Relation between clinical dental status and subjective impacts on daily living

Satisfaction with appearance and the desired treatment to improve aesthetics

Objective. To identify participants' satisfaction with appearance and the desired treatment to improve aesthetics. Materials and Methods. 220 participants (127 males and 93 females, mean age = 21.4 ± 1.5 years) were recruited into the study. A structured questionnaire was used to assess patients' satisfaction with appearance and what treatment they desire to improve aesthetics. Participants scored the level of satisfaction with appearance using visual analogue scale. Results. The VAS mean score of satisfaction with general appearance was 6.8 ± 2.3. Half participants were dissatisfied with tooth appearance and 65.9% were dissatisfied with tooth colour. Higher VAS scores were associated with higher desire for all treatments that improve tooth appearance (P < .05). Dissatisfaction with tooth appearance increased with increased dissatisfaction with teeth colour, feeling of poor tooth alignment, presence of fractured anterior teeth, and increased desire for orthodontic, crowns, and dentures treatments (P < .05). Dissatisfaction with tooth colour was associated with increased desire for tooth whitening and tooth coloured fillings (P < .05). Conclusions. Participants had high levels of dissatisfaction with tooth appearance and tooth colour. Dissatisfaction with tooth colour contributed to the increased dissatisfaction with tooth appearance. Dissatisfaction with tooth appearance, colour, alignment, and condition was significantly related to high desire for aesthetic treatments.

[Self-perceived oral health among elderly individuals in a medium-sized city in Northeast Brazil]

This study focused on self-perceived oral health of the elderly and associated variables. The sample consisted of 321 functionally independent individuals 60 years or older living in Parnaíba, Piauí State, Brazil. Oral examinations were performed and questionnaires were applied during home visits. The elderly presented poor oral health, with mean DMFT 29.41 (SD = 4.10). However, their self-perceived oral health was positive, with 52% showing high scores according to the Geriatric Oral Health Assessment Index (GOHAI). Multivariate analysis showed that predictors of self-perceived oral health included the need for upper prostheses, oral mucosal lesions, and self-rated oral health. The most important predictor was self-rated oral health, with a weight of 20% variation in self-perceived oral health. In conclusion, subjective measurement of oral health in the elderly is less associated with their actual clinical status and more with other subjective factors.

Predictive value of dental readiness and psychological dimensions for oral health-related quality of life in Croatian soldiers: a cross-sectional study

Aim

To determine the predictive value of dental readiness and psychological dimensions for oral health-related quality of life (OHRQoL) in Croatian soldiers.

Methods

The sample consisted of 402 consecutive soldiers aged 21 to 54 years classified into the following groups according to dental readiness: Class 1 – not requiring dental treatment (N = 54), Class 2 – unlikely to need emergency treatment within 12 months (N = 205), and Class 3 – very likely to need treatment within 12 months (N = 143). OHRQoL was assessed by the Oral Health Impact Profile and psychological dimensions by the Brief Symptom Inventory and Dental Anxiety Scale.

Results

Multivariate analysis showed that Class 3 soldiers had higher frequency of psychological discomfort, psychological disability, and physical pain and handicap than Class 1 soldiers (P = 0.019). Multiple linear regression showed that longer military experience, higher level of dental anxiety, and dental unreadiness were significant predictors of lower OHRQoL (P < 0.050) but accounted for low variability. None of the single psychological symptomatic dimensions was a significant predictor of OHRQoL.

Conclusion

Although this study found a moderate association between OHRQoL and clinical, military, demographic, and psychological variables, the significant predictors could be used as a basis for further research of clinical and psychosocial factors of OHRQoL.

A computer-based readability analysis of patient-reported outcome questionnaires related to oral health quality of life

OBJECTIVE

The purpose of this study was to examine the readability of published patient-related outcome (PRO) questionnaires completed by persons with oral disease and to compare the readability results to existing data about average reading levels for adults living in the United States.

METHODS

A search was conducted via Pubmed and Google Scholar to identify PRO oral health-related questionnaires completed by patients. Reading grade levels were analyzed for 10 oral health-related PRO questionnaires using three readability formulas.

RESULTS

The most significant results were as follows:

CONCLUSION

Developers of PRO questionnaires should consider readability as another testable construct.

PRACTICE IMPLICATIONS

To obtain the most useful information for treatment planning and outcomes assessments, the dental professional should consider the reading level needed to understand a particular PRO questionnaire.

The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life

Background

The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL).

Methods

A sample of 515 schoolchildren, aged 12 years was randomly selected by conglomerate analysis from public and private schools in the city of Juiz de Fora, Brazil. The schoolchildren were clinically examined for presence of caries lesions (DMFT and dmft index), dental trauma, enamel defects, periodontal status (presence/absence of bleeding), dental treatment and orthodontic treatment needs (DAI). The SiC index was calculated. The participants were asked to complete the Brazilian version of Child Perceptions Questionnaire (CPQ_11-14) and a questionnaire about home environment. Questions were asked about the presence of general diseases and children's self-perception of their general and oral health status. In addition, a questionnaire was sent to their parents inquiring about their socioeconomic status (family income, parents' education level, home ownership) and perceptions about the general and oral health of their school-aged children. The chi-square test was used for comparisons between proportions. Poisson's regression was used for multivariate analysis with adjustment for variances.

Results

Univariate analysis revealed that school type, monthly family income, mother's education, family structure, number of siblings, use of cigarettes, alcohol and drugs in the family, parents' perception of oral health of schoolchildren, schoolchildren's self perception their general and oral health, orthodontic treatment needs were significantly associated with poor OHRQoL (p < 0.001). After adjusting for potential confounders, variables were included in a Multivariate Poisson regression. It was found that the variables children's self perception of their oral health status, monthly family income, gender, orthodontic treatment need, mother's education, number of siblings, and household overcrowding showed a strong negative effect on oral health-related quality of life.

