Confirmatory factor analysis of the Oral Health Impact Profile

Psychometric Validation of the Macedonian-Language Version of the Ultrashort Five-Item Oral Health Impact Profile in the North Macedonian Population (OHIP5-MAC)

Background and Objectives: Due to a lack of an ultrashort questionnaire for Oral Health-Related Quality of Life (OHRQoL) assessment in the North Macedonian population, the OHIP5 was translated into Macedonian language with aim to test its psychometrical properties. Materials and Methods: Two types of reliability were tested: internal consistency by calculating Cronbach's alpha coefficient (general population), and test-retest reliability by calculating intraclass correlation coefficients (ICC) in a convenient sample of dental students who answered the same questions twice. Two types of validity were also tested: convergent validity (via a Spearman rank correlation) and known-group validity (via a Mann-Whitney U test). Responsiveness was tested by calculating the significance of the differences between the pre-treatment and after-treatment scores and by calculating the effect sizes of different dental treatments. Results: The Cronbach alpha coefficient of 0.756 and inter-item correlations above 0.2 pointed out good internal consistency. The test-retest reliability was confirmed by high ICCs and no significant differences between the OHIP5-MAC scores in a period of two weeks as dental students had no oral health changes. The Spearman rank correlation of -0.88 (p < 0.01) between the OHIP5-MAC summary scores and one simple question scoring self-perceived oral health (1-5; 1-worst oral health; 5-excellent oral health) confirmed the convergent validity. Significant differences between subjects with natural teeth and those with removable dentures (p < 0.01) confirmed the know-group validity, as it was predicted that removable denture wearers would have more impairment of oral health than individuals with natural teeth. The sensitivity of a questionnaire to measure changes elicited by dental treatments, i.e., responsiveness, was confirmed in individuals who received different dental treatments and scored significantly better (lower scores) their OHRQoL one month after the treatment, compared to their pretreatment scores (p < 0.05). Conclusions: Generally good psychometric properties of the OHIP5-MAC justify the recommendation for its future use in clinical settings and research.

ORAL HEALTH IMPACT AMONG CHILDREN: A SYSTEMATIC REVIEW UPDATE IN 2024

INTRODUCTION

The project "Mapping Oral Disease Impact with a Common Metric" (MOM) characterizes the functional, pain-related, aesthetic, and broader psychosocial impacts of oral diseases and conditions using the 4 oral health-related quality of life (OHRQoL) dimensions: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. MOM's 4-dimensional oral health impact information in children was provided by Omara et al. in 2021. We aimed to update this information in 2024 by performing a new systematic review.

METHODS

We performed a systematic review following PRISMA guidelines to identify original studies assessing the OHRQoL of children <18 years using the Oral Health Impact Profile (OHIP). OHIP publications were retrieved from 2 sources: (i) articles identified by Omara et al., 2021 (search date: 9 January 2019) and (ii) newly identified articles published from 2019 to 2024 in the following databases: Embase+Embase Classic (via Ovid), CINAHL, APA PsycINFO (via Ovid), Scopus, and Web of Science (Core Collection). Abstracts of 1128 articles were screened. The full-text of 199 articles was reviewed, and 24 articles were included. Their OHIP information was mapped into the 4-dimensional OHRQoL framework.

RESULTS

Across 3 settings (general population subjects, dental patients, and medical patients) we identified 24 publications. They provided four-dimensional OHRQoL information for 49 populations in 55 samples (N = 8307 study participants). The Orofacial Appearance dimension had the highest impact, while the Psychosocial Impact dimension had the lowest. Functional impact scores were higher than pain-related impact scores. Among dental patients, those with anterior tooth extraction without replacement had the highest impact score within the Orofacial Appearance dimension.

CONCLUSION

Children's 4-dimensional oral health impact information in the "Mapping Oral Disease Impact with a Common Metric" (MOM) project was updated in 2024 with a systematic review. The findings for Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact in children are aligned with findings in adults using the same 4-dimensional impact measurements.

THE CORRELATION BETWEEN ORAL AND GENERAL HEALTH-RELATED QUALITY OF LIFE IN ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

OBJECTIVE

The relationship between general health and oral health is critical for understanding the broader implications of oral health on overall well-being and vice versa. The impact of oral and general health on individuals can be comprehensively captured by the concepts oral and general health-related quality of life (OHRQoL and HRQoL), respectively. This systematic review and meta-analysis aimed to synthesize existing evidence on the correlation between OHRQoL and HRQoL across different adult populations.

METHODS

A comprehensive search strategy was executed across 6 databases (Ovid MEDLINE(R), Embase, CINAHL, APA PsycINFO, Web of Science Core Collection, and Scopus). The search included studies measuring OHRQoL with the Oral Health Impact Profile (OHIP) and HRQoL with a variety of generic patient-reported outcome measures (PROMs). Studies were included if they reported correlations between OHRQoL and HRQoL summary scores in adult populations across dental, medical, or nonpatient settings. If a study examined more than one population, each correlation was included for independent analysis. Data extraction and quality assessment were conducted by independent reviewers, with disagreements resolved by a third reviewer. Random effects meta-analysis was used to summarize the OHRQoL-HRQoL correlations.

RESULTS

From 10 studies, 13 populations (N=6,053 participants) were included in the analysis. The correlation between general health and oral health-related quality of life was of medium size (r=0.41, 95% CI: 0.32-0.50) with high heterogeneity across populations (I2=95%). Results were not unduly influenced by individual populations, study quality, or publication bias.

CONCLUSIONS

The correlation between oral health and general health is of medium size, highlighting the potential for medical-dental integration to enhance patient and community health outcomes.

Translation, cross-cultural adaptation, reliability, and validity assessment of a Turkish version of the oral and systemic health impact profile for periodontal disease (OSHIP-Perio)

The development of the Oral Health Impact Profile-49 (OHIP-49) and its shorter version, OHIP-14, has been criticized for not adequately considering the influence of systemic health on Periodontal health. The lack of a Periodontal status domain in OHIP scales has led to the proposal of the development of a new profile, Oral and Systemic Health Impact Profile (OSHIP-Perio). The newly developed profile has not undergone translation into other languages, cross-cultural adaptation, or validation and reliability testing. The primary objective of this study was to conduct a cross-cultural adaptation, validation, and reliability assessment of the Turkish translation of OSHIP-Perio for the first time. The data set comprises of responses from 354 individuals who participated in a face-to-face survey involving a series of fourteen inquiries related to the influence of Periodontal diseases on their general quality of life. The survey employed the OHIP-14-TR gold standard questionnaire, which has undergone prior validation and reliability testing in cross-cultural adaptation studies. Confirmatory factor analysis was employed to evaluate the construct validity. Test-retest reliability was evaluated using the Spearman-Brown and Gutmann test. Cronbach's alpha was used to assess the internal consistency. The concurrent validity was assessed using Spearman's correlation coefficient. The confirmatory factor analysis revealed that the scale is characterized by a single factor. The Spearman's correlation coefficient results were found to be 0.922 for concurrent validity. The internal consistency analysis yielded a Cronbach's alpha value of 0.944 for the scale. The Spearman-Brown and Guttmann methods yielded coefficients of 0.972 value for test-retest reliability. No floor or ceiling effects were found to be present. The Turkish version of the OSHIP-Perio questionnaire has been found to be valid and reliable. The OSHIP-Perio-TR can be used to assess the relationship between general well-being, its influence on Periodontal health, and the perception of illness in individuals with Periodontal diseases.

Fully digital versus conventional workflow: Are removable complete overdentures equally good? A randomized crossover trial

INTRODUCTION

Implant-supported removable complete overdentures (IODs) are a common treatment in case of edentulism and malfunctioning of the conventional denture. Manufacturing IODs in a conventional way (C-IODs) is time-consuming, but in a digital workflow, this can be done in three sessions. Digitally produced IODs (3D-IODs) are also more advantageous than C-IODs because lost or broken 3D-IODs can be swiftly reproduced as the digital design is always available.

PURPOSE

To prove in a non-inferiority study, with a margin of 0.3 point per Oral Health Impact Profile-20 (OHIP-20) question, that IODs made according to a fully digital workflow (3D-IODs), function as good as C-IODs with respect to patient-reported outcome measures (PROMs).

MATERIALS AND METHODS

This randomized crossover study included 36 fully edentulous patients who showed extreme resorption of the maxillary alveolar process, making denture retention difficult. After a maxillary bone augmentation and the installation of 4-6 implants, each patient wore both types of IOD for 1 year each, with the order reversed in two subsets of patients. The 3D-IODs and C-IODs were fabricated in advance for both jaws (at least two mandibular implants were already present). The OHIP-20 survey was performed at baseline, after 1 year (before the IOD switch), and after 2 years to determine patient satisfaction scores using a visual analog scale (VAS). The general health status was assessed using the Short Form (SF-36) questionnaire.

