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Oral health related quality of life

  • Sri siddhartha dental college and Hospital, Sri Siddhartha academy of higher education, Tumkur

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Diseases and disorders that damage the mouth and face can disturb well-being and his self-esteem. Oral health-related quality of life (OHRQOL) is a relatively new but rapidly growing notion. The concept of OHRQOL can become a tool to understand and shape not only the state of clinical practice, dental research and dental education but also that of community at large. There are different approaches to measure OHRQOL; the most popular one is multiple item questionnaires. OHRQOL should be the basis for any oral health programme development. Moreover, research at the conceptual level is needed in countries where OHRQOL has not been previously assessed, including India.
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1 Journal of International Society of Preventive and Community Dentistry January-June 2013, Vol. 3, No. 1
Oral health related quality of life
Darshana Bennadi, C. V. K. Reddy1
Departments of Public Health Dentistry, Sree Siddhartha Dental College and Hospital, SAHE University,
Tumkur, 1J. S. S Dental College and Hospital, Mysore, Karnataka, India
Corresponding author (email:<>)
Dr. Darshana Bennadi, Department of Public Health Dentistry, Sree Siddhartha Dental College and Hospital,
SAHE University, Agalkote, Tumkur ‑ 572 107, Karnataka, India.
Diseases and disorders that damage the mouth and face can disturb well‑being and his self‑esteem. Oral health‑related
quality of life (OHRQOL) is a relatively new but rapidly growing notion. The concept of OHRQOL can become a
tool to understand and shape not only the state of clinical practice, dental research and dental education but also that
of community at large. There are different approaches to measure OHRQOL; the most popular one is multiple item
questionnaires. OHRQOL should be the basis for any oral health programme development. Moreover, research at the
conceptual level is needed in countries where OHRQOL has not been previously assessed, including India.
Key words: Health, indices, oral health related quality of life, oral health
In the preamble of its constitution, the World Health
Organization (WHO) states “Health is a state of
complete physical, mental, and social well‑being and
not merely the absence of disease and infirmity.”[1]
Recent developments in the definition of health and
measurement of health status have little impact on
dentistry. The dental profession has remained narrowly
clinical in its approach to oral health equating health with
disease. This is the reason why dentistry has remained
immune to this broadening concept of health. So now it
is important to know that quality of life (QOL) measures
are not a substitute of measuring outcomes associated
with the disease, but are adjunct to them.[2]
Oral health related quality of life (OHRQOL) is a
relatively new, but rapidly growing phenomenon, which
has emerged over the past 2 decades. Slade and others
identified the shift in the perception of health from
merely the absence of disease and infirmity to complete
physical, mental, and social well‑being, the definition of
the WHO. This shift happened in the second half of the
20th century and it was the result organization (WHO)
as the key issue in the conception of health related
quality of life (HRQOL) and subsequently OHRQOL a
“silent revolution” in the values of highly industrialized
societies from materialistic values that concentrate on
economic stability and security to values focused on
self‑determination and self‑actualization.[3]
It is evident from the literature that the notion of
OHRQOL appeared only in the early 1980s in contrast
to the general HRQOL notion that started to emerge
in the late 1960s. One explanation for the delay in
the development of OHRQOL could be the poor
perception of the impact of oral diseases on QOL.