Conclusions

It was concluded that the clinical, socioeconomic and home environment factors evaluated exerted a negative impact on the oral health-related quality of life of schoolchildren, demonstrating the importance of health managers addressing all these factors when planning oral health promotion interventions for this population.

Quality of life related to oral health: contribution from social factors

Sociodental indicators have been widely used in epidemiological research related to oral health, as they add the dimension of the impact of oral health on the quality of life of individuals and populations. Various studies have been done in order to validate new instruments to assess these subjective perceptions, however, the association between social parameters and impact on oral health-related quality of life (OHRQoL) has not been systematically studied, thus there is still doubt as to the role of the main social variables as OHRQoL impact modulators. This study aims to systematically review the literature in order to evidence the association between six social parameters and OHRQoL. Based on six exclusion criteria, the literature search revealed 40 eligible publications for analyses. The frequency of expected (positive) association between the social parameters and OHRQoL was greater than the non-expected (negative) associations for the six parameters.

CONCLUSIONS

The social conditions most clearly associated with the perception of negative impact on OHRQoL were: women, with poor education and low income, immigrants or people belonging to minority ethnic groups.

Relationship between impacts of complete denture treatment on daily living, satisfaction and personality profiles

OBJECTIVES

To investigate the association between satisfaction with conventional complete denture prostheses (CDs), impacts of CDs on daily living and personality profiles.

MATERIALS AND METHODS

Fifty-six patients (28 males and 28 females; mean age 53.79 ± 7.762 years) with fitted upper and lower removable CDs were recruited for this study. Clinical success of CDs was assessed according to specific clinical criteria. The dental impact on daily living questionnaire (DIDL) was used to measure satisfaction with CDs and their impacts on daily living. NEO five factor inventory (NEO - FFI) was used to measure patients' personality profiles. Pearson correlation test and regression models were used to analyze the collected data.

RESULTS

Females were more satisfied with appearance and less satisfied with eating and scored higher on neuroticism, and lower on extraversion and openness personality domains (p < 0.05). Older patients were more satisfied with appearance and less satisfied with oral comfort and general performance (p < 0.05). Neuroticism, extraversion, openness and agreeableness personality profiles could predict and had significant relationship with CDs impacts on daily living and satisfaction with CDs.

CONCLUSION

Psychological profiles (e.g. neuroticism, extraversion, openness and agreeableness) might play a role and explain CDs impacts on daily living and patients' satisfaction with their oral status and CD treatment, therefore, might be used to predict satisfactory outcomes of CD treatment. In this regard, technical aspects of CDs are less essential when the prosthesis is clinically successful.

CLINICAL SIGNIFICANCE

Psychological factors may play a role and also provide valuable information for the prediction of satisfactory outcomes of complete denture treatment.

Relationship between personality and impacts of implant treatment on daily living

PURPOSE

The objective of this study was to investigate the relationship between satisfaction with implant-supported fixed rehabilitations (ISFPR), their impacts on daily living, and personality profiles.

MATERIALS AND METHODS

Fifty patients (15 men and 35 women; mean age 44.3 ± 9 years), with fitted ISFPR, and 50 partially dentate controls matched with age and gender participated in this study. A Dental Impact on Daily Living questionnaire was used to assess dental satisfaction and impacts of ISFPR on daily living. NEO Five Factor inventory was used to assess participants' personality profiles. Pearson correlation, analysis of variance, and linear regression tests were used for statistical analysis of the data.

RESULTS

Patients with ISFPR were more satisfied with their dentition than controls (p < .05). Patients and controls demonstrated different relationships between personality, impacts on daily living, and satisfaction. Neuroticism, extraversion, and conscientiousness had significant relationships with satisfaction and impacts on daily living in both groups (p < .05). Openness and agreeableness had significant relationships with satisfaction and impacts on daily living in patients' group (p < .05).

CONCLUSION

ISFPR had positive impacts on participants' daily living and dental satisfaction. Personality traits (neuroticism, extraversion, openness, agreeableness, and consciousness) impact on daily living and satisfaction with ISFPR, and might predict satisfaction with ISFPR and their impacts on daily living.

Indicadores de qualidade de vida e sua importância na Ortodontia

OBJETIVOS: o objetivo desse estudo foi buscar na literatura informações consistentes sobre a qualidade de vida relacionada à saúde bucal, permitindo aos clínicos acessar e compreender sua influência no processo de busca e tratamento de seus pacientes. MÉTODOS: foram pesquisadas as bases de dados eletrônicas MEDLINE, LILACS, BBO e Cochrane Controlled Trials, entre 1980 e 2010. Foram encontrados 158 estudos que discutiam a qualidade de vida relacionada à saúde bucal. RESULTADOS: foram selecionados 30 estudos, sendo dois prospectivos longitudinais, duas revisões sistemáticas, cinco casos-controle, doze estudos epidemiológicos, cinco estudos transversais e três revisões de literatura, além da declaração da Organização Mundial da Saúde. A seleção baseou-se no objetivo de descrever os indicadores de qualidade de vida, e na metodologia utilizada nos estudos. CONCLUSÕES: o uso de indicadores de qualidade de vida na pesquisa odontológica e na clínica ortodôntica é de grande importância e auxílio no diagnóstico e planejamento; todavia, esses não substituem os índices normativos, devendo ser usados em caráter complementar

Tooth loss and oral health-related quality of life: a systematic review and meta-analysis

BACKGROUND

It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this.

METHODS

Relevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only.

RESULTS

From a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts κ = 0.84 ± 0.03; full-texts: κ = 0.68 ± 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss.

CONCLUSIONS

This study provides fairly strong evidence that tooth loss is associated with impairment of OHRQoL and location and distribution of tooth loss affect the severity of the impairment. This association seems to be independent from the OHRQoL instrument used and context of the included samples.

Relationship between dental status and Oral Impacts on Daily Performances in older Southern Chinese people

OBJECTIVE

The objective of this study was to assess the relationship between different clinical indicators of dental status and an Oral Health-Related Quality of Life (OHRQoL) measure, the Oral Impacts on Daily Performances (OIDP) index, using different scoring formats, among older Southern Chinese people.

