OHIP Items Research Articles

The effect of using denture adhesives on patient satisfaction with complete dentures; a randomized clinical trial

BackgroundDenture adhesives can be useful in improving patients’ satisfaction with complete dentures. However, comparison clinical trials are lacking. The purpose of this randomized clinical trial was to assess the satisfaction of edentulous patients and their oral health impact profile when provided with 3 types of denture adhesives.MethodsSixty-four completely edentulous patients seeking complete dentures for their first time were randomly divided into 3 groups. Each group received a set of complete dentures, which were adjusted at review appointments until participants reported no complaints. After 1 month of using the dentures, participants rated their overall satisfaction and their satisfaction regarding comfort, retention, stability, and efficiency of mastication and speech on a 100-mm visual analog scale (VAS). Participants also filled out the oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire. Each group was then given 1 type of denture adhesive to use. Group C received Corega Ultra denture fixative cream (GlaxoSmithKline), Group O received Olivafix (Bonyf), and Group S received Sea. Bond adhesive strips (Sea.Bond). Mann-Whitney U test was used to analyze the differences in VAS scores before and after using the adhesive within each group and Wilcoxon-signed rank test was used to compare OHIP scores and total OHIP values before and after using the adhesive within each group (p = 0.05). Furthermore, Kruskal Wallis test was used to compare the differences before and after using the adhesives in VAS and OHIP values between the 3 groups.ResultsSignificantly higher VAS values were detected in all groups and significantly lower values for many OHIP items in addition to total OHIP values were detected in all groups after using the adhesives (P < 0.05), except for the ease of cleaning for Group O and Group S (P > 0.05). No significant differences were found in VAS and OHIP values between the 3 groups (P > 0.05), except for the ease of cleaning which was significantly different between Group C and Group S (p = 0.005).ConclusionsUsing denture adhesives for completely edentulous patients resulted in higher patient satisfaction as indicated by higher VAS scores as well as improved quality of life as indicated by lower OHIP-EDENT scores after using the adhesives. These improvements were not dependent on the type of adhesive, except for ease of cleaning as adhesive strips were easier to clean than paste type adhesives.Trial registrationThis trial was registered at ClinicalTrials.gov (ID: NCT05496283) on 11/08/2022.

Impact of occupation on oral health outcomes following third molar surgery

Context: The removal of third molar is advised in patients whose occupation precludes ready access to oral health care; however, there is a lack of directly applicable clinical research.Aims: The aim of this study is to assess the outcomes of impacted third molar removal on oral health-related quality of life in these patients.Settings and Design: The prospective study included 178 armed forces personnel who underwent the extraction of symptomatic impacted third molars at Military Dental Center over a 1-year period.Subjects and Methods: Oral health impact profile (OHIP-14) was utilized to analyze the outcomes before surgery and on postsurgical days 1, 7, and 14. Prevalence, extent, and severity scores were calculated.Statistical Analysis Used: The comparison of severity outcomes was analyzed by means of Friedman's test and Wilcoxon signed-rank test.Results: The present study revealed “painful aching in your mouth”, “uncomfortable to eat foods”, “diet been unsatisfactory,” “difficult to relax,” and “difficulty doing usual jobs” were reported “fairly often” or “very often” presurgery by 84%, 25%, 37%, 44%, and 17%, respectively. The median number of all 14 OHIP items reported “fairly often” or “very often” presurgery was 2 (IQ 1, 5.5). Prevalence, extent, and severity scores were the highest on postsurgical day 1 and decreased by postsurgical day 7 and 14. Comparison of severity outcomes revealed a statistically significant increase on postsurgical day 1 followed by significant reduction thereafter.Conclusions: Extraction of symptomatic impacted third molars significantly improve oral health-related quality of life in patients whose occupation dictate that they have to work in conditions isolated from expert treatment.

Validation of the oral health impact profile - 14 in patients with head and neck cancer.

