Changes In Oral Health-related Quality Research Articles

Association between self‐assessment of complete dentures and oral health‐related quality of life

The purpose of this study was to determine which factors related to patient self-assessment of dentures are associated with changes in oral health-related quality of life (OHRQoL) among edentulous patients after replacement of complete dentures, and to determine whether masticatory performance as determined using an objective method affects the changes in OHRQoL among edentulous patients. As a preliminary study, the existing questionnaire regarding self-assessment of dentures consisting of 39 question items, measured with a 100-mm visual analogue scale, was analysed by factor analysis. Then a questionnaire, composed of 22 question items, was developed containing six subscales of 'function', 'lower denture', 'upper denture', 'expectation', 'aesthetic and speech' and 'importance'. Final participants in the present study comprised 93 edentulous patients requiring new conventional complete dentures (44 men, 49 women; mean age, 75·0 years). These patients were asked to complete the Japanese version of the Oral Health Impact Profile (OHIP)-EDENT, comprising 19 question items for assessment of OHRQoL in edentulous patients, along with the developed questionnaire regarding self-assessment of dentures. Moreover, masticatory performance was measured using a colour-changeable chewing gum. The questionnaire and measurement were completed twice; before and after replacement of complete dentures. Stepwise multiple regression analysis identified 'lower denture' and 'aesthetic and speech' as significant independent variables besides OHIP-EDENT scores before replacement. These results suggest that sufficient retention of lower dentures and appropriate appearance may lead to improved OHRQoL in edentulous patients.

Assessing changes in oral health‐related quality of life and its factors in community‐dwelling older Brazilians

To describe changes in oral health-related quality of life and to evaluate the associations of these changes in community-dwelling older people. In this longitudinal study a representative sample of 872 older people, living in Brazil, was evaluated during 2004. The follow-up was carried out during 2008, with 587 older persons evaluated. A questionnaire assessing socio-demographic information, health history, oral health-impact profile and number of natural teeth was used. Changes in oral health-related quality of life were categorized as improvement or deterioration. Data analysis was performed using a hierarchical approach based in a conceptual framework. A hierarchal approach was carried out using Poisson regressions. Older persons living in rural areas, those who reported brushing once a day or less and older persons with fewer natural teeth had an increased chance of reporting deterioration in oral health-related quality of life. Women and participants who received a minimum wage of less than US $219.50 were more likely to report improvement in oral health-related quality of life. The results of this study suggest that changes in the oral health-related quality of life are influenced by many of the variables that were included in the conceptual framework.

Oral health-related quality of life following non-surgical (routine) tooth extraction: A pilot study

Aim:The study was designed to explore the changes in oral health-related quality of life (QoL) in the immediate postoperative period following routine (non-surgical) dental extraction.Setting and Design:A prospective study carried out at the Oral and Maxillofacial Surgery clinic of the Lagos University Teaching Hospital, Nigeria.Materials and Methods:Subjects attending who required non-surgical removal of one or two teeth under local anesthesia were included in the study. A baseline QoL questionnaire (oral health impact profile-14 [OHIP-14]) was filled by each patient just before surgery, and only those who were considered to have their QoL “not affected” (total score 14 or less) were included in the study. After the extraction, each subject was given a modified form of “health related QoL” [OHIP-14]-instrument to be completed by the 3rd day-after surgery, and were given the opportunity to review the questionnaire on the 7th day postoperative review.Results:Total OHIP-14 scores ranged between 14 and 48 (mean ± SD, 26.2 ± 8.3). Majority of the subjects (60%) reported, “a little affected.” Only few subjects (5.8%) reported, “not at all affected,” and about 32% reported, “quite a lot.” Summation of OHIP-14 scores revealed that QoL was “affected” in 41 subjects (34.2%) and “not affected” in 79 subjects (65.8%). More than 30% of subjects reported that their ability to chew, ability to open the mouth and enjoyment of food were affected following tooth extraction. Few subjects (14-34%) reported deterioration in their speech and less than 20% of subjects reported that change in their appearance was “affected.” Only few subjects (12.5-15.1%) reported sleep and duty impairment. Thirty-percent of subjects reported their inability to keep social activities, and 41% were not able to continue with their favorite sports and hobbies. Multiple regression analysis revealed no significant association between age, sex, indications for extraction, duration of extraction, intra-operative complications, and deterioration in QoL (P < 0.05). Consumption of analgesics beyond postoperative day 1 (POD1) was more common in subjects with socket healing complications than those without (P = 0.000). About 33% of subjects reported, “inability to work” (1-3 days).Conclusion:About a third of subjects experienced significant deterioration in QoL. The most affected domains were eating/diet variation and speech variation. Therefore, patients should be informed of possible deterioration in their QoL following non-surgical tooth extraction.

