Aspects Of Oral Health-related Quality Research Articles

The relationship between clinical symptoms of oral lichen planus and quality of life related to oral health

IntroductionOral Lichen Planus (OLP) is a chronic and relatively common mucocutaneous disease that often affects the oral mucosa. Although, OLP is generally not life-threatening, its consequences can significantly impact the quality of life in physical, psychological, and social aspects. Therefore, the aim of this research is to investigate the relationship between clinical symptoms of OLP and oral health-related quality of life in patients using the OHIP-14 (Oral Health Impact Profile-14) questionnaire.Materials and methodsThis descriptive-analytical study has a cross-sectional design, with case–control comparison. In this study, 56 individuals were examined as cases, and 68 individuals were included as controls. After recording demographic characteristics and clinical features by reviewing patients' records, the OHIP-14 questionnaire including clinical severity of lesions assessed using the Thongprasom scoring system, and pain assessed by the Visual Analog Scale (VAS) were completed. The ADD (Additive) and SC (Simple Count) methods were used for scoring, and data analysis was performed using the T-test, Mann–Whitney U test, Chi-Square, Spearman's Correlation Coefficient, and SPSS 24.ResultsNearly all patients (50 individuals, 89.3%) reported having pain, although the average pain intensity was mostly mild. This disease has affected the quality of life in 82% of the patients (46 individuals). The patient group, in comparison to the control group, significantly expressed a lower quality of life in terms of functional limitations and physical disability. There was a statistically significant positive correlation between clinical symptoms of OLP, gender, location (palate), and clinical presentation type (erosive, reticular, and bullous) of OLP lesions with OHIP-14 scores, although the number or bilaterality of lesions and patient age did not have any significant correlation with pain or OHIP scores.ConclusionIt appears that certain aspects of oral health-related quality of life decrease in patients with OLP, and that of the OLP patient group is significantly lower in terms of functional limitations and physical disability compared to the control group. Additionally, there was a significant correlation between clinical symptoms of OLP and pain as well as OHIP scores.

Impact of molar incisor hypomineralization on oral health-related quality of life in 8-10 years old children: A systematic review and meta-analysis.

This study aimed to evaluate the impact of molar incisor hypomineralization (MIH) and its different severities on various aspects of oral health-related quality of life (OHRQoL) in children between 8 and 10 years of age. The search terms were chosen according to the Medical Subject Headings (MeSH) and non-MeSH. Potentially eligible studies involved the OHRQoL evaluation in 8-10 years old children with MIH. An electronic search of published studies was carried out in August 2022 on Scopus, Web of Science, and PubMed databases. Of 130 papers retrieved initially, 21 were eligible to be included in the systematic review, of which 8 were excluded. The OHRQoL questionnaires used in the studies included Caregivers Perceptions Questionnaire (CPQ) 8-10, Child Oral Health Impact Profile questionnaire, and Child Oral Impacts on Daily Performances questionnaire. Nine studies using CPQ8-10 contributed to the meta-analysis. According to meta-analysis, the results revealed that in MIH children a significant increase was observed in the total score of CPQ 810 with the pooled mean of 15.89 (95% confidence interval [CI]:8.95-22.84; P-value = .001) and in oral symptoms, functional limitation and emotional well-being domains with the pooled means of 6.25 (95% CI:4.01-8.50; P-value = .001), 3.88 (95% CI:1.93-5.83; P-value = 0.001), and 3.24 (95% CI:0.96-5.52; P-value = .01), respectively. While the increase in social well-being with the pooled mean of 1.65 (95% CI: -0.47 to 3.76; P-value = .13) was not significant. Subgroup analysis based on MIH severity showed no significant difference in OHRQoL means for all variables. Suffering from MIH, negatively affected the total score and all domains of the CPQ 8-10 questionnaire, except for social well-being. Furthermore, different severities of MIH had no significant impact on OHRQoL in children.