METHODS

A total of 1,196 dentate people aged 55 years and older, attending routine annual health checkups at Guangxi Medical University Hospital Health Centre in Guangxi, China, participated in the study. They had a face-to-face structured interview and a clinical dental examination. The OIDP index was used to assess the impacts of oral conditions on quality of life. Spearman and Pearson as well as partial correlation coefficients were used to assess, respectively, the unadjusted and adjusted associations of 14 clinical indicators with the overall OIDP score, OIDP intensity, and OIDP extent.

RESULTS

All clinical indicators, except number of filled teeth, were significantly correlated with the OIDP index, after controlling for covariates. However, correlations were weak, ranging between 0.07 and 0.26. The strongest correlation was for the relationship between the number of natural plus replaced teeth and the OIDP index, irrespective of whether the overall OIDP score, OIDP intensity, or OIDP extent was used to measure OHRQoL.

CONCLUSIONS

Clinical dental status indicators were related to OIDP, regardless of the scoring format used to calculate the OIDP index. Clinical indicators that included natural plus replaced teeth were more strongly associated with the OIDP index than their corresponding indicators that included only natural teeth.

[Impact of the existing tooth number on daily performance: pilot study]

To establish the relation between the aspects associated to the number of the teeth and the impact on daily performance it was realized a pilot study with 75 voluntary patients that had been divided in three groups: short arch, complete and toothless. To evaluate the impact the IODD was used (Index of the Oral Impacts on Daily Performance). The results had evidenced that 16% of the participants had at least one daily activity affected. Although it have not been registered significant difference between the groups in relation to each one of the activities, the percentage that the complete arch group was less affected with the activity: to chew, to speak/to pronounce words and to smile clearly, on the other hand the activities that had less affected the toothless group were: to clean the mouth/teeth and to sleep. In relation to the mean of the IODD, that was lower in the group with complete arc and it was similar between the others two groups. The means of the variables: frequency and severity of the impacts were less in the group with the complete arch and had values approached in the others two groups. Based on the results, could be concluded that no significant differences were registered between the groups in relation to each one of the affected daily activities.

Relationship between oral clinical conditions and daily performances

The aim of this study was to assess the impact of oral status on the daily performances of civil servants from the Public Works and Waste Management Department of the city of Porto Alegre, located in Southern Brazil. A cross-sectional study was conducted on a representative sample composed of 276 civil servants with ages ranging from 35 to 44 years. The Oral Impacts on Daily Performances index developed was employed to measure impacts caused by oral clinical conditions. Oral examinations were performed after the interviews. Multinomial Logistic Regression Analysis was used. After adjusting for sex and educational level, the results showed that the subjects with high DMFT scores were 5.8 times (95% CI = 2.1-16.1) more likely to have high impacts on their everyday life than those with low DMFT scores. Subjects that presented some coronal caries were 4.3 times (95% CI = 1.9-9.8) more likely to have high impacts on their everyday life than those with no coronal caries. Dental status assessed through the DMFT index and coronal caries are important indicators of impacts on the everyday life of the studied population.

Cynical hostility as a determinant of poor oral health status in an adult population

Our aim in this study was to determine whether there is an association between cynical hostility and clinically determined poor oral health, and whether this association is confounded by socioeconomic position and mediated by health behavior. The sample consisted of 4,207 dentate Finns, 30-64 yr of age. Oral health was measured in terms of numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets (> or = 4 mm). Cynical hostility was measured using the cynical distrust self-administered questionnaire. The subjects with the highest level of cynical hostility had fewer teeth, and a greater number of decayed teeth as well as teeth with deepened periodontal pockets compared to subjects with the lowest level of cynical hostility. The associations between cynical hostility and number of missing and decayed teeth were clearly confounded by level of education. Poor oral health behavior was shown to be a possible mediator between cynical hostility and number of decayed teeth, but not of missing teeth or teeth with deepened periodontal pockets. General health-related behavior did not serve as a possible mediator in any of the associations. In conclusion, cynical hostility can be considered as a risk marker for poor oral health. Interventions aimed to improve oral health should focus on psychosocial factors and on less-educated subjects.

Oral health-related quality of life and its relationship with health locus of control among Indian dental university students

OBJECTIVES

The objectives of this study were to assess the relationship between Oral Health-Related Quality of Life (OHRQoL) and Health Locus of Control (HLC) among students in an Indian dental school.

MATERIALS AND METHODS

A cross sectional study design was used. Three hundred and twenty-five dental students returned completed forms containing the 14 item Oral Health Impact Profile (OHIP-14) and the 18 item Multidimensional Health Locus of Control Scale (MHLC).

RESULTS

The results showed that the perceived OHRQoL differed among students studying in different stages of the dental course. The OHRQoL dimensions of 'Social Handicap' and 'Handicap' were significantly (P < 0.01) lower among the later years of the course than the freshman year students. There was a sharp increase in Self-reported dental problems, in particular, Malocclusion, Tooth decay, Calculus among the third year and final year students respectively. The OHIP-14 scores were significantly higher among those with self-reported oral problems. Correlation analysis between the OHIP-14 and the MHLC scores also showed a statistically significant (P < 0.01) correlation between the 'Chance' dimension of the MHLC and OHIP-14 scores.

CONCLUSIONS

The results of this study underscored the relationship between the OHRQoL and HLC and of importance of assessing health attitudes and their impact on OHRQoL among the dental student community.

Time absent from school due to dental conditions and dental care in Thai schoolchildren

OBJECTIVES

To assess the number of school hours missed for dental reasons per 1,000 grade 5 primary school children in 1 school year and compare dentally related school absences with those related to medical and social reasons.

METHODS

A longitudinal study using a multistage sampling technique was carried out on a sample of 1,211 children attending schools in Lampang province, Thailand. Data on absence were collected from daily school attendance records for 1 year and from children and parents questionnaires and school dental clinic records. Clinical examinations were done using the World Health Organization criteria.