RESULTS

Regarding the PROMs, patients preferred the 3D-IOD: the improvement on the overall OHIP scale (0-4), expressed as a mean, was 0.26 points greater than for the C-IOD (p < 0.001). This applied also to the VAS scale (1-100) with an increase of 7.37 points (p < 0.001). Regarding the SF-36 scale, only for the item "emotional well-being," the 3D-IOD scored significantly better (p = 0.033).

CONCLUSION

Compared with conventionally fabricated C-IODs, fully digitally produced 3D-IODs resulted in significantly higher OHIP-20 and satisfaction scores.

Measuring concern about smile appearance among adults

BACKGROUND/OBJECTIVES

To adapt and estimate the psychometric properties of Utrecht Questionnaire for esthetic outcome assessment in rhinoplasty (OAR) to assess concern about smile appearance and to estimate the influence of demographic characteristics on this concern in adults.

MATERIAL/METHODS

This was a cross-sectional observational study. Individuals aged between 18 and 40 years participated in the study. The Portuguese version of OAR was adapted for smile assessment in dental practice and was named Questionnaire for Outcome Assessment of Smile Aesthetic (OA-Smile). Data validity was estimated using factorial validity [confirmatory factor analysis (CFA)-CFI, Tucker-Lewis index (TLI), SRMR)] and convergent validity (average variance extracted). Reliability was assessed using the alpha ordinal coefficient (αordinal) and the omega coefficient (ω). A structural model was elaborated to assess the contribution of demographic characteristics to smile appearance concerns. Model fit was evaluated, and the z-test (α = 5%) was used to estimate the significance of the path estimates (β).

RESULTS

2.523 subjects participated in the study [mean age = 32.86 (SD = 11.39) years, 68.1% female]. The factor model of orofacial appearance (OA)-Smile presented an adequate fit to the data [CFA: comparative fit index (CFI) = 0.99, TLI = 0.99, SRMR ≤ 0.05]. Convergent validity (AVE ≥ 0.80) and reliability (αordinal and ω ≥ 0.85) were adequate. The structural model presented an acceptable fit (CFI = 0.974; TLI = 0.991 and SRMR = 0.053). Women, younger people, single people, people with lower income, people using dental prostheses, undergoing dental treatment, and those who do not like their smile were more concerned about their smile appearance.

LIMITATIONS

Nonprobability sampling, online data collection, and cross-sectional design are considered limitations of the study.

CONCLUSIONS/IMPLICATIONS

OA-Smile is a suitable scale to assess smile appearance concerns, and the data obtained with this scale were valid and reliable. Demographic characteristics should be considered when measuring concerns about smile appearance.

Analysis of Oral Health-Related Quality of Life in Elderly Romanian Edentulous Patients: Implant-Supported Versus Conventional Complete Dentures

Background/Objectives: The integration of quality of life (QoL) assessments into dental health evaluations acknowledges the profound impact of oral health on overall well-being. This study aims to compare the impact of implant-supported complete dentures versus conventional complete dentures on oral health-related quality of life (OHRQoL) in elderly Romanian edentulous patients. Methods: This longitudinal study involved 93 initially recruited edentulous patients, with 52 completing the study over an 18-month period. Data collection utilized the OHIP-5 questionnaire, assessing the OHRQoL at baseline with conventional dentures and three months post-implant-supported denture placement. Ethical approval was secured from the Faculty of Medicine and Pharmacy University of Oradea, adhering to the Helsinki Declaration principles. A statistical analysis was conducted using SPSS version 25 and included non-parametric tests for score comparisons and Fisher's exact test for categorical data. Results: The comparative analysis of the questionnaire responses revealed significant improvements in all five OHRQoL dimensions post-treatment with implant-supported dentures. For instance, the proportion of patients reporting "never" experiencing difficulty chewing any foods increased from 1.9% at baseline to 57.7% post-treatment. Similarly, those reporting "never" experiencing painful aching rose from 3.8% to 76.9%. There was also a notable reduction in discomfort regarding the appearance of mouth, dentures, or jaws from 3.8% reporting "never" at baseline to 75% post-treatment. The improvements in sense of taste and difficulty in performing usual activities saw comparable increases. Conclusions: The findings support the hypothesis that implant-supported complete dentures significantly enhance OHRQoL among elderly edentulous patients compared to conventional dentures, with improvements noted in mastication ability, pain reduction, aesthetics, taste perception, and activity performance. These results underscore the value of prosthetic interventions in dental care to substantially improve patients' OHRQoL.

The impact of antimicrobial photodynamic therapy on pain and oral health-related quality of life: A literature review

Antimicrobial photodynamic therapy (aPDT) is a non-invasive approach used for microbial decontamination, and it can also be beneficial as an adjunctive strategy for oral infections. The success of treatment in the long term is increasingly recognized to be influenced by patient's perception of the disease and its improvement. Recently, aPDT has been suggested as a dual approach to tissue repair, pain relief, and enhancement of oral health-related quality of life (OHRQoL). The first pathway involves the antimicrobial and anti-inflammatory effects of aPDT. It not only eliminates microorganisms but also helps regulate the immune response and reduce inflammation, leading to a faster and more effective healing process. This, in turn, provides relief from pain and associated symptoms, aiding in the management of treatment complications. The second pathway involves aPDT's ability to modulate nociception and alleviate pain. aPDT induces analgesia by releasing neurotransmitters such as β-endorphin, serotonin, and acetylcholinesterase. It also interacts with mitochondria through photoreceptors, initiating intracellular processes that alleviate pain. Furthermore, the therapy inhibits nerve fibers, reducing nerve impulse conduction and altering the pain threshold. Considering that the impact on patients' pain and OHRQoL is an important aspect of the decision-making process, this study aimed to review patient-based outcome measures during aPDT and assess its effects on pain and OHRQoL in patients. Understanding these factors will contribute to a better assessment of the overall benefits and effectiveness of aPDT as a treatment option for oral infections.

3D printed versus milled stabilization splints for the management of bruxism and temporomandibular disorders: study protocol for a randomized prospective single-blinded crossover trial

BACKGROUND

Nowadays, stabilization splints for the management of bruxism and temporomandibular disorders (TMD) can be produced utilizing a digital workflow comprising a digital impression of the teeth, digital splint design, and computer-aided manufacturing of the splints. The latter is usually a milling process, however, more recently 3D printing gained popularity due to its better cost and time efficiency. It remains unknown whether 3D printed stabilization splints are inferior to milled splints regarding clinical outcomes.

METHODS

This clinical trial assesses the non-inferiority of 3D printed occlusal splints compared to milled occlusal splints in a monocentric prospective randomized single-blinded crossover trial with two cohorts. One cohort includes 20 participants with bruxism, the other 20 participants with pain-related TMD, i.e., myalgia, myofascial pain, or arthralgia of the jaw muscles/the temporomandibular joint(s) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Michigan-type stabilization splints are fabricated in a digital workflow by milling or 3D printing using CE-marked materials within their intended purpose. The participants wear a milled and a 3D printed splint in a randomized order for 3 months each, with follow-up visits after 2 weeks and 3 months. Investigated outcome parameters are oral health-related quality of life (OHRQoL) evaluated by the Oral Health Impact Profile (OHIP-G14), participant satisfaction as rated on a visual analog scale, therapeutic efficacy, and technical result of the splints. In this context, therapeutic efficacy means antagonist wear and-in the TMD group-reduction of pain/disability assessed by the Graded Chronic Pain Scale (GCPS v2.0) and clinical assessment following the DC/TMD standard, while technical outcome measures splint fit, wear and fracture rate.

DISCUSSION

The trial will provide important information on the clinical outcome of 3D printed stabilization splints in comparison to milled splints and will, therefore, enable an evidence-based decision in favor of or against a manufacturing process. This, in turn, will guarantee for a maximum of the patient's OHRQoL during splint therapy, therapeutic efficacy, and longevity of the splints.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) DRKS00033904. Registered on March 15, 2024.

Effect of treatment with implant-supported fixed partial dentures on oral health-related quality of life in patients with unilateral shortened dental arch

Background/purpose

Implant-supported fixed partial dentures (IFPDs) are a treatment option for partially edentulous dentition with missing posterior-most molars despite the concept of a shortened dental arch (SDA). This study aimed to evaluate the effect of IFPD treatment on oral health-related quality of life (OHRQoL) in patients with unilateral SDA missing two adjacent molars and to compare the effects of single- and two-unit IFPDs.

Materials and methods

Forty patients with unilateral SDA missing two adjacent molars (Kennedy Class II) participated in this study; 11 patients received one implant placement in the first molar and were treated with a single-unit IFPD (single-unit group), and 29 received two implant placements and were treated with a two-unit IFPD (two-unit group). The Oral Health Impact Profile (OHIP) questionnaire for OHRQoL assessment and the gummy jelly test for objective masticatory performance were administered before and after IFPD treatment. The Wilcoxon signed-rank test for all patients and Mann-Whitney U test were performed for pre- and post-treatment comparisons and between-group comparisons, respectively.