Background The Oral Health Impact Profile-14 (OHIP-14) was designed to assess patients’ perception of the impact of oral disorders on their quality of life (QoL). Although the OHIP-14 is now frequently used in patients with head and neck cancer, data related to its measurement properties in this population are scarce. The aim of the present study was to evaluate the reliability and validity of the OHIP-14 in a sample of Serbian patients with head and neck cancer. Material and Methods Data were available for 345 patients (257 [74.5%] males; aged 30-92 years), with head and neck cancer. All patients completed the OHIP-14 and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35. Factor analyses, internal consistency reliability (i.e., Cronbach’s α coefficient), and construct validity were analyzed. Results The factor analyses confirmed that 14 OHIP items were measuring a single underlying factor. Cronbach’s α coefficient was 0.98 and corrected item-total correlations ranged 0.77-0.93. Lower OHIP-14 scores (i.e., lower impacts on oral health) were more frequently present among patients who had only surgery as a therapeutic procedure compared to those who had surgery accompanied with radio- and chemotherapy (p< 0.01). Patients with a tumor stage 0-II also had lower OHIP-14 scores compared to those who had a tumor stage III-IV (p< 0.01). The OHIP-14 correlated significantly with the QLQ-C30 and QLQ-H&N35 scales. Conclusions As a unidimensional instrument, the OHIP-14 provides oral QoL assessments with sound internal consistency reliability and construct validity among patients with head and neck cancer. Key words:Quality of life, oral health, psychometrics, reliability, validity.

Impact of restorative treatment of tooth wear upon masticatory performance

ObjectiveThe restorative treatment of generalized tooth wear involves an increase in vertical dimension of occlusion and a comprehensive alteration of occlusal morphology. The aim of this study was to assess the impact of a direct adhesive restorative treatment on masticatory performance parameters. Materials and methodsA sample of 23 fully dentate adult generalized tooth wear patients (17 male, 6 female, age 41.7 ± 8.3 years) undergoing direct composite restorative treatment was selected. Before and one month after restorative treatment with resin bonded composite restorations, masticatory performance was evaluated using 1) a comminution test, 2) a maximum voluntary bite force recording and 3) the sum score of five items related to eating and chewing from the Oral Health Impact Profile (OHIP-49) questionnaire. Statistical analysis was performed using a paired t-test, and analysis per OHIP item was done by a McNemar test (p < 0.05). ResultsThere was no statistically significant difference in median particle size (X50) calculated before and after treatment (4.19 ± 0.97 and 4.03 ± 0.76, respectively, p = 0.327). Maximum voluntary bite force decreased significantly after treatment (baseline 389 ± 90 N, one month recall 323 ± 173 N, p = 0.028). The sum score of the five OHIP items significantly decreased after treatment (baseline 10.6 ± 4.8, one month recall 6.6 ± 2.5, p = 0.001), with the item regarding unsatisfactory diet showing the largest significance (p = 0.029). ConclusionsThis study indicates that the restorative treatment of generalized tooth wear using direct resin bonded composite has no significant short-term effect on masticatory performance as measured with a comminution test, although the self-reported ability to eat and chew, as measured by the sum score of all pertaining OHIP items, did significantly improve. Clinical significanceOn individual level, food comminution could be influenced by restorative treatment with increase of vertical dimension of occlusion, but at group level no significant effect is observed. Nevertheless, tooth wear patients do perceive improved ability to eat and chew foods, which is clinically relevant.

Oral health-related quality of life following orthognathic surgery for class III correction its relationship with cephalometric changes

The aim of this study was to investigate the cephalometric changes following orthognathic surgery for class III correction and to compare these with the changes in patient perceptions of their oral health-related quality of life (OHRQoL). Twenty-nine severe skeletal class III patients, who were candidates for bilateral sagittal split osteotomy and Le Fort I osteotomy, completed the Persian version of the Oral Health Impact Profile OHIP-14 questionnaire before any orthodontic treatment (T0) and at 6 months after the surgery (T1). Cephalometric analyses were performed at T0 and T1 and the changes in 13 hard and soft tissue profile indices were assessed by means of the paired t-test. The correlation between facial changes following treatment and the OHIP-14 item scores were tested by Pearson correlation analysis. The increase in upper lip protrusion following surgery was correlated with an increase in OHRQoL, especially in the domains of pronouncing words, taste, and diet, as well as the total OHIP-14 score. However, the increase in upper lip length and the decrease in lower lip protrusion correlated positively with worsening of some of the OHIP items. Although orthognathic surgery led to ideal cephalometric results, the patients’ OHRQoL was improved in some aspects and impaired in others.

