Oral health-related quality of life in diabetic patients: comparison of the Persian version of Geriatric Oral Health Assessment Index and Oral Health Impact Profile: A descriptive-analytic study

Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understanding and addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significant associations between OHRQoL and factors such as ethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoL of seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoL of older adults, especially those not living in facilities like nursing homes or assisted living centers, tailored oral healthcare plans and strategies are crucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

Self- reported oral health and oral health- related quality of life among patients with diabetes mellitus in a tertiary health facility

BACKGROUND

Considering the inter-relationship between Diabetes Mellitus (DM) and oral tissues, assessment of oral health status in relation to glycemic control might be informative about the disease condition, which might be pivotal to appropriate management and ultimately improve life satisfaction. This study therefore aimed to assess the pattern of self-reported diabetes related oral conditions and oral health-related quality of life (OHRQoL) among patients with DM at the University College Hospital (UCH), Ibadan, Nigeria.

MATERIALS AND METHODS

A cross- sectional study using an interviewer administered questionnaire was conducted among in- and out- patients being managed for DM by the Endocrinology unit of the hospital. Data collected included bio-data, medical history, self-reported oral conditions and dental service utilisation. The impact of oral health related quality of life was measured using OHIP-14. Oral examination was done to assess oral mucosal lesions and their oral hygiene status. Data was analysed using SPSS 21.

RESULTS

Eighty-four patients with diabetes consisting 23 (27%) in-patients and 61 (63%) out-patients were enrolled. Males were 26(31%) and females 58(69%); their ages ranged from 22 to 88 years with a mean of 60.9 ± 12.8 years. Most (67%) of the participants had one or more self-reported oral complaints, dryness (20.4%) being the most common and bad breath (4.6%) as the least reported. Poor glycemic level was found to be higher among the in-patients (82%) with random blood glucose > 200 mg/dL during admission, compared to the out-patient participants (51%) who had fasting plasma glucose > 110 mg/dL. Their oral hygiene status was assessed using simplified oral hygiene index and documented as fair (65%), poor (25%) and good (10%). About two-thirds (61%) had ever visited a dentist, majorly due to toothache. Only the pain (21.9%) and physical disability (26.3%) components of OHIP-14 were mainly found to affect the participants' OHRQOL.

CONCLUSIONS

This study found high rate of self- reported DM related oral conditions notably oral dryness, and periodontal diseases particularly as teeth mobility and spontaneous exfoliation. Nonetheless, most of the study participants had fair OHRQoL while its physical pain, functional limitation and psychological disability components were most reported.

Oral health-related quality of life among diabetic patients: A cross-sectional controlled study

Introduction

Diabetes is a widespread chronic metabolic condition that has a significant negative influence on a person's sociopsychological, physical, and economic well-being. This study was designed to (1) measure the impact of oral health on quality of life (QoL) using the Oral Health Impact Profile-14 (OHIP-14) in association with other factors (age, gender, years of diabetes, level of education, smoking, presence of other conditions, oral complaints, and glycemic control) and (2) validate the Arabic version of the OHIP-14.

Materials and Methods

Diabetic and healthy participants completed a two-part survey including demographic characteristics OHIP-14 questionnaire.

Results

The sample consisted of 121 patients with type 2 diabetes mellitus and 146 healthy controls. Sociodemographic data, OHIP-14 questionnaires, and glycemic control data were collected. The data were statistically analyzed. The results showed that OHIP-14 was found to have sufficient reliability and validity in measuring life quality. Our study documented the effects of oral health complications on QoL among diabetics compared to controls. The type of diabetes had no effect on life quality. The highest OHIP-14 domain affected was functional limitation, while the lowest one was social handicap.

Conclusion

It was concluded that diabetes has a negative effect on life quality. Diabetic patients have unsatisfactory oral health, which affects their QoL. The OHIP-14 is a reliable and valuable instrument to measure life quality.

