated after dental treatments.

Results

The OHIP5-Ar was fitted well in the unidimensional model as indicated by the CFA with fit indices (RMSEA: 0.00, SRMR: 0.010, GFI: 0.998, TLI: 1). Cronbach’s alpha was 0.78 and the ICC agreement was 0.88. The validity tests indicated satisfactory validity of the instrument and the sensitivity to change of the instrument revealed significant change in the OHIP5-Ar total score after the provision of dental treatments (effect sizes: 0.55–1.49).

Conclusion

The OHIP5-Ar showed satisfactory psychometric properties among Arabic-speaking population. This instrument is sensitive to the changes of oral health and can be used to measure the OHRQoL with one total score.

Dialysis vintage time has the strongest correlation to psychosocial pattern of oral health-related quality of life - a multicentre cross-sectional study

Background

Aim of this cross-sectional, multicentre study was to investigate associations of dialysis vintage time in haemodialysis (CKD5D) patients with oral health-related quality of life (OHRQoL) and dental and periodontal treatment need.

Material and Methods

CKD5D patients were divided into subgroups according to dialysis vintage time in different dialysis centres in Germany. OHRQoL was assessed with oral health impact profile (OHIP-G14). Dental treatment need was classified as presence of carious lesions. Periodontal treatment need was defined as periodontal screening index score (PSI) 3-4.

Results

In total, 190 participants were divided into the subgroups according to the time on CKD5D: 0 - 2 (n = 29), 3 - 5 (n = 35), 6 - 8 (n = 34), 9 - 12 (n = 29), 13 - 20 (n = 34) and >20 years (n = 29). The overall treatment need in the total cohort was 92% (dental 56%, periodontal 88%) with a total OHIP-G14 sum score of 4.17 [2; 0-5] without a significant correlation. Time on CKD5D was inversely correlated with the OHIP G14 score (p<0.01, R = -0.201). The pattern psychosocial impact was significantly associated with the dialysis duration (p<0.01) and showed a negative correlation to the OHIP-G14 (R = -0.283, Spearman´s rho test p<0.01). For oral function also a negative correlation with OHIP-G14 was detected (Spearman´s rho: -0.183).

Conclusions

Patients with a prolonged dialysis vintage time show an improved OHRQoL, which might be mainly caused by the positive development of psychosocial pattern of OHRQoL. The oral health situation of HD patients seems unsatisfying, independently of dialysis vintage time and OHRQoL. Accordingly, an improvement in oral health situation of CKD5D patients is mandatory necessary. Thereby, consideration of psychosocial aspects especially at the beginning of CKD5D therapy and a sensitization regarding oral health issues with increasing vintage time might be recommendable.

Key words:Dental care, oral health, oral related quality of life, haemodialysis, chronic kidney disease.

Assessing a conceptual model with both oral health and health related quality of life in community-dwelling elders

PURPOSE

The objective of this study was to test a hypothesized conceptual model for both the clinical and non-clinical status of oral health and health related quality of life (OHRQoL & HRQoL) among community-dwelling elders.

MATERIALS AND METHODS

Study participants (n = 517), who were recruited as part of a Taiwanese elderly community survey, were collected via dental examinations and questionnaires. We collected measures of clinical variables, self-reported symptom status, OHRQoL, nutritional status and HRQoL. The 517 participants were randomly assigned to one of two samples, to provide one training sample for estimation and one testing sample for validation. The path analysis with all observed variables was conducted based on the proposed theoretical model delineating pathways.

RESULTS

All of the direct pathways hypothesized by the model were significant. Functional status (OHRQoL measured by OHIP-14T) mediated clinical occlusion, and symptom status mediated nutritional status (MNA) and HRQoL (WHOQOL-BREF). The model accounted for 29% of the variance in HRQoL and demonstrated a good fit with the data.

