Changes In Oral Health-related Quality Research Articles

Dental treatment under general anaesthetic and children's oral health-related quality of life

Data sourcesMedline, Scopus and the Web of Science.Study selectionStudies conducted in children under 16 undergoing general anaesthesia having change in oral health-related quality of life were considered. Selection was undertaken by two reviewers independently.Data extraction and synthesisData abstraction was undertaken independently by three groups of two reviewers - discrepancies were resolved by discussion. Study quality was assessed using the Quality Assessment Tool for Studies of Diverse Design (QATSDD).ResultsTwenty studies were included; there were 18 prospective studies, one randomised trial and one secondary analysis study. Most studies used a pre-test-post-test design and all but one used proxy measures of oral health-related quality of life (OHRQoL). All of the studies reported improved OHRQoL overall. However, results suggested that some aspects of OHRQoL may worsen.ConclusionsHeterogeneity of included papers limited the conclusions which could be drawn. Treatment under GA appears to result in overall improvements in proxy-reported OHRQoL; however, there is a need for further high-quality studies employing validated, child-reported measures of OHRQoL.

Responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) is related to dental treatment complexity

BackgroundThe responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) has varied greatly across studies; hence, we hypothesized that this discrepancy could be related to the complexity of dental treatment received. Thus, we aimed to evaluate the responsiveness of the ECOHIS to changes in oral health-related quality of life (OHRQoL) following dental treatments of varying complexity in preschool children.MethodsPreschool children aged 3 to 6 years were selected; their parents responded to the ECOHIS at baseline. The parents responded to the ECOHIS again and a global transition question 30 days after the children were treated. The type of treatment received by the children was categorized according to complexity, as follows: 1) non-operative treatment only, 2) restorative treatment, and 3) endodontic treatment and/or tooth extraction. Change scores and effect sizes (ES) were calculated for total scores, as well as considering the different treatment types and global transition question responses.ResultsOf the 152 children who completed the study, the ECOHIS yielded large ES for total scores (0.89). The children showed increasing ES values associated with better perception of improvement, assessed by the global transition question. The magnitude of ES after treatment was related to treatment complexity (0.53, 0.92 and 1.43, for children who received non-operative treatment only, restorative treatment, and endodontic treatment and/or tooth extraction, respectively).ConclusionsParents whose children required more complex dental treatment are more likely to perceive treatment-related changes to OHRQoL assessed with the ECOHIS.

Changes in Oral Health Related Quality of Life (OHRQoL) and Satisfaction with Conventional Complete Dentures Among Elderly People.

To assess the changes in oral health-related quality of life (OHRQoL) and satisfaction among older adults after receiving new complete dentures, and the association of age, gender, education, medical history, past prosthetic history (number of previous complete dentures and time since current complete dentures) and quality of existing complete dentures with patients' ratings of satisfaction with their complete dentures. The study comprised 114 community-dwelling adults ≥ 65 year of age, all wearing complete dentures in both jaws. The sample was selected from four senior day centres. Data were collected using clinical oral examinations and a self-administered questionnaire. Dentures were clinically evaluated for retention, stability, occlusion, articulation and vertical dimension. The questionnaire recorded data on sociodemographic information, previous denture history, oral satisfaction scale (OSS), and OHRQoL through the Oral Impacts on Daily Performance (OIDP) scale. There was a significant improvement in OHRQoL after treatment (mean OIDP score: 2.7) compared to before treatment (mean OIDP score: 6.6). The largest changes were in relation to impacts on eating (33.3% to 15.9%) and smiling (17.5% to 4.5%). Six months after placement of the dentures, patient satisfaction improved compared to before treatment (p < 0.001). The results of this study demonstrated that satisfaction was correlated with age, gender, and past prosthetic history in the patients rehabilitated with complete dentures. The provision of new dentures among older adults resulted in significantly better satisfaction and OHRQoL than wearing existing dentures. There was no significant correlation between the clinical assessment of the dentures and patients' satisfaction with them.

