Subjective Oral Health Indicators Research Articles

Association of service use with subjective oral health indicators in a freedom of choice pilot.

A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018-2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot. SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), (2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome). Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small. Service use during the pilot depended on the subjective oral health. Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.

Oral health and oral health-related quality of life among older adults receiving home health care services: A scoping review.

To map the literature on subjective and objective oral health indicators and oral health-related quality of life (OHRQoL) in older adults receiving home health care services (HHCS). The proportion of older adults in need of HHCS will increase in the coming years. Previous studies indicate that frail and dependent older adults are at increased risk for oral diseases, due to challenges with daily oral hygiene and regular access to dental services. Four databases were searched in November 2020 for relevant literature. Search terms included a comprehensive list of terms for adults 65 years or older receiving HHCS, clinical and subjective oral health indicators, and OHRQoL. The literature was reviewed based on inclusion and exclusion criteria. Of the 3114 sources identified, 18 were included. Data on oral diseases and symptoms among older adults receiving HHCS were limited and heterogeneous. Overall, older adults often lacked some of their natural teeth and often had removable dentures that needed repair. In addition, plaque, caries, xerostomia, and chewing and swallowing problems were common among the population group. Data on OHRQoL were scarce and indicated a positive association with a higher number of present teeth, while decayed teeth, root remnants, and dry mouth had substantial negative impacts on the daily activities of older adults receiving HHCS. This scoping review show that older adults above 65 years receiving HHCS generally have poor oral health status and that there is a knowledge gap regarding their OHRQoL.

Is the association between social support and oral health modified by household income? Findings from a national study of adults in Australia.

To investigate whether the association between social support and oral health outcomes is modified by levels of household income. Data were from the National Study of Adults Oral Health (NSAOH 2004-06), a nationally representative study comprising n=3619 adults in Australia. Effect measure modification (EMM) analysis was adopted to verify whether the association between social support and poor/fair self-rated oral health, lack of a functional dentition (<21 teeth) and low Oral Health Related Quality of Life (OHRQoL; measured using OHIP-14) varies according to levels of income. Poisson regressions adjusted for age, sex, education, country of birth, main language spoken at home and remoteness were used to estimate prevalence ratios (PR) for oral health outcomes for each stratum of social support (overall, family, friends and significant other) and income (effect modifier). We then computed the Relative Excess Risk due to Interaction (RERI), which represents the risk that is over what would be expected if the combination of low social support and low income was entirely additive. Sensitivity analyses for different cut-offs of household income were performed. Adults with lower levels of social support had a 2.1, 1.2 and 1.9 times higher prevalence of fair/poor self-rated oral health, <21 teeth and poor OHRQoL respectively. The RERIs observed were 0.98 (95% CI -0.01; 1.96) for poor/fair self-rated oral health; 0.52 (95% CI -0.06; 1.10) for lack of a functional dentition and 0.50 (95% CI -0.16; 1.15) for poor OHRQoL. For all outcomes and all individual domains of social support, the positive RERIs indicated that the joint association of low social support and low household income surpassed the sum of their separate associations with objective and subjective oral health indicators. Individuals with lower levels of social support had poorer oral health than those with high levels of social support, although this association was small for the outcome <21 teeth. The association between social support and poor oral health indicators is modified by levels of household income. Hence, the provision of social support had a stronger association with the oral health of low-income participants, suggesting that socioeconomically disadvantaged individuals would mostly benefit from a social support intervention.

Oral Health-Related Quality of Life among Croatian University Students.

Oral health-related quality of life (OHRQoL) is utilized in health services research to examine trends in oral health and population-based needs assessment. To determine the impact of oral diseases on everyday life, measures of oral quality of life are needed. In addition to common disease-based measures, they assess the need for oral care to evaluate oral health care programs and treatment management. The aim of this study was to evaluate the OHRQoL among Croatian university students. A cross-sectional study was conducted among 895 students (mean age 22 ± 4 years; 54.75% were females). The data collection was carried out through a self-administered short-form oral health impact profile (OHIP-14) questionnaire which comprises 14 items that describe 7 subscales. Each subscale is named according to its constitutive items: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and social handicap. The quality of data was descriptively analysed and internal consistency reliability was assessed by Chronbach’s alpha coefficient. Pearson’s correlation was performed on the OHIP-14 total score and 7 subscale scores. The level of significance was set to p < 0.05. The prevalence of reported impact on OHRQoL was 31.84% and the mean OHIP-14 score was 11.66 ± 8.72. Chronbach’s alpha for the OHIP-14 total score was 0.91 (range for subscales: 0.70–0.87). Total OHIP-14 score was correlated with each of the seven subscales (correlation range: 0.56–0.84). The psychological discomfort and physical pain subscales recorded the highest impact with 56.09% and 24.47%, respectively, while the least impact was recorded in the physical disability subscale with 13.35%. The mean OHIP-14 score of the students in this study reflects that the oral health status of most of the students did not significantly affect their OHRQoL. However, the psychological discomfort and physical pain subscales were the most severely affected aspects of their OHRQoL. The OHIP-14 had reasonable reliability in relation to subjective global oral health indicators among students and thus appears to be a useful OHRQoL measure in this context.