CONCLUSIONS

This conceptual model suggests that OHRQoL, as an important mediator, links clinical conditions, symptom status, nutritional status, and overall HRQoL. Therefore, when therapeutic efforts are made to improve the outcomes for patients with oral diseases, not only can the OHRQoL be enhanced, but also the HRQoL can be improved as a result.

Long-term changes in oral health-related quality of life over a period of 5 years in patients treated with narrow diameter implants: A prospective clinical study

OBJECTIVES

The aim of this study was to assess long-term changes in oral health-related quality of life (OHRQoL) over a period of 5 years in patients treated with narrow diameter implants (NDI) in the mandible for support of an overdenture.

METHODS

In this prospective clinical study, a consecutive sample of 20 edentulous patients who had worn sufficient complete dentures for at least 12 weeks was provided with four immediately loaded one-piece titanium NDIs in the mandible. The German 49-item version of the Oral Health Impact Profile (OHIP) was applied to assess OHRQoL at baseline and all follow-ups (4 and 8 weeks, 3, 6, and 12 months, and 3 and 5 years after treatment was finished).

RESULTS

Before treatment, OHRQoL was substantially impaired indicated by high OHIP summary score (39.9 points). Four weeks after treatment, a substantial treatment-induced drop of OHRQoL impairment was observed (21.8 OHIP points), and at all follow-ups, OHIP scores were lower than at baseline (15.9-26.5 OHIP points; ANOVA: p<.001). Based on mixed-effect linear regression analyses, the treatment-induced effect on OHRQoL improvement over the entire study period was statistically significant for the OHIP summary scores as well as for all four OHIP domains: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact (all: p<.001).

CONCLUSIONS

This study suggests that four immediately loaded NDIs for the support of conventional complete dentures in edentulous patients with substantially impaired OHRQoL may lead to a long-lasting treatment-induced improvement in OHRQoL.

CLINICAL SIGNIFICANCE

The provision of four NDI in the edentulous mandible is a promising treatment option for patients with substantial OHRQoL impairment and a positive attitude towards implant treatment. Furthermore, patients can be informed that improvements in OHRQoL are expected to last for at least 5 years.

Oral health-related quality of life is associated with disease specific parameters in patients with ankylosing spondylitis

BACKGROUND

The aim of this cross-sectional study was to investigate oral health-related quality of life (OHRQoL) in patients with ankylosing spondylitis (AS) and its association to oral health as well as AS specific parameters.

METHODS

Patients with AS and a healthy control group (HC) were included and examined. The oral examination included decayed-, missing-, and filled-teeth index (DMF-T) as well as assessment of periodontal probing depth and clinical attachment loss to classify patients into healthy/mild, moderate, or severe periodontitis. Furthermore, the German short form of the oral health impact profile (OHIP G14) was used.

RESULTS

A total of 50 patients each group (age: AS, 47.18 ± 15.67; HC, 55.82 ± 10.56; p < 0.01, gender male: AS, 52%; HC, 46%; p = 0.69) was included. AS patients showed worse D-T (p < 0.01) and periodontal condition (p = 0.01). The OHIP G14 score was clinically relevant and statistically significant higher in AS compared to HC (AS, 6.2 [2; 0-10.75]; HC, 1.7 [0; 0-2.0]; < 0.01). Only in HC, an association of OHIP G14 to DMF-T (p = 0.01) and M-T (p = 0.01) was found, while the OHIP G14 in AS group was not associated to oral health parameters. Within the AS group, the majority of investigated AS specific parameters were statistically significant and clinically relevant associated to OHIP G14 scores (p_i < 0.05).

CONCLUSION

Patients with AS show worse OHRQoL compared to HC, irrespective of oral status. The high general disease burden might affect OHRQoL, making an increased attention of these patients in dental care, especially considering psychological aspects, necessary.

CLINICAL RELEVANCE

Increased consideration of psychosocial and disease related aspects in dental care of AS patients appear recommendable.