Changes in oral health-related quality of life during implant treatment in partially edentulous patients: A prospective study

PurposeThe aim of this prospective study was to evaluate the changes in oral health-related quality of life (OHRQoL) during implant treatment for partially edentulous patients, and to evaluate the influence of the type of partially edentulous arch. MethodsTwenty patients with a small number of lost teeth (fewer than 4 teeth) who underwent implant treatment were selected. Chronological QOL change during implant treatment was measured. The subjects completed the shortened Japanese version of the Oral Health Impact Profile (OHIP-J14) before the surgery (T0), 1 week after the surgery (T1), 1 week after interim prosthesis placement (T2), and 1 week after definitive prosthesis placement (T3). Complete data of the twenty subjects were analyzed with the Wilcoxon signed-rank test. ResultsThe total OHIP-J14 score was significantly reduced only at T3 (P<0.05). “Physical pain” and “Physical disability” scores significantly decreased at T3, and “Psychological discomfort” scores also significantly dropped at T2. However, “Functional limitation” scores significantly increased at T1. “Psychological disability”, “Social disability”, and “Handicap” scores remained the same. On the other hand, in the comparison depending on the type of partially edentulous arch, the total OHIP-J14 score significantly decreased at T3 in the unilateral free-end edentulous space, whereas no significant difference was observed in the bounded edentulous space. ConclusionAlthough there is a temporary functional limitation after implant placement in overall OHRQoL improvement was observed after the definitive prosthesis placement. Moreover, implant treatment was more effective in the unilateral free-end edentulous space.

Oral health-related quality of life following dental treatment under general anaesthesia for early childhood caries - a UK-based study.

To assess parental reports of changes in oral health-related quality of life (OHRQoL) of young children in the UK with early childhood caries (ECC) following dental treatment under general anaesthesia (DGA). To compare the impact of oral rehabilitation (OR) and extraction-only (Exo) treatment approaches on this. Data were collected using the proxy reported components of the Child Oral Health-Related Quality of Life (COHRQoL® ) questionnaire: the Parent-Caregivers Perceptions questionnaire (P-CPQ) and Family Impact Scale (FIS), from a convenience sample of parents of children receiving DGA at a UK Paediatric Dental Department. Mean scores and prevalence impacts were compared pre- and postoperatively with mean change score and effect sizes calculations. Seventy-eight parents were recruited (51 children undergoing OR, 27 Exo) with 6 lost to follow-up (92.3%). Following treatment, changes in mean P-CPQ and FIS scores were statistically significant (P<0.0001) with medium to large effect sizes (0.45-1.39). The differences in change scores between the two treatment approaches were not statistically different. DGA for young children with early childhood caries resulted in substantial improvements in parent's ratings of their child's OHRQoL and of the impact on their families. Larger cohort studies are needed to validate these preliminary findings.

The Effect of Full-Mouth Rehabilitation on Oral Health-Related Quality of Life for Children with Special Health Care Needs.

Changes in oral health-related quality of life (OHRQoL) among 40 children with special health care needs (CSHCN) aged 5-14 years before and 12 months after full-mouth rehabilitation (FMR) under general anesthesia (GA) in two hospitals in Jeddah city were assessed. The questionnaire was delivered to the parents/caregivers at baseline (pre-operative) and at the 12-month post-operative follow-up visit. Medical and dental histories and clinical findings were correlated accordingly. The follow-up response rate was 87.5% with 35 children completing a 12-month follow-up visit. The age range was from 5 to 12 years with a mean of 7.3 ± 2.4 years. More than half of the study sample was boys (63%) in the 5-8 year age-group (69%). The impact on OHRQoL was reportedly negative before FMR under GA, with overall scores ranging from 12 to 68 and a mean of 43.34 ± 14.83. OHRQoL improved significantly in all aspects evaluated (P<0.05) following FMR under GA with overall scores ranging from 4 to 41 and a mean of 18.86 ± 8.54. Treating CSHCN under GA, with 3-month recall visits for the patients, had a significant long-term effect on their OHRQoL extending up to 12 months postoperatively.

Does orthodontic treatment improve oral health-related quality of life?

