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

Orofacial esthetics, chewing function, and oral health-related quality of life in Kennedy class I patients with mini-implant-retained removable partial dentures: A 3-year clinical prospective study

This prospective clinical study aimed to assess self-reported orofacial esthetics, chewing function, and oral health-related quality of life (OHRQoL) over three years in the Kennedy Class I patients without posterior dentition who received free-end saddle removable partial dentures (RPDs) retained by two mini dental implants (MDIs) inserted in the canine/first premolar region. The study's robust findings reaffirm the viability of MDI-retained RPDs as a treatment modality in contemporary prosthodontics, instilling confidence in the dental community.

MATERIALS AND METHODS

92 participants with posterior edentulism in the maxilla or mandible received 184 MDIs and 92 RPDs. After one year, three participants were excluded, and another seven were excluded after three years. The final sample was 82 participants. Self-perceived orofacial esthetics was assessed by the Orofacial Esthetic Scale (OES), chewing function by the Chewing Function Questionnaire (CFQ), and the OHRQoL by the OHIP-14. Statistical analysis utilized multivariate regression analysis, standardized effect size calculation, Wilcoxon Signed Rank test, and Friedman's test.

RESULTS

OHRQoL and chewing function significantly improved (p < 0.001) one month after MDI loading by the new RPDs and continued to improve over the observation period (p < 0.05). The OES also significantly improved (p < 0.001) and remained almost unchanged over the next three years (p = 0.440).

CONCLUSION

Despite the limitations of this study, the MDI-retained RPD appears to be a viable treatment modality in contemporary prosthodontics from the patients' perspective.

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.

The Development and Evaluation of the Slovenian Version of the Early Childhood Oral Health Impact Scale (ECOHIS-SVN)

Introduction

There has been no valid and reliable instrument available to measure the impact of oral health on the quality of life of Slovenian preschool children. The main aim of this study was to develop and evaluate the validity and reliability of the first Slovenian instrument assessing Oral Health-Related Quality of Life (OHRQoL) preschool children: the ECOHIS-SVN.

Methods

The ECOHIS-SVN was developed using forward-backward translations and with the participation of children aged under six and their parents. The children's teeth were examined, and parents were asked to complete questionnaires, including the ECOHIS-SVN. The internal consistency of ECOHIS-SVN was evaluated through the calculation of Cronbach's alpha (α), test-retest reliability with an intra-class-correlation coefficient (ICC), convergent validity with Spearman's rank correlation (r) and criterion validity with the Mann-Whitney test. The association between the ECOHIS-SVN score and parents' age, educational level, self-reported oral health and OHIP-SVN14 was estimated using multiple linear regression.

Results

In the study, 255 children participated, with a mean age of 4.8 years (±0.8). The ECOHIS-SVN questionnaire was completed by the parents of all 255 children and re-filled by 71 parents. The results of the total ECOHIS-SVN scale include α=0.85, ICC=0.85, and r=0.6-0.75. A statistically significant association was found between the ECOHIS-SVN and parents' age and between the ECOHIS-SVN and parents' OHIP-SVN14 in the whole group and in the subgroup of children with no teeth affected by cavitated caries (dmft=0) (p=0.025, p=0.028), respectively.

Conclusion

ECOHIS-SVN enables further studies to assess the OHRQoL of preschool children in the Slovenian-speaking population.

Oral health-related quality of life, impaired physical health and orofacial pain in children and adolescents with juvenile idiopathic arthritis - a prospective multicenter cohort study

BACKGROUND

Knowledge on oral health-related quality of life (OHRQoL) in children and adolescents with juvenile idiopathic arthritis (JIA) is limited, and longitudinal studies are lacking. We aimed to describe OHRQoL in children and adolescents with JIA compared to controls, and to explore the validity and internal consistency of the Early Childhood Oral Health Impact Scale (ECOHIS) and the Child Oral Impact on Daily Performance (Child-OIDP). Furthermore, we wanted to investigate associations between OHRQoL and orofacial pain, physical health, disease activity, and temporomandibular joint (TMJ) involvement in JIA.

METHODS

The Norwegian prospective, multicenter cohort study recruited participants with JIA between 4 and 16 years of age and corresponding controls from three pediatric university hospital departments and public dental health services. In the present study, we analyzed OHRQoL in all children < 12 years with the ECOHIS and adolescents ≥ 12 years with the Child-OIDP at the first visit and the two-year follow-up. Associations between OHRQoL and JIA characteristics, collected in clinical exam and questionnaires, were analyzed in logistic regressions.