Frequency of Oral Impacts on Daily Performances and Dental Pain Among Indigenous Adolescents of Himalayas (Leh, Ladakh): A Cross-Sectional Study.

Psychosocial impacts on quality of life among adolescents with access to affordable dental care is not well documented. In addition, dental pain is accelerating towards a public health problem that needs immediate attention. The objective was to determine impacts on quality of life using the Oral Impacts on Daily Performances (OIDP) frequency scale and to determine prevalence of dental pain with its impact. A total of 288 students (mean age 15.72 ± 1.5) completed the survey instrument (sociodemographic variables, consumption of chocolates/candies, perceived need for dental care, history of dental pain in last 6 months and OIDP frequency scale) designed to measure subjective oral health indicators. Mean OIDP simple count scores were analysed using logistic regression and additive (ADD) scores for dental pain were compared using student's t test. The response rate was 96%. About 44.4% reported impacts affecting daily performances. About 11.4% consumed tobacco and 92.7% consumed forms of refined sugars. About 39% perceived a need for dental care and 32.3% experienced dental pain with problem in eating and cleaning teeth. Those not perceiving a need for dental care were more likely to have an impact (OR: 2.3; CI: 1.2-4.4). Males had higher OIDP ADD scores for dental pain than females (p = 0.015). Overall impact was less than 50%. Dental pain was reported among students with access to dental care with impacts on eating and cleaning of teeth. Oral health promotion needs to be reinforced by strengthening school community relationship.

Association between Oral Health and Frailty among Older Adults in Madinah, Saudi Arabia: A Cross-Sectional Study.

This study aimed to examine the association between normative and subjective oral health indicators and frailty assessed by Frailty Phenotype (FP) and frailty index (FI) among older Saudi adults. cross-sectional study. community and hospital-based. participants were 356 community-dwelling older adults attending dental clinics and social centres at Madinah, Saudi Arabia. Frailty was measured with the frailty phenotype and a 34-item FI. Oral health included the following measures: self-rated oral health, number of teeth, and functional dentition. Covariates included sociodemographic factors and nutritional status. Logistic regression and negative binomial regression models were constructed to test the association between oral health indicators, FP, and FI, respectively. The first model was adjusted for demographic and socioeconomic factors, the second model was additionally adjusted for nutritional status. The number of teeth, functional dentition and self-rated oral health showed significant associations with frailty after adjusting for demographic and socioeconomic variables for both FP and FI. Adjusting for nutritional status attenuated the associations. This study has shown significant associations between oral health indicators namely number of teeth, functional dentition and self-rated oral health, and both FP and FI among Saudi older adults. Nutritional status appeared to mediate the association between oral health and frailty implicating inability to eat in this relationship.

Social gradients in oral health status in Korea population

ObjectivesThe aim of the present study was to investigate whether clinical (severe tooth loss) and subjective (chewing difficulties) indicators of oral health outcomes are associated with socioeconomic position and to explore the age-sex differences in the magnitude of the social gradient in Korea using data from the representative national data. MethodsData were acquired from 10,939 men and women, ≥30 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2012 to 2014. Education and income were used as socioeconomic position. Self-rated chewing difficulties and severe tooth loss were assessed by dentists and trained interviewers. Confounding variables were demographic factors, general health behaviors, and systemic health status. ResultsSignificant differences in oral health outcomes were observed according to the quartiles of income and education. In particular, the quartiles of education were significantly associated with oral health outcomes in the fully adjusted model with a dose-response trend. In participants aged 40–49 (OR = 2.30, 95% CI = 1.37–3.88) and 50–59 years (OR = 2.16, 95% CI = 1.49–3.14), the associations between the lowest quartiles of income and chewing difficulties were stronger than in the total population. ConclusionsOur findings demonstrate a clear and distinct social gradient in clinical and subjective oral health indicators based on socioeconomic position.