PubMed, Embase, Cochrane Central Register of Controlled Trials, China Biology Medicine disc and Goggle-Scholar databases and the journals; American Journal of Orthodontics and Dentofacial Orthopedics, European Journal of Orthodontics, Angle Orthodontist, Journal of Orthodontics and World Journal of Orthodontics. Studies in patients receiving orthodontic treatment (fixed, removable appliance or interceptive) with outcomes that showed changes in oral health-related quality of life (OHRQoL) from baseline (pre-treatment) to follow-up after at least one month were considered. Two reviewers independently selected studies and abstracted data. Pooling of data was based on study design, population characteristics, outcomes and OHRQoL-domains affected. A narrative summary was planned. Eleven studies were included (six cohort studies, four cross-sectional studies, one case-control study). The majority (seven studies) were conducted among child/adolescent populations. An observed association between quality of life and orthodontic treatment was generally detected irrespective of how they were assessed. However, the strength of the association could be described as modest at best. Findings of this review suggest that there is an association (albeit modest) between orthodontic treatment and quality of life. There is a need for further studies of their relationship, particularly studies that employ standardised assessment methods so that outcomes are uniform and thus amenable to meta-analysis.

Is Social Capital a Determinant of Oral Health among Older Adults? Findings from the English Longitudinal Study of Ageing.

There are a number of studies linking social capital to oral health among older adults, although the evidence base mainly relies on cross-sectional study designs. The possibility of reverse causality is seldom discussed, even though oral health problems could potentially lead to lower social participation. Furthermore, few studies clearly distinguish between the effects of different dimensions of social capital on oral health. The objective of the study was to examine the longitudinal associations between individual social capital and oral health among older adults. We analyzed longitudinal data from the 3rd and 5th waves of the English Longitudinal Study of Ageing (ELSA). Structural social capital was operationalized using measures of social participation, and volunteering. Number of close ties and perceived emotional support comprised the functional dimension of social capital. Oral health measures were having no natural teeth (edentate vs. dentate), self-rated oral health and oral health-related quality of life. Time-lag and autoregressive models were used to explore the longitudinal associations between social capital and oral health. We imputed all missing data, using multivariate imputation by chained equations. We found evidence of bi-directional longitudinal associations between self-rated oral health, volunteering and functional social capital. Functional social capital was a strong predictor of change in oral health-related quality of life – the adjusted odds ratio of reporting poor oral health-related quality of life was 1.75 (1.33–2.30) for older adults with low vs. high social support. However in the reverse direction, poor oral health-related quality of life was not associated with changes in social capital. This suggests that oral health may not be a determinant of social capital. In conclusion, social capital may be a determinant of subjective oral health among older adults rather than edentulousness, despite many cross-sectional studies on the latter.

Shortened dental arch concept shown to be cost effective

Randomised controlled trial. All patients received treatment to render them dentally fit. Patients were randomly allocated to either the removable dental prostheses (RPD) or the shortened dental arch (SDA) group. Patients in the RDP group were restored to complete arches with RDP using cobalt-chromium frameworks according to a standardised protocol. For the SDA group, patients were restored to a shortened arch of ten occluding pairs of natural and replacement teeth using resin-bonded bridgework (RBB). Treatment effect was measured using the change in oral health-related quality of life (OHrQOL). For each patient the costs of delivering treatment were recorded by a research nurse during the intervention period. Laboratory costs were recorded as part of normal hospital policy for all patients. All of the dental materials used were recorded and given a unit price. The cost of professional time per patient was estimated using the highest point of the salary scale for the Community Dental Service in Ireland. One hundred and thirty-two patients were randomised; 65 to the RPD group and 67 to the SDA group. Ninety-two patients (69.7%) completed the study (46 in RPD group; 46in SDA group). There was no difference in the success rates of the two treatments over the period. Five pieces of resin-bonded bridgework (RBB) debonded and were recemented over the 12-month period giving a success rate of 95.5% for the RBB. Four patients discontinued wearing their RPDs; all four RPDS were fitted in the lower arch and included bilateral free end saddles, a success rate of 95.9%. Both RPD and SDA groups demonstrated statistically significant improvements in OHrQoL scores after 12 months.The total cost of achieving the minimally important clinical difference (MID) in OHrQOL for an average patient in the RDP group was [euro ]464.64. For the SDA group, the cost of achieving the MID for an average patient was [euro ]252.00. The cost-effectiveness ratio was therefore 1:1.84 in favour of SDA treatment. With an increasingly ageing population, many patients will continue to benefit from removable prostheses to replace their missing natural teeth. From a purely economic standpoint, the results from this analysis suggest that the treatment of partially dentate older adults should be focused on functionally orientated treatment because it is simply more cost-effective.