Results

The OHIP summary score and gummy jelly glucose concentration in all patients showed significant improvements after treatment (all P < 0.05). No significant differences were observed between the single- and two-unit groups for any of the items. Using the minimal important difference in the OHIP summary score, 63.6 % and 58.6 % of patients in the single- and two-unit groups, respectively, showed improvement by 6 points or more.

Conclusion

IFPD treatment for patients with SDA missing two adjacent molars may provide clinically meaningful improvements in OHRQoL.

Association between the treatment choice of implant-supported fixed partial dentures and oral health-related quality of life in patients with a shortened dental arch: A preliminary observational study

Background/purpose

In cases of missing posterior teeth, treatment modalities based on the shortened dental arch (SDA) concept may be a viable alternative. However, the association between oral health-related quality of life (OHRQoL) and patients' treatment decisions remains unclear. This study aimed to investigate the association between OHRQoL and the decision to be treated with implant-supported fixed partial dentures (IFPDs) or take a wait-and-see approach in patients with an SDA missing a single second molar and to clarify the impact of IFPD treatment on the OHRQoL.

Materials and methods

The Oral Health Impact Profile (OHIP) questionnaire was administered twice (pre- and post-treatment) and once to 41 patients with a unilateral SDA missing a single second molar who chose IFPD treatment (IFPD group, n = 22) and the wait-and-see approach (no treatment group, n = 19), respectively. Logistic regression analysis was performed with IFPD treatment choice as the objective variable and the four OHIP dimension scores, age, and sex as covariates. The pre- and post-treatment values of the OHIP summary and four-dimension scores were compared using a paired t-test.

Results

The IFPD treatment choice was significantly associated with sex (male), higher Oral Function dimension scores, and lower Psychosocial Impact dimension scores (all P < 0.05). The OHIP summary and four-dimension scores were significantly lower following IFPD treatment (all P < 0.05).

Conclusion

IFPD treatment for a single missing second molar may be clinically beneficial for improving the OHRQoL of patients with an SDA who experience a decline in masticatory function.

Psychometric Properties of General Oral Health Assessment Index Across Ages: COSMIN Systematic Review

OBJECTIVES

To systematically review the psychometric properties of the Geriatric Oral Health Assessment Index (GOHAI) across age groups using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.

METHODS

Data: English peer-reviewed articles reporting studies of the development, translation, or validation of GOHAI.

SOURCES

PubMed, Web of Science, and EMBASE from Jan 1990 until December 31, 2023. Methodological evaluation: based on COSMIN methodology. The results are presented overall and for 4 age groups (≥60 years, all ages, <60 years, ≤45 years). Structural validity was summarized qualitatively. Internal consistency and reliability were synthesized via random-effects meta-analysis of T-transformed Cronbach α values, and Fisher's Z transformed correlation coefficients. Construct validity and responsiveness were assessed using effect sizes.

RESULTS

Four hundred ninety-seven records were identified, 72 underwent full-text assessment, resulting in 60 included reports. Structural validity was inconsistent across all age groups and overall. Internal consistency was sufficient with overall α = 0.81, and high evidence quality. Test-retest reliability was consistently sufficient across age groups with overall r = 0.84. For construct validity 361 hypotheses were assessed (37.4% for convergent-, 62.6% for known-groups validity). The percentage of confirmed hypotheses in ≥60-years, all ages, <60-years and ≤45-years were 75.5%, 66.7%, 78.9%, and 88.9%, respectively. Responsiveness was not assessed in the <60-years and ≤45-years age groups, leading to indeterminate overall rating with very low evidence quality.

CONCLUSIONS

This review affirms that GOHAI has sufficient psychometric properties as an oral health-related quality of life instrument in various age groups, but its responsiveness is scarcely researched and its utility for individual-level follow-up is limited. The measurement properties of oral health-related quality of life tools must be scrutinized in the changing demands of personalized and value-based dental care. (PROSPERO registration: CRD42022384132).

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.

3D printing vs traditional workflow for the fabrication of mandibular implant overdentures: study protocol for a mixed-methods cross-over RCT

BACKGROUND

Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods.

METHODS/DESIGN

We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs.

DISCUSSION

This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic.

CLINICALTRIALS

gov/ct2/show/NCT06155630.

The oral health impact profile and well-being on mothers and preschool children

OBJECTIVES

to verify the contribution of mothers' oral health impact profile to their children's oral health profile and the contribution of mothers' well-being and the caries index (dmft) to children's well-being.

METHODS

This is a cross-sectional observational study. Mothers and pre-school children enrolled in public schools in the municipality of Araraquara-SP took part. The Oral Health Impact Profile Questionnaire (OHIP-14), Satisfaction with Life Scale (SWLS), Early Childhood Oral Health Impact Scale (ECOHIS) and the Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI) were used. To diagnose caries, a clinical examination was carried out to calculate the dmft index. Path analysis was carried out and the path coefficients were estimated (β) and evaluated using the z-test (α = 5%).

RESULTS

443 children took part (5.19 ± 0.64 years; 52.4% boys) with an mean dmft of 1.31 ± 2.19. The mean age of the mothers was 33.4 ± 7.01 years. There was a significant impact of dmft and maternal well-being on the child's subjective well-being (s2explained = 43%). The mothers' oral health impact profile and the child's caries experience had a significant influence on both the child (OHIP: β = 0.22; p < 0.001; dmft: β = 0.48; p < 0.001) and the family (OHIP: β = 0.29; p < 0.001; dmft: β = 0.32; p < 0.001). The child's dmft (β=-0.10; p = 0.005) and the mothers' subjective well-being (β=-0.61; p < 0.001) had a significant impact on the child's subjective well-being.

CONCLUSION

The mothers' oral health impact profile and the child's caries experience had an impact on both the child and the family. Mothers' subjective well-being and caries experience should be considered when assessing the subjective well-being of Brazilian preschool children.

Oral health-related quality of life in patients with cleft lip and/or palate or Robin sequence

PURPOSE

To compare the oral health-related quality of life (OHRQoL) in patients with cleft lip and/or palate or Robin sequence versus a healthy control group using the Child Oral Health Impact Profile (COHIP-G19). Factors such as age, gender, and cleft type were considered.

METHODS

Over an 8-month period, the OHRQoL was surveyed by using the COHIP-G19 questionnaire. Included were patients with a craniofacial disorder (n = 61; average age 11.24 years) and a healthy control group (n = 70, average age 12.63 years) for a total of 131 patients (average age 11.99 years) from the Department of Orthodontics University Hospital Tübingen, Germany. These were divided into two age groups (6-11 years; 12-18 years).

RESULTS

Statistically, patients with a craniofacial disorder presented a significantly lower OHRQoL than the control group (p = 0.0055). In the craniofacial disorder group, older patients revealed a significantly (p = 0.005) lower OHRQoL than the younger patients. Female patients showed in nearly all groups a better OHRQoL than male patients, but this difference was not statistically significant (p > 0.05). Males with a craniofacial disorder scored significantly lower than males without (p = 0.016); females showed no differences between the groups. Visibility, location, and severity of the craniofacial malformation did not have a significant influence on the OHRQoL.

CONCLUSION

The occurrence of a craniofacial malformation impacted the OHRQoL especially in older and male affected patients, unrelated to the expression level or localization. An early instruction about oral health, rehabilitation and functional training should be considered in therapy.

Impact of loading protocol of a mandibular single implant-supported complete denture on oral health-related quality of life over a period of 5 years: A randomized controlled trial

OBJECTIVES

The aim of the present study was to assess the long-term course of OHRQoL and the impact of the loading protocol in patients receiving a single mandibular implant supporting a complete denture over a period of five years.

METHODS

In this multicenter RCT, a total of 158 edentulous patients were initially included and were randomly allocated immediately after placement of a mandibular midline implant to either immediate loading (IL) or to conventional loading (CL) with submerged healing. The assessment of OHRQoL was performed with the 49-item Oral Health Impact Profile (OHIP) at baseline and 1, 4, 12, 24, and 60 months after loading. At 5-year follow-up, 100 patients (mean age: 69.2 years; 45.0% female) with completed OHIP were available for analyses. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement.

RESULTS

The OHRQoL improved substantially after loading, indicated by a decrease of mean OHIP summary scores from 51.0 points at baseline, by 14.2 (95%-CI: 9.4 - 19.1; p<0.001) points to 37.2 points at 1-month follow-up, and by continuous improvement to 20.4 OHIP points at final follow-up. Considering constant treatment effects, the loading protocol had no significant effect on OHIP scores (-3.7, 95%-CI: -9.4 - 2.2; p = 0.204). Time effect was statistically significant with -0.21 (95%-CI: -0.28 - -0.15; p<0.001) points per month.

CONCLUSION

Both the immediate and conventional loading of a single mandibular midline implant supporting a complete denture offer long-lasting high levels of OHRQoL, with no significant or clinically relevant long-term differences.