RESULTS

A total of 1,158 children (response rate: 95.7 percent) aged 9 to 13 years were examined and returned completed questionnaires. Their caries level was relatively low (DMFT 1.4 +/- 1.7). The children (22.5 percent) reported school absence for any dental reason. The mean number of hours of school absence per year for dental care was 434 hours per 1,000 children (613 hours per 1,000 children when dental screening was included). Among those who actually missed school for dental reasons, the numbers of hours missed were 1,923 hours per 1,000 children.

CONCLUSIONS

The level of school absence for dental-related conditions and care was low per child but cumulatively was considerable. The time missed because of dental reasons was substantially less than the time missed because of other health and social reasons.

Idosos vivendo na comunidade e a satisfação com a própria saúde bucal

O presente estudo, de abordagem quali-quantitativa, objetiva levantar a satisfação de idosos em relação à saúde bucal, observar variáveis associadas e aspectos necessários para se sentirem satisfeitos com a saúde bucal. Foram aplicadas entrevistas domiciliares em 261 idosos (Ribeirão Preto/SP), os quais representavam a população de idosos cadastrados em um Núcleo de Saúde da Família. Foi elaborado um questionário semi-estruturado abordando as variáveis sexo, idade, escolaridade, autonomia financeira, quantidade de dentes e uso de prótese. A análise dos dados se baseou em associações estatísticas e análise de conteúdo. Observou-se que 49,2% dos desdentados totais estavam satisfeitos, sendo que 73,9% dos insatisfeitos eram idosos-jovens (60-69 anos). Houve associação estatisticamente significante entre escolaridade e satisfação (p=0,009), onde 76,0% dos idosos com baixa escolaridade relataram estar insatisfeitos com a própria saúde bucal. Os insatisfeitos relataram diversas situações em que se sentiriam satisfeitos. A situação mais representativa esteve associada às queixas relatadas no momento da entrevista, como solucionar o desconforto causado pelas próteses bucais. Concluiu-se que a maioria dos idosos estava satisfeita, porém quanto maior a idade e menor a escolaridade, menor foi o número de insatisfeitos.

Saúde bucal e o desempenho diário de adultos em Chapecó, Santa Catarina, Brasil

O uso de indicadores subjetivos na odontologia vem se ampliando. Este estudo transversal de base populacional realizado em Chapecó, Santa Catarina, Brasil, analisou a relação entre condição bucal e qualidade de vida em adultos de 35 a 44 anos de idade (n = 622) e verificou a influência de: hábitos, visita ao dentista, auto-avaliação da saúde e características sócio-demográficas nesse processo. Usou-se uma amostra selecionada em múltiplos estágios e coleta com profissionais previamente treinados. A proporção de respostas foi de 81%. Na análise dos fatores determinantes para baixa (Oral Impact on Daily Performance - OIDP < 3) e alta (OIDP > 10) interferência da saúde bucal no cotidiano, utilizou-se modelo de regressão logística múltipla, não condicional, hierarquizada. A saúde bucal interferiu no cotidiano de 20,7% dos participantes e foi mais grave em 11,4%. Morar em domicílios de maior aglomeração e áreas de pior condição de vida, ser mulher e sentir dor orofacial no último semestre compuseram fatores associados a maior interferência. É recomendável que a percepção dos indivíduos seja considerada simultaneamente à condição clínica na definição de ações dos serviços e de grupos prioritários ao atendimento em saúde bucal.

What dentition assures oral function?

OBJECTIVE

To evaluate the relationship between dentition and oral function.

MATERIAL AND METHODS

A search of the English literature was undertaken using PubMed and appropriate keywords. Citations were identified and hand sorted to confirm their validity against our inclusion criteria. Four specific areas of oral function were addressed; (I) masticatory function, (II) aesthetics, satisfaction and psychosocial ability, (III) occlusal support and stability and (IV) other functionality including tactile perception, phonetics and taste.

RESULTS

From an initial pool of 1460 citations, 83 articles met the inclusion criteria. These were summarized and relevant data extracted for incorporation into the review. Masticatory efficiency (assessed as comminution efficiency) and masticatory ability (self-reported) are both linked to the number of teeth. A minimum of 20 teeth with nine to 10 pairs of contacting units (including anterior teeth) is associated with adequate efficiency and ability. Tooth numbers below that level yield impaired masticatory efficiency and are likely to result in reduction in reported masticatory ability. Aesthetics and satisfaction are markedly impaired with loss of anterior teeth. Satisfaction is most likely to be achieved in people who also retain a premolar dentition. Further, there is little increase in satisfaction seen in subjects who retained molar teeth. However, there are marked variations in subjective measures of aesthetics and psychosocial comfort between age groups, social classes, cultures, regions and countries. For most people, occlusal support and stability are obtained with three to four functional posterior units with a symmetrical pattern of tooth loss or five to six units with an asymmetrical pattern. There was no relationship between occlusal factors and symptoms of temporomandibular dysfunction. Phonetics may be maintained even with large anterior restorations. Patients generally attribute a low significance to phonetics, tactile perception and taste compared with mastication and appearance.

CONCLUSIONS

The World Health Organization goal for the year 2000, namely to maintain a natural dentition of not less than 20 teeth throughout life, is substantiated by the current literature review as this proposed dentition will assure an acceptable level of oral function.