Oral health-related quality of life among institutionalized patients after dental rehabilitation.

The aim of the present study was to determine the changes in oral health-related quality of life before and 3 months after dental rehabilitation among geriatric patients residing in a state-owned nursing home, using the General Oral Health Assessment Index (GOHAI). Data from 40 patients were collected through the administration of a structured questionnaire, as well as from medical records and intraoral examinations. Sociodemographic and behavioral variables, and denture use/length of use were recorded. The GOHAI questionnaire was completed before and 3 months after dental rehabilitation by the same examiner. Normality of the GOHAI scores was examined with the Kolmogorov-Smirnov test. Data were analyzed using descriptive statistics, t-tests, one-way ancova and ancova (P < 0.05). The study sample included 32 men (80%) and eight women (20%) with a mean age of 72.75 years. Mean GOHAI scores increased from 41.275 (low) to 53.100 (moderate) 3 months after dental rehabilitation (t = 1.42, P < 0.001, r = 0.86). Patients with poor oral hygiene (P = 0.000), those who had been using dentures (P = 0.000) and patients younger than 70 years-of-age (P = 0.03) provided higher GOHAI scores after dental rehabilitation. GOHAI scores before and after dental rehabilitation were not influenced by sociodemographic and behavioral variables (P > 0.05). The after treatment GOHAI scores, which were corrected according to gender and age, showed no significant differences regarding the education level, income, behavioral variables, use of dentures, oral hygiene status and presence of systemic diseases (F = 0.62, P = 0.69). Dental rehabilitation of institutionalized geriatric patients resulted in a significant improvement in GOHAI scores, indicating an improvement in oral health-related quality of life after receiving proper dental care.

Assessing Changes in Oral Health-Related Quality of Life Following Dental Rehabilitation under General Anesthesia

To determine whether dental treatment under general anesthesia (GA) improved oral health-related quality of life (OHRQoL) in pre-school children, to evaluate the sensitivity and responsiveness of the Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS) and to examine parental satisfaction with the care received. The parents/caregivers of 120 pre-school children receiving dental treatment under GA, were asked to complete the ECOHIS before and after treatment. Participants were also asked a global transition judgement concerning change in their child's condition after treatment. Global transition judgement and distribution changes in ECOHIS scores were used to assess the sensitivity and responsiveness. 98 children completed the follow-up survey. Between pre- and post-treatment ECOHIS scores, significant reduction was observed (p < 0.001). The effect sizes were moderate and large (0.36 to 1.63). Global transition rating groups were compatible with statistical differences between pre- and posttreatment scores, supporting the responsiveness of the ECOHIS. 91% of parents regarded the experience to be positive. Children's OHRQoL showed significant improvement after treatment. The majority ofparents reported a high degree of satisfaction. Also, Turkish version of the ECOHIS was sensitive to dental treatment under GA for pre-school children and responsive to treatment-associated changes.

A prospective study of changes in oral health‐related quality of life during immediate function implant procedures for edentulous individuals

The aim of this prospective clinical study was to evaluate longitudinal changes in oral health-related quality of life (OHRQoL) attributable to fixed dental prostheses during All-on-4(®) treatment in one or both jaws. Ten patients underwent placement of four or six endosteal dental implants on the basis of the All-on-4(®) treatment concept in the edentulous maxilla or both jaws and immediate loading with acrylic interim prostheses. The prostheses were replaced after 3-6 months, and definitive prostheses with titanium framework and reinforced resin facing were fixed after another 5 months or more. The subjects completed the shortened Japanese version of the Oral Health Impact Profile (OHIP-J14) before the surgery (T0), 1 week after the initial (T1) and secondary (T2) interim prostheses were placed, and 3 months after definitive prosthesis placement (T3). Complete data of nine subjects were analyzed with the Wilcoxon signed-rank test. The total OHIP-J14 score significantly reduced only at T3 (P < 0.05). "Functional limitation," "physical pain," "physical disability," and "psychological disability" scores significantly decreased at T3, and "psychological discomfort" scores also significantly dropped at T2. "Social disability" and "handicap" scores remained unchanged throughout. Fixed definitive prostheses with metal framework are more effective than fixed all-acrylic prostheses in improving OHRQoL during All-on-4(®) treatment.