Impact of social marginalization on oral health-related quality of life in older adults

The aim of this study was to determine the association between oral health-related quality of life (OHRQoL) and social marginalization in people aged 60 years and older enrolled in social security in Mexico. A cross-sectional and analytical study was carried out in older adults. To assess the OHRQoL, the OHIP-14 instrument was applied, and the degree of social marginalization and sociodemographic characteristics were analyzed. Measures of central tendency and dispersion, simple frequencies and proportions were estimated. Student's t-test was used for comparison of means, and prevalence ratio (PR) and logistic regression were used to assess associations, all with a significance value of 0.05 and 95% confidence intervals. Perceived OHRQoL in the population measured through the OHIP-14 reached an average value of 9.84 ± 8.91, with the highest value in the dimension of physical pain (2.06 ± 1.91). Perceived treatment need was higher among people with social marginality (p = 0.011). The multivariate analysis shows that marginalized people have a lower OHRQoL. Socially marginalized older adults showed a low a better perception of OHRQoL, independent of demographic and clinical factors.

The effect of diabetes mellitus on oral health-related quality of life: A systematic review and meta-analysis study

Background

Diabetes mellitus is related to variable dental and oral complications like xerostomia and periodontal problems. Therefore, diabetes can affect the oral status and oral health-related quality of life (OHRQoL). A systematic review of evidence can determine the association between diabetes and OHRQoL. so, this study aimed to evaluate the effects of diabetes on OHRQoL.

Methods

After determining the PECO and eligible criteria, a comprehensive search was conducted in PubMed, Scopus, Web of Science, and Embase without any restriction. Further searches were performed in Google Scholar and reference lists of selected articles. Two independent reviewers carried out paper selection, data extraction, and quality assessment. A meta-analysis was conducted using a "random effect model" and the standardized mean difference of OHRQoL with a 95% confidence interval (CI) was reported as estimating pooled effect size.

Results

After screening 237 identified records, three case-control and ten cross-sectional studies met eligibility criteria. Two cross-sectional studies were excluded in the quality assessment phase and the rest of the studies have a low or moderate risk of bias. The pooled standardized mean difference between the case and the control groups was 0.148 (95% CI: -0.045 to 0.340).

Conclusion

Diabetes mellitus has no statistical significant association with OHRQoL. Nevertheless, based on the articles' review, it seems that diabetes can lead to functional limitations, physical pain, and psychological discomfort. Also, complications of diabetes adversely affect wellbeing. Hence dentists can play an essential role in the awareness of persons with diabetes about these problems and improve their OHRQoL.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022303038, identifier CRD42022303038.

Quality of life in health Iranian elderly population approach in health promotion: A systematic review

BACKGROUND

The quality of life (QOL) is essential in all different stages of life; however, It is more important for older people as it can be effective in promoting their health. Therefore, the present study aimed to review the literature on the QOL in the Iranian elderly population.

MATERIALS AND METHODS

The study was carried out as a systematic review. For this purpose, all databases were searched in March 2021. The keywords used for the search were "quality of life, elderly, older adults, aging, seniors, and Iran" along with the Persian equivalents. PRISMA protocol was used to screen articles. After removing duplicate and irrelevant items, two evaluators appraised the articles separately based on a researcher-made checklist derived from the SBEM and STROBE Statement standard checklists.

RESULTS

The initial search yielded 3734 studies on the QOL in the Iranian elderly population. After screening and assessing the studies based on inclusion and exclusion criteria, 22 articles remained in the study. Most of the studies (cross-sectional) were conducted in Tehran using a 36-item Short-Form Health Survey to assess the QOL. The studies investigated sociodemographic determinants, physical and health-related behaviors, and spirituality and psychological determinants of the QOL. The sociodemographic determinants were the most common factors under study. The results showed that the role of gender and socioeconomic status was the strongest among the sociodemographic characteristics. A significant association was found between the QOL in the Iranian elderly population and factors such as depression and religious confrontation.

CONCLUSION

In addition to chronic diseases, diseases of the oral and dental, as well as an unhealthy diet, should be considered in the elderly. Therefore, attention should be paid to all social, physical, and psychological variables that affect the QOL of older people.