Only 40 years ago, researchers rejected the idea that
oral diseases could be related to general health. Davis
asserted that apart from pain and life‑threatening
cancers, oral disease does not have any impact on
social life and it is only linked with cosmetic issues.[4]
Likewise, others have argued that dental disease was one
of the frequent complaints such as headache, rash, and
burns that were perceived as unimportant problems[5]
that rarely contributed to the classic “sick role” and
therefore should not be an excuse for exemption from
work.[6] Later, in the late 1970s, the OHRQOL concept
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Journal of International Society of Preventive and Community Dentistry 2January-June 2013, Vol. 3, No. 1
Bennadi and Reddy: Oral health related quality of life
started to evolve as more evidence grew of the impact of
oral disease on social roles.[7‑10]
Clearly, clinical indicators of oral diseases such as
dental caries or periodontal diseases were not entirely
suitable to capture the new concept of health declared
by WHO, particularly the aspects of mental and social
well‑being. This has created a demand for new health
status measures, in contrast to clinical measures of
disease status. As a result, researchers started to develop
alternative measures that would evaluate the physical,
psychological, and social impact of oral conditions on an
individual. These alternative measures are in the form
of standardized questionnaires.[11]
The concept of “OHRQOL” captures the aim of
new perspective i.e., the ultimate goal of dental
care mainly good oral health. According to the US
Surgeon General, oral disease and conditions can
“…undermine self‑image and self‑esteem, discourage
normal social interaction, and cause other health
problems and lead to chronic stress and depression
as well as incur great financial cost. They may also
interfere with vital functions such as breathing, food
selection eating, swallowing and speaking, and with
activities of daily living such as work, school, and
family interactions”.[12] People assess their HRQOL by
comparing their expectations and experiences.[13]
QOL is a highly individual concept. Mount and Scott
likened the assessment of it to assessing the beauty
of rose: No matter how many measurements are
made (Ex‑color, Smell, Height, etc.) the entire beauty of
the rose is never captured. QOL that are important to
an individual, although systems in which patient specify
at least some of the qualities are likely to come closest.
Florence Nightingale was one of the first clinician to
insist on measures the outcome of care to evaluate
OHRQOL as “a multidimensional construct that
reflects (among other things) people’s comfort when
eating, sleeping, and engaging in social interaction; their
self‑esteem; and their satisfaction with respect to their
oral health.”[14]
OHRQOL is associated with:[15] Functional factors,
Psychological factors, Social factors, and Experience of
pain or discomfort [Figure 1].
Uses of quality of life measures in clinical practice
• Identifyingandprioritizingproblems
• Facilitatingcommunication
• Screeningforhiddenproblems
• Facilitatingsharedclinicaldecisionmaking
• Monitoringchanges/responsestotreatment.[15]
Properties needed by measures used in clinical practice
• Validity
• Appropriatenessandacceptability
• Reliability
• Responsivenesstochange
• Interpretability.[15]
Indices used to measure OHRQOL
For the public health purposes, oral health can be
quantified at the macro level using the societal measures
of oral conditions, which demonstrate that oral disease
creates a substantial burden of illness, particularly
among disadvantaged groups. The OHRQOL is a
multidimensional concept that is capturing people’s
perception about factors that are important in their day
today life. The need to develop patient centered measures
of oral health status was first recognized by Cohen and
Jago.[7] Fundamentally, there are three categories of
OHRQOL measure as indicated by Slade.[16] These are
social indicators, global self‑ratings of OHRQOL and
multiple items questionnaires of OHRQOL. Briefly, social
indicators are used to assess the effect of oral conditions at
the community level. Typically, large population surveys
are carried out to express the burden of oral diseases
on the whole population by means of social indicators
such as days of restricted activities, work loss, and school
absence due to oral conditions. While social indicators
are meaningful to policy‑makers, they have limitations
in assessing OHRQOL. For example, using work loss to
measure the impact of oral diseases is not an appropriate
indicator for those who are not working.