Dental esthetics and quality of life in adults with severe malocclusion before and after treatment

To investigate the association between satisfaction with dental esthetics and quality of life, and esthetics satisfaction in relation to esthetic evaluations of three panel groups. Fifty-two patients (36 women, 16 men; age 18-61 years) with severe malocclusion were treated in Oulu University Hospital. Of these, 38 and 14 patients underwent orthodontic/surgical treatment and orthodontic treatment, respectively. A questionnaire and dental photographs were collected before and after treatment. The 14-item Oral Health Impact Profile (OHIP-14) was used to measure oral health-related quality of life. Satisfaction with dental esthetics was evaluated using the Visual Analogue Scale. Dental photographs were presented to three panel groups: 30 laypersons, 30 dental students, and 10 orthodontists, who rated the photographs using the Aesthetic Component of the Index of Orthodontic Treatment Need. Oral health-related quality of life (OHIP-14 severity score) and esthetic satisfaction (according to the Visual Analogue Scale) improved after the treatment (P < .001). The most unsatisfied patients reported oral effects more often both before and after treatment. Changes in oral health-related quality of life components of severity, psychological discomfort, and psychological disability correlated positively with the changes in esthetic satisfaction. Orthodontists graded the situation before treatment as worse and the outcome as better than the laypersons; the level of grading by dental students fell between these two groups. Improvement in esthetic satisfaction due to the treatment of severe malocclusion improves oral health-related quality of life, particularly by decreasing psychological discomfort and psychological disability.

Changes in oral health related quality of life after dental bleaching in a double-blind randomized clinical trial

ObjectivesThis study aimed to assess changes in oral health-related quality of life (OHRQoL) in individuals enroled in a double-blind randomized clinical trial conducted to evaluate the efficacy and safety of two carbamide peroxide concentrations used in at-home vital bleaching in the city of Pelotas, Southern Brazil. MethodsNinety-two volunteers with a shade mean of C1 or darker for the six maxillary anterior teeth were randomized into two balanced groups (n=46) according to bleaching agent concentration: 10% or 16% carbamide peroxide. The patients were instructed to use the whitening agent in a tray for 2h once a day for three weeks. To assess changes in OHRQoL, participants completed the oral impact on daily performance (OIDP) at the start and one week after the completion of treatment. Because there was no difference with regard to whitening effect or tooth sensitivity during or after treatment the two groups were merged for the analyses of the current article. Before-and-after changes in OIDP scores were assessed by chi-square and McNemar tests (p<0.05). ResultsMean pre- and post-treatment OIDP scores varied from 0.42 to 0.60. When the frequency of impacts for different activities were compared, there was an increase in difficulty in cleaning teeth (p=0.02) and a significant reduction in smiling and showing teeth with embarrassment (p=0.03). Regarding the symptoms and main oral conditions that generated impact, there was higher number of participants reporting pain (p=0.05) after treatment. In opposite, significant decrease was observed in individuals reporting being unhappy with their appearance (p=0.03). On the contrary, it was showed a decrease in impacts resulting from dental colour was observed after bleaching (p=0.03). ConclusionQuality of life is complex and encompasses different domains. Although positive impact of the dental bleaching was detected, with patients showing more their teeth without embarrassment, difficult in dental hygiene and pain resulting from the treatment were also reported, and this can negatively impact daily performances. Dentists must consider these aspects when performing aesthetics procedures.