Reproducibility and validity of self-perceived oral health conditions

The reproducibility and validity of self-perceived periodontal, dental, and temporomandibular joint (TMJ) conditions were investigated. A questionnaire was applied in interview to 200 adults aged from 35 to 44, who were attending as casual patients at Araraquara School of Dentistry, São Paulo State University, São Paulo, Brazil. Clinical examination was based on the guidelines of the World Health Organization manual. The interview and the clinical examination were performed in two occasions, by a calibrated examiner. Reproducibility and validity were, respectively, verified by kappa statistics (kappa) and sensitivity (Sen) and specificity (Spec) values, having clinical examination as the validation criterion. The results showed an almost perfect agreement for self-perceived TMJ (kappa = 0.85) and periodontal conditions (kappa = 0.81), and it was substantial for dental condition (kappa = 0.69). Reproducibility according to clinical examination showed good results (kappa = 0.73 for CPI index, kappa = 0.96 for dental caries, and kappa = 0.74 for TMJ conditions). Sensitivity and specificity values were higher for self-perceived dental (Sen = 0.84, Spec = 1.0) and TMJ conditions (Sen = 1.0, Spec = 0.8). With regard to periodontal condition, specificity was low (0.43), although sensitivity was very high (1.0). Self-perceived oral health was reliable for the examined conditions. Validity was good to detect dental conditions and TMJ disorders, and it was more sensitive than specific to detect the presence of periodontal disease.

O impacto odontológico no desempenho diário dos trabalhadores do departamento municipal de limpeza urbana de Porto Alegre, Rio Grande do Sul, Brasil

O objetivo deste estudo foi investigar a prevalência do impacto bucal no desempenho diário em adultos brasileiros. Uma amostra representativa, composta por 276 funcionários do Departamento Municipal de Limpeza Urbana de Porto Alegre, Rio Grande do Sul, Brasil, entre 35 e 44 anos, responderam a entrevista e permitiram a realização do exame clínico. O Oral Impacts on Daily Performances (OIDP) foi utilizado para avaliar o impacto bucal no desempenho diário. Do total de participantes, 73,6% tiveram pelo menos um desempenho diário afetado por problemas odontológicos nos últimos seis meses. O mais afetado foi comer e apreciar a comida (48,6%). O desconforto (40,6%) e a insatisfação com a aparência (31,5%) foram os sintomas mais prevalentes. A falta de dentes (21,7%) e a dor de dente (20,7%) foram as principais causas percebidas de impacto no desempenho diário. O OIDP mostrou-se útil para avaliar os impactos odontológicos nas dimensões físicas, psicológicas e sociais do desempenho diário.

Clinical correlates of oral health-related quality of life: evidence from a national sample of British older people

This study investigated the relationships between an oral health-related quality of life (OHRQoL) indicator and specific clinical dental measures, in a national representative sample of the British older population. A random subsample was drawn from the free-living sample of the National Diet and Nutrition Survey (people aged >or= 65 yr). This subsample consisted of 407 dentate and 346 edentate participants, who were clinically examined and interviewed. The OHRQoL was assessed through the Oral Impacts on Daily Performance (OIDP) indicator. After adjusting for age, gender, and education, dentate subjects with up to 8 occluding pairs of teeth were 2.66 [95% confidence interval (CI): 1.08, 6.51) times, and those with up to 2 anterior occluding pairs were 3.00 (95% CI: 1.55, 5.81) times, more likely to report oral impacts when compared with those having more occluding pairs of teeth. Edentate participants with inadequate denture adaptation were 1.92 (95% CI: 1.04, 3.53) times, and subjects with inadequate denture retention were 2.04 (95% CI: 1.13, 3.69) times, more likely to report oral impacts than the remaining edentate sample in each case. OHRQoL in older British people is significantly related to the number of occluding pairs of natural teeth among the dentate and denture quality among the edentate.

Psychological impact on implant patients' oral health-related quality of life

OBJECTIVES

The literature has shown that patients' satisfaction with dental prostheses is associated with the existence of certain personality profiles. It is important to study such relationships in dental implant patients.

MATERIAL AND METHODS

Fifty patients (28 men and 22 women), aged between 22 and 71 years (mean age 43.22 years, SD 12.24 years), who were partially edentulous and were seeking dental implant therapy were entered into this study. The patients were requested to answer two reliable and valid questionnaires--the Dental Impact on Daily Living (DIDL) and the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI)--before implant treatment and 2-3 months after prosthodontic rehabilitation therapy.

RESULTS

Certain personality traits were found to have a significant relationship with patients' satisfaction with dental implants both before and after implant therapy (P < 0.05). Neuroticism score had valuable features in predicting patients' total satisfaction ratings (P = 0), satisfaction with appearance dimension (P = 0), satisfaction with oral comfort dimension (P = 0.005) as well as satisfaction with general performance dimension (P = 0).

CONCLUSION

Personality traits have an impact on patients' satisfaction with dental implant therapy. In addition, personality traits provide valuable information for the prediction of patients' satisfaction with their implant-supported prostheses. Neuroticism, openness, agreeableness and consciousness are very helpful in this regard. Neuroticism was found the main predictor of the patients' oral health-related quality of life following implant treatment.

Oral Impacts on Daily Performance in Norwegian adults: the influence of age, number of missing teeth, and socio-demographic factors

This study investigates the relationships among socio-demographic factors, dental status, and impaired oral health-related quality of life (OHRQoL) using a translation into Norwegian of the Oral Impacts on Daily Performance (OIDP) inventory. Data were collected as part of the Central Bureau of Statistics (CBS) OMNIBUS survey in Norway. The CBS drew a two-stage proportionate random sample, comprising 2,000 residents aged 16-79 yr, from the national population register. Information was available for 1,309 individuals (response rate 66.0%) who completed telephone interviews in November and December 2003. A total of 18.3% (95% confidence interval: 16.2-20.4) reported that an oral problem had affected at least one daily oral performance during the 6 months preceding the survey. The proportion of adults who confirmed impacts varied from 11.3% (eating) to 2.1% (social contact). Multiple logistic regression analysis revealed statistically significant disparities regarding respondents' age, residential area, dental attendance, and number of remaining teeth. The prevalence of OIDP in the Norwegian population was modest, but varied systematically with both socio-demographic and oral health-related factors. The consistently declining OIDP with increasing age after controlling for dental status suggests age-related changes of participants' values and expectations.

The effect of denture quality attributes on satisfaction and eating difficulties

OBJECTIVES

The development of a measure, with complimentary normative and perceived needs, for the investigation of functional impairment of individual patients and the investigation of the physical causative bases of impairment.