Changes in oral health-related quality of life during fixed orthodontic appliance therapy: An 18-month prospective longitudinal study

There is an increasing research interest in quality of life issues in orthodontics. In this study, we aimed to investigate changes in oral health related quality of life (OHRQoL) among adults during fixed orthodontic appliance therapy (FOAT). Two hundred thirty-two adult patients were enrolled from a consecutive sample at a university dental hospital. OHRQoL was assessed by 2 standardized instruments (OHIP-14 and OHQoL-UK) at 4 times: before treatment (T0), 6 months after bonding and banding (T1), 12 months after bonding and banding (T2), and 18 months after bonding and banding (T3). Friedman 2-way analysis of variance (ANOVA) and Wilcoxon signed rank tests were used to compare the relative changes of OHRQoL among the different time points. Significant changes in the summary scores of both the OHIP-14 and OHQoL-UK were observed during fixed orthodontic treatment (P <0.001). There were significant OHRQoL deteriorations at T1 and T2 compared with T0; these were reflected by summary scores of both the OHIP-14 and OHQoL-UK as well as some of their domain scores (P <0.05). However, at T3, the OHIP-14 suggested deterioration in OHRQoL, but the OHQoL-UK suggested improvement in OHRQoL. Changes in OHRQoL occur during fixed orthodontic appliance therapy. In the early phase of treatment, the greatest deterioration in OHRQoL occurs. With ongoing treatment, the detrimental effects to OHRQoL are reduced.

Fixed Orthodontic Appliance Therapy and Its Impact on Oral Health-Related Quality of Life in Chinese Patients

To determine changes in oral health-related quality of life (OHRQoL) during fixed orthodontic appliance therapy in Chinese patients. Two-hundred fifty Chinese orthodontic patients completed six distinct intervals of the 14-item Oral Health Impact Profile (OHIP-14, Chinese version): before treatment (T0); after the placement of the fixed appliance at 1 week (T1), 1 month (T2), 3 months (T3), and 6 months (T4); and posttreatment (T5). The overall response rate was 88.8% (222 of 250). Significant differences of overall OHIP-14 scores could be found between any two time points (P < .001), except for between T0 and T2 (P > .05) and between T3 and T4 (P > .05). Overall scores at T1 were significantly higher than the scores at the other intervals (P < .001), with a significant change in the scores on physical pain (P < .001), psychological discomfort (P < .001), and physical disability (P < .001). Scores at T5 were lowest among the six time points (P < .001). Fixed orthodontic appliance therapy did affect Chinese patients' OHRQoL. Patients were considerably compromised in terms of their overall OHRQoL until approximately 1 month after insertion. The severity of the compromised condition in terms of overall OHRQoL was greatest at 1 week with the reported impact on physical pain, psychological discomfort, and physical disability. Patients' OHRQoL was better after they completed the orthodontic treatment than before or during treatment.

Changes in oral health-related quality of life during fixed orthodontic appliance therapy

Our objective was to determine changes in oral health-related quality of life (OHRQoL) during fixed orthodontic appliance therapy. This prospective cohort study included a consecutive sample of 217 children receiving fixed orthodontic appliance therapy. Each subject completed the 37-item child perception questionnaire (CPQ) at 5 times: before treatment (T0), and after the placement of the fixed appliance at 1 week (T1), 1 month (T2), 3 months (T3), and 6 months (T4). The response rate was 91% (198 of 217). There were significant changes in overall CPQ scores (P <.001), oral symptom scores (P <.001), functional limitation scores (P <.001), and emotional well-being scores (P <.001) over the study period (6 months). There were significant differences in certain CPQ domain scores at T1, T2, T3, and T4 compared with T0 (P <.05) and consistently with respect to oral symptoms. Significant changes in certain CPQ domain scores also occurred between T1 and T2 (P <.05) and between T2 and T3 (P <.05). However, there were no significant changes in social well-being scores (P >.05). Changes in OHRQoL occur after fixed orthodontic appliance therapy. Compared with pretreatment, a patient's OHRQoL is frequently worse during treatment (oral symptoms, functional limitations), although it is better in some aspects (emotional well-being). The period of greatest change in OHRQoL occurs during the first month of treatment.

