Changes in the Oral-Health-Related Quality of Life of Thai patients with oral lichen planus after topical corticosteroid treatment: a 1-month longitudinal study

BACKGROUND

Oral lichen planus (OLP) is a chronic inflammatory disease of the oral cavity that affects many patients' daily living activities. Topical corticosteroids are the first-line drug for treating OLP. The Oral Impact on Daily Performances index (OIDP) is an Oral-Health-Related Quality of Life (OHRQoL) measure developed to assess the ultimate impacts. The aims of this study were to evaluate the clinical, pain and OHRQoL responses after treating OLP patients with topical corticosteroids for 1 month, and secondly to assess the relationships of changes in the clinical sign score, pain score, and OHRQoL.

METHODS

Seventy-two OLP patients were treated by topical corticosteroids based on their dentists' clinical judgments. Clinical and patient-based outcomes were assessed at baseline and follow-up visit. The clinical outcomes were evaluated by the highest and total Thongprasom sign score. Patient-based outcomes were evaluated by numeric rating scale (NRS) and OIDP. The self-rated overall changes in quality of life during the 1-month treatment period using the Patient Global Impression of Change (PGIC) were also recorded at the follow-up visit.

RESULTS

This study comprised 59 women and 13 men. All clinical and patient-based outcomes were significantly reduced after 1-month treatment with topical corticosteroids (P < 0.01). The most commonly affected activities were Emotional stability, followed by Eating and Cleaning the oral cavity. Forty-six percent reported the same or up to moderately improved, while 54% had a greatly improved quality of life as assessed by PGIC. There were no significant differences in the improvement of clinical and patient-based outcomes between these groups. There were significant relationships between the differences in the highest Thongprasom sign score and the differences in total Thongprasom sign score (r = 0.293; P < 0.05), and the differences in total OIDP percentage score and the difference in pain score (r = 0.427; P < 0.001). The differences in the total Thongprasom sign score also significantly related to the difference in the total OIDP percentage score (r = 0.335; P < 0.01).

CONCLUSIONS

Topical corticosteroids were significantly effective after 1-month treatment of OLP based on the clinical and patient-based outcomes. The OHRQoL improvement was significantly related to the reductions in pain and clinical severity.

TRIAL REGISTRATION

The trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR 20221110001).

Impact of oral diseases on 12- and 15-year-old children's quality of life: condition-specific oral health related quality of life analysis

BACKGROUND

Oral diseases can affect children's quality of life. The aim of the present study was to assess the Condition-Specific (CS) impacts from oral diseases in 12- and 15-year-old Thai population using data from the two consecutive national oral health-related quality of life surveys.

METHODS

The oral health-related quality of life surveys were conducted for this study as a part of 6th and 7th national oral health survey. The study sample of 1,066 12- and 815 15-year-olds from 6th national oral health survey; and 556 12- and 351 15-year-olds from 7th national oral health survey were from Bangkok and four regions of Thailand. Oral impacts were assessed by the Child-Oral Impacts on Daily Performances index for 12- and Oral Impacts on Daily Performances index for 15-year-olds. The overall impacts and CS impacts attributed to oral diseases were calculated. The detailed characteristics of the CS impacts were analyzed. Cochran's Q test and McNemar's test were used to determine the difference between the proportions of CS impacts of caries, gingival diseases, oral lesions, and malocclusion.

RESULTS

CS impacts-caries were prevalent for both age, followed by gingival disease and oral lesions. CS impacts-caries were the highest in the intensity and extent for both age groups. CS impacts-caries were significantly higher than those of gingival diseases for eating, speaking, relaxing, emotional state, and studying. CS impacts-gingival disease was significantly higher than caries for cleaning in one survey.

CONCLUSIONS

CS impacts-caries were the most prevalent and severe among adolescent. Gingival disease was infrequently related to severe impacts on daily performances.

Thai version of shortened Oral Impact on Daily Performances index for evaluating oral lichen planus patients

BACKGROUND

Patients' perceptions and Oral Health-related Quality of life (OHRQoL) are important parts of dental treatment in all fields, including oral lichen planus (OLP) patients. A shortened version of the Oral Impact on Daily Performances (OIDP) might be more practical and feasible in clinical setting due to the busy nature of oral medicine clinics and staff availability to conduct the interview for data collection. The aim of the study was to develop a Thai version of shortened OIDP for assessing the OHRQoL in OLP patients.

METHODS

Two types of shortened OIDP versions were tested in 69 OLP patients, one comprising the most commonly interfered with daily performances (OIDP-3 and OIDP-2) and another comprising either the highest frequency (OIDP frequency) or severity score (OIDP severity). The Numeric Rating Scale (NRS) and Thongprasom sign score were used to assess oral pain and clinical severity. Spearman rank-order correlation coefficients (r_s) were used to demonstrate the associations between the shortened and original OIDP, pain, and clinical severity.