Evaluation of an educational activity in the oral health of students.

To investigate the influence of educational activity in the school environment based on prescriptive and subjective oral health indicators. Cross-sectional, comparative study involving students between 9 and 12years of age, from schools that have educational activities and those that do not, designated schools A and B. The oral health indicators used were the Simplified Oral Hygiene Index (OHI-S) and the Community Periodontal Index (CPITN). Knowledge and attitudes with regard to oral health were evaluated using a structured questionnaire. A total of 289 schoolchildren took part, 50.5% from school A and 49.5% from school B, in the town of Montes Claros, in the Brazilian state of Minas Gerais. In school A, the schoolchildren's OHI-S was satisfactory for 9.6%, normal for 78.8% and deficient for 11.6%, while in school B, the respective percentages were 3.5%, 17.5% and 79% (chi-squared, P<0.001). The students in school A showed better CPITN results, namely lack of bleeding for 61.6%, the presence of bleeding for 29.5% and presence of tartar for 8.9%, while in school B, the respective results were 25.2%, 45.5% and 29.4% (chi-squared, P<0.001). Students in school A achieved more correct answers in questions that evaluated knowledge of oral health. The account of daily use of dental floss in school A was 21.7% and in B, 3.6% (chi-squared, P<0.001). It is believed that educational activity in the school environment had a positive effect on oral health conditions, the consolidation of knowledge and incorporation of oral hygiene habits.

Intergenerational mobility and adult oral health in a British cohort.

This study aimed to characterize trajectories of intergeneration mobility from birth to age 33 years and to assess the influence of these trajectories on adult oral health. Repeated data on occupational social class (birth and 7, 11, 16, 23 and 33 years) and two subjective oral health indicators (lifetime and past-year prevalence of persistent trouble with gums or mouth) measured at age 33 years, from the 1958 National Child Development Study, were used for this analysis. Latent class growth analysis (LCGA) was used to identify different trajectories of exposure to manual social class over time. Binary logistic regression was then used to explore the association between these trajectories and each oral health indicator, adjusting for participants' sex. Latent class growth analysis showed that a four trajectory model provided the best fit to the data. The four trajectories that emerged were identified as stable manual, stable nonmanual, late steep increase (those who were likely to be in the manual social class until age 16 years but ended up in the nonmanual social class afterwards) and steady increase (those whose likelihood of leaving the manual social class increased gradually over time). Lifetime and past-year prevalence of persistent trouble with gums or mouth was significantly higher in the stable manual trajectory than in all other trajectories. No differences were found between the stable nonmanual, late steep increase and steady increase trajectories. Although four distinctive trajectories were identified in the 1958 NCDS, only those who remained in the manual social class over time reported worse oral health by age 33 years. Proximal socioeconomic experiences may be more relevant to adult oral health than early life experiences.

Association between Oral Health Status and Type 2 Diabetes Mellitus among Sudanese Adults: A Matched Case-Control Study

AimThe purpose of this study was to compare the clinical and subjective oral health indicators of type 2 diabetic patients (T2DM) with age and gender matched non-diabetic controls. A second aim was to identify clinical and subjective oral health indicators that discriminate between well-controlled and poorly controlled T2DM patients as well as between patients with long and short duration of the disease.MethodsA total of 457 individuals participated in the study (154 T2DM cases and 303 non-diabetic controls). The T2DM group was sub-divided according to metabolic control [(well-controlled: glycosylated haemoglobin test ≤8%), (poorly controlled: glycosylated haemoglobin test > 8%)] and according to duration of T2DM [(long duration: >10 years), (short duration: ≤10 years)]. Participants were interviewed using a structured questionnaire including socio-demographics, lifestyle and oral health related quality of life factors. The clinical examination comprised full mouth probing depths, plaque index, tooth mobility index, furcation involvement and coronal and root surface caries.ResultsThe T2DM patients presented with more probing depths ≥4mm, furcation involvement, tooth mobility, missing teeth, and oral impacts on daily performance (OIDP). The corresponding adjusted odds ratios and their 95% confidence intervals were 4.07 (1.74–9.49), 2.96 (1.36–6.45), 5.90 (2.26–15.39), 0.23 (0.08–0.63) and 3.46 (1.61–7.42), respectively. Moreover, the odds ratio was 2.60 (1.21–5.55) for the poorly controlled T2DM patients to have high levels of mobility index and 2.94 (1.24–6.94) for those with long duration of T2DM to have high decayed, missed and filled teeth (DMFT) values.ConclusionThis study revealed that chronic periodontitis, tooth mobility, furcation involvement and OIDP were more prevalent among T2DM patients compared to their non-diabetic controls.

Validity and Reliability of Oral Impacts on Daily Performances Frequency Scale

To examine reliability and validity of an abbreviated version of Oral Impacts on Daily Performances (OIDP) questionnaire and to analyze the interrelationship among OIDP scores, socio-demographic characteristics and oral health status among 12-15 year old adolescents in Davanagere city, Karnataka, India. The descriptive cross-sectional survey was conducted among 900 adolescents aged between 12-15 years. The study subjects were randomly selected from six high schools. Selected subjects completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. The study participants were clinically examined for dental caries and completed a self-administered questionnaire about demographic information and oral behaviors. 44% of the students reported at least one oral impact in the last six months. Cronbach's alpha for the OIDP frequency items was 0.81. Eating was the most common performance affected (33%) followed by cleaning teeth (22%) and speaking (20%). The severity of impacts was low for relaxing and carrying out works. The OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among 12-15 year old adolescents.

Comparative assessment of validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross‐sectional survey among adolescents in Davanagere city, Karnataka, India

To evaluate reliability and validity of an abbreviated version of the Oral Impact on Daily Performance (OIDP) questionnaire and to analyse the interrelationship between OIDP scores, socio-demographic characteristics and oral health status among high school children in Davanagere city, Karnataka, India. This cross-sectional survey was conducted with 900 school children aged between 12 and 15. The subjects were randomly selected from six high schools. Selected subjects completed a survey instrument predesigned to measure subjective oral health indicators including the eight-item OIDP frequency scores. The study participants were clinically examined for dental caries, and they completed a self-administered questionnaire about demographic information and oral behaviours. 44% of the students reported at least one oral impact in the previous 6 months. The reliability of the instrument was measured in terms of Cronbach's alpha for the OIDP frequency. It was found to be 0.81. Eating was the most common performance affected (33%) followed by cleaning teeth (22%) and speaking (20%). The severity of impacts was low for relaxing and carrying out works. The OIDP frequency score has acceptable psychometric properties in the context of an oral health survey among high school children of Davanagere city, Karnataka, India.

Validity and reliability of the Oral Impacts on Daily Performance (OIDP) scale in the elderly population of Bosnia and Herzegovina

To adapt the Oral Impacts on Daily Performance (OIDP) index for elderly people in Bosnia and Herzegovina and test its validity, reliability and responsiveness to change. Clinical measures alone may not be adequate for assessing the oral health of individuals. Subjective oral health indicators tested within a particular cultural context may not be relevant across cultures. The study population comprised 231 free-living adults aged 65 years or older. The OIDP was cross-culturally adapted from English into the Serbian language and its psychometric properties were tested. Data were collected using a clinical examination and a questionnaire containing the OIDP. In terms of reliability, Cronbach's alpha coefficient was 0.82 and the intraclass correlation coefficient 0.88. The very high correlation of OIDP with self-rated oral health (r = 0.78) verified criterion validity, while construct validity was demonstrated through its significant and graded associations with other subjective health measures. OIDP change scores on a treated subsample showed moderate effect size (0.59) and were associated with perceptions of oral health change, providing evidence for its responsiveness to change. The Bosnian version of the OIDP showed satisfactory validity, reliability and responsiveness to change confirming its appropriateness for use among older populations in Bosnia and Herzegovina.

Satisfaction with teeth and life‐course predictors: a prospective study of a Swedish 1942 birth cohort

This study aimed to assess the stability or change in satisfaction with teeth among Swedish adults between the ages of 50 and 65 yr, and to identify the impact of socio-demographics and of clinical and subjective oral health indicators on participants' satisfaction with teeth during that period. Self-administered standardized questionnaires were used as part of a longitudinal study. In 1992, 1997, 2002, and 2007 all residents (born in 1942) of two Swedish counties were invited to participate in the study. A total of 63% women and 66% men reported being satisfied with their teeth between 50 and 65 yr of age. The corresponding figures, with respect to dissatisfaction, were 7% and 6% respectively. Generalized estimated equation models revealed a decline in the odds of being satisfied with advancing age, which was particularly important in subjects with lower education, tooth loss, and smokers. Consolidation in oral health perceptions starts before age 50, suggesting early intervention before that age. Promotion of a healthy adult lifestyle and improved access to quality oral healthcare might increase the likelihood of people being satisfied with their teeth throughout the third age-period in both genders.

Self-reported dental pain and associated factors in Ugandan schoolchildren

There is a limited amount of research on the prevalence and determinants of subjective oral health indicators in children. Objective: to assess the prevalence of self-reported dental pain and to explore its relationship with socio-demographic characteristics in 10-14 year olds attending primary schools. Method: A cross-sectional survey was conducted during January-March 2004, including 11 public primary schools in Kampala, Uganda. A total of 614 children completed questionnaires administered in schools. Dental caries and plaque status were recorded in permanent teeth. Results: Experience with dental pain was confirmed by 42.1% boys and 52.3% girls. The crude prevalence of dental caries was 37.9% in boys and 42.1% in girls. Plaque was present on anterior teeth and 84.3% complained of at least one oral problem. Multiple logistic regression analysis revealed that reporting at least two oral problems (OR = 2.7), being dissatisfied with dental appearance (OR = 2.7) and having visited a dentist twice during the previous 3 years (OR = 2.2) were associated with higher odds of reported dental pain. Conclusion: A substantial proportion of school children had experience with dental pain. Dental pain associated positively with dental caries, subjective oral health indicators and dental attendance. Knowledge about the extent and significance of dental pain is important for the planning and evaluation of preventive and treatment efforts.

Association of urgent dental care with subjective oral health indicators and psychosocial impact.

Pressures on public dental services require new approaches to managing demand. To identify possible predictors of urgency of clinically assessed emergency dental care using self-reported oral health indicators. This study was a prospective study examining associations between patient reports of oral health indicators and psychosocial impact of oral disorders and a clinical determination of a hierarchy of urgency of emergency dental care. The data set comprised a random sample of 839 eligible adults presenting to nine public dental clinics across South Australia and New South Wales for emergency dental care. All participants held a government health concession card and were aged 18+ years and had a minimum of six natural teeth. Significant associations between self-reported oral health indicators and psychosocial impacts and a normative clinical assessment of urgency of emergency dental care were examined by means of binary logistic regression analysis in order to develop prediction models. Prediction of the urgency of emergency dental care was based on the assessment of two models--Model 1: urgency of care = <48 hours vs. 2+ days, Model 2: urgency of care = 2-7 days vs. 8+ days. Some 35.8%, 34.8% and 29.4% of respondents were classified by the assessing dentist as requiring dental care within 48 hours, 2-7 days and 8+ days respectively. For Model 1, difficulty sleeping all the time (OR = 4.8, CI = 3.0-8.0), pain in the jaw when opening wide (OR=2.4, CI=1.6-3.7), having a broken filling (OR = 1.7, C1 = 1.1-2.4), having a loose tooth (OR = 2.4, CI = 1.5-3.8), bleeding gums (OR = 0.7, CI = 0.5-1.0) and being dentally anxious (OR = 1.5, CI = 1.0-2.3) had a statistically significant association with needing to be seen within 48 hours. For Model 2, factors significantly associated with an urgency of care in the period 2-7 days included experience of toothache (OR = 2.6, CI = 1.6-4.3), pain in teeth with hot food or fluids (1.9, CI = 1.2-2.9), bleeding gums (OR = 2.0, CI = 1.3-3.2), having a broken filling (OR = 2.1, CI = 1.2-3.5), difficulty sleeping all the time (OR = 2.9, CI=1.4-6.4), and being concerned about the appearance of teeth or mouth very often (OR=0.3, CI = 0.1-0.7). This study has identified a pertinent set of self-reported oral health indicators that can be used to predict the urgency of emergency dental care.

Variation in subjective oral health indicators of 65-year-olds in Norway and Sweden

Objective. Guided by the conceptual framework of Gilbert and co-workers, this study assesses satisfaction with oral health as reported by 65-year-olds in Sweden and Norway, the relationship of socio-demographic factors, clinical and subjective oral health indicators with satisfaction of oral health, and the consistency of those relationships across countries. Material and methods. In 2007, standardized questionnaires were mailed to all the residents in two counties in Sweden and three in Norway who were born in 1942. Response rates were 73.1% (n=6078) in Sweden and 56.0% (n=4062) in Norway. Results. Totals of 76.8% of the Swedish and 76.5% of the Norwegian participants reported satisfaction with oral health. Corresponding figures for toothache were 48.1% (Sweden) versus 51.5% (Norway), and for temporomandibular joint symptoms, 10.9% (Sweden) versus 15.1% (Norway). Multiple logistic regression analysis revealed that subjects who perceived they had bad health, smoked daily, had missing teeth, experienced toothache, had problems with chewing, bad breath, and oral impacts were less likely than their counterparts in the opposite groups to be satisfied with their oral health status. The corresponding odds ratios (ORs) ranged from 0.08 (problems chewing) to 0.2 (oral impact). No statistically significant two-way interactions occurred and the model explained 46% of the variance in satisfaction with oral health across the two countries (45% in Sweden and 47% in Norway). Conclusions. The oral condition of 65-year-olds in Norway and Sweden produced impacts in oral symptoms, functional limitations, and problems with daily activities that varied to some extent. Satisfaction with oral health varied by socio-demographic factors and subjective oral health indicators. A full understanding of the oral health and treatment needs of 65-year-olds cannot be captured by clinical measures alone.

What do measures of ‘oral health‐related quality of life’ measure?

The terms 'health-related quality of life' and 'quality of life' are now in common use to describe the outcomes of oral health conditions and therapy for those conditions. In addition, there has been a proliferation of measures designed to quantify those outcomes. These measures, which were initially designated as socio-dental indicators or subjective oral health indicators are now more usually referred to as measures of oral health-related quality of life (OH-QoL). This is based on the assumption that the functional and psychosocial impacts they document must, of necessity, affect the quality of life. While this assumption has been subject to critical scrutiny in medicine, this is not the case with dentistry. Consequently, exactly what is being measured by indexes of OH-QoL is somewhat unclear. Based on the debate between Gill and Feinstein and Guyatt and Cook, we outline a number of criteria by means of which the construct addressed by measures of OH-QoL may be assessed. These are concerned with how the measures were developed and validated. These criteria are then used to appraise five of the many measures that have been developed over the past 20 years--the GOHAI, OHIP, OIDP, COHQoL and OH-QoL. The main conclusion is that while all document the frequency of the functional and psychosocial impacts that emanate from oral disorders they do not unequivocally establish the meaning and significance of those impacts. Consequently, the claim that oral disorders affect the quality of life has yet to be clearly demonstrated. Verifying this claim requires further qualitative studies of the outcomes of oral disorders as perceived by patients and persons, and the concurrent use of measures that more explicitly address the issue of quality of life.

Seniors' attitudes: oral health and quality of life

The objective of this study was to determine what impact, if any, oral health was having on the quality of life for selected seniors in Prince Edward Island, Canada. The attitudes of seniors towards oral health and its relationship to quality of life is important to define. This self-reported assessment provides information on this particular relationship. The research design was a random cluster sampling that covered all geographical areas of Prince Edward Island. It represented the cultural diversity within these geographical areas. The survey instrument selected was the Subjective Oral Health Indicators' Status, a validated survey instrument. This particular instrument addressed all the issues raised in the objectives. Data were analysed using Pearson's correlation with age and number of teeth present. The independent t-test was used to identify differences in responses by gender. Results of the survey showed identification of individual indicators that were having an impact on quality of life. Gender differences in responses were identified in four of the eight subject areas. The level of worry/concern was inconclusive because of the high non-response rate to the last question. Non-response rates increased with each topic in the questionnaire. More research is needed to identify clinical needs of seniors on Prince Edward Island. Qualitative study to determine attitudes and beliefs could provide groundwork for future programme design.

Validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional study of adolescents in Uganda.

BackgroundAssessing oral health related quality of life impact of mouth in adolescents is a relatively ignored area in dental research. This study aimed to examine reliability and validity of an abbreviated version of the oral impact of daily performance (OIDP) questionnaire and to analyse the interrelationship among OIDP scores, socio-demographic characteristics and oral health status in Uganda.Method1146 adolescents (mean age 15.8, response rate 87%) attending secondary schools in Kampala (urban) and Lira (rural) completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. A clinical examination was conducted among 372 students (mean age 16.3, response rate 72%) and caries was assessed following the World Health Organisation criteria (1997).Results62% of the students experienced at least one oral impact during the 6 months preceding the survey. Cronbach's alpha for the OIDP frequency items was 0.91 and the corrected item-total correlation ranged from 0.62 to 0.75. Discriminant and construct validity were demonstrated in that the OIDP scores varied systematically in the expected direction with missing teeth and self-report indicators of oral health status, respectively. Socio-demographics and dental attendance did not predict OIDP through interaction with clinical indicators but varied systematically and independently with OIDP frequency scores in the multivariate analysis.Conclusionthe OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among Ugandan adolescents. Some evidence of the importance of social and personal characteristics in shaping adolescents' responses to oral disorders was provided.