SUBJECTS

A consecutive sample of 119 complete denture (CD) wearers attending a Greek department of prosthetic dentistry took part in the study. All subjects presented with some complaint(s) of their dentures.

METHOD

Functional assessment of dentures (FAD) criteria and structured questionnaires were used covering denture satisfaction (DS) and food difficulties with CDs. The questions used a five-point Likert scale.

RESULTS

The results showed that there were statistically significant associations between satisfaction from dentures and eating specified foods. Statistically significant associations were also found between denture qualities and movement of upper dentures and difficulty eating specified foods, but not with an open question on the difficulty of eating unspecified foods.

CONCLUSIONS

This study successfully validated a suitable model for the combined evaluation of denture quality with clear diagnostic criteria and closed questions on DS and perceived difficulties when eating specified foods. This could predict the need for treatment, monitor the impact of care and provide a feasible measure to meet the need of everyday clinical situations.

Percepção das condições de saúde bucal por gestantes atendidas em uma unidade de saúde no município de Araraquara, São Paulo, Brasil

OBJETIVOS: avaliar a percepção das condições de saúde bucal de um grupo de gestantes, através da aplicação do índice General Oral Health Assessment Index (GOHAI). MÉTODOS: participaram do estudo 53 gestantes que freqüentavam uma Unidade Básica de Saúde em Araraquara, São Paulo. Foi aplicado um questionário contendo questões do índice GOHAI, questões sobre a autopercepção das condições bucais e sobre as características sócio-demográficas. Por meio dos testes não-paramétricos Mann-Whitney e Kruskall-Wallis, foram determinados a associação das variáveis sociais e de autopercepção com o índice GOHAI. RESULTADOS: a percepção das condições bucais, medida pelo índice GOHAI, foi positiva e apresentou um valor médio de 31,6. Os dados subjetivos mostram que apenas 12,0% das gestantes classificaram sua condição bucal como "ruim", a maioria declarou nenhum problema dentário, embora 58,7% tenha relatado distúrbios gengivais. As questões como dor e/ou desconforto foram as mais percebidas pelas gestantes. CONCLUSÕES: as gestantes fizeram uma avaliação positiva de sua condição bucal, estando o índice GOHAI associado a variáveis relacionadas à autopercepção. Tal índice pode ser aplicado em grupos populacionais como as gestantes, possibilitando medidas educativas e/ou preventivas direcionadas às suas reais necessidades.

Oral Impacts on Daily Performance in Norwegian adults: validity, reliability and prevalence estimates

The Oral Impacts on Daily Performance (OIDP) instrument was translated into Norwegian and reviewed for cultural and conceptual equivalence by a group of bilingual academics. A sample of employees from the University of Bergen completed the Norwegian OIDP frequency questionnaire twice. A total of 173 and 108 subjects participated in the first and the second administration, respectively, of this questionnaire. A two-stage proportionate random sample, comprising 2,000 residents (age-range 16-79 yr), was drawn from the national population register by the Central Bureau of Statistics. Information became available for 1,309 persons who completed telephone interviews. The Norwegian OIDP preserved the overall concept of the English version. Test-retest reliability, in terms of Cohen's kappa, was 0.65, and Cronbach's alpha was high (> or = 0.80). In both samples, variations in the OIDP scores were apparent in relation to self-reported oral health and number of remaining teeth, supporting construct and criterion validity of the inventory. Only three of the OIDP interviews were discarded, which supports face validity. A total of 18.3% confirmed that they had at least one oral impact. Age-specific rates were 17.5%, 19.0%, 17.9% and 18.4% among 16-24, 24-44, 45-66 and 67-79-yr-old participants. The satisfactory psychometric properties provide evidence for the cross-cultural use of the OIDP. The presence of a distinct floor effect indicates poor sensitivity of the OIDP to detect improvements of oral health-related quality of life at a population level. Prevalence estimates were low, suggesting that the current oral health status has little impact on the daily performance of the Norwegian adult population.

Oral Health Impacts on Daily Living Related to Four Different Treatment Protocols for Chronic Periodontitis

BACKGROUND

The aims of this study were to evaluate the oral health impacts perceived by patients submitted to different treatments of chronic periodontitis and their association with clinical parameters.

METHODS

Sixty patients were assigned to one of the following therapeutic groups: control, treated with full-mouth scaling and root planing (SRP); test 1, treated with SRP and 400 mg systemically administered metronidazole (MET) three times per day for 10 days; test 2, treated with SRP and professional supragingival plaque removal (PP) every week for 3 months; and test 3, treated with SRP and MET plus PP. Clinical periodontal measurements and data regarding patients' oral health impacts (perceived impacts on bleeding gums, gingival recession, sensitivity to cold, packing foods, aesthetics, bad breath, and tooth mobility) were collected at baseline and 3 months after therapy.

RESULTS

All groups presented significant improvement in oral health perceived impacts. There was no statistically significant difference in the improvement of oral health impacts among groups subjected to different treatments. The clinical data of percentage of deep probing depth, deep clinical attachment level, and bleeding on probing were found to be correlated significantly with oral health impacts.

CONCLUSIONS

Periodontal treatment leads to a significant reduction of self-perceived impacts regardless of the non-surgical treatment protocol employed. Most of the clinical data were associated with oral health impacts.

Development of a new questionnaire to assess pain-related limitations of daily functions in Japanese patients with temporomandibular disorders

BACKGROUND

Various measures/scales have been used to assess oral health-related quality of life in patients with temporomandibular disorders (TMDs). However, there have been few reports on the validity of questionnaires, and even fewer assessments of their use in Japanese sociocultural conditions.

OBJECTIVES

The objectives of the study were: (i) to develop and refine the number of questions concerning pain-related limitations of daily function in the TMD questionnaire (LDF-TMDQ, 13 items) in Japanese patients with TMD, (ii) to assess factor validity, and (iii) to determine convergent and discriminant validity of the LDF-TMDQ with the observed items within a multidimensional questionnaire.

