Nordic Orofacial Test-Screening Score Research Articles

Oro-facial function and quality of life in children and adolescents with large horizontal maxillary overjet-A case-control study.

Large horizontal maxillary overjet (overjet) is associated with reduced bite force (BF) and number of contacts, which influence the chewing effectivity (CE). Oral health, oro-facial function (OF) and malocclusion have great impact on psychological well-being and quality of life (QoL). The aims of the study were to examine OF, temporomandibular disorders (TMD), BF, CE, QoL and well-being in children and adolescents with large overjet. The study was a case-control study including healthy children with large overjet in the study group compared to a control group of healthy children with neutral occlusion, all 9-14 years old. OF was examined by use of Nordic Orofacial Test-Screening (NOT-S), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and registration of morphological and functional occlusion. QoL and well-being were examined using KIDSCREEN-10 and Strengths and Difficulties Questionnaire. The study and control groups included 37 and 32 participants, respectively. Significantly increased NOT-S score (p < .001) and reduced BF (p = .011), numbers of contacts (p < .001) and CE (p = .005) were found in the study group. BF, numbers of contacts and CE were negatively associated with erupting canines and premolars. No significant difference was found in age, gender, dental eruption, TMD diagnosis or QoL between the groups. Significantly increased emotional symptoms (p = .007), hyperactivity (p = .043) and total difficulties score (p = .009) were found in the study group. The study group showed higher NOT-S score and reduced BF, number of contacts and CE. No difference in QoL were found between the groups, although reduced well-being and increased emotional symptoms, hyperactivity and total difficulties were found in the study group.

Oral health-related quality of life, oral aesthetics and oral function in head and neck cancer patients after oral rehabilitation.

Head and neck cancer (HNC) is diagnosed in more than 500000 patients every year worldwide with increasing prevalence. Oral rehabilitation is often needed after HNC treatment to regain oral function, aesthetics and oral health-related quality of life (OHRQoL). The objectives were to evaluate OHRQoL, oral aesthetics and oral function after oral rehabilitation in HNC patients and compare it to that of non-HNC patients. Eighteen patients treated for HNC who subsequently had oral rehabilitation (2014-2017), and a control group of eighteen age- and gender-matched non-HNC patients treated with removable prostheses (2014-2018) were included in a cross-sectional study. The OHRQoL was assessed by the Oral Health Impact Profile 49 questionnaire (OHIP-49), the oral aesthetics by the Prosthetic Esthetic Index (PEI) and the Orofacial Esthetic Scale (OES), and the oral function by the Nordic Orofacial Test-Screening (NOT-S). The HNC patients had worse oral function and OHRQoL than the control patients (mean NOT-S score 4.56 vs 0.56, P<0.01 and mean OHIP-49 score 42.50 vs 20.94, P=0.050). When including number of replaced teeth and type of prosthesis in the tests, no significant difference in OHRQoL was found between the groups. No difference was found in the overall aesthetic outcomes (mean PEI total score 32.28 vs 30.67, P=0.367 and mean OES total score 48.78 vs 53.56, P=0.321). Multiple regression analyses showed that being HNC patient compared to control patient impaired the oral function. Oral function is significantly impaired in HNC patients compared to non-HNC patients after oral rehabilitation.

A comparison of orofacial profiles in 5- and 10-year-old Swedish children with and without cleft lip and/or palate.

The objectives of this study were to assess orofacial profiles in 5- and 10-year-old children with cleft lip and/or palate (CL/P) compared to controls and to estimate a possible association between orofacial dysfunction and caries frequency. A total of 133 children with CL/P (77 5-year-olds and 56 10-year-olds) and 308 controls (142 5-year-olds and 166 10-year-olds) were included in the study. Orofacial function was evaluated with Nordic Orofacial Test-Screening (NOT-S), and caries were scored according to the International Caries Detection and Assessment System (ICDAS). The total NOT-S score was higher in children with CL/P compared to controls (mean 3.2 vs 0.9, p < 0.001). The domains frequently scored in CL/P children were speech (82%), face at rest (72%), and facial expression (58%). There was a significantly positive correlation between NOT-S scores and caries frequency. Children with CL/P have impaired orofacial function compared to controls. There seems to be a correlation between orofacial function and caries. Impaired orofacial function seen in children with CL/P can be one of many risk factors for caries development, and it is suggested to be a part of caries risk assessment.