Impact of primary endodontic treatment provided by undergraduate students and endodontic specialists on patients’ quality of life

Everyday life of individuals can be significantly influenced by positive and negative changes in oral health status, by symptoms and severity of oral disorders and diseases. The World Health Organization (WHO) proclaims a necessity to measure health and the effects of health care not only on the basis of changes in the frequency and severity of diseases but also by estimation of patients’ well-being assessed with the improvement in their quality of life. The aim of our study was to investigate the impact of primary root canal treatment on the perceived quality of life amongst patients treated by providers with different qualification and experience. Two hundred systemically healthy, mentally fit and legally capable of signing an informed consent patients needing an endodontic care were randomly selected and participated voluntarily in the study conducted in the Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria. The treatment was provided by fourth-year and fifth-year students in the course of their clinical exercises and by five endodontic specialists. The study instrument was the modified Oral Health Impact Profile comprising 17 items which was filled in anonymously by all participants. The interview was carried out before the root canal treatment and two weeks after it was completed by one and the same examiner. The impact of endodontic disease and its treatment was recognized by seven conceptual dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and handicap. The responses of the OHIP items were made on a five-point scale ranging from 0 = never, 1 = hardly ever, 2 = occasionally, 3 = fairly often to 4 = very often. The analyses of the results revealed that patients perceived their quality of life impaired because of the irreversible inflammation of the dental pulp. The negative impact of the endodontic disease was similar for the patients treated by students and specialists as the difference between the registered mean impact values at the first appointment was insignificant. Experience and training level influenced the degree of improvement as registered mean impact values were significantly greater in the group treated by endodontic specialists when compared to the one treated by undergraduate students.

Oral health-related quality of life improves in employees with disabilities following a workplace dental intervention

This pilot study evaluated a dental intervention for employees with disabilities by measuring changes in self-rated oral health, dental behaviours and oral health-related quality of life (OHRQol). Consenting employees with disabilities (≥18years) at two worksites in South Australia underwent dental examinations at baseline, three and six months. Referrals were arranged as needed to public dental clinics. At one and two months a dental hygienist provided group oral health education to the employees. Employees’ demographics, self-rated oral health, dental behaviours and OHRQol were collected via face-to-face interviews. Of the 39 referred employees, 28 (72%) of them completed the recommended treatment. Self-rated oral health improved and there were significant reductions in the prevalence of oral health impact on quality of life (percentage of employees reporting 1+ items fairly/very often) from 27% to 11% (McNemar’s test, p<0.05); the extent of impact (mean number of items reported fairly/very often) from 1.3 to 0.6 and the severity of impact (mean of summed OHIP item scores) from 3.6 to 1.8 (paired t-tests, p<0.01). As this pilot study indicates that enabling urgent referral for treatment and regular oral health education can improve OHRQol and self-rated oral health among employees with disabilities, a larger study with a control group should be undertaken.

The use of Subject Matter Experts in Validating an Oral Health-Related Quality of Life measure in Korean.

ObjectivesThis paper aimed to employ subject matter experts (SMEs) to assess the extent to which the Korean version of the short-form of the OHIP (OHIP-14 K) is culturally valid and equivalent in Korean.MethodsWe approached 17 bilingual Korean SMEs from which 10 independently rated the clarity, relevance, and cultural equivalence of the OHIP-14 K. SME's varied between 10 and 41 years of clinical experience and were mostly males (# 7). We used Item-level Content Validity Index (I-CVI) to gauge the proportion of SMEs who considered the content of OHIP items (e.g., instruction, response format, etc.) to be culturally valid. We also performed additional analysis to determine the level of agreement between the SMEs.ResultsThe experts rated most of the items to be clear (S-CVI = 0.93) while having difficulties in assigning relevance of the questions to the expected domains (S-CVI = 0.42). Moreover, considerable disagreement existed among the experts in regard to the relevance (Kfree = 0.19 to 1.00) and the cultural equivalence indexes (ADM = 0.36 to 0.96). The content of the OHIP-14 K for the most part clearly reproduced the language of the original OHIP-14. However, experts disagreed on the relevance and conceptual equivalence of the OHIP-14 K for a Korean population.ConclusionsPatient-oriented outcome measures such as the OHIP can be used across cultures once there are indeed assessing the same domains and constructs of interest. The CVI technique seems to be an alternative tool for evaluating content validity and equivalency of an OHQoL measure. A more refined, culturally relevant version of OHIP-14 K was proposed although there is no available data yet to support a better score validity, reliability and responsiveness of this proposed version.

Oral health-related quality of life and complications after treatment with partial removable dental prosthesis.

The aims of this study were to measure and describe the oral health-related quality of life (OHRQoL) and to identify the complications caused by partial removable dental prosthesis (RDPs) in patients 1-5 years after treatment. Complications were identified in 65 patients who were treated with 83 RDPs (48 upper, 35 lower). OHRQoL was measured using the OHIP-49 before treatment and at the baseline (1-2 months after treatment) and follow-up (1-5 years after treatment) examinations. The types and numbers of oral problems that were experienced were described based on OHIP items with a score of 3 and 4. A significant improvement (P < 0·05) in the total OHIP-49 was registered from pre-treatment (mean 42, SD ± 37) to baseline (mean 29, SD ± 27) and from pre-treatment to 1-5 years after treatment (mean 32, SD ± 30). There was no significant difference between the baseline and 1- to 5-year follow-up examinations. Problems with eating and appearance registered at pre-treatment were improved at baseline and after 1-5 years. Problems with dentures that had been registered pre-treatment were improved at baseline but reoccurred after 1-5 years. The two most frequent complications were ill-fitting RDPs and inflammation of the oral mucosa, followed less frequently by fractures of the clasps. Treatment with RDPs improved OHRQoL, but denture-related problems partly remained, and new problems related to RDPs occurred 1-5 years after treatment. The two most frequent complications were ill-fitting RDPs and inflammation of the oral mucosa.

Self‐reported ability to concentrate in patients with painful temporomandibular disorders compared to the general population

This study explored whether patients with painful temporomandibular disorders (TMD) differ from the general population in the frequency of self-reported disability to concentrate, because altered processing of sensory information had been reported previously. Additionally, the correlation of the frequency of concentration problems with the dysfunctional grade of TMD pain shall be evaluated. Subjects were 286 consecutive German patients with painful TMD diagnosed using the Research Diagnostic Criteria (RDC/TMD) and 2026 members of a representative German community sample. Concentration was measured using two questions, one from the 'Oral Health Impact Profile (OHIP-49 G)' and one from the German version of 'Center for Epidemiologic Studies - Depression Scale (CES-D)'. The dysfunctional grade of TMD pain was measured using the Graded Chronic Pain Scale. Responses between the two individual questions concerning the ability to concentrate (OHIP item and CES-D item) correlated moderately (r(Spearman) =0.58, P<0.001). A two-sample test of proportions revealed that patients with TMD pain reported a significantly greater frequency of 'fairly often' or 'very often' occurring concentration problems, 24.0%, than did the general population subjects, 1.2% (P<0.001). Moreover, the frequency of concentration problems correlated with an increase in dysfunctional pain grade in the patients with TMD pain (tetrachoric correlation coefficient of 0.52, P<0.001). Self-reported frequency of concentration problems is greater in patients with TMD pain than in the general population and is reported at a higher frequency in patients with more severe dysfunctional pain grades. These findings are consistent with the concept that TMD pain is associated with changes in the central processing.

Validation of the response format of the Oral Health Impact Profile

The study investigated the validity of the response format of the Oral Health Impact Profile 49 (OHIP-49). The OHIP-49 was completed by 145 consecutive prosthodontic patients. For each OHIP item, subjects completed the standard ordinal response format (with responses given as never, hardly ever, occasionally, often, or very often, and scored from 0 to 4, respectively). Subjects also separately reported the absolute frequency of impacts for each item (numerical response format) in a personal interview. Response codes for the standard ordinal response format (0-4) and for the numerical response format were summed to give two separate OHIP summary scores. The reliability and validity of the scores generated from each response format were compared using the numerical response format as the standard. Score reliability was high and almost identical for both response formats. Score validity was also satisfactory with a high correlation of scores between response methods. There was also a moderate correlation of scores from both response methods with a single global rating of perceived oral health. These data support the validity of the standard ordinal response format of the OHIP and suggest the use of the numerical response format in order to help capture impacts on oral health when they are infrequent.

The Oral Health Impact Profile: ranking of items for temporomandibular disorders

The study aimed to rank the Oral Health Impact Profile (OHIP-49) items by relevance to temporomandibular disorders (TMD). A modified version of the OHIP-49 was completed by 110 patients with TMD and by age- and gender-matched TMD-free individuals. Patients were diagnosed using the Research Diagnostic Criteria (RDC) for TMD. The modified OHIP included a reference to the 'jaw' and a 1-month reference period. The difference in item prevalence for problems reported fairly/very often (FOVO) between the two groups was calculated for each OHIP item. The FOVO prevalence differences were ranked to reveal the most relevant problems for TMD. Patients' total OHIP scores were higher (60.6, SD = 31.6) than those of controls (17.1, SD = 18.1). Patients scored higher on all items, with 41 items showing a statistically significant difference between the patient score and the control score. The patient-control difference in FOVO item prevalence varied considerably between different items, ranging from 1 to 67%. Substantial differences were noted between patients and controls for a number of specific items, including those relating to pain and physical impact. Smaller differences across most items were also noted, even those not expected to have an impact. The OHIP provides a starting point for a measure of TMD treatment outcome, once items less attributable to TMD are excluded.

Quality of Life Implications of Bisphosphonate-Associated Osteonecrosis of the Jaw

Potentially debilitating, osteonecrosis of the jaw (ONJ) is an emerging complication of bisphosphonates. However, its effect on quality of life (QoL) is unknown. We determined the ONJ-related QoL decline in a cancer patient cohort. Thirty-four cancer patients with bisphosphonate-associated ONJ completed a telephone survey (October 2007 through May 2008). The Oral Health Impact Profile 14 (OHIP) retrospectively assessed participant oral health-related QoL before and after ONJ. Standardized ONJ descriptions were developed in a multidisciplinary, iterative process and were evaluated with three frequently used preference-based QoL measurement methods on a 0 (death) to 1 (perfect health) scale: Visual Analogue Scale (VAS), Time Trade-Off (TTO), and EQ-5D. ONJ significantly (p < .001) increased OHIP scores (worse QoL) for additive (3.56-16.53) and weighted (7.0-17.5) methods. Seven individual OHIP items significantly increased (Bonferroni correction p < .0035): pain, eating discomfort, self-consciousness, unsatisfactory diet, interrupted meals, irritability, and decreased life satisfaction. Mean preference-based QoL values significantly decreased (p < .001) with worsening ONJ stage (VAS, TTO, and EQ-5D): no ONJ (0.76, 0.86, 0.82), ONJ stage 1 (0.69, 0.82, 0.78), ONJ stage 2 (0.51, 0.67, 0.55), and ONJ stage 3 (0.37, 0.61, 0.32). As ONJ worsened, EQ-5D domain scores significantly increased (p < .001). Pain/discomfort and anxiety/depression contributed most to declining QoL. ONJ significantly affects QoL, a detriment that increases with worsening ONJ. QoL impairments for ONJ stages 2 and 3 are similar to other treatment side effects that influence decision-making. Bisphosphonate-associated ONJ QoL is an important consideration for patients, clinicians, and policy makers.

Impaired oral health-related quality of life in Hungary

Objectives. To describe the prevalence of impaired oral health-related quality of life (OHRQoL) in the adult Hungarian population and to determine population-based norms for three Hungarian versions of the Oral Health Impact Profile (OHIP-H). Material and methods. In a survey of 1059 randomly selected subjects, OHIP responses, age, gender, and denture status [natural dentition or fixed partial dentures (FPDs), removable partial dentures (RPDs), or complete dentures (CDs)] were collected. Study outcomes were item prevalence and OHIP summary score frequency (‘norms’). Results. The prevalence of OHIP items ranged from 2% to 43%, with a mean item prevalence of 14%. The distribution of summary scores was characterized by decile norms. Median scores for OHIP-H49, the 49-item questionnaire, were 6 OHIP units for subjects with FPDs, 10 OHIP units for subjects with RPDs, and 6 OHIP units for subjects with CDs. The median scores were 0, 0, and 1 OHIP units for the 14-item OHIP-H, and 0, 0, and 0 OHIP units for the five-item OHIP-H. Conclusions. Our sample demonstrates substantial OHRQoL impact in the Hungarian general population. The derived norms provide a framework for interpretation of data in future studies using the Hungarian OHIP versions, as well as data on how oral conditions and cultural factors affect perceived oral health when compared with international findings.

Mapping oral health related quality of life to generic health state values

BackgroundA summary utility index is useful for deriving quality-adjusted life years (QALY) for cost analyses or disability weights for burden of disease studies. However, many quality of life instruments provide descriptive profiles rather than a single utility index. Transforming quality of life instruments to a utility index could extend the use of quality of life instruments to costs analyses and burden of disease studies. The aims of the study were to map a specific oral health measure, the Oral Health Impact Profile to a generic health state measure, the EuroQol, in order to enable the estimation of health state values based on OHIP data.MethodsData were collected from patients treated by a random sample of South Australian dentists in 2001–02 using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental conditions and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol (EQ-5D) and 14-item version of the Oral Health Impact Profile (OHIP-14) instruments. Data were available from 375 patients (response rate = 72%). A random two-thirds sample of patients was used in tobit regressions of EQ-5D health state values estimated using OHIP-14 in a model with categories of OHIP responses as indicator variables and in a model with OHIP responses as continuous variables. Age and sex were included as covariates in both models. The remaining one-third sample of patients was used to test the models.ResultsThe OHIP item 'painful aching in mouth' was significantly related to health state values in both models while 'life less satisfying' was also significant in the continuous model. Mean forecast errors relative to the mean observed health state value were higher when fitted to the categorical model (17.4%) compared to the continuous model (15.2%) (P < 0.05).ConclusionThe findings enable health state values to be derived from OHIP-14 scores for populations where utility has not or cannot be measured directly.

Dimensions of oral health related quality of life measured by EQ-5D+ and OHIP-14

BackgroundThe aims of the study were to compare the dimensions of oral-health-related quality-of-life measured by a generic health state measure, the EuroQol, and a specific oral health measure, the Oral Health Impact Profile.MethodsData were collected in 2001–02 from a random sample of South Australian dentists using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental problems and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol (EQ-5D+) and 14-item version of the Oral Health Impact Profile (OHIP-14) instruments.ResultsData were available from 375 patients (response rate = 72%). The EuroQol items of mobility, self care and usual activities formed a separate cluster of variables, as did anxiety/depression and cognition, while pain clustered with items from the OHIP physical pain subscale. OHIP items tended to form clusters consistent with the subscales of social disability, physical disability, physical pain, functional limitation and psychological discomfort. The OHIP handicap items clustered between the OHIP social disability and physical disability subscales. The OHIP psychological disability items split between the social disability and psychological discomfort subscales.ConclusionsThe observed clusters of variables empirically supported most of the conceptual dimensions of the OHIP. Both instruments covered symptom experience of pain indicating overlapping domains. However there was partial separation of the generic and specific items, EuroQol covered daily activities such as self-care and usual activities and OHIP covered oral health-specific aspects of functional limitation and physical disability as well as psychological and social aspects of disability and handicap.