Global self‑ratings of OHRQOL, also known as
- Mastication
- Speech
Pain / Discomfort:
- Acute
- Chronic
- Intimacy
- Communication
- Appearance
- Self esteem
Figure 1: Factors associated with oral health related quality of life
3 Journal of International Society of Preventive and Community Dentistry January-June 2013, Vol. 3, No. 1
Bennadi and Reddy: Oral health related quality of life
addition, these measures can be classified into generic
instruments that measure oral health overall versus
specific instruments. The latter can be specialized
to measure specific oral health dimensions such as
dental anxiety[17] or conditions such as head and neck
cancer[18] or dentofacial deformity[19] or to assess specific
populations such as denture impact on nutritional status
of aged population[20] or children.[21]
Furthermore, OHRQOL instruments vary widely
in terms of the number of questions (items), and
format of questions and responses. Ten OHRQOL
instruments that have been thoroughly tested to
assess their psychometric properties such as reliability,
validity, and responsiveness were presented at the
First International Conference on measuring oral
health.[22] Different measures of OHRQOL with their
author name and year[23] is shown in Table 1 whereas
Table 2 shows different Oral health related quality of life
Importance of QOL measurement
Most studies that evaluate changes in the oral health
status of individual subjects and populations have
been based on the clinical indicators of disease; there
are relatively few evaluation studies on health and
Table 1: Name of measures with their authors
name and year
Authors Name of measure
Cushing et al., 1986 Social impacts of dental disease
Atchison and Dolan, 1990 Geriatric oral health assessment
Strauss and Hunt, 1993 Dental impact profile
Slade and Spencer, 1994 Oral health impact profile
Locker and Miller, 1994 Subjective oral health status
Leao and Sheiham, 1996 Dental impact on daily living
Adulyanon and Sheiham, 1997 Oral impacts on daily performances
McGrath and Bedi, 2000 OH‑quality of life UK
OH = Oral health
single‑item ratings, refer to asking individuals a general
question about their oral health. Response options to
this global question can be in a categorical or visual
asking: “How do you rate your oral health today?” can
have categorical responses ranging from “Excellent” to
Multiple items questionnaires are the most widely
used method to assess OHRQOL. Researchers have
developed QOL instruments specific to oral health
and the number continues to grow rapidly to comply
with the demand of more specific measures. In
Table 2: Oral health related quality of life questionnaires
Instrument Dimensions measured No. of question Response format
Social dental scale Chewing, talking, smiling, laughing, pain
14 Yes/no
RAND dental health index Pain, worry, conversation 3 4 categories; “not at all” to “a great deal”
General oral health
assessment index
Chewing, eating, social contacts,
appearance, pain, worry, self‑consciousness
12 6 categories; “always‑never”
Dental impact profile Appearance, eating, speech, confidence,
happiness, social life, relationships
25 3 categories; good effect, bad effect, no
Oral health impact profile Function, pain, physical disability, social
disability, handicap
49 5 categories; “very often‑never”
Subjective oral health status
Chewing, speaking, symptoms, eating,
communication, social relations
42 Various depending on question format
Oral‑health quality of life
Oral health, nutrition, self‑related oral
health, overall quality of life
56 Part A: 4 categories “not at all” to “a
great deal”
Part B: 4 categories “unhappy‑happy”
Dental impact on daily living Comfort, appearance, pain, daily activities,
36 Various depending on question format
Oral health related quality
of life
Daily activities, social activities,
3 6 categories; “all of time” to “none of
the time”
Oral impacts on daily
Performance in eating, speaking, oral
hygiene, sleeping, appearance emotion
9 Various depending on question format
RAND = The short form (36) Health survey is a survey of patient health, The SF‑36 is a measure of health status and is commonly used in health economics as
a variable in the quality‑adjusted life year calculation to determine the cost‑effectiveness of a health treatment, The original SF‑36 came out from the Medical
outcome study, MOS, done by the RAND Corporation. Since then a group of researchers from the original study released a commercial version of SF‑36 while the
original SF‑36 is available in public domain license free from RAND. The SF‑36 and RAND‑36 include the same set of items that were developed in the Medical
Outcomes Study. Scoring of the general health and pain scales is different, however, The differences in scoring are summarized by Hays, Sherbourne, and Mazel
(Health Economics, 2: 217‑227, 1993). RAND name originated as a contraction of research and development
Journal of International Society of Preventive and Community Dentistry 4January-June 2013, Vol. 3, No. 1
Bennadi and Reddy: Oral health related quality of life
welfare from the subject’s perception.[24] Over the
last 30 years, the use of socio‑dental indicators in oral
epidemiology has been widely advocated, because
single measures of clinical disease do not document
the full impact of oral disorders.[25,26] These indicators
were constructed and tested in epidemiological studies
on different populations to build a more concrete
relationship between subjective and objective oral
health measures, which would help to estimate the real
population needs.[26]