Reliability and Validity of the Italian Version of the Protocol of Orofacial Myofunctional Evaluation with Scores (I-OMES)

Objective: To evaluate the reliability, validity, and responsiveness of the Italian OMES (I-OMES). Patients and Methods: The study consisted of 3 phases: (1) internal consistency and reliability, (2) validity, and (3) responsiveness analysis. The recruited population included 27 patients with orofacial myofunctional disorders (OMD) and 174 healthy volunteers. Forty-seven subjects, 18 healthy and all recruited patients with OMD were assessed for inter-rater and test-retest reliability analysis. I-OMES and Nordic Orofacial Test – Screening (NOT-S) scores of the patients were correlated for concurrent validity analysis. I-OMES scores from 27 patients with OMD and 27 age- and gender-matched healthy subjects were compared to investigate construct validity. I-OMES scores before and after successful swallowing rehabilitation in patients were compared for responsiveness analysis. Results: Adequate internal consistency (Cronbach α = 0.71) and strong inter-rater and test-retest reliability (intraclass coefficient correlation = 0.97 and 0.98, respectively) were found. I-OMES and NOT-S scores significantly and inversely correlated (r = –0.38). A statistical significance (p < 0.001) was found between the pathological group and the control group for the total I-OMES score. The mean I-OMES score improved from 90 (78–102) to 99 (89–103) after myofunctional rehabilitation (p < 0.001). Conclusion: The I-OMES is a reliable and valid tool to evaluate OMD.

Profile of orofacial dysfunction in Brazilian children using the Nordic Orofacial Test-Screening

Objective: The parameters of orofacial dysfunction (OFD) in children can guide clinicians and researchers in the monitoring of deviations from normality. The aim for this study was to evaluate manifestation patterns and the prevalence of OFD in children.Materials and methods: A population-based cross-sectional study was conducted involving 531 schoolchildren (8–10 years old) in a small city in southern Brazil. OFD was evaluated using the Nordic Orofacial Test-Screening (NOT-S). Poisson multiple regression analysis with robust variance was used to estimate adjusted NOT-S rate ratios (ratio of arithmetic means) among the different categories of covariables and their respective 95% confidence interval (RR: 95%CI).Results: The mean NOT-S score was 2.1 (SD 1.4, median: 2.0; range: 0–8). The majority of children (87.6%) had at least one domain of the scale affected. The most affected were Chewing and Swallowing (50.5%), Habits (41.4%) and Breathing (26.4%). NOT-S scores were lower among children from higher income families (RR = 0.73; 95% CI: 0.61–0.87) and higher among those with difficulty regarding access to dental services (RR = 1.14; 95% CI: 1.01–1.28), those with sleep bruxism (RR = 1.18; 95% CI: 1.04–1.32) and those with open bite (RR = 1.65; 95% CI: 1.42–1.93).Conclusions: The prevalence of OFD was high and both socioeconomic and clinical factors exerted an influence on NOT-S scores.

Relationship between orofacial function, dentofacial morphology, and bite force in young subjects

The aim was to evaluate the relationship between orofacial function, dentofacial morphology, and bite force in young subjects. Three hundred and sixteen subjects were divided according to dentition stage (early, intermediate, and late mixed and permanent dentition). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S). Orthodontic treatment need, bite force, lateral and frontal craniofacial dimensions and presence of sleep bruxism were also assessed. The results were submitted to descriptive statistics, normality and correlation tests, analysis of variance, and multiple linear regression to test the relationship between NOT-S scores and the studied independent variables. The variance of NOT-S scores between groups was not significant. The evaluation of the variables that significantly contributed to NOT-S scores variation showed that age and presence of bruxism related to higher NOT-S total scores, while the increase in overbite measurement and presence of closed lip posture related to lower scores. Bite force did not show a significant relationship with scores of orofacial dysfunction. No significant correlations between craniofacial dimensions and NOT-S scores were observed. Age and sleep bruxism were related to higher NOT-S scores, while the increase in overbite measurement and closed lip posture contributed to lower scores of orofacial dysfunction.

Relationship among oral habits, orofacial function and oral health-related quality of life in children

The objective was to evaluate the relationship among oral habits, oral function and oral health-related quality of life (OHRQoL) in children. Three hundred and twenty-eight subjects (8-14 years old) were assessed for orofacial function using the Brazilian version of the Nordic Orofacial Test-Screening (NOT-S). OHRQoL was assessed using the Child Perceptions Questionnaires (Brazilian versions) for the 8-10 (CPQ(8-10)) and 11-14 (CPQ(11-14)) year age groups. The subjects were distributed into a Habit group and a Habit-free group according to domain III (Habits) of the NOT-S. Oral habits were present in 71.3% of the sample (p = .0001), with a higher prevalence in females (62.8%, p = .001). The NOT-S, CPQ(8-10) and CPQ(11-14) scores were higher in the Habit group (P = .0001, P = .009 and p = .001, respectively). Domain I (Sensory Function) was significantly more affected in Habit group subjects (p = .001). The NOT-S scores were positively correlated with the CPQ(8-10) and CPQ(11-14) scores only in the Habit group (r = .32, p = .0003 and r = .30, p = .001, respectively). These results indicate that oral habits can impact OHRQoL. Moreover, orofacial dysfunctions were associated with worse OHRQoL in subjects with oral habits.