Impact of periodontal disease and periodontal therapy on oral health-related quality of life

To determine the impact of periodontal disease and periodontal therapy on oral health-related quality of life using the German version of the Oral Health Impact Profile, taking into account the possible effects of age, gender and socioeconomic factors. This is a study of 93 patients of both sexes aged 27-74 years. The sample included 82 patients with a diagnosis of periodontal diseases, 11 patients without periodontitis (control group). All patients used the German 14-item version of the Oral Health Impact Profile, as well as a socioeconomic and demographic questionnaire. This was used to assess oral health-related quality of life issues. The questionnaire and clinical inspection were done before and 6-8 weeks after the periodontal treatment. Periodontal diseases have an effect on oral health-related quality of life issues. Scores for the German 14-item version of the Oral Health Impact Profile were associated with severity of periodontal diseases, sex, age, oral hygiene and smoking habits. The highest scores included those patients with a probing pocket depth of > 7 mm. The median score of these patients was reduced from 14.4 at baseline to 5.5 after treatment (P = 0.007). These patients perceived physical, social and psychological changes in oral health-related quality of life after periodontal therapy. Median OHIP-G-14 scores were reduced from 6.3 at baseline to 4.8 6-8 weeks after treatment (P < 0.001). The number of teeth with a probing pocket depth > 3 mm could be reduced from 76.0% at baseline to 27.6% after treatment. The association between periodontal diseases and the oral health-related quality of life was determined. The positive effect of the periodontal treatment on the oral health related quality of life was also shown and was most pronounced for patients with a probing pocket depth of > 7 mm.

Changes in oral health-related quality of life reports in children during orthodontic treatment and the possible role of self-esteem: a follow-up study

As a continuation of a baseline study on oral health-related quality of life (OHRQoL) and the role of self-esteem (SE), the aim of this research is to investigate the changes in OHRQoL reports in children during orthodontic treatment and the influence of SE. This longitudinal study comprised 109 children (50 boys and 59 girls) aged 11-16 years, all receiving orthodontic treatment. Questionnaires were administered at baseline and at follow-up (1 year after start of orthodontic treatment). OHRQoL was assessed by the child perception questionnaire (CPQ). The Dutch adaptation of the Harter's Self-Perception Profile for Adolescents was used to assess SE and the Index of Orthodontic Treatment Need defined the need for treatment. The questionnaires also included questions related to motivation for treatment. Spearman correlations, Wilcoxon signed rank tests and Mann-Whitney U-tests were performed. A significant increase in total CPQ score was found during orthodontic treatment. This increase was also significant for the subdomains functional limitations, oral symptoms, and social well-being, whereas for the subdomain emotional well-being a non-significant decrease in CPQ score was found. Children with high SE at baseline showed significantly lower variability in OHRQoL measures at follow-up. OHRQoL deteriorates in children during orthodontic treatment. There is evidence that SE can be a protective factor in OHRQoL during orthodontic treatment.

The Impact of Orthognathic Surgery on Oral Health-Related Quality of Life

Introduction: This study aimed to measure the changes in oral health-related quality of life of the patients, referred to Shahid Chamran Hospital in Shiraz before and after the orthognathic surgery. Methods: This prospective study was performed using the 14-item oral health impact profile (OHIP-14) questionnaire. The questionnaires were given both before and four months after the orthognathic surgery to all the patients referred to Shahid Chamran Hospital of Shiraz between 20th of November 2012 and 20th of February 2013. The patients were asked about their motivation for surgery and the responses were classified as functional, esthetic or a combination of functional and esthetic problems. The data achieved from all the questions before and after the surgery were analyzed using repeated measures test. Results: Twenty eight patients including 10 men and 18 women participated in this study. The mean scores of quality of life after the surgery decreased significantly compared to that before the treatment (P<0.001). The quality of life was not significantly different among patients with different reasons to undergo orthognathic surgery (P=0.290). Conclusion: The results of this study indicated that the oral-health related quality of life of the patients significantly improved following surgical-orthodontic treatment.