Oral health-related quality of life in US adults with type 2 diabetes

OBJECTIVES

The objective of this study was to analyze factors associated with oral health-related quality of life (OHRQoL) between type 2 diabetes mellitus (T2DM) and nondiabetic US adults.

METHODS

The study sample included 2945 participants (aged ≥20) selected from National Health and Nutrition Examination Survey (NHANES) 2003-2004 that represented 130,689,262 million persons in a probability weighted sample. Oral health outcomes were measured by the NHANES version of Oral Health Impact Profile (OHIP) for OHRQoL and summarized as additive scores (OHIP-ADD) and as prevalence of negative impacts (OHIP-SC). Multiple logistic regression models used dichotomous outcome variables OHIP-ADD and OHIP-SC. The cut-off values for poor OHRQoL were heuristically defined as OHIP-ADD ≥6 and as OHIP-SC > 0.

RESULTS

Poor OHRQoL was significantly (p < 0.0001) predicted by T2DM (OR_{SC-controlled}  = 1.43, OR_{SC-uncontrolled}  = 1.73), obesity (OR_SC  = 1.24), untreated dental caries (OR_SC  = 1.79), periodontal disease (OR_ADD  = 1.07), evaluated unmet denture need (OR_SC  = 1.72), low income (OR_ADD  = 1.22), smoking (OR_{SC-former-smoker}  = 1.04, OR_{SC-current-smoker}  = 1.99), African-American (OR_SC  = 1.19), and female (OR_SC  = 1.66) in both logistic regression models. In contrast, protective factors significantly (p < 0.0001) associated with poor OHRQoL were private dental insurance (OR_SC  = 0.81), college education (OR_SC  = 0.85), and annual dental prophylaxis (OR_SC  = 0.83), after adjustment for covariates.

CONCLUSIONS

This study showed that private insurance coverage and annual prophylaxis are associated with better average OHRQoL among individuals with T2DM. Improved OHRQoL may be associated with glycaemia control, decreased BMI, and smoking cessation. The highest odds for poor OHRQoL were found among US adults with T2DM with uncontrolled HbA1c, untreated dental caries, and current smoking.

Health-related quality of life in edentulous patients

This study aimed to assess Oral Health-Related Quality of Life (OHQoL) and satisfaction in patients who had complete denture treatment and were diagnosed with systemic diseases. Eighty edentulous patients using new complete dentures were separated into four groups according to their diseases [diabetes mellitus (DM)/osteoporosis (OP)/hypertension (HP)/healthy (control)]. The groups answered the Turkish version of the United Kingdom-Oral Health-Related Quality of Life (OHQoL-UK) and Visual Analog Scale (VAS) questionnaire four weeks after treatment. OHQoL-UK scores were slightly higher for females regardless of the type of disease. Compared with the control participants (57.95±5.33), the scores of the OHQoL-UK were not significantly different in OP and HP groups except for the DM group (58.7±5.37, 58.9±6.44, 45.3±5.19 respectively). DM was significantly associated with the increase of OHQoL values (p<0.05). Patients in all groups reported significantly higher "physical health" scores than other subdomains of OHQoL-UK, although positive correlations were determined among them. Presence of disease had no relationship to the VAS scores. This study shows that systemic diseases might not affect and predict patients' satisfaction with their complete dentures and OHQoL. DM is an independent risk factor for oral health. Satisfaction with the prosthesis might concern a patient's level of OHQoL.

Oral health-related quality of life (OHRQoL) in cardiovascular patients referring to Fatima Zahra Hospital in Sari, Iran

Background

Cardiovascular Disease (CVD) is one of the leading causes of mortality and morbidity and significantly impacts the health-related quality of life. Oral infections have been linked to cardiovascular diseases such as thrombosis, cardiac infarction, stroke, and peripheral vascular disease. This study aims to evaluate the effects of oral health on the quality of life in cardiovascular patients.