Several methods have been developed to minimize
the complexity and social and cultural relative aspects
of QOL as well as to provide indexes capable to
capture data beyond the biological and pathological
disease process. In general, health‑related QOL can
be determined by two approaches: The first includes
an interpretative and qualitative explanatory method
and the second, which is the most common approach
is usually based on the questionnaires that emphasize
the subject’s perception on physical and psychological
health and functional capacity.[27]
The results obtained by using these instruments are
usually reported as a score system, which indicates the
severity of the outcome measures or oral diseases.[28]
Information on QOL allows the evaluation of feelings
and perceptions in the individual level, increasing
the possibility of effective communication between
professionals and patients, better understanding of the
impact of oral health on the lives of the subject and family,
and measuring the clinical results of services provided.[26]
In public health, QOL measurement is a useful tool to
plan welfare policies because it is possible to determine
the population needs, priority of care, and evaluation
of adopted treatment strategies; thus helping in the
decision making process.[29] Regarding research, these
measurement tools help to assess the outcomes of
treatments or actions and further develop guidelines for
evidence‑based clinical practice.[27]
OHRQOL to refocus dental education
Educating patient about good oral health promotion and
preventive care will therefore be crucial. OHRQOL
considerations can serve as a tool for bringing about
these changes in the perspective of future clinician.
Dental education aims at training future clinician,
researchers, and administrators as well as future dental
educators. OHRQOL is a crucial concept in professional
lives of all these groups. It provides researchers with a
chance to consider the larger perspective of how their
research will ultimately serve point. It focuses clinician
on providing truly patient centered care, culturally
competent and able to work from an interdisciplinary
perspective. It can contribute to prioritizing the work
of administrators and it can motivate dental educators
by showing them the tremendous difference that their
students can make in the lives of patients.[15,26]
Research on OHRQOL: Current status and future
Research on QOL has gained interest and visibility
in recent decades internationally. “How” we live and
not just “how long” we live has increasingly become
recognized as a central issue in health‑care and health
research. QOL assessment received heightened visibility
with the release of the healthy people 2010 health
promotion and disease prevention initiative. The first
healthy people initiative was started in 1979 and focused
mainly on changes in disease measures.
Current objectives of this initiative are to increase
quality and years of healthy life and to eliminate health
Workshops on QOL outcomes assessment are;
Major research recommendations that arose from the
workshop were,
• Oralhealth needs to bedefinedandconceptualized
and appropriate operational measures need to be
brought into systematic use
• More research needs to be conducted to
conceptualized and measure oral health as a system
contributing to total health
• Mediatingandindependentvariableinfluencingoral
health outcomes need to be thoughtfully considered
• An assessment of “Outcomes for whom” needs
to be made to determine the nature and extent of
• Methodologicalissuessuchasfollowingneedtobe
addressed, development of outcome measure for
longitudinal studies; appropriateness of measures
as influenced by the passage of time, sensitivity,
specificity, reliability, and validity.[15]
Specific research recommendations that focus on social,
psychological, and economic impacts of oral conditions
and treatment,
• Testing the sensitivity of generic health status
indicators for persons with oral conditions and
• Exploring whether generic instruments such as
sickness illness profile could be modified for use in
patients with oral conditions
5 Journal of International Society of Preventive and Community Dentistry January-June 2013, Vol. 3, No. 1
Bennadi and Reddy: Oral health related quality of life
• Addressing methodological problems as well as
comparing responses to various subjective oral health
indicators in the same population or patient groups
• Investigatingrelationshipsbetweenclinicalindicators
of disease and subjective indicators measuring disease
• Assessingthevalueofsubjectiveindicatorsinclinical
• Testing measures and indicators in populations of
all ages.[15]
The OHRQOL can provide the basis for any oral
health‑care program and it has to be considered one
of the important element of the Global oral health
program.[30] Research on trends in dentistry and dental
education shows that in future, fewer dentists will take
care of the increasing number of patients. Therefore,
educating these patients about promoting good oral
health and preventive care will be crucial. Research also
shows that certain population segments are drastically
underserved. Dental education has to make a contribution
if this situation is to change. Finally, with rapidly changing
knowledge base and technology in all health‑care fields,
interdisciplinary considerations and collaborations
become increasingly important. QOL measures are
not only being used in population surveys, but also in
randomized clinical trials, technology assessment in
health‑care and evaluation of health‑care delivery systems.