RESULTS

OIDP-3 (Eating, Cleaning, and Emotional stability) and OIDP-2 (Eating and Emotional stability) were developed. The associations of the original OIDP with OIDP-3 and OIDP-2 (r_s = 0.965 and 0.911) were significantly higher than those of the original OIDP with OIDP frequency and OIDP severity (r_s = 0.768 and 0.880). The original OIDP, OIDP-3, and OIDP-2 were more significantly associated with pain compared with OIDP frequency and OIDP severity. The association between the clinical severity and oral impacts assessed by the original OIDP, OIDP-3, and OIDP-2 were similar and had higher correlation coefficients compared with those of OIDP frequency and OIDP severity.

CONCLUSION

OIDP-3 and OIDP-2 performed more similarly to the original OIDP than OIDP frequency and OIDP severity in assessing the OHRQoL of OLP patients.

TRIAL REGISTRATION

The trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR 20190828002).

Social backgrounds, oral behaviors and dental service utilization among Thai older adults: data from the national oral health survey

Purpose

The number of older adults in Thailand is currently increasing. To create the appropriate oral health service for this age group requires an understanding of the factors that are associated with their dental service utilization. This study aimed to determine the associations between social backgrounds, oral behaviors and dental service utilization among Thai older adults.

Design/methodology/approach

This was a cross-sectional study on a representative sample of older adults in the 8th Thai National Oral Health Survey (TNOHS). Data of 4,130 Thai older adults were collected through interviews. The association between social backgrounds, oral behaviors and dental service utilization were investigated using chi-square and logistic regression models.

Findings

Of the older adults aged 60–74 years old, 38.4% had used dental services in the last 12 months. Smokers used dental services the least (32.1%). Location, income, education and social welfare were significantly associated with dental service utilization. Among the oral behaviors evaluated, smoking was significantly associated with low dental service utilization.

Originality/value

Thai older adults with a poor social background including location, income, education, entitlement to the Universal Coverage Scheme (UCS) and smoking made less use of dental services.

Condition-Specific Oral Health Impacts in Thai Children and Adolescents: Findings From the National Oral Health-Related Quality of Life Survey

This study was a part of the 7th National Oral Health Survey of Thailand and aimed to assess overall and condition-specific oral health-related quality of life of 12 and 15 year olds. Oral impacts were assessed using the Child-Oral Impacts on Daily Performances Index for 12 year olds and the Oral Impacts on Daily Performances index for 15 year olds. Overall oral impacts and condition-specific oral impacts (CS-impacts) were calculated. Detailed characteristics of CS-impacts were analyzed. Seventy-five percent of 12 year olds and 70.1% of 15 year olds had one or more oral impacts. CS-impacts attributed to dental caries were 37.8% and 36.5% for 12 and 15 year olds, respectively, followed by CS-impacts attributed to periodontal diseases and oral lesions. Dental caries was the most important cause of oral impacts. The severe impacts on daily performances of 12 year olds were mainly caused by dental caries, while those of 15 year olds related to dental caries and oral lesions. The majority of Thai children and adolescents experienced oral impacts. CS-impacts attributed to dental caries were most prevalent and most severe.

The Associations of School Oral Health-Related Environments with Oral Health Behaviours and Dental Caries in Children

Creating supportive oral health-related environments in schools is an important strategy for promoting schoolchildren’s oral health. This study determined the associations between school environments and children’s oral behaviour and dental caries. The data on school oral health-related environments were obtained through observation and interviews. Oral behaviour and dental caries data were collected through interviews and oral examinations of 984 sixth grade children. χ2 and multiple logistic regression, adjusted for sociodemographic and economic status, other school environment variables, and oral behaviour were used. Providing fresh fruit with school meals was associated with low sweets consumption and low caries levels. Children’s daily sweets consumption was positively associated with sweetened milk sales in schools. Selling sweetened beverages, including sweetened milk, sweetened drinks, and soft drinks, was associated with high caries levels, while selling meat and crispy packed snacks was associated with low caries levels. Children in schools with integrated oral health education were significantly more likely to brush their teeth twice a day and to brush after lunch. In conclusion, school oral health-related environments, especially available food choices, were associated with sweets consumption behaviour and caries levels. Children in schools with integrated oral health education had better brushing habits.

Which aspects of an oral health-related quality of life measure are mainly associated with global ratings of oral health in children?