CLINICAL SIGNIFICANCE

The study firstly presents long-term data for OHRQoL by investigating the loading protocol of single mandibular implant-supported complete dentures. Since immediate loading has been associated with a reduced implant survival rate for this concept, information on patient benefits is essential for evidence-based decision making.

Impact of dental prosthetic treatment and patients' expectations on the seven domains and four-dimensional scale of the Oral Health Impact Profile

BACKGROUND

Recently, recommendations were given for a new scoring of the Oral Health Impact Profile (OHIP). The original seven domain structure should be replaced by a four-dimensional scale.

OBJECTIVES

To investigate the effect of dental prosthetic treatment on the seven domains and the four-dimensional scale of the OHIP-G49/53 questionnaire.

METHODS

Seventy four patients were grouped according their pre- and post-treatment situation and the type of treatment they received. Patients completed the OHIP-G49/53 questionnaire before prosthetic treatment (T0), and at 1 week (T1), 3 months (T2) and 6 months (T3) after treatment. Treatment effects on the seven domains and the four dimensions of the OHIP scale were analysed, and the oral health-related quality of life (OHRQoL) was measured. Patients' expectations of their prosthetic treatment were also evaluated. Data were analysed using two-way Mixed ANOVA, regression analysis, and Cronbach's alpha test with a level of significance of α ≤ .017.

RESULTS

OHRQoL significantly improved following prosthetic treatment compared with baseline. The largest improvement was found between T0 and T1 evaluations (all p ≤ .001). Unlike the seven-domain scale, the four OHIP dimensions demonstrated further significant improvements across the T1/T2/T3 evaluations (all p ≤ .017). Different pre-treatment findings had different treatment effects on the four OHIP dimensions and seven OHIP domains. Patients' expectations were mainly fulfilled.

CONCLUSION

Compared with the seven-domain scale, the four dimensions showed significant follow-up changes, suggesting the four dimensions are suitable for evaluating treatment effects up to 6 months. Clinically meaningful effects of dental prosthetic treatment can be sensitively measured using the four-dimensional OHIP scale.

THE 3P MODEL AND ORAL HEALTH IMPACT: DEMONSTRATING THE IMPORTANCE OF BEHAVIORAL AND SOCIAL SCIENCES IN THE FUTURE OF EVIDENCE-BASED DENTISTRY

Oral health impact or oral health related quality of life is an increasingly important and well-known metric in dental care and research. There have been recent calls for greater integration of the behavioral and social sciences into oral health research and practice, including the need for frameworks and theories to guide this work. One such framework for understanding the role of predisposing, precipitating, and perpetuating biopsychosocial mechanisms in health and disease is the "3P" model. Here, the 3P model is described and applied to case examples to help understand the development and maintenance of oral health impact. Additionally, this paper outlines how this conceptualization using the 3P model and oral health impact makes way for greater integration of behavioral interventions to prevent, mitigate, or treat the negative impact that oral, craniofacial, or dental disease may have on individuals. Doing this allows for a broadening of what evidence-based dentistry means for the future and provides a roadmap going forward.

GLOSSARY FOR DENTAL PATIENT-CENTERED OUTCOMES

Dental patient-centered outcomes can improve the relevance of clinical study results to dental patients and generate evidence to optimize health outcomes for dental patients. Dental patient-reported outcomes (dPROs) are of great importance to patient-centered dental care. They can be used to evaluate the health outcomes of an individual patient about the impact of oral diseases and treatment, and to assess the quality of oral health care delivery for a health care entity. dPROs are measured with dental patient-reported outcome measures (dPROMs). dPROMs should be validated and tested before wider dissemination and application to ensure that they can accurately capture the intended dPROs. Evidence suggests inadequate dPRO usage among dental trials, as well as potential flaws in some existing dPROMs. This Glossary presents a collection of main terms in dental patient-centered outcomes to help clinicians and researchers read and understand patient-centered clinical studies in dentistry.

Oral health quality of life is associated to jaw function and depression in patients with myogenous temporomandibular dysfunction

OBJECTIVE

To determine which factors influence and better differentiate between good and poor oral health-related quality of life (OHRQoL) in patients with myogenous TMD and which cut-off could predict a good/poor OHRQoL.

METHODS

Fifty-eight women with myogenous TMD were included. Factors of interest were collected (i.e., demographic variables, depression symptoms (Symptom Checklist-90 R (RDC/TMD)), pain intensity (Visual Analog Scale), jaw function (Mandibular Functional Limitation Questionnaire), and OHRQoL (Oral Health Impact Profile-14). A multivariable regression model, logistic regression, and receiver operating curve (ROC) analyses were conducted.

RESULTS

Depression symptoms (β = 0.139) and jaw function (β = 0.478) were significantly associated with OHRQoL in the multivariable model. The best model to discriminate between good/poor OHRQoL included only jaw function (AUC = 0.90), with the best cut-off of 17 points (sensitivity: 0.93; specificity: 0.79).

CONCLUSION

Depression symptoms and jaw function were significantly associated with OHRQoL. The best model and cut-off to discriminate good/poor OHRQoL included only jaw function.

Validation of the HeLD-14 functional oral health literacy instrument in a general population

Background

Oral health literacy (OHL) is recognized as an important determinant of oral outcomes. Measuring OHL with a valid and reliable instrument that accurately captures the functional nature of this construct across cultures is needed. The short version of the Health Literacy in Dentistry scale (HeLD-14) shows promise as an appropriate instrument due to its inclusion of comprehensive domains hypothesized to comprise OHL. While studies validating the instrument in several languages have occurred, the number of dimensions in the various analyses range from one to seven. Validation of the HeLD-14 in a general English-speaking population is also lacking. The purpose of this study was to explore and confirm the dimensionality of the HeLD-14 in a general US English-speaking population.

Methods

The psychometric properties of HeLD-14 were evaluated in a sample of 631 participants attending the Minnesota State Fair. Construct validity was assessed using exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) on the data set split into two groups. Internal consistency reliability was assessed using the Cronbach's alpha coefficient. Concurrent validity was established between the HeLD-14 and the Oral Health Inventory Profile (OHIP-5) using Pearson's correlation.

Results

EFA found, and CFA reinforced, a unidimensional structure of the HeLD-14. Cronbach's alpha was acceptable at 0.92. Fit assessment also supported a unidimensional structure, comparative fit index = 0.992, Tucker-Lewis index = 0.991, root mean square error of approximation = 0.065, and standardized root mean square residual = 0.074. Concurrent validity analyses showed that the HeLD-14 correlated with the OHIP-5.

Conclusions

The HeLD-14 is a unidimensional reliable and valid instrument for measuring the oral health literacy in the general US English-speaking adult population.

Perception of oral health related quality of life and orofacial aesthetics following restorative treatment of tooth wear: A five-year follow-up

OBJECTIVES

Non-carious tooth wear often has a multifactorial etiology and may lead to functional or aesthetically related problems. The most common complaints associated with tooth wear are dissatisfaction with dental appearance and a negative impact on the experienced Oral Health Related Quality of Life (OHRQoL). The aim of this study was to investigate the change in OHRQoL and the perception of aesthetics, following restorative treatment of moderate to severe tooth wear patients, with a five-year follow-up.

METHODS

An explorative study, based on prospective data, was performed. OHRQoL and the perception of aesthetics were measured with the OHIP-NL and OES-NL. These questionnaires were completed before treatment, one month after treatment, and at 1-, 3- and 5-years post-treatment. Treatment involved full mouth reconstruction with composite resin restorations. The data was analysed as repeated measures by using a linear mixed-effects model.

RESULTS

One hundred and twenty-three tooth wear patients that received restorative rehabilitation were included (97 males, 26 females, 37.5 ± 8.8 years-old). Data showed a statistically significant increase in both experienced OHRQoL and orofacial appearance after restorative treatment. The OHIP-scores remained stable over time, while the OES-scores slightly decreased during the years after treatment. Regarding the seven domains of the OHIP, the largest difference in OHIP-score was found in the domain of 'Psychological Discomfort'. The mean overall OHIP-score was 1.8 at baseline and 1.3 at the 5-years recall. The mean OES score increased from 41.8 at baseline to 66.1 at the 5-years follow-up.

CONCLUSIONS

Tooth wear patients reported significant improvements in their OHRQoL and their perception of orofacial aesthetics after restorative treatment. This increase remained at least five years post-treatment.

CLINICAL SIGNIFICANCE

The clinical impact of restorative treatment for tooth wear patients is considerable. This paper emphasizes the need to include a discussion of the patient related outcome measures when planning care.

IMPACT OF LOADING PROTOCOL OF 2-IMPLANT BAR-RETAINED MANDIBULAR OVERDENTURES ON ORAL HEALTH-RELATED QUALITY OF LIFE: A RANDOMIZED CONTROLLED TRIAL

OBJECTIVES

Aim was to assess whether immediate loading (IL) is more effective than delayed loading (DL) for 2-implant bar-retained mandibular overdentures in terms of oral health-related quality of life (OHRQoL) improvement over a period of 24-month.

