Oral Health-related Impact Research Articles

Effects of dental insurance and dental care utilization on oral health-related daily life activities among federally qualified healthcare center patients in the United States.

To assess the association between dental insurance, dental care utilization and oral health-related impact on daily activities among patients visiting Health Resources and Services Administration (HRSA)-funded health centers in the United States. This cross-sectional study examined the 2014 Health Center Patient Survey (HCPS), a survey of patients who received care at US health centers. Logistic regression analyses were conducted to explore the likelihood of the oral health-related impact on daily activities domains such as school/work performance, sleeping, eating/chewing, social and home activities considering sociodemographic, dental insurance, and dental care utilization. Among 7002 total participants, 6890 self-reported oral health-related impact on daily activities. Adults aged 18-44 were 2.6 times more likely to report an overall impact on everyday life activities compared to children and adolescents. After adjusting for sociodemographics, Hispanic patients were less likely to report any oral health-related impacts, while patients visiting rural centres reported higher odds of oral health related impairment. Patients who experienced delays in receiving dental care or were unable to access dental care when needed were 4.5 times more likely to encounter difficulties in their daily activities. This study linked limited dental insurance and care to increased oral health issues impacting daily life, particularly among adults, rural populations, and those facing delay in dental care. This highlights the need for policy reforms and interventions aimed at improving dental care access to mitigate the detrimental effects of poor oral health on daily functions for vulnerable populations.

Oral health and oral health-related quality of life in a homeless population in Ireland: a pilot study

##Background Smile agus Sláinte – the National Oral Health Policy (2019), aims to reduce oral health inequalities by enabling vulnerable groups, including the homeless, to access oral healthcare. However, there is sparse evidence regarding the oral health of people experiencing homelessness. This study aims to assess the oral health and oral health-related impact on quality of life among homeless adults for the first time in an Irish population. ##Methods A pilot cross-sectional epidemiological study of homeless adults in Cork City, Ireland, including clinical examination and interviewer-administered questionnaire and OHIP-14 survey, was conducted. A convenience sample was recruited in collaboration with homeless service providers. ##Results The sample consisted of 25 participants. The mean D3vcMFT of the participants was 19.4 (SD ± 7.1). The D3vcT% was 41.8%. Participants had poor oral hygiene, and 70.8% had periodontal pocketing of 4mm or more. Some 79% of participants had experienced dental trauma. Participants’ most commonly reported oral health-related impacts on quality of life were feeling embarrassed (60%), feeling uncomfortable to eat (56%), feeling self-conscious (48%), and painful aching (48%). Conclusions ##Homeless adults in Ireland experience extreme oral health inequalities. To achieve the goals of Smile agus Sláinte, a foundation of high-quality epidemiological evidence is required. Further research will require extensive collaboration with homeless service providers and the wider health profession, and should seek to inform the design of oral healthcare services for homeless adults.

Oral health-related impact profile of patients treated with fixed, removable, and telescopic dental prostheses in student courses\u2014a prospective bicenter clinical trial

ObjectivesTo analyze the oral health-related impact profile in patients treated with three different types of dental prosthesis in student courses.Materials and MethodsThis prospective bicenter clinical trial was conducted with 151 patients being treated with fixed (n = 70), removable (n = 61), or telescopic dental prostheses (n = 20) in clinical student courses of two German universities from October 2018 to October 2019. All patients completed three standardized German versions of the Oral Health Impact Profile (OHIP-G49/53) before prosthetic treatment (T0), at control after 1 week (T1), and after 3 months (T2), divided into five dimensions: (a) appearance, (b) oral function, (c) psychosocial impact, (d) linguistic limitations, and (e) orofacial pain. Data were analyzed with Kolmogorov–Smirnov, Wilcoxon signed-rank, Kruskal–Wallis, Mann–Whitney, and Cronbach’s alpha tests.ResultsWithin T0–T1 and T0–T2, greater improvements were determined for removable compared with fixed dental prostheses for the dimensions’ oral function (p ≤ 0.014), linguistic limitations (p ≤ 0.016), and appearance (p ≤ 0.003). No significant differences were found between fixed and telescopic dental prostheses (p ≥ 0.104) or between removable (partial dental prosthesis with clasps and complete dental prosthesis) and telescopic dental prostheses (p ≥ 0.100). Within T1–T2, a significant improvement in orofacial pain could be determined (p = 0.007).ConclusionsRestorations presented an improvement in oral health-related quality of life. Removable dental prostheses showed better improvement than fixed ones in various dimensions.Clinical relevanceKnowledge about the influence of oral health-related quality of life on the three different types of prosthesis used in student courses can be of decisive help in dental consultations.