OBJECTIVES

To assess the associations of global subjective ratings of oral health with different aspects of an oral health-related quality of life measure, namely total Oral Impacts on Daily Performances (OIDP) and Child-Oral Impacts on Daily Performances (Child-OIDP) scores, extent and intensity of oral impacts, the different performance scores and oral impacts attributed to certain groups of oral conditions.

METHODS

This study was part of the Sixth Thailand National Oral Health Survey. One thousand and sixty-six 12-year-olds and 815 15-year-olds were interviewed on their OHRQoL using Child-OIDP and OIDP indices, respectively, and rated their overall oral problems on 3-point and 5-point scales, respectively. Associations of global rating of oral health with different Child-OIDP/OIDP outcome variables were estimated using Spearman's rank correlations and logistic regressions.

RESULTS

Child-OIDP/OIDP scores were significantly associated with global ratings. Intensity was associated with global ratings, whereas extent was not. Impacts of 'very little' intensity were associated with a slightly higher chance of having poorer oral health perceptions. Global ratings were associated most with oral impacts attributed to dental caries, but not with the impacts related to natural process, such as eruption. Eating, cleaning teeth, emotional stability and smiling, plus social contact in 15-year-olds were performances associated with global ratings. Fifteen-year-old girls were more likely to perceive more oral problems than boys.

CONCLUSIONS

Associations of global ratings of oral health with Child-OIDP/OIDP scores were mainly due to the intensity of impacts. Global ratings were related to multidimensional aspects of children's quality of life.

Sociodemographic differences in oral health-related quality of life related to dental caries in thai school children

OBJECTIVE

This study aimed to assess associations between sociodemographic and oral health behavioural factors with dental caries and oral health-related quality of life (OHRQoL) attributed to dental caries in a national representative sample of 12- and 15-year-old Thai children.

METHOD

A representative subsample from the sixth Thailand National Oral Health Survey, 1,063 12-year-olds and 811 15-year-olds, completed a questionnaire on sociodemographic and behavioural information and were orally examined and interviewed about OHRQoL using the Child-OIDP or OIDP indexes. Associations of sociodemographic and behavioural factors with DMFT and Condition-Specific impacts (CS-impacts) attributed to dental caries were investigated using Chi-square tests and regressions.

RESULTS

For both groups, DMFT scores were associated with gender, geographic area and recently receiving dental treatment. Geographic area was the only sociobehavioural factor independently associated with CS-impacts. Dental caries accounted for the significant associations of sugary snacks and drinks consumption with CS-impacts. Significant associations of CS-impacts with consuming crispy snacks in 12-year-olds and fizzy drinks in 15-year-olds became non-significant when DT was entered into models.

CONCLUSIONS

There were considerable geographic differences in DMFT and CS-impacts attributed to dental caries among Thai children.

Impacts on quality of life related to dental caries in a national representative sample of Thai 12- and 15-year-olds

Dental caries is generally given the highest priority in national oral health services for school-aged populations. Yet, there is no study exploring the impacts on quality of life specifically related to dental caries in national samples of school-aged children. This study assessed prevalence and characteristics of oral impacts attributed to dental caries on quality of life and compared them with overall oral health impacts. In addition, associations of oral impacts attributed to dental caries and dental caries status were investigated. A national representative sample of 1,063 12- and 811 15-year-olds completed a sociodemographic and behavioural questionnaire, and were orally examined and interviewed about oral health-related quality of life using the Child-OIDP or OIDP indexes, respectively. Associations of condition-specific impacts (CS impacts) attributed to dental caries with components of DMF were investigated using χ(2) tests and multivariate logistic regressions. CS impacts attributed to dental caries were reported by nearly half the children and such impacts accounted for half of overall oral impacts from all oral conditions. The majority of impacts were of little intensity and affected only 1-2 daily performances, particularly performances on Eating, Emotional stability and Cleaning teeth. CS impacts were significantly positively associated with number of decayed teeth, and strongly associated with severe decay.

Setting oral health goals that include oral health-related quality of life measures: a study carried out among adolescents in Thailand

The aim of this study was to assess the association between oral diseases and condition-specific oral health-related quality of life (CS-OHRQoL) as a basis for proposing OHRQoL-based goals for the population of 15-year-olds in Thailand. Oral examinations and OHRQoL interviews were conducted with 871 15-year-olds as part of the Sixth Thailand National Oral Health Survey. The severity of oral impacts was categorized using "intensity". Associations between oral diseases and CS-OHRQoL were analyzed using chi-square and logistic regression. Thirty-nine percent of 15-year-olds experienced moderate/higher levels oral impacts on quality of life. Compared to those individuals with no tooth decay, adolescents with one or four or more decaying teeth were three and seven times more likely to experience moderate/higher impacts, respectively. Adolescents with extensive gingivitis in 3 or more mouth sextants were twice as likely to experience moderate/higher CS-impacts. Based on these findings, it is proposed that goals should focus on untreated decaying teeth and extensive gingivitis. Oral health goals for 15-year-olds should include specific OHRQoL measures.