Oral health-related quality of life in patients with oligodontia: A FACE-Q assessment

ObjectivesThe present study aimed to investigate the impact of oligodontia on appearance and on the functional and psychosocial aspects of oral health-related quality of life (OHrQoL) in patients aged 8-29 years. Methods62 patients with oligodontia that were registered at Radboud University Medical Center, Nijmegen, The Netherlands were included. A control group included 127 patients that were referred for a first orthodontic consultation. Participants completed the FACE-Q Dental questionnaire. Regression analyses were performed to explore relationships between OHrQoL and patient-identified gender, age, the number of congenitally missing teeth, active orthodontic treatment, and previous orthodontic treatment. ResultsThe only clear significant difference between the oligodontia and control groups was that patients with oligodontia scored lower in the domain, ‘eating and drinking’ (p < 0.001). It was found that, in oligodontia, the greater the number of agenetic teeth, the more difficulties eating and drinking. In fact, the Rasch score was reduced by 1.00 (95% CI: 0.23−1.77; p = 0.012) for each extra agenetic tooth. Older children scored significantly lower than younger ones on five out of nine scales: appearance of the face, smile, and jaws; social function; and psychological function. Females scored significantly lower than males on four scales: appearance of the face, appearance distress, social function, and psychological function. ConclusionThese findings suggested that, when treating patients with oligodontia, the number of agenetic teeth, age, and gender should be taken into account. These factors could have negative effects on their self-assessment of appearance, their facial function, and their quality of life. Clinical significanceThe increased difficulty with eating and drinking associated with more agenetic teeth highlighted the importance of functional (re)habilitation.

Dimensional structure of the OHIP-14 and associations with self-report oral health-related variables in home-dwelling Norwegians aged 70+

Objectives The primary objective of the present study was to investigate the dimensional structure of the OHIP-14 in a sample of elderly Norwegians. A secondary objective was to describe associations between the exposed OHIP-14 dimensions and additional self-report oral health-related variables to assess the dimensions’ criterion validity. Materials and methods A survey questionnaire including the OHIP-14 and additional self-report oral health-related measures was completed by 325 home-dwelling Norwegians aged 70+. Exploratory factor analysis was used to investigate the dimensional structure of the OHIP-14 in this sample. Bivariate correlations were used to describe associations between the exposed OHIP-14 dimensions and additional self-report oral health-related variables. Results Three dimensions named psychosocial impacts, oral function impacts and general function impacts were revealed. Convergent and discriminant validity of these dimensions were largely supported, and internal consistency reliability for each dimension was good. Statistically significant associations were found between the exposed dimensions and additional self-report oral health-related variables, supporting the dimensions’ criterion validity. Conclusions A three-dimensional structure of the OHIP-14 was exposed and validated in the present study sample. Since different aspects of oral health-related quality of life (OHRQoL) may be perceived and weighted differently in various populations, suggestions for future research include more profound investigations of the construct validity of the OHIP-14 and similar instruments assessing OHRQoL. Such research should include an exploration of various dimensions and the weights given to them through qualitative research in the target population(s).

Temporomandibular disorder symptoms in young adults: Three-dimensional impact on oral health-related quality of life.

The impact of temporomandibular disorders on functional, pain, and psychosocial aspect of patients' quality of life needed to be assessed. This study examined the three-dimensional impact of pain-related and/or intra-articular Temporomandibular disorder (TMD) symptoms and ascertained the inter-relationships between the functional, pain, and psychosocial aspects of oral health-related quality of life (OHRQoL). Young adults were enlisted from a local university and TMD symptoms were assessed with the Diagnostic Criteria for TMDs Symptom Questionnaire (DC/TMD-SQ). Participants were stratified into those with no (NT), pain-related (PT), intra-articular (IT), and mixed (MT) TMD symptoms. OHRQoL was examined using the Oral Health Impact Profile-14 (OHIP-14), and dimensional effects (oral function [OF], orofacial pain [OP], and psychosocial impact [PI]) were established subsequently. Data were evaluated with Kruskal-Wallis, Dunn, and Wilcoxon signed-rank tests (α=.05). The mean age of the participants (n=1205) was 7 ± 1.3 years (71.8% women). While 42.2% reported no TMD symptoms, 22.3%, 16.9%, and 18.5% had PT, IT, and MT accordingly. The MT, PT, and IT groups presented higher total OHIP-14 and dimension scores than the NT group (p < .01). Scores were also significantly different between the MT and IT groups except for OF. For all TMD groups, the ranking of dimensional impact was OP > PI > OF, and associations between the OP and PI dimensions were the strongest (correlation coefficient [rs ]=.57-.76). Young adults with PT and/or IT symptoms have poorer OHRQoL, especially in the OP and PI dimensions, which were moderate to strongly correlated. The use of the three dental Patient-reported Outcome (dPRO) dimensions could provide construct equivalency among OHRQoL measures.

