Abstract
BackgroundIt is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this.MethodsRelevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only.ResultsFrom a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts κ = 0.84 ± 0.03; full-texts: κ = 0.68 ± 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss.ConclusionsThis study provides fairly strong evidence that tooth loss is associated with impairment of OHRQoL and location and distribution of tooth loss affect the severity of the impairment. This association seems to be independent from the OHRQoL instrument used and context of the included samples.
Highlights
It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status
It is increasingly recognized that the impact on quality of life (QoL) of disease and treatment of disease and its consequences should be taken into account when assessing health status and evaluating treatment outcomes
Medline, PubMed, Embase and the Cochrane Library were initially searched for papers published from 1990 to June 2008 to answer the following question: is tooth loss associated with impairment of people’s oral health related quality of life and what is the role of location and distribution of tooth loss in this relationship? The search was updated in July 2009
Summary
It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is increasingly recognized that the impact on quality of life (QoL) of disease and treatment of disease and its consequences should be taken into account when assessing health status and evaluating treatment outcomes. Clinical indicators only are not sufficient to describe health status and it has been reported that people with chronic disabling disorders can perceive their quality of life as better This might explain that clinical indicators of caries or periodontal involvement, such as number of decayed teeth, respectively tooth mobility and pocket depth are not strongly associated with impairment of OHRQoL [4,5]. The Oral Health Impact Profile (OHIP), one of the most popular measures, was developed on basis of this model [8]
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