Assessment of masticatory performance, bite force, orthodontic treatment need and orofacial dysfunction in children and adolescents

ObjectivesFew studies have evaluated the relationship between morphological and functional characteristics of the masticatory apparatus in young subjects. Thus, the aim of this study was to evaluate masticatory performance (MP), maximal bite force (BF), orthodontic treatment need and orofacial dysfunction in children and adolescents. DesignThe sample consisted of 316 subjects of both genders, with an age range 6–16years divided into 4 groups: early mixed, intermediate mixed, late mixed and permanent dentition. MP was evaluated by the individual's ability to comminute a chewable test material in order to determine median particle size (X50) and distribution of particles in different sieves (“b”). BF was determined using a digital gnatodynamometer with fork strength of 10mm. Orofacial function and orthodontic treatment need were screened using the Nordic Orofacial Test-Screening (NOT-S) protocol and Index of Orthodontic Treatment Need (IOTN), respectively. The results were submitted to descriptive statistics, normality test, analysis of variance and stepwise multiple linear regression to test relationship between MP and studied independent variables. ResultsVariance of X50 and b between groups was statistically significant. But evaluation of variables that significantly contributed to MP variation showed that age, body mass index (BMI), BF and the presence of sleep bruxism were negatively related to X50 and the NOT-S clinical exam scores showed a positive relationship with X50. ConclusionIn the studied sample, age, BMI, BF and the presence of sleep bruxism were related to better MP; but the increase in NOT-S scores was significantly related to poorer MP.

Assessment of orofacial dysfunctions, salivary cortisol levels and oral health related quality of life (ORHQoL) in young adults

ObjectiveTo investigate the relationship of orofacial dysfunction and salivary cortisol levels with oral health quality of life (ORHQoL) in young adults. DesignThirty individuals of both genders (22.93±2.42 years) participated. The orofacial dysfunction was evaluated using the Nordic Orofacial Test-Screening (NOT-S) and the ORHQoL using the Oral Health Impact Profile (OHIP-49). Saliva samples were collected during three days, at waking up and 30min after, obtaining the awakening cortisol response – ACR. The data were analysed by Mann–Whitney test, Spearman's correlation and multiple linear regression (α=0.05). The NOT-S scores and ACR (μg/dl) were dichotomized by the median (2.0 and 0.15, respectively). ResultsNOT-S and ACR showed similar values between genders (P>0.05). The individuals with NOT-S scores above the median presented values of “physical pain” domain significantly higher than the individuals with scores bellow or equal to the median. Significant correlations were found between the OHIP-49 domains “physical pain” and “physical disability” and NOT-S scores. In multiple linear regression, significant values were observed between NOT-S and OHIP-49 and the domains physical pain, physical disability, psychological disability, social disability and handicap, with determination coefficients ranging from 0.09 to 0.15. There was not association with the ACR. ConclusionsIndividuals with orofacial dysfunction presented impairment in ORHQoL, but not enough to change salivary cortisol levels. Furthermore, gender did not have influence on ORHQoL in the studied sample.

Orofacial dysfunction in individuals with Prader-Willi syndrome assessed with NOT-S

Objective. The objective of the study was to evaluate orofacial dysfunction in individuals with Prader-Willi syndrome (PWS) and compare it with a healthy reference group. Methods and materials. The Nordic Orofacial Test-Screening (NOT-S) protocol was used for evaluation of orofacial function in 45 (23 Male, 22 Female) individuals with PWS, aged 19.8 ± 9.5 years, and a reference group of 40 (18 M, 22 F) healthy individuals, aged 24.0 ± 16.3 years. Results. The NOT-S score was markedly higher for the individuals with PWS than for the healthy reference group (3.9 ± 2.1 vs 0.3 ± 0.5, p < 0.001). The most common domains of dysfunction in individuals with PWS were Oral motor function (60.0%), Habits (55.6%), Face at rest (53.3%), Speech (44.4%), Drooling (44.4%) and Breathing (42.2%). Conclusions. Eighty-seven per cent of the participants with PWS demonstrated dysfunction in two or more domains, particularly in the domains Oral motor function, Habits and Face at rest.

Orofacial dysfunction in ectodermal dysplasias measured using the Nordic Orofacial Test-Screening protocol

Objective. To screen orofacial function in people with various ectodermal dysplasia (ED) syndromes and compare with a healthy reference sample. Material and methods. The ED group comprised 46 individuals (30 M and 16 F; mean age 14.5 years, range 3–55). Thirty-two had hypohidrotic ED, while 14 had other ED syndromes. The reference sample comprised 52 healthy individuals (22 M and 30 F; mean age 24.9 years, range 3–55). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S) protocol containing 12 orofacial function domains (maximum score 12 points). Results. The total NOT-S score was higher in the ED group than in the healthy group (mean 3.5 vs. 0.4; p<0.001). The dysfunctions most frequently recorded in the subjects with ED occurred in the domains chewing and swallowing (82.6%), dryness of the mouth (45.7%), and speech (43.5%). Those with other ED syndromes scored non-significantly higher than those with hypohidrotic ED (mean 4.6 vs. 3.0; p>0.05). Conclusions. Individuals with ED scored higher than a healthy reference sample in all NOT-S domains, especially in the chewing and swallowing, dryness of the mouth, and speech domains. Orofacial function areas and treatment and training outcomes need to be more closely evaluated and monitored.