Changes in parent‐assessed oral health‐related quality of life among young children following dental treatment under general anaesthetic

To estimate the nature and magnitude of changes in oral health-related quality of life (OHRQoL) among children having dental treatment under general anaesthetic (GA) and to examine the evaluative properties of the Child Oral Health-related Quality of Life Questionnaire (COHQOL). Data from a consecutive clinical sample of the parents/caregivers of children receiving dental treatment under GA at Wellington and Kenepuru Hospitals were collected from parents using the Parental-Caregivers Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS), which both form part of the COHQOL Questionnaire. The first questionnaire was completed before treatment or while the participant's child was undergoing treatment. The follow-up questionnaire was completed 1-4 weeks afterward. Treatment-associated changes in OHRQoL were determined by comparing baseline and follow-up data for the mean scores and the prevalence of impacts. The discriminative properties of the instrument were confirmed and then its evaluative properties were assessed (by examining its test-retest reliability, responsiveness and longitudinal construct validity). The minimally important difference was determined for the overall scale and subscales. Complete baseline and follow-up data were obtained for 202 and 130 participants, respectively (64.4% follow-up rate). The evaluative properties of the P-CPQ and FIS were acceptable. There were substantial and highly statistically significant reductions in mean P-CPQ and FIS scores after treatment, with effect sizes ranging from moderate to large, depending on the subscale being examined. The minimally important difference was shown by almost two-thirds of the children treated. The provision of dental treatment under GA for young children with severe dental caries experience is associated with substantial and highly significant improvements in both their OHRQoL and in the impact on their families. The P-CPQ and the FIS show promise as evaluative measures for use in dental health services research.

Can third molar surgery improve quality of life? A 6-month cohort study

Purpose: In this study, we evaluated patients’ perceptions of changes in oral health-related quality of life (OHQOL) over a 6-month period after third molar surgery. Patients and Methods: One hundred patients participated in this prospective study. Two specific OHQOL measures, the 14-item Oral Health Impact Profile (OHIP-14) and the 16-item UK Oral Health-Related Quality of Life measure (QHQoL-UK), were administered to the study group before surgery. Standardized surgical and analgesic protocols were used. Patients kept a diary of changes in life quality each postoperative day (POD) for 7 days and were contacted at 1, 3, and 6 months after surgery. Results: Both measures identified a significant deterioration in quality of life in the immediate postoperative period ( P < .01). However, there was an improvement in OHQOL compared with preoperative status at 1 ( P < .05), 3 ( P < .05), and 6 ( P < .01) months after surgery. Patients perceived physical, social, and psychologic changes in life quality after surgery. Previous pericoronitis was associated with changes in quality of life ( P < .05). Conclusion: The study concludes that third molar surgery is associated with changes in OHQOL. This has implications for understanding the value of third molar surgery from patients’ perspectives and in assessing health gain.

Assessing change in quality of life using the Oral Health Impact Profile.

Traditionally, longitudinal studies of oral health have measured only disease progression and ignored improvements in health. This study examines methodological issues that arise in longitudinal assessment of change in oral health-related quality of life (OHRQOL). Baseline and 2-year follow-up data were used from an observational longitudinal study of 498 people aged 60 years or more living in South Australia. Oral health-related quality of life was measured using the Oral Health Impact Profile (OHIP). Three hypothesized risk predictors (tooth loss, problem-based dental visits and financial hardship) were selected to examine the effects of four methods of measuring change: categorical measures of improvement, deterioration and net change, and a quantitative measure of net change in OHIP scores. Some 31.7% of people experienced some improvement and 32.7% experienced some deterioration in OHRQOL. All three high-risk groups had approximately twice the rate of deterioration in OHRQOL compared with their corresponding low-risk groups. Surprisingly, high-risk groups also had higher rates of improvement. When measured categorically, these effects did not cancel one another, indicating that improvement and deterioration in OHRQOL can be experienced simultaneously. However, quantitative analyses cause improvements and deteriorations to cancel, and analysis of mean OHIP scores created a spurious impression that change in OHRQOL did not differ between dental visit groups. Furthermore, changes in mean OHIP scores were masked by regression to the mean. Oral health-related quality of life measures capture both improvement and deterioration in health status, creating new complexities for conceptualizing and analyzing change in longitudinal studies.