Methods

The oral health-related quality of life was measured using the OHIP-14 questionnaire. Demographic information, questions regarding smoke consumption, wearing removable prostheses, nine questions regarding xerostomia, and the existence of other systemic diseases were asked from 240 participants with cardiovascular diseases. The DMFT index was clinically examined in each patient. Also, the Plaque, Gingival, and Sulcular Bleeding Indices were measured on the Ramfjord teeth. Data analysis was conducted using SPSS version 16. The independent t test, Mann–Whitney test, the variance analysis, and the Kruskal–Wallis test were used to compare variables in the present study. Also, regression models were used to eliminate the effect of confounding variables.

Results

Gender variables, removable prosthesis, xerostomia, DMFT, and SBI were the main determinants of quality of life in CVD patients. The mean ADD-OHIP14 of participants in the study was calculated at 21.34 ± 17.40, and the SC-OHIP14 was 6.11 ± 5.07. The mean OHRQoL was higher in females than in males, and this difference was statistically significant. OHRQoL was significantly lower in patients wearing a removable prosthesis than in those without one. The relationship between age and xerostomia was significant in this study, and patients with xerostomia had a lower quality of life than those without xerostomia. Also, the mean DMFT index in subjects with xerostomia was 23.69 ± 7.76, which was statistically significant compared to those without xerostomia.

Conclusion

Cardiovascular patients experienced a decreased OHRQoL. Prevention or treatment of these problems seems to justify improving the quality of life in these patients.

Oral Health-Related Quality of Life of Adult Orang Asli in Jelebu, Malaysia: A Cross-Sectional Study

Aims:

This study aimed at exploring the self-perception of Orang Asli (OA) from the Temuan tribe in Jelebu by using the Global Self-rated Oral Health (GSROH) and General Oral Health Assessment Index (GOHAI).

Materials and Methods:

It was a cross-sectional study involving a two-stage sampling to select the district and villages. A total of 325 participants were selected based on convenience sampling.

Results:

Almost half of the participants rated their oral health as poor or average. The mean GOHAI score was 52.96 (±7.749), ranging from 29 to 60. The GOHAI score was statistically significantly lower for female gender (P = 0.025), lower education level (P = 0.001), and elderly (P = 0.001). The GSROH score was also statistically significant with GOHAI score (P = 0.001).

Conclusions:

A limited number of studies were conducted in this area, particularly in the vulnerable population of OA. Our study found that half of the OA living in the fringe had a poor GOHAI score. It is, therefore, suggested that potential study and intervention programs concentrate on the low GOHAI score group; the male, lower educational context, and the elderly.

Comparison of decayed, missing, filled teeth index between thalassemia major patients and control group in Iran: a systematic review and meta-analysis

Introduction

Scientific evidence of the association between Decayed, Missing, and Filled Teeth (DMFT) and thalassemia are conflicting and difficult to establish conclusions. Therefore, this study aimed to determine the relationship between dental caries (using the DMFT index) and thalassemia major using meta-analysis.

Methods

Databases were searched using such keywords as “Thalassemia,” “Caries,” “decay,” “DMFT,” “Iran,” and OR operators, AND, and NOT. After the elimination of duplicate documentation, the articles which met the inclusion criteria were selected. Quality assessment was performed based on the Newcastle-Ottawa Quality Checklist. Thereafter, the standardized mean difference of the DMFT index was estimated.

Results

In eight studies, the mean DMFT was compared between patients with thalassemia major and the control group. In six studies, the mean of this index was higher in patients with thalassemia major than in the control group and in all six of the studies, the differences were statistically significant. The mean standardized difference of DMFT, D, M, and F were reported as 1.36 (0.41, 2.30), 2.63 (0.42, 4.84), 1.65 (−0.14, 3.45), and 0.02 (−1.67, 1.72), respectively.

Conclusion

The results of this meta-analysis indicated that DMFT index was more inappropriate in patients with thalassemia, as compared to the control group which represents the higher incidence of dental caries among patients with thalassemia compared to the control group.

Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: a matched case-control study

BACKGROUND

Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM.

METHODS

This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire as well as the Oral Health Impact Profile short form (OHIP-14), which measures OHRQoL. Clinical examinations were conducted to assess participants' dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3 mm and CAL ≥3 mm. Linear regression models were used to identify the association among OHIP domains, clinical attachment loss, DMFT scores, and diabetes status.