METHODS

In this randomized controlled trial, 32 edentulous patients (mean age: 65.7 ± 10.6 years, 50.0% female) were included. Potential participants had to be unsatisfied with the retention of their current mandibular complete denture and demanded implant treatment for inclusion in the study. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP) at baseline before treatment and 1, 3, 6, 12, and 24 months after implant loading and insertion of implant-retained bars for overdenture support. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement.

RESULTS

Patients' OHRQoL impairment at baseline was substantial indicated by mean OHIP summary score of 45.1 points. OHIP summary scores decreased substantially from baseline to 1-month follow-up to a mean of 33.5 points (P = .020). OHRQoL further improved during study period indicated by OHIP summary score of 25.7 points at 24-month follow-up. Raw treatment effects (IL vs. DL) ranged from -1.2 OHIP points for 12-month follow-up to 5.8 OHIP points for 24-month follow-up. Assuming constant treatment and time effects, treatment effect was small and not statistically significant (-0.7 OHIP points; P= .918).

CONCLUSION

A 2-implant bar-retained mandibular overdentures substantially improves OHRQoL over a period of at least 24 months. There seems to be no significant effect of implant loading protocol.

Treatment effect of implant-supported fixed complete dentures and implant overdentures on patient-reported outcomes: A systematic review and meta-analysis

OBJECTIVES

To analyze the effect of implant treatment in edentulous patients rehabilitated with implant-supported fixed complete dentures (IFCDs) or implant overdentures (IODs) on dental patient-reported outcomes (dPROs).

MATERIALS AND METHODS

In January 2022, Medline, Embase, CINAHL, Cochrane Library, PubMed Central, Web of Science, and ClinicalTrials.gov were screened for prospective clinical studies on completely edentulous patients treated with IFCDs and/or IODs, reporting pre-treatment and follow-up dPROs. Hedges' g effect sizes (ES) with corresponding 95% confidence intervals (CI) were calculated. Afterward, meta-analyses were conducted using random effect models.

RESULTS

A total number of 1608 records was initially identified. Of those, 28 studies reporting dPROs from 1457 patients were finally included. The applied dental patient-reported outcome measures (dPROMs) included several versions of the Oral Health Impact Profile (OHIP) or specific items assessing satisfaction with Visual Analogue Scales (VAS). The overall ES was large for rehabilitation with IFCDs (1.68 [CI: 1.15, 2.20]) and IODs (1.26 [CI: 0.99, 1.52]) with no significant difference (p = .165) between the two. Denture stability was the only factor rated significantly higher for IFCDs (ES difference: 2.37 [CI: 0.21, 4.54]; p = .032). Subgroup analyses revealed moderately higher ES for IODs on two implants relative to one implant (ES difference: 0.73 [CI: 0.34, 1.12]; p < .001).

CONCLUSIONS

There is a strong positive effect of implant treatment in edentulous patients, independent of the type of prosthetic rehabilitation. In patients seeking high stability, IFCDs may be preferable. In mandibular IODs on a single implant, there was a significantly positive effect of an additional implant on dPROs.

Use test with l-carvone in toothpaste on sensitized individuals

BACKGROUND

The mint flavour carvone (l-carvone) is considered a weak contact allergen. However, contact allergy to carvone is more prevalent in patients with oral lichen planus or oral lichenoid lesions (OLP/OLL).

OBJECTIVE

Our aim was to investigate how carvone affects sensitized individuals through a use test with toothpaste containing carvone. Non-flavoured toothpaste served as control.

METHODS

Subjects were patch tested prior to the use test-14 subjects allergic to carvone (11 with OLP/OLL), 20 subjects with OLP/OLL and 3 healthy controls. The month-long use test comprised of using toothpaste twice daily. Subjects were examined fortnightly. Clinical signs were assessed with a mucosal scoring system. The subjects' oral health-related quality of life was measured with the oral health impact profile (OHIP-49).

RESULTS

Local reactions to the carvone toothpaste presented as aggravated OLL (7/10) and peri-oral eczema (2/10) in allergic subjects. They also had significantly higher mucosal and OHIP scores compared with those receiving non-flavoured toothpaste.

CONCLUSION

In sensitized individuals, oral exposure to carvone gives aggravated oral lesions and/or peri-oral eczema. The lesions mimic OLP and allergic individuals are therefore at risk of not being assessed with regard to flavour contact allergy.

Cross-cultural adaptations of the oral health impact profile - An assessment of global availability of 4-dimensional oral health impact characterization

OBJECTIVE

The 4-dimensional (4D) structure of oral health-related quality of life (OHRQoL), comprising of the dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, is clinically plausible and psychometrically solid. The original Oral Health Impact Profile (OHIP) instrument and its short-form versions have been proven to lend themselves well to the assessment of these 4 OHRQoL dimensions. However, whether this 4-dimensional approach to oral health impact characterization can be performed on a global scale, that is, for most of the world's population, is not known. The purpose of this study was perform a systematic review to identify all cross-cultural adaptations of OHIP versions with 49, 20/19, 14, and 5 items. The global availability of 4D oral health impact characterization was investigated.

METHODS

We performed searches of electronic databases- Scopus, Pubmed, Web of Science, along with hand searching in June 2022 to identify all cross-cultural language adaptations of the different OHIP versions available in the literature. Whether the 4D oral health impact assessment can be considered a global approach was judged based on the criteria whether 4D psychometric information was available for at least 75% of the most widely spoken languages with an OHIP version.

RESULTS

We identified 82 studies with a total of 90 individual OHIP language versions for 45 languages. Among the top 20 languages with most first-language (native) speakers, 16 (80%) had OHIP versions. Among the top 20 languages with the most first- and second-language speakers, also 16 (80%) had OHIP versions. Of these 16 OHIP versions, across both language categories, 13 versions (81%) allowed for 4D oral health impact characterization.

CONCLUSION

Four-dimensional oral health impact assessment using the dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact can be considered a globally available approach given that OHIP versions with 4D information are readily available for most widely spoken languages. Thus, psychometrically sound, practical, and internationally comparable oral health impact characterization can be easily performed to study population oral health and determine oral disease impact and treatment efficacy for dental patients.

EXISTING EVIDENCE FOR DENTAL HYGIENE AND DENTAL THERAPY INTERVENTIONS: A DETERMINATION OF DISTINCT PATIENT POPULATIONS

BACKGROUND

Dental patients seeking care expect to receive treatment options that are supported by evidence-based dental research based on dental patient-reported outcomes (dPROs). In dental hygiene and dental therapy, there is little usage of dPROs and dental patient-reported outcome measures (dPROMs) to assess the four-dimensions of oral health-related quality of life (OHRQoL). In order to assess the current evidence for dental hygiene and dental therapy interventions, the determination of distinct patient populations is essential.

AIMS

To determine patient populations that are clinically distinct groups of dental hygiene and dental therapy patients. To provide a preliminary literature search for a systematic review to identify interventions that provide four-dimensional oral health impact information for these patient populations.

METHODS

This narrative and methodological manuscript utilizes an allied dental expert panel consisting of two dental hygienists, two dental therapists, and a moderator to generate a list of clinically distinct patient populations within the scopes of dental hygiene and dental therapy. Additionally, a preliminary literature search utilizing PubMed was completed to assess the current research within the scopes of practice of dental hygiene and dental therapy that uses dPROs and dPROMs to assess the four-dimensions of OHRQoL. The patient population list generated by the allied dental expert panel and the patient populations from the articles identified in the preliminary literature search were compared to determine the needed and available evidence for dental hygiene and dental therapy interventions.

RESULTS

There were 19 distinct patient populations derived from the allied dental expert panel. Nine of the distinct patient populations were shared in the dental hygiene and dental therapy scopes of practice, six were specific to the dental hygiene scope of practice, and four were specific to the dental therapy scope of practice. From the preliminary literature search, five distinct patient populations had corresponding research. Of those, three distinct populations were shared between dental hygiene and dental therapy, and two were dental hygiene specific. There  : were no distinct patient populations found from the preliminary search specific to dental therapy.

CONCLUSION

There is a lack of research in the dental hygiene and dental therapy scopes of practice regarding utilization of dPROs and dPROMs to assess the four-dimensions of OHRQoL. In order to standardize the assessment of OHRQoL, the development of a list of distinct patient populations for dental hygiene and dental therapy interventions is essential. This initiative identifies which populations are lacking evidence and provides a pragmatic approach to conducting a systematic review to assess the four-dimensions of OHRQoL in the field of dental hygiene and dental therapy.

HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA: TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH

BACKGROUND

When dental patients seek care, treatments are not always successful,that is patients' oral health problems are not always eliminated or substantially reduced. Identifying these patients (treatment non-responders) is essential for clinical decision-making. Group-based trajectory modeling (GBTM) is rarely used in dentistry, but a promising statistical technique to identify non-responders in particular and clinical distinct patient groups in general in longitudinal data sets.