Implant-supported rehabilitation following transcrestal and lateral sinus floor elevation: analysis of costs and quality of life from a bicenter, parallel-arm randomized trial.

The aim of this study was to comparatively evaluate costs and specific aspects of oral-health related quality of life (OhRQoL) related to the period between the surgery phase of transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively) and 6 months after delivery of implant-supported prosthesis. A bicenter, parallel-arm, randomized trial comparatively evaluating tSFE and lSFE when applied concomitantly with implant placement was conducted. At 6 months after prosthesis delivery, data on cost-associated items related to the post-surgery period and selected aspects of OhRQoL were collected. Analyses of costs and quality of life was conducted on 56 patients (tSFE: 28; lSFE: 28) and 54 patients (tSFE: 26; lSFE: 28), respectively. Significantly lower dose of anesthetic (2 vs. 3 vials), amount of xenograft (420 mg vs. 1975 mg), and duration of surgery (54' vs. 86') were observed for tSFE compared to lSFE. No significant differences in the number of additional surgical sessions, postoperative exams, specialist consultations and drug consumption were found between groups. In a limited fraction of patients in both groups, improvements were observed for pain (tSFE: 3.8%; lSFE: 7.4%), comfort in eating any food (tSFE: 11.5%; lSFE: 3.6%), self-consciousness (tSFE: 19.2%; lSFE: 14.3%), and satisfaction about life (tSFE: 19.2%; lSFE: 10.7%). The surgery phase of maxillary sinus floor elevation is characterized by more favorable cost-associated items for tSFE compared to lSFE. Differently, tSFE and lSFE do not differ for either costs related to the post-surgery phases or impact of the implant-supported rehabilitation on specific aspects of OhRQoL.

Oral Health and Nutritional Characteristics of Adults With Morbid Obesity: A Multivariate Analysis.

The relationship between oral health and nutritional aspects are complex, especially in individuals with chronic diseases and comorbidities, such as morbid obesity. Thus, the aim of the present study was to identify oral health and nutritional-related patterns in 113 individuals, aged 19–68 years (92 females), seeking treatment for morbid obesity. Sociodemographic variables and medical records were examined, in addition to the consumption of fruit, vegetables, candies, and processed foods. Measures of body mass index, neck, waist and hip, caries experience (DMFT index), Community Periodontal Index (CPI index), and salivary physicochemical aspects were gathered. Aspects of oral health-related quality of life and symptoms of dry mouth were evaluated by means of Oral Health Impact Profile (OHIP-14) and Xerostomia Inventory-XI questionnaires. K-means cluster analysis and, subsequently, comparisons between clusters (one-way ANOVA) were performed (α = 5%). Three clusters were generated: Cluster 1 (labeled “Young”; n = 77) was characterized by younger participants with higher BMI, who reported the use of distractors while eating, the smallest number of meals/day, and who consumed sweetened drinks and processed food the day before. Cluster 2 (labeled “Diabetic individuals”; n = 12) was characterized by older participants with the highest proportion of diabetic participants (100% were diabetic; 73% insulin users), lower BMI, higher DMFT index and OHIP-14 and xerostomia scores, and who reported having consumed fruit and vegetables the day before. Finally, Cluster 3 (labeled “Poor periodontal health”; n = 24) was characterized by participants with the worse periodontal condition (higher CPI), and lower salivary flow, pH, and buffer capacity. Cluster 1 and 2 were the groups that showed higher demand for nutritional and dietetic counseling, because of the poor eating behavior and higher serum glucose levels, respectively. On the other hand, Cluster 2 and 3 showed the higher demand for oral rehabilitation and dental treatment because of the loss of teeth and worse periodontal condition, respectively, besides the need for dietetic counseling. This sample of individuals with morbid obesity showed very unique oral-health and nutritional characteristics and special needs patterns that should be identified to adjust or change unhealthy habits, thus improving the assistance of this condition.