METHODS

Four hundred and fifty-six (85.9%) outpatients with TMD were enrolled. The subjects were allocated into two roughly equal groups--E-group (233) for exploratory factor analysis and C-group (223) for confirmatory factor analysis [structural equation modeling (SEM)].

RESULTS

The exploratory factor analysis extracted 10 items and three factors. SEM showed the revised model to accurately describe the relationships between the measured items. As to convergent validity, the factor 'limitation in executing a certain task' and 'limitation of mouth opening' showed significant correlations with the observed items within the multi-dimensional questionnaire. However, the factor 'limitation of sleeping', show no correlation with any item. As to discriminant validity, all three factors had correlation coefficients below 0.4 with the psychological scale, the personality scale, and the visual analog scale for pain intensity.

CONCLUSION

The LDF-TMDQ was reduced from 13 items to 10. The factor validity of the LDF-TMDQ, and the construct validity of 'limitation in executing a certain task' and 'limitation of mouth opening' were confirmed, while that of 'limitation of sleeping' remains to be determined.

The impact of conventional and implant supported prostheses on social and sexual activities in edentulous adults

OBJECTIVES

To determine the impact of mandibular two-implant overdentures or conventional complete dentures on leisure and sexual activities.

METHODS

One hundred and two subjects, aged 35-65 years, received either mandibular overdentures retained by two implants (IOD; n=54) or new mandibular conventional complete dentures (CD; n=48) in a randomized controlled clinical trial. A Social Impact Questionnaire was used to assess the impact on social and sexual activity including avoiding conversation, refusing invitations, avoiding sport and feeling uneasy when kissing and in sexual relationships, and the looseness of the prostheses during such activities. Ratings were recorded on categorical scales at baseline and 2 months after treatment. Oral health related quality of life was measured with the Oral Health Impact Profile (OHIP). Between and within group comparisons were carried out using regression models. The correlation between post-treatment OHIP scores and the leisure and sexual impact items was assessed.

RESULTS

Two months after delivery of the prosthesis there was significant improvements in the IOD group for looseness when eating, speaking, kissing and yawning. The IOD group reported significantly less post treatment looseness than the CD group for all parameters investigated (p<0.0001). IOD subjects felt less uneasy kissing and less uneasy during sexual activity than CD subjects. Correlations between the two sexual activity items (uneasiness when kissing and during sexual relations) and the OHIP scales were weak.

CONCLUSIONS

Edentulism has a negative impact on social and sexual life. Mandibular overdentures provide greater improvement in of unease in intimate activities than new conventional mandibular dentures.

Effectiveness of dental services in facilitating recovery from oral disadvantage

OBJECTIVE

To determine the effectiveness of dental health care services in facilitating recovery from quality of life decrements in symptom-specific subgroups with the most prevalent chronic infectious diseases (periodontal disease and dental caries), and a 'stained teeth' subgroup.

METHODS

Data were taken from the prospective longitudinal Florida Dental Care Study of 873 individuals 45+ years old. Logistic regression modeling quantified associations between recovery from oral health-related quality of life decrements ('recovery') and dental services.

RESULTS

Adjusting for age, race, gender, income, approach to dental care, and signs/symptoms, any dental visit (odds ratio, OR: 4.0; 95% confidence interval, CI: 2.3, 6.9), corrective treatment (OR: 3.8; 95% CI: 1.6, 8.7), denture visit (OR:4.8; 95% CI: 1.1, 21.9), or extraction (OR: 6.2; 95% CI: 2.2, 17.4) were positively associated with recovery. Upon conditioning the analyses on specific symptoms, point estimates increased substantially for most service types, and dental cleaning was associated with recovery for the stained teeth subgroup (OR: 10.9; 95% CI: 1.2, 99.4).

CONCLUSION

Dental care was highly effective in treating quality of life decrements. Treatment effectiveness increased substantially when analyses were restricted to symptom-specific subgroups similar to selection criteria of randomized clinical trials (RCTs). Restricted cohort analyses can be applied to many other health outcomes for which RCTs are not feasible or ethical.

Impact of oral health on quality of life among the elderly population of Joaçaba, Santa Catarina, Brazil

The objective of this study was to investigate the impact of oral health conditions on the quality of life of elderly people in Joaçaba - SC, in Southern Brazil. A survey based on systematic sampling of clusters was carried out with 183 elderly people that belong to old age groups. The survey was conducted in order to assess the oral conditions of the participants (use of and need for prosthesis) based on the criteria from the World Health Organization publication "Oral Health Surveys, Basic Methods", 4th edition. The oral health impact profile (OHIP) was used to evaluate the impact of oral condition in the quality of life. ABIPEME (Brazilian Association of Market Research Institutes) criterion was used, together with the level of education and the number of people in the household to determine social inequalities. The participants were mostly women (82%) and the OHIP mean was 10.35. No correlation was observed between the OHIP level and formal education or between OHIP and number of residents per household. There was a correlation of 0.240 (p = 0.001) between ABIPEME and OHIP. The OHIP mean for those not using maxillary prosthesis was 12.48 and the mean for those using it was 9.81 (p = 0.399). The mean OHIP for those in need of maxillary prosthesis for those who did not need it was 13.00 and 8.88, respectively (p = 0.014). The same trend was found for the use and need for mandibular prosthesis. The conclusion was that the need for maxillary and mandibular prosthesis impacted the quality of life among the elderly population of Joaçaba.

Demographic factors, denture status and oral health-related quality of life

OBJECTIVES

This study investigated the association between denture status, demographic factors, and oral health-related quality of life (OHRQoL).

METHODS

OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G, 53 items), which was administered in a personal interview to 2050 subjects (60% of eligible subjects responded) 16-79 years of age in a national survey. Median regression was used to analyze the influence of denture status (no, removable, complete dentures), age, gender, education (less than 10 years of schooling, 10-12 years, more than 12 years), and residential area (rural, urban) on the OHIP-G summary score.