RESULTS

The same OHRQoL questionnaire was completed both at first visit and two-year follow-up in 101 children < 12 years (47 JIA, 54 controls) and 213 adolescents ≥ 12 years (111 JIA, 102 controls). The frequency of OHRQoL impacts in children was similar at the first visit and the two-year follow-up (ECOHIS > 0: JIA group 81% and 85%, p = 0.791; control group 65% and 69%, p = 0.815), while adolescents with JIA reported fewer impacts at the two-year follow-up (Child OIDP > 0: JIA group 27% and 15%, p = 0.004; control group 21% and 14%, p = 0.230). The internal consistency of the OHRQoL instruments was overall acceptable and the criterion validity indicated that the instruments were valid at both visits. Orofacial pain was more frequent in children and adolescents with JIA than in controls. We found associations between OHRQoL impacts and orofacial pain, impaired physical health, disease activity, and TMJ involvement.

CONCLUSIONS

Children and adolescents with orofacial pain or impaired physical health were more likely to report impacts on daily life activities than those without. Pediatric rheumatologists and dentists should be aware of impaired OHRQoL in individuals with JIA with active disease or temporomandibular joint involvement.

TRIAL REGISTRATION

Registered on clinicaltrials.gov (NCT03904459, 05/04/2019).

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

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

Body Mass Index as a Proxy Indicator for Poor Oral Hygiene Habits in Adult Diabetic Patients

AIM

To analyse if body mass index (BMI) could be used as a fast proxy indicator of poor oral hygiene habits (POHH) among the adult population with diabetes mellitus.

METHODS

Adults, aged 25-74, from the Slovenian 2016 nationwide cross-sectional survey based on the Countrywide Integrated Non-Communicable Disease Intervention (CINDI) Health Monitor methodology, who reported being diabetic, were included in the study (n=560). We assessed the relationship between POHH and BMI, adjusted to confounders, using multiple binary logistic regression.

RESULTS

In the total sample, the POHH prevalence was 50.9%. Taking into account BMI, POHH prevalence in participants with normal BMI values was only 37.8%, in the overweight group it was 1.22-times higher (46.0%), while in the obese group it was 1.63-times higher (61.6%) (p<0.001). Also, the odds for POHH were 2.64-times higher in the obese group in comparison to the normal BMI group (95% CI: 1.55-4.51; p<0.001). After adjustment for confounders, this OR decreased only moderately (OR=2.45; 95% CI: 1.35-4.44; p=0.003).

CONCLUSIONS

BMI could be used as a readily assessable, fast, simple, and cheap tool indicating higher odds for having POHH among the diabetic population. By defining the high-risk group it could be easier for physicians and dentists to take further referrals and actions for promoting oral health in this group. The suggested tool can save time and could have an important positive impact on the quality of life of diabetics, as well as on health expenditures.

Impact of oral hygiene habits on oral health-related quality of life of in-school adolescents in Ibadan, Nigeria

Background

Recent evidence has shown that the prevalence of periodontal diseases is still high among adolescents and, thus, there is an impetus to promote good oral hygiene habits among them through schools. There is a need to provide baseline data on the oral hygiene habits of adolescents and how it impacts their oral health-related quality of life for appropriate intervention to be instituted. Moreover, oral health-related quality of life describes how oral health affects the daily activities of individuals; thus, it provides a holistic means of involving individuals in making decisions about their oral health including uptake of oral hygiene habits.

Aim

To assess the impact of oral hygiene habits on adolescents' oral health-related quality of life.

Methods

A cross-sectional study was conducted among 1,800 adolescents aged 14–18 years attending 36 Senior Secondary Schools in the metropolis of Ibadan, Nigeria. Data were collected using a self-administered questionnaire, which assessed students' sociodemographic characteristics, oral hygiene habits, and oral health-related quality of life with COHIP-SF19. Data obtained was analyzed with SPSS version 25 and the p-value was set at <5%.

Results

The mean age of the adolescents was 15.16 (±1.16) years. Many 1,094 (60.3%) cleaned their teeth twice or more often daily with 126 (7.0%) cleaning after meals and 1,519 (84.4%) changing their tooth cleaning agent at three months intervals or less. About 1,215 (67.5%) spent three minutes or longer in cleaning their teeth. Only a few 238 (13.2%) cleaned interdentally and 137 (7.6%) used dental floss. The OHRQoL scores of the adolescents ranged from 9–76. A total of 1,612 (93.5%) had at least an impact on their OHRQoL. Those who cleaned their teeth more frequently (twice or more) were more likely to have better OHRQoL (OR = 1.6, 95% CI = 1.1–2.4, p = 0.025) and those who did not clean interdentally were more likely to have better OHRQoL (OR = 2.8, 95% CI = 1.2–6.5, p = 0.014) than others.