Status and perception of oral health in 6-17-year-old psychiatric inpatients-randomized controlled trial

AIM

The following are the aims of the study: assessment of oral health status, oral health-related quality of life (OHRQoL) and the effect of oral health care training over OHRQoL in children and adolescents hospitalized with mental disorders.

METHODOLOGY

This randomized case controlled prospective interventional study involved 81 child and adolescent psychiatric inpatients (CAP) aged between 6 and 17 years (mean age 10.6 ± 2.4 years), compared to 81 mentally healthy patients attending routine dental examinations (DC group) matched according to age and sex of the CAP group. Oral examinations were performed by two calibrated dentists. OHRQoL was assessed with the German version of the Child Perceptions Questionnaire. CAP inpatients were randomly divided in two equal subgroups, an intervention (IG) and a non-intervention group (non-IG). The IG received oral health care training at admission to the hospital.

RESULTS

CAP inpatients, especially those with stress-related disorders, revealed significantly higher caries prevalence and experience than DC patients. Although OHRQoL did not differ from the German reference values, CAP inpatients compensated higher impairment due to oral symptoms and functional limitations with lower impairment due to emotional and social well-being. OHRQoL increased in all CAP patients during hospitalization, regardless of receiving oral health care training.

CONCLUSION

Poorer oral health of CAP inpatients was not accompanied by higher impairment of OHRQoL. Oral problems seem to be overshined by better self-perceived emotional and social well-being. OHRQoL was not improved by individualized oral health care training.

CLINICAL RELEVANCE

Children and adolescents with mental disorders are at risk for oral diseases and need referral to dental services.

Association among oral symptoms, oral health-related quality of life, and health-related quality of life in a sample of adults living with HIV/AIDS in Malaysia

Background

Health-related quality of life (HRQOL) is a multidimensional construct that refers to an individual’s self-perceived well-being. This study used the revised Wilson and Cleary HRQOL model to investigate the associations among oral symptoms, oral health-related quality of life (OHRQOL), and HRQOL of people living with HIV/AIDS (PLWHA) in Malaysia.

Methods

A total of 121 PLWHA receiving medical care in Kota Bharu (Kelantan, Malaysia) participated in this cross-sectional study. The Malay version of the short Oral Health Impact Profile (S-OHIP(M)) and the Malay version of the 36-item Medical Outcome Study Short Form (SF-36) were used to assess OHRQOL and HRQOL, respectively. A higher S-OHIP(M) score indicates greater oral impact and worse OHRQOL; a higher SF-36 score indicates better HRQOL. An additional structured self-administered questionnaire was used to obtain other variables of interest from the participants.

Results

Most participants had at least one oral symptom (69.4%), and the most common oral symptom was a cavitated tooth (55.4%). The prevalence of oral impacts was 33.9%, and the mean S-OHIP(M) score was 8.8 (SD = 7.92). The mean S-OHIP(M) score was significantly higher in participants who had toothaches, cavitated teeth, gum abscesses, and bad breath. In addition, participants with lower S-OHIP(M) scores had significantly higher scores in all SF-36 domains.

Conclusions

Our study provides evidence for an association among oral symptoms, OHRQOL, and HRQOL in PLWHA from Malaysia. In particular, the presence of oral symptoms was significantly associated with more severe oral impacts and poorer OHRQOL. The presence of less severe oral impacts was associated with a better HRQOL.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-017-0409-y) contains supplementary material, which is available to authorized users.

Location of implant-retained fixed dentures affects oral health-related quality of life

BACKGROUND

The effects of the locations of dental implants on treatment outcomes, as evaluated by oral health-related quality of life (OHRQoL) assessment, remain controversial.

PURPOSE

To investigate the association between the locations of dental implants and changes in OHRQoL.

MATERIALS AND METHODS

Sixty-eight subjects received implant treatment in the anterior or posterior region and completed the Oral Health Impact Profile (OHIP) questionnaire before and after treatment. Change in OHIP summary scores and the 4 dimension scores were calculated to evaluate the effects of implant treatment on OHRQoL.