Determinants of change in oral health‐related quality of life over 7 years among older Japanese

Because there are more elderly people than ever before and because they are living for longer periods of time, it is essential to understand the determinants of healthy ageing. This study examined changes in oral health-related quality of life (OHRQoL) among Japanese elderly over a 7-year period. A sample of independently living individuals (aged 60+ years) underwent a questionnaire and dental examination at baseline and 7 years afterwards. The Geriatric Oral Health Assessment Index (GOHAI) was used to assess the impact of oral conditions. Occlusal force and salivary flow were also assessed. Of the 411 participants assessed at baseline, 130 (31·6%) accepted to participate after 7 years. There were no significant differences between those lost to follow-up and those assessed at 7 years, except that a higher proportion of the latter rated their baseline general health as good. Among the latter, the overall mean GOHAI score did not change significantly (11·8 at baseline and 11·1 at follow-up; P = 0·16). However, after controlling for age, gender and baseline GOHAI score, participants who had lost teeth or experienced a decline in occlusal force after 7 years had higher follow-up GOHAI scores (indicating poorer OHRQoL). Unfavourable changes in clinical oral status over time are reflected in poorer self-rated oral health.

Self-perceived changes in oral health-related quality of life after receiving different types of conventional prosthetic treatments: A cohort follow-up study

ObjectivesTo evaluate the changes in oral health-related quality of life (OHRQoL) reported by subjects treated with conventional prostheses. MethodsA consecutive sample of 153 patients seeking prosthodontic rehabilitation was recruited. Socio-demographic and prosthetic-related factors (Eichner Index; number of occlusal, aesthetic, and lost units) were registered. Baseline impacts on OHRQoL were collected using the OHIP-14 questionnaire. One month after treatment, the participants answered whether the prostheses had generated better, equal, or poorer effects within the 14 items of a retrospective scale (Post-OHIP). The study patients were compared with the reference population (P-population; n=123) in terms of OHRQoL. Such P-population consisted of Spanish adults wearing conventional dental prostheses who were not seeking any dental treatment. The reliability and validity of the tests applied and the factor structure of the Post-OHIP were investigated. A Poisson regression model was calculated to predict what items would change favourably after treatment. ResultsFour prosthetic cohorts were established according to the types of rehabilitations performed: 1-FDPs: metal–ceramic fixed dental prostheses; 2-M-RPDs: metal-based removable partial dentures; 3-ADs: acrylic partial dentures and 4-CDs: complete dentures. Both tests confirmed adequate psychometric properties. Most items of the Post-OHIP consistently loaded on a single factor. Patients requiring ADs or CDs reported significantly lower baseline OHRQoL than those needing M-RPDs or FDPs. Pain/discomfort was the only hampering issue subsequent to removable rehabilitation. M-RPDs are expected to provide the significantly highest therapeutic improvements. ConclusionsPatients perceived benefits in chewing ability, aesthetics and satisfaction with their mouth after receiving conventional dental prostheses. Clinical significanceConventional prosthetic therapy enhances patients’ overall well-being although it can cause discomfort and chewing dysfunction in more than 20% of subjects. Metal-based removable partial dentures are the most predictable in terms of patient satisfaction. The higher the clinical impairment felt by patients, the higher the increase in OHRQoL after rehabilitation.

Impact of response shift on the assessment of treatment effects using the Oral Health Impact Profile

The assessment of changes in oral health-related quality of life (OHRQoL) is challenging because individuals' concepts and internal standards of OHRQoL may change over time. The aim of this study was to detect response shifts in OHRQoL assessments made using the Oral Health Impact Profile (OHIP). Oral health-related quality of life was assessed in a consecutive sample of 126 patients seeking prosthodontic care. Patients were asked to rate their OHRQoL before treatment started and 1 month after treatment was finished, using the German 49-item version of the OHIP. When rating their OHRQoL after treatment, patients were also asked to rate their pre-treatment OHRQoL without having access to their baseline data. The response shift was calculated as the difference in OHIP summary scores between the initial assessment and the retrospective baseline assessment. The OHIP mean scores decreased from 31.8 at the initial baseline assessment to 24.4 after treatment. The retrospective baseline assessment resulted in an OHIP mean score of 38.1, corresponding to a response shift of 6.3 OHIP points. The effect size (Cohen's d = 0.21) of the response shift was considered small. The response shift phenomenon and its magnitude have important implications for dental practice, where patients and dentists often assess perceived treatment effects retrospectively.