RESULTS

The mean age of participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥3 mm than non-diabetic patients (10%). No significant differences in OHIP scores were observed between diabetic and non-diabetic patients. The results of the linear regression suggested that irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetic patients, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetic patients, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetic patients.

CONCLUSIONS

Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both diabetic and non-diabetic patients.

Impact of Wearing Two Different Types of Partial Dentures on Oral Health-related Quality of Life in Geriatric Diabetic Patients – A Crossover Study

OBJECTIVE: This study aimed to evaluate oral health-related quality of life (OHRQoL) of partially edentulous elderly diabetic patients before and after wearing heat-cured acrylic resin and flexible partial dentures. BACKGROUND: In the past two decades, an increased concern about the effect of oral conditions on a patient’s quality of life leads to the development of a wide range of OHRQoL measurements. There is a necessity for evaluation required for setting the measurements that are recommended to be used for different needs of geriatric patients. MATERIALS AND METHODS: One hundred partially edentulous bilateral free-end saddle diabetic elderly patients have been randomly selected from the outpatient clinics of the Excellence Centre at National Research Centre. Heat-cured acrylic resin partial denture and flexible removable partial dentures were made for all patients. General oral health assessment questionnaire was completed before and after wearing the two types of partial dentures. The criteria of assessment were speech, mastication and associated pain, esthetics and physiological status, and general life satisfaction and practicing daily activity. RESULTS: The results revealed a significant improvement regarding all aspects of OHRQoL after wearing both partial dentures for diabetic elderly patients. More improvement was observed after wearing the flexible one. CONCLUSIONS: Our findings indicated that OHRQoL in diabetic elderly patients was markedly improved by restoring edentulous spaces using flexible partial dentures than using heat-cured acrylic resin partial dentures.

The effects of periodontal treatment on diabetic patients: The DIAPERIO randomized controlled trial

AIM

To assess whether periodontal treatment can lead to clinical, glycaemic control and quality of life improvements in metabolically unbalanced diabetic patients (type 1 or type 2) diagnosed with periodontitis.

METHODS

In this open-labelled randomized controlled trial, diabetic subjects (n = 91) were given "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral health instructions). The main outcome was the effect on glycated haemoglobin (HbA_1C ) and fructosamine levels. The General Oral Health Assessment Index and the SF-36 index were used to assess quality of life (QoL).

RESULTS

Periodontal health significantly improved after periodontal treatment (p < 0.001). Periodontal treatment seemed to be safe but had no significant effects on glycaemic control based on HbA_1C (adjusted mean difference with a 95% confidence interval (aMD) of 0.04 [-0.16;0.24]) and fructosamine levels (aMD 5.0 [-10.2;20.2]). There was no obvious evidence of improvement in general QoL after periodontal treatment. However, there was significant improvement in oral health-related QoL (aMD 7.0 [2.4;11.6], p = 0.003).

CONCLUSION

Although periodontal treatment showed no clinical effect on glycaemic control in this trial, important data were provided to support periodontal care among diabetic patients. Periodontal treatment is safe and improves oral health-related QoL in patients living with diabetes. ISRCTN15334496.

Impact of gingivitis treatment for diabetic patients on quality of life related to periodontal objective parameters: A randomized controlled clinical trial

OBJECTIVES

Patients with diabetes have a poor oral health-related quality of life (OHRQoL). It is not clear if this situation could be changed with effective periodontal treatment. This study examined both patients with diabetes and systemically healthy individuals to discover the impact of a gingivitis treatment protocol on OHRQoL and its relation to objective periodontal parameters.

DESIGN

After ultrasonic debridement, patients were randomly assigned to an essential-oils (EO) or placebo mouthwash group. At baseline and 3 months, OHRQoL was assessed with the Oral Health and Quality of Life-United Kingdom questionnaire (OHQoL-UK) along with clinical, halitometric, microbiological and inflammatory objective parameters. The primary outcome was a change in OHQoL-UK scores. A factor analysis was performed and the impact of the extracted quality of life factor (QLF) and its interactions with diabetes, treatment, and time on the objective parameters, were tested by multiple linear regression models (p < 0.05). Chi-Square test compared questionnaire-answering profiles (p<0.05).