Oral health-related impact profile in full-mouth restored patients with two different tooth-colored restoration materials.

To analyze the change of oral health impact profile (OHIP) in patients with full-mouth rehabilitations due to moderate/severe tooth wear dependent on different restorative materials (ceramic/experimental CAD/CAM composite). Twenty-nine healthy patients (15 male/14 female, age 44.6 ± 28.4years) requiring full-mouth rehabilitation due to different degrees of tooth wear were instructed to fill the German version OHIP-G49 questionnaire before (baseline) and 30days after prosthetic treatment with ceramic (n = 17) or experimental CAD/CAM composite (n = 12) restorations. Questions were divided into five dimensions: appearance, oral functions, psychosocial impact, linguistic limitations, and orofacial pain; changes between both OHIP-questionnaires for each question and patient were dissected by difference values, separately. Data were analyzed with the Kolmogorov-Smirnov, Wilcoxon's signed-rank, Kruskal-Wallis, Mann-Whitney, and Cronbach's alpha tests (significance level p = 0.01). The appearance dimension showed the highest results (p < 0.001, 100% improvement with all values > 0); the linguistic limitations dimension presented the lowest improvement (p < 0.001). The other three dimensions were not statistically different. No statistical differences between the two materials depending on OHIP questionnaire results occurred. The esthetic appearance of the patients was influenced positively by full-mouth rehabilitation, irrespective of the material used. Improvements were also made in the parameters "toothache" and "problem of food intake." No statements could be made for the parameter "language." With an increasing number of patients with moderate/severe tooth wear, thorough knowledge about the improvement of OHIP is important. This information is advantageous for the consultation and handling of patients when complex treatments are planned.

Oral health and performance impacts in elite and professional athletes.

To measure dental caries, erosive tooth wear (ETW), periodontal health, self-reported oral health problems and performance impacts in a representative sample of UK elite athletes from different sports using standardized conditions clearly defined clinical indices and a measure of impact on performance with evidence of validity in sport. Cross-sectional study, with single, calibrated examiner, conducted in the local facilities of elite and professional UK athletes (UCL ethics number 6388/001). Main oral measures: dental caries (ICDAS), erosive tooth wear (BEWE), periodontal health (BPE) and athlete-reported performance impacts. We recruited 352 athletes from eleven sports. The mean age was 25years (range 18-39), and 67.0% were male. We found caries (ICDAS code ≥3) in 49.1% of athletes, ETW (BEWE score of ≥7) in 41.4%, gingival bleeding on probing/presence of calculus (BPE score 1 or 2) in 77.0% and pocket probing depths of at least 4mm (BPE score 3 or 4) in a further 21.6%. One in five athletes reported previous wisdom teeth problems. The odds of having caries were 2.4 times greater in team sport than endurance sport (95% CI 1.3-3.2). The odds of having erosion were 2.0 times greater in team sport than endurance sport (95% CI 1.3-3.1). Overall, 32.0% athletes reported an oral health-related impact on sport performance: oral pain (29.9%), difficulty participating in normal training and competition (9.0%), performance affected (5.8%) and reduction in training volume (3.8%). Other impacts were difficulty with eating (34.6%), relaxing (15.1%) and smiling (17.2%). Several oral health problems were associated with performance impacts. This is the first large representative sample study of oral health in athletes from different sports at elite level. Although experience of oral disease differs by sport, the prevalence, in UK elite and professional athletes, is substantial, with common self-reported performance impacts. Regular screening and use of effective oral health promotion strategies may minimize performance impacts from poor oral health.