AIM

Using group-based trajectory modeling, this study aimed to demonstrate how to identify oral health-related quality of life (OHRQoL) treatment response patterns by the example of patients with a shortened dental arch (SDA).

METHODS

This paper is a secondary data analysis of a randomized controlled clinical trial. In this trial SDA patients received partial removable dental prostheses replacing missing teeth up to the first molars (N = 79) either or the dental arch ended with the second premolar that was present or replaced by a cantilever fixed dental prosthesis (N = 71). Up to ten follow-up examinations (1-2, 6, 12, 24, 36, 48, 60, 96, 120, and 180 months post-treatment) continued for 15 years. The outcome OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). Exploratory GBTM was performed to identify treatment response patterns.

RESULTS

Two response patterns could be identified - "responders" and "non-responders." Responders' OHRQoL improved substantially and stayed primarily stable over the 15 years. Non-responders' OHRQoL did not improve considerably over time or worsened. While the SDA treatments were not related to the 2 response patterns, higher levels of functional, pain-related, psychological impairment in particular, and severely impaired OHRQoL in general predicted a non-responding OHRQoL pattern after treatment. Supplementary, a 3 pattern approach has been evaluated.

CONCLUSIONS

Clustering patients according to certain longitudinal characteristics after treatment is generally important, but specifically identifying treatment in non-responders is central. With the increasing availability of OHRQoL data in clinical research and regular patient care, GBTM has become a powerful tool to investigate which dental treatment works for which patients.

Reliability and Validity of a Lithuanian Version of the Oral Health Impact Profile-A Study in Patients with Stage III-IV Periodontitis

Background and Objectives: The study aimed to translate the original English version of Oral Health Impact Profile (OHIP) into Lithuanian and to assess reliability and validity of the translated instrument (OHIP-Lt) in patients with advanced stages of periodontitis. Materials and Methods: Subjects (N = 67) with stage III-IV periodontitis aged 30-63 years were surveyed by questionnaire and examined clinically. Psychometric analysis included explanatory (EFA) and confirmatory (CFA) factor analyses and psychometric tests. Results: Cronbach's alpha of the translated OHIP was 0.96. EFA revealed four dimensions which Cronbach's alpha ranged from 0.75 to 0.96. Construct validity of the four-factor model derived from the OHIP-Lt was supported by findings of CFA (RMSEA = 0.077). The total OHIP-Lt and its subscale scores increased as the patients' self-rated oral health status changed from healthy to unhealthy. Discriminative validity of the OHIP-Lt was confirmed by its higher scores among patients who had an increased spacing between the maxillary anterior teeth and increased clinical attachment level (CAL ≥ 5 mm) compared to those who did not. Conclusions: The translated Lithuanian version of OHIP-Lt was identified as four-dimension inventory. Good reliability and validity of the OHIP-Lt provide the evidence for its further use in study on advanced periodontal disease burden among Lithuanian patients.

Implant or Tooth?-A Prospective Clinical Study on Oral Health-Related Quality of Life for Patients with "Unrestorable" Teeth

In cases of severely compromised teeth, dental practitioners are confronted with the therapeutic decision of whether to restore a tooth or replace it with an implant. Comparative scientific evidence on patient perception of both treatment approaches is scarce. The subject of this prospective clinical study was to compare oral health-related quality of life (OHRQoL) between two treatment groups: restoration of severely destroyed teeth after orthodontic extrusion (FOE) versus tooth extraction and implant-supported single crown restoration (ISC). A self-selected trial was performed with 21 patients per group. OHRQoL was assessed with the aid of the Oral Health Impact Profile (OHIP-G49) at different time intervals: before treatment (T1), after treatment (T2), after restoration (T3) and at recall (T4). Overall, OHIP scores improved from baseline to follow-up for both concepts with no significant differences between groups. There were no significant differences in subscales between FOE and ISC at T1, T3 and T4. In terms of functional limitations (p = 0.003) and physical disability (p = 0.021), patients in the FOE group temporarily exhibited lower OHRQoL at T2 in comparison to the ISC group. However, at baseline, after final restoration and at recall, the study demonstrates the same level of OHRQoL for both treatment concepts.

Oral Health-Related Quality of Life among Children and Adolescents with Beckwith–Wiedemann Syndrome in Northern Italy

Due to associated maxillofacial growth anomalies and the impairment of oral functions, macroglossia may negatively impact the oral health-related quality of life (OHRQoL) of people with Beckwith–Wiedemann syndrome (BWS). Therefore, the aim of this cross-sectional study was to determine the OHRQoL of Italian children and adolescents with BWS compared to healthy peers and to identify which symptoms related to macroglossia had the highest impact. A total of 48 patients with BWS and 48 age- and gender-matched controls completed the Italian version of OHIP-14 and a questionnaire on functional, oral and aesthetic outcomes. Parents of patients with BWS who had undergone tongue reduction surgery (TRS) answered additional questions related to surgery. The BWS group scored higher than controls on the total OHIP-14 and on the dimensions of oral function (p: 0.036) and psychosocial impact (p: 0.002), indicating a reduced OHRQoL. Neither gender nor age had an impact on OHRQoL. Scores were worse in children and adolescents treated with TRS, as most of them still had open bite malocclusion and speech difficulties. The OHRQoL of children and adolescents affected by BWS is worse than that of their healthy peers in spite of the surgical treatment of macroglossia.

Comparison of two rating scales with the orofacial esthetic scale and practical recommendations for its application

Purpose

We compared measurement properties of 5-point and 11-point response formats for the orofacial esthetic scale (OES) items to determine whether collapsing the format would degrade OES score precision.

Methods

Data were collected from a consecutive sample of adult dental patients from HealthPartners dental clinics in Minnesota (N = 2,078). We fitted an Item Response Theory (IRT) model to the 11-point response format and the six derived 5-point response formats. We compared all response formats using test (or scale) information, correlation between the IRT scores, Cronbach’s alpha estimates for each scaling format, correlations based on the observed scores for the seven OES items and the eighth global item, and the relationship of observed and IRT scores to an external criterion using orofacial appearance (OA) indicators from the Oral Health Impact Profile (OHIP).

Results

The correlations among scores based on the different response formats were uniformly high for observed (0.97–0.99) and IRT scores (0.96–0.99); as were correlations of both observed and IRT scores and the OHIP measure of OA (0.66–0.68). Cronbach’s alpha based on any of the 5-point formats (α = 0.95) was nearly the same as that based on the 11-point format (α = 0.96). The weighted total information area for five of six derived 5-point response formats was 98% of that for the 11-point response format.

Conclusions

Our results support the use of scores based on a 5-point response format for the OES items. The measurement properties of scores based on a 5-point response format are comparable to those of scores based on the 11-point response format.

Validation of the French version of COHIP-SF-19 among 12-years children in New Caledonia

BACKGROUND

Assessment of oral health-related quality of life is now associated to clinical indicators in epidemiological studies. This study aimed at validating the French Short Form of the Child Oral Health Impact Profile (COHIP-SF-19) and assessing the impacts of oral diseases among schoolchildren in New Caledonia (NC).

METHODS

A sample of 12-years-old children (n = 971) was selected in 2019 in NC using a random, stratified, and clustered sampling technique. Children filled the French COHIP-SF-19 questionnaire. Information on sociodemographic characteristics, oral hygiene habits, perception of oral health problems were also collected through self-administered questionnaires or from the schools' database. Dental status (dental caries, gingival status, and dental functional units) was clinically recorded at school by four calibrated examiners. Cronbach's alpha and intraclass correlation coefficients (ICC) were calculated. Kruskal-Wallis tests and spearman correlations were used along with multilevel mixed models taking into account the cluster and examiner effects. A confirmatory factor analysis was conducted and sensitivity analyses were performed.

RESULTS

Among the 693 children examined, 557 children were included. Oral diseases were frequent in the study population 40% had dental caries and 55% presented gingivitis. The COHIP scores ranged from 7 to 76 (57.9 ± 9.96) with 96.4% of the children having experienced oral health problems, 81.7% reporting functional impacts and 90.5% socio-emotional impacts. Overall, the French COHIP-SF-19 showed satisfactory psychometric characteristics. Internal consistency was high (Cronbach's alpha = 0.80) and reproducibility excellent (ICC = 0.9). Discriminant and concurrent validity were adequate. Indeed, children with less optimal social situation, impaired dental status, declaring severe dental problems or difficulties in accessing oral health care showed lower COHIP-SF-19 scores. Factor analyses suggested a four-component structure with identification of a new domain (self -image) and changes in the repartition of the items within the original domains. Sensitivity analyses showed similar results for children with partial or complete answers in the COHIP questionnaire.

CONCLUSIONS

The French COHIP-SF-19 showed satisfactory psychometric characteristics and allowed to identify the high impacts of oral diseases in New Caledonian children, namely for socially deprived children.