RESULTS

Combined treatment with EO provided OHQoL improvements in both systemic conditions. Positive effect of oral health status on quality of life increased in EO groups but not in placebo groups. Question I (self-confidence) showed the greatest factorial weight, while Question A (food intake) showed the lowest factorial weight. All patients who showed OHRQoL improvements and used the EO rinse showed the lowest plaque and gingival indices and lower levels of bacteria and volatile sulfur compounds.

CONCLUSIONS

OHRQoL positively changed overtime. Most effective treatment protocols would provide better improvements in OHRQoL which is related to periodontal objective measures.

The effect of xerostomia and hyposalivation on the quality of life of patients with type II diabetes mellitus

BACKGROUND

Diabetes mellitus is a chronic metabolic disease which can have numerous physical effects for patient. Xerostomia is one of these complications. Compared to healthy people, patients with diabetes mellitus, have a worse quality of life, and complications of diabetes are the main determinants of quality of life in these patients.

OBJECTIVE

The aim of this study was to determine the effects of xerostomia and hyposalivation on quality of life of patients with type 2 diabetes mellitus.

METHODS

This descriptive-analytical epidemiological study was conducted on 200 patients with type 2 diabetes mellitus referred to the diabetes clinic of Shahid Mostafavi in Sari city from October 2015 to January in 2016. A questionnaire containing personal characteristics and medical situation was completed by each person. Then, the Persian Oral Health Impact Profile-14 (OHIP-14-PER) questionnaire was completed by the patients. Eventually, with the use of chewable paraffin for 1.5 min by the patient, stimulated salivary flow rate (SSFR) test was performed, and in order to determine hyposalivation, their saliva amount underwent a gravimetric test. Finally, using statistical software SPSS16, the information was statistically analyzed by independent-samples t-test, Mann-Whitney U, Chi-squared and fisher exact tests.

RESULTS

The average age of patient was 56.41 years old (43% male and 57% female). Mean SSFR was 0.7 ml/min in patients and xerostomia were confirmed in 112 patients. Difference between age, gender, drug use, years affecting to diabetes and FBS amount in patient with hyposalivation were not statistically meaningful in proportion to patients without it. But difference between HbA1C and SSFR in patients with hyposalivation were statistically meaningful than to patients without it (p=0.03, p=0.001 respectively). The mean patient score to OHIP-14 were obtained as 38.17. The questionnaire score difference in patients with hyposalivation in proportion to patients without it were not statistically meaningful.

CONCLUSION

Hyposalivation possibility increases in diabetic patients with low metabolic control which can cause more severe side effects in relation to oral health. Xerostomia in diabetic patients has negative effects on oral health related quality of life. Diabetic control and patients' oral problem improvement is effective in their quality of life promotion.

"Assessment of relationship between xerostomia and oral health-related quality of life in patients with rheumatoid arthritis"

OBJECTIVE

To determine the relationship between xerostomia and oral health-related quality of life in patients with rheumatoid arthritis.

MATERIALS AND METHOD

Two hundred patients with rheumatoid arthritis were assessed using Fox and OHIP-14 questionnaires concerning xerostomia and oral health-related quality of life, respectively. The sum of decayed, missing, and filled teeth (DMFT) was determined via an intra-oral examination. In addition, intergroup comparisons were evaluated using t test, chi-square, regression, and Tukey analysis.

RESULT

Among rheumatoid arthritis patients, 51% had been afflicted with xerostomia. We found a statistically significant relationship between xerostomia and oral health-related quality of life (p-value=.004), as xerostomia cases have significantly worse oral health-related quality of life. Also, there was a statistically significant association between oral health-related quality of life and gender as well as DMFT.

CONCLUSION

Because there seem to be a high prevalence of xerostomia in patients with rheumatoid arthritis, screening in such population is highly recommended. Therefore, educational programs and/or workshops should be encouraged among healthcare providers to prevent worsening of oral health-related quality of life.