Translation and validation of the Swedish version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) for adolescents

Objective The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument developed for assessment of orthodontic aspects of oral health-related quality of life (OHRQoL). This study aimed to translate and validate the Swedish version of PIDAQ for use in Swedish adolescents 12–19 years of age. Material and methods The translation was made according to the process described in ‘Guidelines for Establishing Cultural Equivalency of Instruments’ by Ohrbach et al. Field testing was performed in a group of consecutive patients who were about to start orthodontic treatment (untreated group) and a group of consecutive patients who had recently finished orthodontic treatment (treated group). Results During the translation procedure, a Swedish version of PIDAQ was formed. In the field testing, a total of 144 questionnaires, 72 from untreated patients (mean age 14.6 years) and 72 from treated patients (mean age 17.3 years) were collected. The exploratory factor analysis detected two factors, which differs from the factor structure in the original questionnaire. The mean total PIDAQ score was significantly higher (p < .001) in the untreated group, 40.6 (20.3), than in the treated group, 9.4 (10.5), implying a high discriminant validity. Reliability was excellent, with internal consistency Cronbach’s alpha values varying from 0.94 to 0.97. Conclusion The Swedish version of PIDAQ demonstrates good validity and excellent reliability and is suitable for future research on the effect of malocclusion on OHRQoL in Swedish 12- to 19-year-olds.

Relationship Between the Severity of Malocclusion and Oral Health Related Quality of Life: A Systematic Review and Meta-analysis.

To investigate the impact of untreated malocclusion on different aspects of oral health-related quality of life (OHRQoL). All relevant literature published up to February 18, 2016 was collected from nine electronic databases. To make studies comparable, studies that used the dental aesthetic index (DAI), index of orthodontic treatment need (IOTN), or index of complexity, outcome and need (ICON) to measure malocclusion and oral health impact profile (OHIP) to measure OHRQoL were selected for systematic review. Meta-analysis, two independent-samples t-test and binary logistic regression were used to test whether different malocclusion severity groups had different OHIP scores. A total of 564 non-duplicate publications were identified first. Of these, 13 studies were included in this review. All studies had a cross-sectional design and most of them used convenience samples. Eleven studies presented a significant result about the association of malocclusion and OHIP scores. Statistical analyses showed that malocclusion had an impact on all subscales scores, and more severe malocclusion indicated higher OHIP scores on the subscales of physical disability, physical pain, psychological discomfort, psychological disability, and social disability. Untreated malocclusion was significantly associated with OHRQoL. The more severe the malocclusion, the worse was the impact on some physical domains and all psychosocial domains of OHRQoL. There was a lack of longitudinal population-based studies to confirm this result.

Association of overjet and overbite with esthetic impairments of oral health-related quality of life.

Esthetics is an important part of quality of life and a frequent reason for orthodontic treatment demand. It was the aim of this study to investigate whether esthetic impairments, related to overjet and overbite, can be assessed with an established oral health-related quality of life instrument. Data from 1968 participants (age: 16-90 years; 69.8% female) from three German surveys were analyzed. Esthetic impairments of oral health-related quality of life were measured with four questions of the Oral Health Impact profile (OHIP), which comprise esthetic aspects of oral health-related quality of life. Higher values represent greater esthetic impairment (sum score: 0-16). Overbite and overjet values were categorized (≤ - 1 mm, 0-1 mm, 2-3 mm, 4-5 mm, ≥ 6 mm). The specific impact of each category on esthetic impairment, in relation to the reference category (2-3 mm), was calculated in linear regression analyses. The type of relationship and the specific impact of overbite and overjet were evaluated in regression analyses with fractional polynomials. Overbite ranged from - 5 to 15 mm (mean: 3.2 mm) and overjet from - 7 to 19 mm (mean: 3.1 mm). Both an increase and a decrease in overjet, in relation to the reference category, resulted in more esthetic-related oral health-related quality of life impairments. However, in this model, only the effect for increased overjet was statistically significant (4-5 mm: + 0.4 OHIP points; ≥ 6 mm: + 0.9 OHIP points). In the regression analysis with fractional polynomials, both an increase and a decrease in overjet resulted in more esthetic impairments, characterized by a U-shaped relationship. No association could be verified for overbite. A substantial increase or decrease of overjet from the reference values is associated with esthetic impairments of oral health-related quality of life, whereas the extent of overbite seems to have no impact on esthetics.