Oral Health-Related Quality of Life Appraised by OHIP-14 Between Urban and Rural Areas in Kutai Kartanegara Regency, Indonesia: Pilot Pathfinder Survey.

Background:Health-Related Quality of Life (HRQoL) periphrastically has a significant impact on oral health. A recent study has shown the significant facts of the oral health-related quality of life based on many factors such as individual, social status, household management, daily habits, and local factors. The differences in the oral health status possibly occur in between countries, different regions, and topographical areas frequently and indirectly contributing to oral health status.Objective:The objective is to evaluate the difference of Oral Health-Related Quality of Life (OHRQoL) and to assess the main affected dimension between rural and urban areas in Kutai Kartanegara Regency.Methods:This study uses pilot pathfinder design. The respondents comprised of 214 adults who were elder than 18 years and were randomly selected from urban and rural areas in Kutai Kartanegara Regency, Indonesia. The data were collected by 103 samples from the rural area and 111 respondents from the urban area. Oral Health Impacts Profile (OHIP-14) has been translated to Bahasa (Indonesia version). OHIP-14 was used to assess the subjects’ oral health-related impact. Shapiro-Wilk and Mann Whitney tests were used to analyze the data, and p-value was set at P < 0.05.Results:The mean OHIP scores in the urban and the rural areas were 25.4 and 28.8, respectively. The overall OHIP-14 score showed a significant statistical difference P= 0,009 (P < 0.05) between rural and urban area.Conclusion:This study illustrates that oral health-related quality of life in the urban area is better than in the rural area. Physical pain components of the OHRQoL are the major oral problems associated with both the areas.

Orthodontic Treatment of Malocclusion and its Impact on Oral Health-Related Quality of Life.

Objectives:Malocclusion, though not life-threatening, has vast impact on individual’s social interactions and self-esteem. Therefore, the aim of the current study was to assess whether orthodontic treatment of adolescents with malocclusion had any association with their oral health-related quality of life (OHRQoL).Methods:The subjects for this study were recruited at a state-funded university clinic. Data were collected from 100 participants aged 17 to 21 with moderate to severe malocclusion. Experimental group comprised of 50 subjects who were in the retention phase of their orthodontic treatment and the control group comprised of 50 untreated subjects. The shortened version of the Oral Health Impacts Profile (OHIP-14) as used to assess the subjects’ oral health-related impact. T-test, Kruskal-Wallis, and Mann Whitney tests were used to analyze the data and p-value was set at P < 0.05.Results:In general, oral health-related quality of life of all subjects significantly improved after orthodontic treatment. (p<0.001) Subjects with moderate malocclusion showed better improvement than severe malocclusion subjects. (P<0.001)Conclusion:This study showed that oral health-related quality of life improves with the treatment of malocclusion.

Oral health status and its impact on the quality of life of children and adolescents living with HIV-1.

BackgroundOral health problems can generate considerable negative effects on the quality of life of individuals living with HIV. The aim of this study was investigate the oral health status and its impact on the quality of life of 1 to 18 years-old living with HIV-1 under follow-up at referral centers in Southern Brazil.MethodsA cross-sectional study involving individuals under follow-up (n = 36) was carried out. The individuals living with HIV-1 and their guardians underwent individual interviews using validated questionnaires for assessing oral health-related quality of life according to age group. Clinical oral examinations were performed to establish oral health status, in terms of caries and treatment need, HIV-1-related gingival as well as stomatological changes. Medical records were reviewed searching for clinical history of the infection and the presence of HIV-1-related diseases. Association studies between frequent/very frequent oral health-related impact on quality of life and independent variables were performed using Fisher’s exact test.ResultsThe prevalence of frequent/very frequent oral health-related impact on quality of life was 69.0%. The prevalence of caries was 75.9%. Gingival changes were present in 20.7% of the individuals. Dental treatment was needed in 72.4% of the patients. HIV-1-related disease was present in 55.2%. The variables significantly associated with the prevalence of frequent/very frequent impact on oral health-related quality of life were dental treatment need (p = 0.037) and being more than 12 years of age (p = 0.041).ConclusionsIndividuals living with HIV-1 with need for dental treatment and those over 12-years of age reported a statistically higher frequency of frequent/very frequent oral health-related impact on quality of life.