RESULTS

The mean Oro-facial Appearance score for the anterior group was significantly higher than that for the posterior group (10.4 ± 5.1 and 7.2 ± 3.8, respectively; P ＝ .005; Effect size = 0.63) at baseline. All questionnaire scores were significantly improved following implant treatment in both groups, and no significant group differences were observed at follow-up. Regression analysis revealed a significant association between the locations of most anterior implants and changes in the Oro-facial Appearance score (adjusted R²  = 0.073; P = .015).

CONCLUSION

Our results suggest that the locations of dental implants influence OHRQoL impairments and improvements after treatment. This information might be useful in clinical decision-making.

Oral health-related quality of life in patients on chronic haemodialysis and after kidney transplantation

OBJECTIVES

The objective of the study was to evaluate oral health-related quality of life (OHRQoL) depending on dental and periodontal situation in patients on haemodialysis (HD) and after kidney transplantation (KTx) compared to healthy controls (HC).

SUBJECTS AND METHODS

OHRQoL was assessed using the German short form of Oral Health Impact Profile (OHIP G14). Dental health was estimated using the decayed, missing and filled teeth index (DMF-T). Periodontal health was classified as healthy/mild or moderate/severe periodontitis.

STATISTICAL ANALYSIS

Mann-Whitney U-test, Kruskal-Wallis test, chi-square test and Fisher's test.

RESULTS

Eighty-seven HD patients, 39 KTx patients and 91 HC were included. Significant differences in DMF-T, D-T, M-T and F-T scores were identified between groups (P < 0.001). The prevalence of moderate/severe periodontitis was significantly higher in the HD and KTx group compared to HC (P = 0.002). Differences in OHIP G14 between groups were neither clinical relevant nor statistically significant (P = 0.199). A significant effect of DMF-T (P = 0.012), M-T (P < 0.001) and periodontitis (P = 0.023) on the OHIP G14 scores was identified only in HC.

CONCLUSIONS

Improvement in dental care of HD and KTx patients is required. OHIP G14 values provide a subjectively considered low importance of oral health in HD and KTx patients, leading to need of motivation and sensitisation of these patients.

Impact of oral health on health-related quality of life: a cross-sectional study

Background

Despite the consensus regarding the existence of a relationship between “impacts on oral health” and “health-related quality of life”, this relationship, considering the latent nature of these variables, is still poorly investigated. Thus, we performed this study in order to determine the magnitude of the impacts of oral health, demographic and symptom/clinical variables on the health-related quality of life in a Brazilian sample of dental patients.

Methods

A total of 1,007 adult subjects enrolled in the School of Dentistry of São Paulo State University (UNESP) - Araraquara Campus for dentistry care between September/2012 and April/2013, participated. 72.4 % were female. The mean age was 45.7 (SD = 12.5) years. The Oral Health Impact Profile (OHIP-14) and the Short Form Health Survey (SF-36) were used. The demographic and symptom/clinical variables collected were gender, age, economic status, presence of pain and chronic disease. The impact of studied variables on health-related quality of life were evaluated with a structural equation model, considering the factor “Health” as the central construct. The fit of the model was first analyzed by the evaluation of the goodness of fit indices (χ²/df ≤ 2.0, CFI and TLI ≥ 0.90 and RMSEA < 0.10) and the evaluation of the variables’ impact over health-related quality of life was based on the statistical significance of causal paths (β), evaluated by z tests, for a significance level of 5 %.

Results

We observed adequate fit of the model to the data (χ²/df = 3.55; CFI = 0.95; TLI = 0.94; RMSEA = 0.05). The impacts on oral health explained 28.0 % of the variability of the health-related quality of life construct, while the total variance explained of the model was 39.0 %. For the demographic and symptom/clinical variables, only age, presence of pain and chronic disease showed significant impacts (p < 0.05).

Conclusion

The oral health, age, presence of pain and chronic disease of individuals had significant influence on health-related quality of life.