RESULTS

In bivariable analyses, compared to the base category, the OHIP-G median increased 8.0 U for subjects with removable dentures, 20.0 U for subjects with complete dentures, 1.7 U for each 10-year age period, 2.0 U for men, 3.0 U for less than 10 years of schooling (compared to > or =10 years.), and 1.0 U for urban areas (P < 0.05 for all effects except for residential area). In the multivariable analysis, compared to subjects without dentures, subjects with removable dentures had a 7.5 (95% CI: 5.2-9.8) higher OHIP-G median and subjects with complete dentures had a 18.5 (95% CI: 14.7-22.4) higher median when demographic variables were controlled. No demographic variables were statistically significant except for residential area (P = 0.04).

CONCLUSIONS

Denture status was a stronger predictor for impaired OHRQoL than demographic variables and rendered age and education almost negligible in their influence on OHRQoL.

Why are we ‘weighting’? An assessment of a self-weighting approach to measuring oral health-related quality of life

OBJECTIVE

To determine whether or not self-weighting at an item level contributes to the performance of an oral health-related quality-of-life measure.

DESIGN

Data were collected in two national surveys conducted a month apart, one using the "weighted" measure and the other an "unweighted" version of the UK oral health-related quality-of-life measure. In addition, sociodemographic and self-reported oral health status were recorded.

RESULTS

The UK oral health-related quality-of-life measure discriminated between groups based on age group (<65, 65 and older) and social class (higher and lower) irrespective of the version of the questionnaire used. Both versions also showed significant associations with self-reported oral health: denture status (P < 0.01) and number of teeth possessed (P < 0.01). In addition, both versions demonstrated predictive ability in identifying those in prosthetic need (<20 teeth and without recourse to a denture, P < 0.01).

CONCLUSION

Weighting the UK oral health-related quality-of-life instrument does not improve the psychometric properties of the instrument and thus raises questions about the value of self-weighting at an item level.

Assessment of oral health related quality of life

In Dentistry, as in other branches of Medicine, it has been recognised that objective measures of disease provide little insight into the impact of oral disorders on daily living and quality of life. A significant body of development work has been undertaken to provide health status measures for use as outcome measures in dentistry. In descriptive population studies, poor oral health related quality of life is associated with tooth loss. There is a less extensive literature of longitudinal clinical trials, and measurement of change and interpretation of change scores continues to pose a challenge. This paper reviews the literature regarding the development and use of these oral health related QoL measures and includes an appraisal of future research needs in this area.

Measuring the impact of oral health on quality of life in Britain using OHQoL-UK(W)

OBJECTIVES

This study assessed the impact of oral health on quality of life (OHQoL) in Britain and identified disparities in OHQoL among subgroups of the population.

METHODS

A national survey involved a random probability sample of 2,667 households. Participants were interviewed about their oral health status and sociodemographic information was collected. The impact of oral health on life quality was measured utilizing the OHQoL-UK(W).

RESULTS

The response rate was 68 percent. Most people in Britain (73%) claimed their oral health did affect their life quality, most frequently through physical influences rather than social or psychological. Disparities in perceived influences of oral health on life quality among subgroups of the population were apparent by age, sex, and social class; OHQoL also was influenced by oral health status (self-reported).

CONCLUSION

Most Britons claim their oral health affects their life quality and OHQoL was associated with sociodemographic and oral health factors.

Validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional study of adolescents in Uganda

BACKGROUND: Assessing oral health related quality of life impact of mouth in adolescents is a relatively ignored area in dental research. This study aimed to examine reliability and validity of an abbreviated version of the oral impact of daily performance (OIDP) questionnaire and to analyse the interrelationship among OIDP scores, socio-demographic characteristics and oral health status in Uganda. METHOD: 1146 adolescents (mean age 15.8, response rate 87%) attending secondary schools in Kampala (urban) and Lira (rural) completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. A clinical examination was conducted among 372 students (mean age 16.3, response rate 72%) and caries was assessed following the World Health Organisation criteria (1997). RESULTS: 62% of the students experienced at least one oral impact during the 6 months preceding the survey. Cronbach's alpha for the OIDP frequency items was 0.91 and the corrected item-total correlation ranged from 0.62 to 0.75. Discriminant and construct validity were demonstrated in that the OIDP scores varied systematically in the expected direction with missing teeth and self-report indicators of oral health status, respectively. Socio-demographics and dental attendance did not predict OIDP through interaction with clinical indicators but varied systematically and independently with OIDP frequency scores in the multivariate analysis. CONCLUSION: the OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among Ugandan adolescents. Some evidence of the importance of social and personal characteristics in shaping adolescents' responses to oral disorders was provided.

The impact of stomatological disease on oral health-related quality of life

The clinical diagnosis of stomatological disease may indicate its cause and prognosis; however, it says little about the resulting level of impairment from the patient's perspective. The primary objective of this study was to test whether patients attending an outpatient oral medicine clinic would have worse oral health related quality of life (OHR-QoL) compared with the general population. In addition, we aimed to assess whether anxiety or depression could be predicted by OHR-QoL and to explore the relationship between clinical diagnoses, OHR-QoL and anxiety/depression. Data were collected from patients (n = 97) through face-to-face interviews using the Oral Health Impact Profile Short form (OHIP-14) to measure OHR-QoL, the Hospital Anxiety and Depression Scale (HADS) for psychiatric morbidity, and a visual analogue scale for self-rated general health. Age- and sex-matched controls (n = 388) were provided from a normative data set collected in a UK national survey in 1998. Participants had significantly lower OHR-QoL scores than the general population on all domains and overall OHR-QoL scores. Of the variance in anxiety, 55% was predicted by general health ratings and OHR-QoL domains of 'psychological discomfort' and 'psychological disability'. Of the variance in depression, 54% was predicted by general health ratings and OHR-QoL domains of 'functional limitation' and 'social disability'. Patient centred, routine assessment of OHR-QoL provides an additional dimension that may help to improve awareness of the impact of disease on the individual's life and enhance the clinical decision-making process.