Disparities in aspects of oral‐health‐related quality of life among Chilean adults

Socioeconomic disparities in oral health among adults have been observed in many countries, but it is not clear whether they exist in aspects of Oral Health-Related Quality of Life in Chile. Data were analyzed from the 1st National Health Survey (NHIS) of Chilean adults, conducted in 2003. It included questions on aspects of oral-health-related quality of life (OHRQoL), including problems ('always' or 'almost always') with speaking, eating, pain, or daily activities. These were the dependent variables. Covariates included age, sex, education level, rurality, smoking, general quality of life, the number of remaining teeth, the number of untreated decayed teeth, and the reason for the last dental visit. Multivariate modelling was used to describe disparities in aspects of OHRQoL, using education level as the marker for socioeconomic status. The sample comprised 3050 participants (54.7% female), of whom 49.0%, 40.5% and 10.5% had been educated to primary, secondary or tertiary level respectively. In the bivariate analysis, there were significant gradients in all four aspects of OHRQoL across those three categories. Covariates significantly associated with poorer OHRQoL were female gender, rurality, and poor self-reported general quality of life, and these were subsequently controlled for in the multivariate analysis. Adults with primary education (or less) were more likely than their tertiary-educated counterparts to report problems speaking (relative risk = 2.38; CI: 1.41, 4.05), trouble or pain (relative risk = 2.77; CI: 1.56, 4.91), discomfort in eating with others (relative risk = 2.35; CI: 1.34, 4.10), and interference with activities of daily living (relative risk = 2.29; CI: 1.15, 4.55). Those educated only to secondary level had relative risks which were lower than these but still significantly different from the reference category. The number of teeth with untreated caries was positively associated with impaired OHRQoL, and the number of remaining teeth was negatively associated with it. Socio-economic disparities in oral-health-related quality of life are apparent among Chilean adults, and remain after adjusting for dental status.

Exploratory factor analysis of the Brazilian OHIP for edentulous subjects

The use of seven domains for the Oral Health Impact Profile (OHIP)-EDENT was not supported for its Brazilian version, making data interpretation in clinical settings difficult. Thus, the aim of this study was to assess patients' responses for the translated OHIP-EDENT in a group of edentulous subjects and to develop factor scales for application in future studies. Data from 103 conventional and implant-retained complete denture wearers (36 men, mean age of 69.1 +/- 10.3 years) were assessed using the Brazilian version of the OHIP-EDENT. Oral health-related quality of life domains were identified by factor analysis using principal component analysis as the extraction method, followed by varimax rotation. Factor analysis identified four factors that accounted for 63% of the 19 items total variance, named masticatory discomfort and disability (four items), psychological discomfort and disability (five items), social disability (five items) and oral pain and discomfort (five items). Four factors/domains of the Brazilian OHIP-EDENT version represent patient-important aspects of oral health-related quality of life.

Impact of dry mouth conditions on oral health‐related quality of life in older people

The aim of the present study was to evaluate the impact of dry mouth conditions on oral health-related quality of life in frail old people, residents at community care centers. Further, reliability and validity of a visual analogue scale (VAS) for dry mouth symptoms were determined within the study cohort. In old people functional, social and psychological impacts of oral conditions are associated with an overall sense of well being and general health. Subjective dry mouth and reduced saliva flow are common disorders in old people caused by disease and medication. Thus, dry mouth conditions may be determinants for compromised oral health-related quality of life in old people. In total, 50 old people living at service homes for the old people were asked to answer questionnaires on subjective dry mouth (VAS) and Oral Health Impact Profile (OHIP14) for oral health-related quality of life. Saliva flow was estimated by absorbing saliva into a pre-weighed cotton roll. The final study cohort comprised 41 old people (aged 83-91 years). Significant associations were identified between both objective and subjective dry mouth and overall or specific aspects of oral health-related quality of life. Dry mouth (objective and subjective) is significantly associated with oral health-related quality of life strengthening the value of monitoring dry mouth conditions in the care of frail old people.