Conclusion

The oral hygiene habits of the adolescents were suboptimal and those who cleaned their teeth twice or more often each day had fewer impacts on their OHRQoL, whereas those who engaged in interdental cleaning had higher impacts on their OHRQoL than others.

Analysis of oral health care delivery in patients with autism

Background/Aim: Autism spectrum disorder (ASD) is pervasive neurodevelopmental condition with raising prevalence over the last decades. Oral health related problems arise mostly due to challenging behavior, communication limitation, and resistance to receiving dental treatment. The aim of this retrospective study was to investigate the frequency, quality and type of dental care during routine appointments and under general anesthesia (GA) in persons with ASD. Matreial and Methods: The data were obtained in retrospective cross-sectional study by analyzing patients' records from the central electronic database of the Clinic for Dentistry of Vojvodina. Demographic, medical and dental data were analyzed employing Mann Whitney U test, Kruskal Wallis test and CATREG regression analysis. Results: A total of 51 patients from 4.2-47.6 years of age had an average of 13.2 ±13.5 dental appointments, with 2.27±4.23 treatments done under GA in a period of 7 years. The average number of restored teeth was 3.64±4.42 and 4.64±5.95 teeth were extracted. Only 21.5% of participants regularly attended scheduled appointments. Patients who started oral health care earlier had more teeth restored and extracted during RDT, and were less subjected to treatment under GA. Conclusions: Dental services to patients with ASD are commonly limited to more radical approach comprising multiple teeth extractions and repeated treatment under GA. It is of utmost importance to tailor comprehensive plan for dental care provision in individuals with ASD at earliest possible age.

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.

Diabetes and Oral Health: Summary of Current Scientific Evidence for Why Transdisciplinary Collaboration Is Needed

This Perspective provides a brief summary of the scientific evidence for the often two-way links between hyperglycemia, including manifest diabetes mellitus (DM), and oral health. It delivers in a nutshell examples of current scientific evidence for the following oral manifestations of hyperglycemia, along with any available evidence for effect in the opposite direction: periodontal diseases, caries/periapical periodontitis, tooth loss, peri-implantitis, dry mouth (xerostomia/hyposalivation), dysbiosis in the oral microbiome, candidiasis, taste disturbances, burning mouth syndrome, cancer, traumatic ulcers, infections of oral wounds, delayed wound healing, melanin pigmentation, fissured tongue, benign migratory glossitis (geographic tongue), temporomandibular disorders, and osteonecrosis of the jaw. Evidence for effects on quality of life will also be reported. This condensed overview delivers the rationale and sets the stage for the urgent need for delivery of oral and general health care in patient-centered transdisciplinary collaboration for early detection and management of both hyperglycemia and oral diseases to improve quality of life.

Psychometric Characteristics of the Croatian and the Serbian Versions of the Oral Health Impact Profile for Edentulous Subjects, with a Pilot Study on the Dimensionality

Introduction

The aim was to adapt the Croatian and the Serbian versions of the Oral Health Impact Profile for the edentulous population (OHIP-EDENT-CRO and OHIP-EDENT-SRB).

Methods

The translation and cross-cultural adaptation were carried out in accordance with accepted international standards. A total of 95 and 177 removable denture wearers were recruited in Croatia and Serbia respectively. The reliability was evaluated by calculating Cronbach’s alpha coefficient and by test-retest (30 participants in each country). The concurrent validity was determined by calculating the Spearman’s rank coefficient between the OHIP-EDENT summary scores and one question related to removable denture satisfaction. Construct validity was determined by exploratory factor analysis (EFA). Responsiveness was determined by comparison of the OHIP-EDENT summary scores before and after dental implant placement to support mandibular overdentures (23 patients in Croatia, 21 in Serbia).

Results

Cronbach’s alpha coefficient was 0.92 in Croatia and 0.87 in Serbia. The intraclass correlation coefficient was 0.98 in Croatia and 0.94 in Serbia. In Croatia the Spearman’s correlation coefficient was -0.71 (p<0.001) and in Serbia -0.74 (p<0.001). Both confirmed concurrent validity. Construct validity was tested by EFA, which extracted four factors in each country, accounting for 66.59% of the variance in Croatia and 59.33% in Serbia. Responsiveness was confirmed in both countries by a significant OHIP-EDENT summary score reduction and a high standardised effect size (3.9 in Croatia, 1.53 in Serbia).

Conclusion

The results prove that both instruments, the OHIP-EDENT-CRO and the OHIP-EDENT-SRB, have very good psychometric properties for assessing OHRQoL in the edentulous population.