The Influence of Steroid Hormones on Tooth Wear in Children and in Adolescents

(1) Background: From a young age, boys are more often affected by tooth wear than girls. This suggests an influence of the male sex hormone (testosterone) on the aetiology of tooth wear. The aim of the present study was to investigate the incidence of tooth wear in relation to steroid hormone levels in children. (2) Methods: 1022 test persons aged between 10 and 18 (491 male, 531 female) from the LIFE Child study underwent medical and dental examination. Tooth wear was measured through clinical inspection. Blood samples were taken to determine hormone levels (testosterone, SHBG). The level of free testosterone was calculated from the ratio of testosterone to SHBG. Using multivariable methods, the incidence of tooth wear was analyzed as a function of hormone levels, while controlling for confounders such as age, sex, social status, and orthodontic treatment. (3) Results: The incidence of tooth wear increased with age in both sexes. Boys showed significantly more often attrition facets than girls (17.5% vs. 13.2%, p < 0.001). Subjects with tooth wear showed significantly higher free testosterone levels than those without (males: p < 0.001, females: p < 0.05). After controlling for confounding variables, the risk of tooth wear increased by approximately 30.0% with each year of life (odds ratio [OR]boys = 1.29, 95% confidence interval [CI] = 1.04−1.56; [OR]girls = 1.32, 95% CI = 1.08−1.61). In addition, the risk of tooth wear increased by 6.0% per free testosterone scale score only in boys (OR = 1.06, 95% CI = 1.01−1.12). (4) Conclusions: Tooth wear is common in children and in adolescents, and it increases steadily with age in both sexes. The stronger increase and the higher prevalence among male adolescents can be explained by the additional effect of free testosterone.

Commonalities among dental patient-reported outcomes (dPROs)—A Delphi consensus study

Improvement of patients’ oral health-related quality of life (OHRQoL) is the main goal of oral health care professionals. However, OHRQoL is not a homogenous construct and how to assess it is challenging because of the large number of currently available instruments. Investigating available instruments and what they have in common would be necessary for consolidation and standardization of these instruments into a smaller set of tools. If the OHRQoL dimensions including Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the fundamental building blocks of the dental patient’s oral health experience, then these dimensions should be measured by generic multi-item dPROMs. In this study, a panel of 11 international dentists use the Delphi consensus process to determine how well 20 of these instruments measured the four OHRQoL dimensions. All 20 dPROMs questionnaires assessed at least one OHRQoL dimension while all four OHRQoL dimensions were measured by at least one dPROM instrument, i.e., the four OHRQoL dimensions were essential components of the patient’s oral health experience. This shows that the currently available generic multi-item dPROMs have a lot in common, in that they share Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact as targeted dimensions. Based on these commonalities, it is plausible and desirable to move towards a single four-dimensional metric to assess oral health impact in all clinical, community-based, and research settings. This step is necessary to advance evidence-based dentistry and value-based oral health care.

Assessment of Orofacial Esthetics among Different Specialists in Dental Medicine: A pilot study

Objectives

Little is known whether specialists in different dental fields assess orofacial esthetics differently due to various focus of their interest. The aim was to find out if there is a difference in judgement of orofacial esthetics among specialists in three different fields of Dental Medicine, i.e. specialists in Prosthodontics (S-Prosthod), Periodontology (S-Perio), and Orthodontics (S-Ortho).

Material and methods

A total of 69 specialists (23 participants in each group) assessed the same 60 photographs of the lower third of the face of young healthy people with Angle Class I and natural teeth while smiling. Moreover, the assessed anterior teeth on the photographs of similes had to be without any restorations. The assessments were made using 7 out of 8 Items of Orofacial Esthetic Scale (OES). A face profile assessment was not performed. A Likert 1-5 scale was used for assessments (1-the worst score; 5-the best score). Mean values of summary scores as well as of each OES item were calculated for each specialist for further statistical analysis. One-sample Kolmogorov-Smirnov test, descriptive statistics, one-way ANOVA, and Sheffe post-hoc tests were performed.

Results

The specialists in Periodontology gave significantly lowest scores to all 7 items related to orofacial esthetics, while the specialists in Prosthodontics gave the highest scores (p<0.05).

Conclusion

Assessments of orofacial esthetics differ significantly among specialists in Prosthodontics, Periodontology and Orthodontics. Further study is needed to clarify the factors which influence the judgement, and to find out if specific education in certain specialties can modify the assessment.

RECOMMENDATIONS FOR USE AND SCORING OF ORAL HEALTH IMPACT PROFILE VERSIONS

BACKGROUND

OHIP's original seven-domain structure does not fit empirical data, but a psychometrically sound and clinically more plausible structure with the four OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact has emerged. Consequently, use and scoring of available OHIP versions need to be revisited.

AIM

We assessed how well the overall construct OHRQoL and its four dimensions were measured with several OHIP versions (20, 19, 14, and 5 items) to derive recommendations which instruments should be used and how to score them.

METHODS

Data came from the "Dimensions of OHRQoL Project" and used the project's learning sample (5,173 prosthodontic patients and general population subjects with 49-item OHIP data). We computed correlations among OHIP versions' summary scores. Correlations between OHRQoL dimensions, on one hand, and OHIP versions' domain scores or OHIP-5's items, on the other hand, were also computed. OHIP use and scoring recommendations were derived for psychometrically solid but also practical OHRQoL assessment.

RESULTS

Summary scores of 5-, 14-, 19- and 49-item versions correlated highly (r = 0.91-0.98), suggesting similar OHRQoL construct measurement across versions. The OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were best measured by the OHIP domain scores for Physical Disability, Physical Pain, Psychological Discomfort, and Handicap, respectively.

CONCLUSION

Recommendations were derived which OHIP should be preferably used and how OHIP versions should be scored to capture the overall construct and the dimensions of OHRQoL. Psychometrically solid and practical OHRQoL assessment in all settings across all oral health conditions can be achieved with the 5-item OHIP.

Comparing oral health-related quality of life, oral function and orofacial aesthetics among a group of adolescents with and without malocclusions

OBJECTIVE

The aim was to analyze how malocclusion relates to perception of oral health-related quality of life (OHRQOL), oral function and orofacial aesthetics among a group of adolescents in Sweden.

MATERIAL AND METHODS

Thirty patients with a need for orthodontic treatment (IOTN-DHC grade 4 and 5) and 30 patients with normal occlusion (IOTN-DHC grade 1), aged 13-17 years, were included in the study. A questionnaire containing three parts was used; The Oral Health Impact Profile (OHIP-S14), Jaw Functional Limitational scale (JFLS-20) and Orofacial Aesthetic scale (OES). Malocclusions, orthodontic treatment need and confounders, such as earlier dental treatment and temporomandibular disorders, were registered.

RESULTS

Adolescents with malocclusions were more often embarrassed by their mouth and teeth compared to controls (p < .05). Aesthetically, adolescents with malocclusions were more negatively affected by the appearance of the mouth and teeth as well as the over-all facial appearance (p < .05).

CONCLUSIONS

Malocclusions clearly affects the adolescents with need for orthodontic treatment in this study. It influences their OHRQOL in the psychosocial impact dimension. Aesthetically they perceive their oral and facial appearance as worse compared to controls. Although embarrassed and unpleased with their oral appearance they still rate themselves as having a good oral health with low jaw function limitations.

Should the frequency, severity, or both response scales be used for multi-item dental patient-reported outcome measures?

BACKGROUND

The Oral Impacts on Daily Performances (OIDP) index asks the respondents to indicate both, the frequency and severity of the impact. However, it is not clear if the two scaling methods are correlated, and if using one scale is sufficient. The purpose of the study was to investigate the correlation between frequency and severity rating scales of the OIDP instrument, and whether only one of the rating scales can be used instead of both.

METHODS

A battery of patient-reported outcome questionnaires were administered to a consecutive sample of adult dental patients from HealthPartners dental clinics in Minnesota (N = 2,115). Only those who responded to any of the OIDP items were included in the analysis for this study (N = 873). We assessed correlations between the frequency and severity scales for all OIDP items, and for the summary scores of the two OIDP response scales. We additionally fit a categorical structural equation model (SEM) (or an item factor analysis model) and examined the correlation between two latent variables (Frequency and Severity).

RESULTS

The correlation estimates for all OIDP items were greater than 0.50, indicating large correlations between the frequency and severity scores for each OIDP item. The correlation estimate between the two summary scores was 0.85 (95% CI [0.82-0.86]). When we calculated the correlation coefficient using a latent variable model, the value increased to 0.96 (95% CI [0.93-1.00]).

CONCLUSION

Our study findings show that OIDP frequency and severity scores are highly correlated, which indicates the use of one scale only. Based on previous evidence, we recommend applying the frequency rating scale only in research and clinical settings.