General Oral Health Assessment Index: A new evaluation proposal

OBJECTIVES

To validity the General Oral Health Assessment Index (GOHAI) among adults who sought dental care and to present a new proposal for calculating scores on self-perception of oral health.

BACKGROUND

There is no study that presents a GOHAI scores using weight of the items.

MATERIALS AND METHODS

The one-factor model, the three-factor model (physical function, psychosocial/psychological function and pain/discomfort) and the second-order hierarchical model (SOHM) were evaluated from confirmatory factor analysis (λ, χ² /df, CFI,GFI and RMSEA). The reliability (CR,α) was estimated. Concurrent validity was assessed using the Oral Health Impact Profile (OHIP-14). The invariance of the models was estimated in independent samples. The calculation of an overall score using the factor scores was proposed to obtain the overall weighted scores. These overall weighted scores were compared to the scores estimated as the simple arithmetic mean (overall unweighted scores) using a repeated measures analysis of variance.

RESULTS

A total of 1000 individuals participated (74.1% female; age: 40.7 (SD=14.3) years). Three items of the GOHAI were excluded (λ<0.40). The one-factor model (λ=0.40-0.77; χ² /df=6.291; CFI=0.947; GFI=0.960; RMSEA=0.073) and the three-factor model (λ=0.40-0.78; χ² /df=8.321; CFI=0.932; GFI=0.954; RMSEA=0.086) each presented an adequate fit. Reliability was adequate (one-factor: CR=0.83/α=0.83; three-factor: CR=0.53-0.76/α=0.53-0.73), with the exception of the pain/discomfort factor. The GOHAI was invariant in independent samples, and the concurrent validity was adequate. The overall unweighted scores overestimated self-perceptions of oral health when compared with the weighted scores.

CONCLUSION

Both the one-factor and three-factor models of the GOHAI were found to be valid, reliable and invariant for the sample after the exclusion of three items. The use of overall weighted scores is recommended for calculating the score of self-perception of oral health.

Oral health-related quality of life and related factors among residents in a disaster area of the Great East Japan Earthquake and giant tsunami

Background

Oral health is one of the most important issues for disaster survivors. The aim of this study was to determine post-disaster distribution of oral health-related quality of life (OHRQoL) and related factors in survivors of the Great East Japan Earthquake and Tsunami.

Methods

Questionnaires to assess OHRQoL, psychological distress, disaster-related experiences, and current systemic-health and economic conditions were sent to survivors over 18 years of age living in Otsuchi, one of the most severely damaged municipalities. OHRQoL and psychological distress were assessed using the General Oral Health Assessment Index (GOHAI) and the Kessler Psychological Distress Scale (K6), Japanese version, respectively. Among 11,411 residents, 1,987 returned the questionnaire (response rate, 17.4 %) and received an oral examination to determine number of present teeth, dental caries status, and tooth-mobility grade, and to assess periodontal health using the Community Periodontal Index. Relationships between GOHAI and related factors were examined by nonparametric bivariate and multinomial logistic regression analyses using GOHAI cutoff points at the 25^th and 50^th national standard percentiles.

Results

GOHAI scores were significantly lower in the 50–69-age group compared with other age groups in this study and compared with the national standard score. In bivariate analyses, all factors assessed in this study (i.e., sex, age, evacuation from home, interruption of dental treatment, lost or fractured dentures, self-rated systemic health, serious psychological distress (SPD), economic status, number of teeth, having decayed teeth, CPI code, and tooth mobility) were significantly associated with OHRQoL. Subsequent multinomial logistic regression analyses revealed that participants of upper-middle age, who had received dental treatment before the disaster, who had lost or fractured dentures, and who had clinical oral health problems were likely to show low levels of OHRQoL. In addition, perceived systemic health and SPD were also related with OHRQoL.

Conclusions

OHRQoL of disaster survivors was associated with oral problems stemming from the disaster in addition to factors related to OHRQoL in ordinary times such as clinical oral status and perceived systemic health. Furthermore, SPD was also associated with OHRQoL, which suggests the disaster’s great negative impact on both oral and mental health conditions.