Relationships between oral diseases and impacts on Thai schoolchildren's quality of life: evidence from a Thai national oral health survey of 12- and 15-year-olds

OBJECTIVES

To assess the associations between oral disease and oral health-related quality of life (OHRQoL) in a nationally representative sample of 12- and 15-year-old Thai populations.

METHODS

The study was part of Thailand National Oral Health Survey. Data on oral diseases using WHO criteria and OHRQoL using the Child-Oral Impacts on Daily Performances (Child-OIDP) for 12-year-olds and Oral Impacts on Daily Performances (OIDP) indexes for 15-year-olds were collected from 1063 12-year-olds and 811 15-year-olds. The associations of oral diseases and OHRQoL and perceived dental need were investigated using logistic regression models.

RESULTS

Of 81.7% of 12-year-olds and 83.2% of 15-year-olds had impacts on OHRQoL. For both age groups, gingivitis was the most common oral disease (79.3% in 12-year-olds, 81.5% in 15-year-olds). Oral impacts were significantly associated with high levels of untreated decay. Perceived dental needs were significantly associated with untreated decay and extensive gingivitis for both age groups, and with calculus for 12-year-olds. Having decayed teeth was statistically associated with impacts on relaxing, emotion and study for both age groups. Gingivitis and calculus were significantly associated with impacts on smiling, study and social contact in 12-year-olds, and with impacts on smiling in 15-year-olds.

CONCLUSIONS

Gingivitis was the most common oral disease whereas dental caries affected children's quality of life most. Dental caries impacted on various daily life performances while gingivitis and calculus related to psychosocial aspects in 12-year-olds.

Disparities in early childhood caries and its impact on oral health-related quality of life of preschool children

This study aimed to investigate the caries experience and its impact on preschool children's quality of life and the associations between these outcomes and underlying determinants. A survey was conducted on 5- to 6-year-old children (503 in all) in Bangkok who were orally examined and interviewed on their oral health-related quality of life (OHRQoL). In addition, behavioral questionnaires were sent to parents. Associations between determinants and oral health outcomes were tested through logistic regression. It was found that 28% of children experienced high-level impacts on quality of life, mostly dental pain (58.3%) and eating difficulties (45.9%). Children of low socioeconomic status were more likely to have a high level of dental caries and subsequent OHRQoL impact. Oral status was related to oral behaviors and OHRQoL. Social disparities in preschool children's OHRQoL were identified.

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

OBJECTIVE

To assess the prevalence and characteristics of oral impacts on daily life, and the relationship between certain dental conditions and impacts attributed to them, in a nationally representative population of Thai school children aged 12 and 15 years.

METHODS

A cross-sectional study on a representative sample of children in Sixth Thailand National Oral Health Survey. Sample included half the children aged 12- and 15-year-old selected in Bangkok and all participants in 8 of 16 provinces included in national survey. Children were individually interviewed using the Child-OIDP (12-year-old) and OIDP indices (15-year-old), and two questions for overall subjective assessments.

RESULTS

A total of 1066 12-year-olds and 815 15-year-olds were interviewed. Some 85.2% of 12-year-olds reported experiencing oral impacts during the past 3 months. Child-OIDP scores ranged from 0 to 68.0 (mean = 7.83, SD = 7.8). Eating was the most commonly affected performance (64.4%), followed by cleaning teeth (51.7%) and maintaining emotional state (49.1%). Among 15-year-old children, 83.3% had oral impacts during the past 6 months. OIDP scores ranged from 0 to 39.5 (mean = 5.47, SD = 6.0). The three most commonly affected performances were eating (64.0%), cleaning teeth (55.3%) and maintaining emotional state (53.1%). Toothache and oral ulcers were the two most important perceived causes in 12-year-olds. Impacts from toothache were the most prevalent (39.2%) and had a condition-specific (CS) Child-OIDP score of 7.0, while oral ulcers affected 24.7% of children; mean CS-score of 8.0. Among 15-year-olds, oral ulcers ranked first in terms of both prevalence (36.2%) and CS-score (6.0), followed by toothache (prevalence 33.9% and CS-score 5.0). For both age groups, problems with gums were of less concern.

CONCLUSIONS

Oral impacts were common but not severe in Thai children and adolescents. For both age groups, impacts were mostly on eating performance; toothache and oral ulcers were the two important perceived causes reflecting needs for oral health promotion and treatment of dental caries and oral ulcers.