Measurement of oral status and treatment need among subjects with dental prostheses: Are the measures less reliable than the prostheses? Part I: Oral status in removable prosthodontics

Abstract

Indices used to measure the oral status of removable dental prostheses generally do not conform to criteria essential to high-quality measures. Existing indices fail to meet accepted standards of reliability and validity, and most lack specified training protocols, use ambiguous terminology, are limited to nominal, ordinal, or dichotomous level data, and require high levels of observer inference. As a result it is virtually impossible to compare one study with another, to combine data from more than one study to broaden the results obtained, and even to collect longitudinal data without being able to rule out examiner drift. More successful measures, in particular for vertical dimension of occlusion, maxillary denture retention, and arch size and shape, hold promise for future developments in research data collection and quality assessment. These improvements, combined with a growing awareness of the importance of measuring nondental factors, should lead to more reliable, valid measures of need for treatment.