Dental visiting history between ages 13 and 30 years and oral health-related impact

The aim was to assess the role of visit history factors between the age of 13 and 30 years on oral health-related impact. In 1988-89, n=7,673 South Australian school children aged 13 years were sampled with n=4,604 children (60.0%) and n=4,476 parents (58.3%) returning questionnaires. In 2005-06, n=632 baseline study participants responded (43.0% response of those traced and living in Adelaide). Oral health impact was measured at age 30 years using OHIP-14. Multivariate regression showed that OHIP scores were significantly higher (P<0.05) for those with episodes of relief of pain visits once (β=1.487) or two or more times (β=2.883), and episodes of extraction once (β=1.301) or two or more times (β=3.172). Higher positive dental visit attitude scores were associated with lower OHIP scores (β=-1.265), as were being male (β=-0.637), having a job (β=-1.555) and being tertiary educated (β=-0.632). History of adverse dental events between the age of 13 and 30 years such as episodes of relief of pain visits and episodes of extraction was associated with higher impact of oral health problems at age 30 suggesting a cumulative effect.

Assessing the oral health-related quality of life in Iranian adolescents: validity of the Persian version of the Child Oral Health Impact Profile (COHIP).

To evaluate the psychometric properties of an oral-health related quality of life (OHRQoL) instrument for application in the population of Iranian adolescents and to assess the discriminate and convergent validity and reliability of the Persian version of the Child Oral Health Impact Profile (COHIP) in a representative sample of this population. Using multistage stratified sampling, 597 schoolchildren aged from 13 to 18 years living in the city of Isfahan were recruited to complete the Persian COHIP questionnaire. They were also examined for dental caries and malocclusion by two trained, calibrated examiners. Overall COHIP scores ranged from 15 to 135 (mean ± SD: 103.6 ± 18). Sixty-six percent of the students experienced at least one frequent oral health-related impact over the past three months. The Cronbach alpha coefficient was 0.89 for the overall score. Discriminate validity was supported by the significant difference between COHIP scores in the caries-free group and the others (P = 0.01). In addition, the questionnaire was able to differentiate among the groups by various degrees of need for orthodontic treatment (P < 0.01). Convergent validity was confirmed by significant association between the quality of life scores, the self-perceived health and oral health ratings and the self-perceived treatment need (r = 0.36, 0.57, -0.40). The Persian COHIP demonstrated acceptable psychometric properties for the descriptive purposes. Some discrepancies observed between the clinical data and quality of life status were confirmed by the perceptual identity of such indices influenced by several overt and covert variables.

Prosthetic considerations

Implants have changed prosthodontics more than any other innovation in dentistry. Replacement of lost teeth by a fixed or removable prosthesis is considered to be a restitutio ad similem, while implants may provide a feeling of restitutio ad integrum. Implant prosthodontics means restoring function, aesthetics, and providing technology; biology and technology are combined. Placement of implants is a reconstructive, preprosthetic surgical intervention and is therefore different from most goals in oral surgery that consist of tooth extraction, treating infection and removing pathology from soft or hard tissues. Thus, implants are part of the final prosthetic treatment which encompasses functional, aesthetic and social rehabilitation. The patient's needs and functional status determine the goal of prosthetic treatment. Treatment outcomes in implant prosthodontics are survival of implants and prostheses, impact on physiological and psychological status, oral health-related impact on quality of life, and initial and maintenance costs. A variety of prosthetic solutions are available to restore the partially and completely edentulous jaw and more recently specific methods have been developed such as computer guided planning and CAD-CAM technologies. These should allow more uniform quality and passive fit of prostheses, and simultaneously enables processing of biologically well-accepted materials.