Identification of Preferred Representational Sensory System in Neuro-Linguistic Programming

The paper highlights the scientific debate on the Neurolinguistic programming (NLP) issue. NLP is a collection of approaches, communication tools, techniques, and perspectives that determine how individuals think and communicate through language. NLP is used to recognize and modify patterns of human behavior. The sensory representational system, or the method for recognizing representational systems, which is made up of five main senses, influences this process. Systematization literary sources and approaches to this issue indicate that three sensory representational systems exist in the NLP approach: visual, auditory, and kinesthetic (VAK), and that the individual’s preferred representational sensory system could explain manifested behavior and characteristics in the managerial and marketing sphere. The central purpose of the research and the significance of choice made about this area of interest is to determine each individual’s preferred representational sensory system (VAK) utilizing the original PRSS-VAK methodology. The methodological research tool was the PRSS-VAK methodology which contains nine statements, which are assessed on a scale from 1 (the least describes me) to 4 (the most describes me). The PRSS-VAK methodology would help to comprehend patterns of an individual’s behavior and allied cognitive or emotional processes. EFA (Exploratory Factor Analysis) with Varimax rotation was used to verify the methodology on a sample of 214 respondents from the Slovak Republic, and CFA (Confirmatory Factor Analysis) was used to validate the structure on a sample of 268 respondents from the Slovak Republic. This research empirically and theoretically confirms that one of the preferred representational sensory systems may be dominant. However, this may change regarding the current situation (stimulus, impulse). The research results could be beneficial as a springboard not only for researchers concerning this issue. It also indicates that quantitative research does not determine exactly to which category (visual, auditory, or kinesthetic) a certain individual belongs. Using the identification of a preferred representational sensory system could help to facilitate both management and marketing communications.

Development of a one-item version of the Orofacial Esthetic Scale

OBJECTIVES

Orofacial appearance is increasingly recognized as an important dental patient-reported outcome making instrument development and refinement efforts to measure the outcome better necessary. The aim of this study was to derive a one-item version of the Orofacial Esthetic Scale (OES).

MATERIALS AND METHODS

OES data were collected from a consecutive sample of a total of 2113 adult English- or Spanish-speaking dental patients from HealthPartners dental clinic in Minnesota. Participants with missing data were excluded and analysis were performed using data from 2012 participants. Orofacial appearance was assessed with the English and the Spanish language version of the OES. Linear regression analysis was performed, with the OES item 8 ("Overall, how do you feel about the appearance of your face, your mouth, and your teeth?") as the predictor variable and the OES summary score as the criterion variable, to calculate the adjusted coefficients of determination (R2).

RESULTS

The value of adjusted R2 was 0.83, indicating that the OES item 8 score explained about 83% of the variance of the OES summary score. The difference in R2 scores between the two language groups was negligible.

CONCLUSION

The OES item 8 can be used for the one-item OES (OES-1). It is a psychometrically sound instrument for measuring orofacial appearance.

CLINICAL RELEVANCE

Due to its easy application and sufficient psychometric properties, the OES-1 can be used effectively as an alternative to longer OES instruments in all areas of dental practice and research.

STANDARDIZATION OF DENTAL PATIENT-REPORTED OUTCOMES MEASUREMENT USING OHIP-5 - VALIDATION OF "RECOMMENDATIONS FOR USE AND SCORING OF ORAL HEALTH IMPACT PROFILE VERSIONS"

BACKGROUND

Recently, "Recommendations for use and scoring of Oral Health Impact Profile versions" (here abbreviated as Recommendations Project) were proposed by an international group of oral health researchers to standardize assessment of perceived oral health. They recommended a four-dimensional measurement approach consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact as the set of dental patient-reported outcomes to be measured with the 5-item Oral Health Impact Profile (OHIP-5).

AIM

This study aimed to validate the "Recommendations for use and scoring of Oral Health Impact Profile versions" by replicating the findings they are based on.

METHODS

OHIP data came from the "Dimensions of OHRQoL Project." Its Validation Sample (5,022 prosthodontic patients and general population subjects) as well as its Additional Sample (N = 583 prosthodontic patients and general population subjects) were used. Validation of the Recommendations Project's findings was performed in two steps. First, correlations among OHIP versions presented in the Recommendations Project were replicated in the Validation Sample. Second, participants of the Additional Sample were subjected to a hypothetical treatment program that assigned two treatments to them according to their level of perceived oral health impact using OHIP versions. The performance of abbreviated OHIP versions was evaluated.

RESULTS

The high correlations among summary scores of 5-, 14-, 19-, and 49-item OHIP versions (r = 0.91-0.98), found in the Recommendations Project, were replicated. All short OHIP versions performed similarly when classifying participants for a hypothetical tailored treatment program.

CONCLUSIONS

Findings reported in "Recommendations for use and scoring of Oral Health Impact Profile versions" were validated, thus supporting the feasibility of a standardized assessment of perceived oral health in all settings across all oral diseases. Psychometrically solid and practical assessment can be performed with OHIP-5.

IMPACT OF SHORTENED DENTAL ARCH ON ORAL HEALTH-RELATED QUALITY OF LIFE

BACKGROUND

A shortened dental arch (SDA) is an established treatment concept for patients with missing molars. However, little is known regarding long-term course of oral health-related quality of life (OHRQoL) in patients with SDA and the benefits from replacement of missing molars.

OBJECTIVE

Purpose of this multi-center randomized clinical trial was to assess OHRQoL over a period of 15 years in patients with molar replacement by a removable partial denture (RPD) compared to patients with a restored SDA without molar replacement.

METHODS

Patients at least 35 years of age with all molars missing in 1 jaw and at least the canine and one premolar present on each side were included. Patients received either a precision attachment-retained, RPD for replacement of missing molars (n = 79), or the dental arch ended with the second premolar (SDA) that had to be present or replaced by a cantilever fixed dental prosthesis (n = 71). Follow-up examinations continued for 15 years. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). OHIP summary and dimension scores were longitudinally modeled in the statistical analyses to assess course of OHRQoL over time applying an intention-to-treat approach. In addition, scores for the OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were analyzed.

RESULTS

After an initial improvement in OHRQoL indicated by a mean decrease of 20.0 OHIP points with an effect size of 0.61 in the entire study population, OHRQoL stayed relatively constant over the entire follow-up period. Assuming a constant time and treatment effects over the study period, OHRQoL did not differ statistically significant between the 2 treatments (0.4 OHIP points; 95%-CI: 7.1 - 6.2). OHRQoL after treatment did not change notably over 15 years and was statistically nonsignificant as well (P = .872). Similar findings were observed in all 4 OHRQoL dimensions.

CONCLUSIONS

In patients, missing all molars in one jaw OHRQoL improved providing RPD or restoring SDA to a clinically relevant degree. Treatment-related improvement remained mostly stable over a period of at least 15 years. Therefore, patients can be informed that both treatment concepts are equivalent concerning long-term OHRQoL. Accordingly, patients' preferences regarding treatment options should be granted priority in treatment decision making with the SDA treatment option being the default.

Comparison of general satisfaction, oral health-related quality of life, and patient's self-assessment between mandibular single-implant overdentures and experimental removable complete dentures: A randomized crossover clinical trial

Objective Patient satisfaction with single-implant overdentures (1-IODs) is unclear. This randomized crossover trial aimed to compare the general satisfaction, oral health-related quality of life, and patients' self-assessment between mandibular 1-IODs and experimental removable complete dentures (eRCDs). Methods New mandibular RCDs were fabricated for 22 patients with edentulous mandibles. After adapting to the RCDs, one implant was inserted in the mandibular midline. The participants were then randomly classified into groups 1 and 2. Group 1 received IODs for the first 2 months, while group 2 used eRCDs with a non-loaded implant in the midline. After 2 months, the treatment was switched. Four validated, patient-reported dental outcome measures were assessed: general satisfaction, Japanese version of the Oral Health Impact Profile for edentulous subjects (OHIP EDENT-J), General Oral Health Assessment Index (GOHAI), and Patient's Denture Assessment (PDA). The assessments were performed at the end of the IOD- and eRCD- use periods. Results General satisfaction was significantly higher during the IOD period (p = 0.002). Significant differences were observed in all domains of the OHIP, except orofacial pain (p = 0.084). Further, the total score (p<0.001) and the scores of the physical (p<0.001) and psychosocial functioning (p = 0.001) domains of the GOHAI differed significantly. The total PDA score (p = 0.001) and the scores of the function (p = 0.004), lower denture (p = 0.002), esthetics and speech (p = 0.026), and importance (p = 0.009) domains were significantly higher during the IOD period than during the eRCD period. Conclusion General satisfaction, oral health-related quality of life, and patient self-assessment scores were significantly higher for 1-IODs than for eRCDs. Clinical significance Within the limitations of this study, we found that mandibular single-implant overdentures may be an efficient alternative to mandibular experimental removable complete dentures due to higher general satisfaction, oral health-related quality of life, and patient self-assessment scores of dentures.

Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists

OBJECTIVES

To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions.

METHODS

An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions.

RESULTS

Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1).

CONCLUSION

According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields.