Oral Health Impact Profile Summary Scores Research Articles

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.

Developing abbreviated OHIP versions for use with TMD patients

The aim of this study was to evaluate the psychometric characteristics of three versions of the Dutch Oral Health Impact Profile (OHIP-NL), for clinical use with temporomandibular disorder (TMD) patients. To that end, two abbreviated OHIP versions (OHIP-NL14 and OHIP-NL5) were developed by respectively selecting 14 and five items from the officially translated and culturally adapted original 49-item OHIP-NL questionnaire. A total of 245 consecutive patients, referred by their dentist to the TMD clinic of the Academic Centre for Dentistry Amsterdam (77% women; mean age ± s.d. = 41·0 ± 14·9 years), completed the Research Diagnostic Criteria for TMD (RDC/TMD) axis II questionnaire and the OHIP-NL. Reliability and validity of all three OHIP versions were compared, and their associations with four psychological axis II variables, indicating the level of impairment of patients with TMD, were examined. According to guidelines for clinical application, internal consistency scores were sufficient for OHIP-NL and OHIP-NL14, but insufficient for OHIP-NL5. Test-retest reliability (n = 64) was excellent for OHIP-NL and OHIP-NL14 and fair to good for OHIP-NL5. For all three versions, there was evidence for score validity: associations between OHIP summary scores on the one hand and validation variables and other RDC/TMD axis II variables on the other hand met the expectations and were statistically significant (P < 0·001). In conclusion, the OHIP-NL and OHIP-NL14 both performed comparatively well and better than the OHIP-NL5. When the length of the questionnaire (i.e. the time needed for its completion) is an issue, the OHIP-14 would therefore be the preferred version.

Oral health‐related quality of life in patients seeking care for dentin hypersensitivity

The aim of the present study was to evaluate oral health-related quality of life (OHRQoL) impairment in patients seeking care for their hypersensitive teeth in comparison with general population subjects and to investigate the influence of gender and age on OHRQoL in these populations. Study participants were 656 patients without removable prosthodontics who sought treatment for their hypersensitive teeth in German dental offices. These patients were asked to complete the German form of the Oral Health Impact Profile (OHIP-G) prior to treatment. The sum of OHIP-G item responses (OHIP-G49, 0-196) characterized the OHRQoL impairment. Patients' OHIP summary scores were compared with those in a sample of the German general population (n = 1541). The influence of population (patients vs. general population subjects), gender and age was investigated using a multivariable linear regression model. Age presented a curvilinear association with OHRQoL, with lower OHIP scores associated with younger and older adults and higher OHIP scores (indicating impaired OHRQoL) associated with middle-aged adults in both the patient and general populations. Gender influence depended on the population, i.e. female general population subjects had lower OHIP scores than male general population subjects and female patients had higher OHIP scores than male patients. Mean OHIP summary scores indicated that patients with hypersensitive teeth reported considerably more impaired OHRQoL (approximately 22 OHIP units) than subjects in the general population. The present study suggests that the oral condition of hypersensitive teeth is significantly associated with impaired OHRQoL.

Psychometric Properties of Croatian and Slovenian Short Form of Oral Health Impact Profile Questionnaires

To develop Croatian and Slovenian versions of the 14-item Oral Health Impact Profile (OHIP) Questionnaire. The English original version of the OHIP questionnaire was translated into Croatian (OHIP-CRO14) and Slovenian (OHIP-SVN14) language by a forward-backward translation method. The psychometric properties of the OHIP-CRO14 and OHIP-SVN14 were tested. Concurrent validity was tested on 623 subjects (193 Croatian and 430 Slovenian), test-retest reliability on 115 subjects (55 Croatian and 60 Slovenian), internal consistency on 678 subjects (218 Croatian and 460 Slovenian), and responsiveness on 51 patients (21 Croatian and 30 Slovenian) in demand of treatment (toothache). Concurrent validity was confirmed by the association between the OHIP summary scores and self-reported oral health (correlation coefficients ranged from 0.40 to 0.60, P<0.001). Test-retest reliability showed high intraclass correlation (correlation coefficients, 0.79-0.94). Internal consistency showed high Cronbach alpha (0.77-0.91). Responsiveness was confirmed by a significant difference between the mean OHIP score at baseline and follow-up (P<0.001 for both Croatian and Slovenian patients) and high effect size in Croatian and Slovenian patients in demand of treatment (3.00 and 0.57, respectively). Psychometric properties of OHIP-CRO14 and OHIP-SVN14 render these instruments suitable for the assessment of Oral Health Related Quality of Life in Croatia and Slovenia.

Comparison of perceived oral health in patients with temporomandibular disorders and dental anxiety using oral health-related quality of life profiles

Oral health-related quality of life (OHRQoL) instruments provide information beyond what is represented in their summary scores. Individual item information also provides useful insight into patient-related oral health problems. Our study aim was to compare patients' perceived impact from temporomandibular disorders (TMD) and from dental anxiety on oral health using item profiles contained within the Oral Health Impact Profile (OHIP). We measured OHRQoL using the German version of the 14-item OHIP in 416 TMD patients, 173 dental anxiety patients, and 2,026 general population subjects. Dental anxiety patients demonstrated the highest mean OHIP summary scores, i.e., the worst OHRQoL (22.4 in anxiety patients, 14.0 in TMD patients, 4.1 in general population; P<0.001). The prevalence of frequently occurring responses of the individual items was 6-62% in dental anxiety patients, 3-40% in TMD patients, and 0.2-0.4% in the general population. The item prevalence of both patient groups was very similar for functional and pain-related OHRQoL domains. Dental anxiety patients indicated problems more frequently than TMD patients in the OHIP domains of psychological discomfort and psychological disability. This insight into patients' perceived oral health provided by OHIP item profiles may be important for patient diagnosis and outcome assessment in the clinical setting.

No significant retest effects in oral health-related quality of life assessment using the Oral Health Impact Profile

Objective. To investigate retest effects in assessment of the Oral Health Impact Profile (OHIP) in patients requiring prosthodontic treatment. Material and methods. The German 49-item OHIP was administered in 21 patients requiring prosthodontic treatment on three pretreatment occasions: twice (t1 and t2) on day 1, 1–2 h apart, and on day 2 (t3), 3–78 days later. Differences in reliability coefficients, OHIP summary scores, and item responses, and the influence of time on score differences were analyzed. Results. Some evidence of retest effects in oral health-related quality of life (OHRQoL) was found (the difference in reliability coefficients between t1–t2 and t2–t3 was 0.08; p=0.02). Conclusions. The findings support repeated OHRQoL assessment over short periods of time when perceived oral health is rapidly changing. This is important because many oral conditions have acute symptoms and treatments have immediate OHRQoL effects that need to be measured.

Oral health‐related quality of life in patients with dental anxiety

To investigate the frequency of impaired oral health-related quality of life (OHRQoL) in patients with dental anxiety. OHRQoL was measured with the German version of the 14-item Oral Health Impact Profile (OHIP) developed by Slade and Spencer (1994) in 173 adult patients with dental anxiety [Dental Anxiety Scale (DAS) score 15 or above and Dental Fear Survey (DFS) score 60 or above]. The OHIP summary scores were characterized with an empirical cumulative distribution function and compared with the level of impaired OHRQoL in the general population (n = 2026, age: 16-79 years). In addition, OHIP item prevalences (responses 'fairly often'/'very often') were compared between patients and population subjects. The correlation between DAS, DFS and OHIP scores was calculated using the Pearson correlation coefficient. A median value of 1 and a 90th percentile value of 13 were observed for general population subjects. In contrast, patients with phobic dental anxiety had a median OHIP-14 of 21 and the 90th percentile of 40. All problems mentioned in the OHIP-14 were more prevalent in patients than in population subjects. The most frequently occurring items in patients were 'self-conscious', 'life in general was less satisfying', and 'feeling tense' with prevalences of 50% or greater. In contrast, these items had prevalences of only 1-3% in the general population. A low to moderate relationship between OHRQoL and both dental anxiety measures (DAS and DFS) was observed (r = 0.25/0.26, P < 0.01). Patients with dental anxiety/fear suffer considerably from impaired OHRQoL and the degree of this impairment is related to the extent of dental anxiety/fear.

An Arabic version of the Oral Health Impact Profile: translation and psychometric properties

To translate the original English version of the Oral Health Impact Profile (OHIP) into an Arabic version, and to investigate the psychometric properties of the translated instrument among adults in Saudi Arabia. The original English version of OHIP with 49 items was translated into Arabic following accepted cultural adaptation technique guidelines using a forward-backward method. After pilot testing, the instrument was administered to 426 adults in Saudi Arabia. A priori hypothesised associations between the OHIP summary score, self-reported oral health and five oral disorders were confirmed in a convenience sample of the general population (n = 356). These associations were interpreted as support for construct validity. The instrument's responsiveness, as indicated by a mean OHIP summary score change from 62.27 to 14.00, was established in 30 consecutive patients treated for complete and removable partial dentures. Test-retest reliability was demonstrated by intraclass correlation coefficients of 0.75 - 0.90 for dimensions and summary score (n = 40). Internal consistency was high (Cronbach's alpha > 0.74) in the general population sample. Sufficient psychometric properties of the OHIP-A make the instrument suitable for assessment of oral health-related quality of life in Saudi Arabia.

Japanese version of the Oral Health Impact Profile (OHIP‐J)

The objective of the study was to develop a Japanese version of the Oral Health Impact Profile (OHIP). The original 49 items were translated using a forward-backward method following accepted cultural adaptation guidelines. A de novo development of Japanese items was conducted to establish content validity. The associations between the OHIP summary score and self-reported oral health (n = 220) and self-reported denture quality (n = 155) were investigated for construct validity. The association between the OHIP summary score and six oral conditions (n = 227) were also tested. The responsiveness of the instrument was established by comparing the score before and after using newly fabricated removable partial dentures (n = 30). The test-retest reliability (n = 37) and internal consistency (n = 251) were also calculated. After the de novo development, five new items were added to the OHIP. The priori hypothesized associations between the OHIP score and oral health conditions were confirmed (P < 0.001). The change in the OHIP scores from 63.6 to 40.6 (P < 0.001) supports the responsiveness of the instrument. Intra-class correlation coefficients of 0.81 and Cronbach's alpha of 0.98 indicate high test-retest reliability and internal consistency of the instrument's summary score. Sufficient discriminative and evaluative psychometric properties of the currently developed Japanese version of the OHIP in typical target populations make the instrument suitable for assessing the oral health-related quality of life in cross-sectional as well as longitudinal studies.

The Hungarian version of the Oral Health Impact Profile

Oral health-related quality of life (OHRQoL) is increasingly of interest in dentistry. The current internationally accepted instruments used to measure OHRQoL need to be cross-culturally adapted for use in other cultural environments. It was the aim of the present study to develop a Hungarian version of the Oral Health Impact Profile (OHIP-H) following accepted guidelines. The original English-language version was translated into Hungarian, back-translated into English, and tested for its psychometric properties. Construct validity was tested on 144 prosthodontic patients and 200 randomly selected subjects. A priori hypothesized associations between OHIP summary scores and self-reported oral health and six self-reported oral conditions were investigated. The pattern of the observed associations supported the new instrument's construct validity. Responsiveness tested in 28 oral surgery patients was indicated by a statistically significant mean OHIP score change from 39.2 to 23.0. Test-retest reliability was demonstrated by intraclass correlation coefficients of 0.81-0.90 for OHIP summary scores and subscales in 31 prosthodontic patients. Cronbach's alpha values between 0.71 and 0.96 proved to have high internal consistency. Adequate psychometric properties in typical patient populations make the new instrument suitable for assessment of OHRQoL in Hungary.

Factors associated with oral health-related quality of life in institutionalized elderly

Objective. The aim of this study was to investigate factors associated with the oral health-related quality of life (OHRQoL) of institutionalized elderly in Germany. Material and Methods. One-hundred-and-fifty-eight subjects from old people's homes were selected (mean 82.8 years). OHRQoL was measured using the Oral Health Impact Profile (OHIP). Denture characteristics (kind and age of denture, retention of removable denture, number of teeth in static occlusion) and general issues (age, gender, education level, and general pain status) were assessed. All factors were subjected to bivariate testing for their effects on the OHIP summary score (OHIP-SC) and to multivariate testing in subjects with removable dentures (n=128); a linear regression model with backward elimination was used, with OHIP-SC as the dependent variable. Results. In the context of other studies, a median OHIP-SC of 29 indicated highly impaired OHRQoL. According to the bivariate analysis, retention, age of denture, number of teeth in static occlusion, general pain status, and education all exhibited significant influence on OHIP-SC. In the final linear regression model, general pain status, education level, and retention of denture remained at a statistically significant level. The model explained 34% (R2=0.34) of the variance of the OHIP-SC. The kind of denture had no significant impact on OHIP-SC. Conclusions. In contrast to other groups, the kind of denture exhibited little impact on OHIP-SC for this highly specific collective. However, there were functional aspects of dentures which seemed to be important. Non-dental factors had a striking effect on OHRQoL.

Mundgesundheitsbezogene Lebensqualität älterer Menschen

The aim of this study was to describe the oral health related quality of life (OHRQoL) of institutionalized elderly. 159 elderly were randomly selected for this, study ranging in age from 61 to 98 (mean age 82.8; 19.1% male, 80.9% female). For measuring the OHRQoL the Oral Health Impact Profile (OHIP) was used. Additionally, a dental status was evaluated. 15% of the subjects had only natural teeth or fixed dentures, 80% removable dentures and 15% no dentures at all. OHIP-mean reached 33+/-25 points, between 0 and 112. The subcategory "functional limitation" showed the highest impairment (6.3%). The items with the highest impairment on OHRQoL in the different subcategories were: dentures not fitting properly, uncomfortable dentures, self-conscious due to teeth, avoid eating some foods, felt depressed, avoid going out and general health worsened. The OHIP summary score represents an overview of OHRQoL and answers detailed questions with the help of the single items. In institutionalized elderly many items showed impairment, especially in items concerning the prosthetic restorations. This demonstrates the need for dental aftercare and not only dental interventions for acute pain. Establishing aftercare and prophylaxis could increase the OHRQoL and subsequently the overall well-being.

Impact of Sjögren's syndrome on oral health-related quality of life in southern Chinese.

The effect of oral symptoms of Sjögren's syndrome (SS) on health-related quality of life is presently uncertain. This study aimed to investigate oral health-related quality of life (OHRQOL) among southern Chinese people with SS. Twenty-six primary SS cases, 25 secondary cases and 29 matched controls took part in this cross-sectional study. Each participant completed a SF-36 questionnaire, the Oral Health Impact Profile and a dry mouth measure, assisted by a trained interviewer. Data on socio-demographic variables were also collected. The dry mouth measure revealed that people with primary and secondary SS had significant problems associated with subjective symptoms of dry mouth generally, and dry mouth when eating and speaking (P < 0.01). Sticky saliva and coughing were also problems in some primary SS cases. OHIP summary and sub-scale scores did not reveal differences in negative impacts between groups. Mean SF-36 sub-scale scores were significantly different between groups (P < 0.05). In physical function, role-physical and general health domains, primary and secondary SS sufferers had lower scores indicating poorer health. Oral symptoms of SS, notably xerostomia, had a negative effect on OHRQOL. Health-related quality of life in general was also impaired in SS sufferers. The OHIP did not appear to discriminate oral problems of concern to SS sufferers.

The German version of the Oral Health Impact Profile--translation and psychometric properties.

The need for cross-culturally adapted oral-health specific health outcome measures is increasingly recognized in Germany. Following accepted cultural adaptation technique guidelines, we report the development of the German version of the Oral Health Impact Profile (OHIP). The original 49 items were translated using a forward-backward method. A de novo development of German items established content validity. A priori hypothesized associations between the OHIP summary score and self-reported oral health and five oral disorders were confirmed in a random sample of the general population (n = 163, age 20-60 yr). These associations were interpreted as support for construct validity. The instrument's responsiveness, as indicated by a mean OHIP summary score change from 45.0 to 28.3, was established in 67 consecutive patients treated for temporomandibular disorder pain (age 19-85 yr; 72% women). Test-retest reliability was demonstrated by intraclass correlation coefficients of 0.63-0.92 for dimensions and summary scores (convenience sample, n = 30, age 18-85 yr; 53% women). Internal consistency was high (Cronbach's alpha > 0.74). Sufficient discriminative and evaluative psychometric properties of the Oral Health Impact Profile German version (OHIP-G) make the instrument suitable for assessment of oral health-related quality of life in cross-sectional as well as longitudinal studies.