The perception of QOL has a subjective component and
therefore varies from one culture to another. Therefore,
research at the conceptual level is needed in countries
where the OHRQOL has not been described, like
India. This is a necessary step because adapting models
developed and validated in other cultures could lead to
inaccurate measurement of OHRQOL and may not
address the important issues pertaining to Indian culture.
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How to cite this article: Bennadi D, Reddy C. Oral health related
quality of life. J Int Soc Prevent Communit Dent 2013;3:1-6.
Source of Support: Nil, Conict of Interest: None declared.
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... That is why as per the recommendations of the World Health Organization (WHO) twelve-year-old children are assessed for the presence of dental caries. The data accessed from the WHO datasheet for decayed, missing, and filled teeth (DMFT) index regarding twelve-year-old children from Pakistan have shown an increase in prevalence score rate from 0.9 to 1.38 [11][12][13][14][15][16][17][18]. The disease has thus been regarded not only as a medical as well as a social problem faced by school-going children [5]. ...
... A high prevalence of dental caries in males (67.5%) has been reported by our study as compared to females (63.6%). This finding has been found in contradiction to another India-based study where a high prevalence percentage was reported in girls as compared to boys [15]. On the other hand, the gender-wise prevalence of dental caries as reported by our study has also been found in accordance with other India-based and Karachi, Pakistan -based studies [16]. ...
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Dental caries may have a huge and direct impact on quality of life of an individual. In case of children, it is even more important to have healthy teeth Objective: To evaluate the impact of dental caries on quality of life in children less than 5 years of age Methods: In this cross-sectional analytical study conducted in DHQ Hospital, Hafizabad, Pakistan, 370 children of both genders and within age range of 1-5 years during a period of 9 months. Decayed Missing Filled (DMF) Index was used for the assessment of dental caries. Data was analysed by using SPSS version 23.0 Results: There was high frequency (243, 65.7%) of dental caries in children. Mostly their parents were illiterate (70%) and children were not brushing their teeth regularly (93.8%). Conclusions: Poor oral hygiene and dental caries was associated with low quality of life.
... Oral diseases are also accompanied by serious health and economic burdens and impose large economic burdens on families and healthcare systems [3]. These diseases can disturb individuals' well-being and self-esteem, as well [4]. Despite its preventable nature, it is still one of the costliest diet-and lifestyle-related diseases. ...
Full-text available
Introduction. Oral health is one of the most important issues in public health. Most educational interventions, as the primary prevention strategy, are focused on increasing information and knowledge and are not usually effective. Therefore, the present study is aimed at determining the effect of theory-based education on oral health behavior and its psychological determinants including dental health literacy. Method. This randomized controlled educational trial was conducted in two girls’ high schools that were selected by multistage cluster sampling and were divided into an intervention and a control group. Literacy, knowledge, oral health behavior, dental plaque index, and constructs of the protection motivation theory were evaluated before and one month after four training sessions. Finally, the data were entered into the SPSS 19 software and were analyzed using the chi-square test, independent t-test, and Mann–Whitney test at the significant level of 0.05. Result. Before the intervention, there was no significant difference between the intervention and control groups regarding the mean scores of knowledge, behavior, and oral health literacy; plaque index; and protection motivation theory constructs. After the educational intervention, however, the means of these variables were significantly improved in the intervention group compared to the controls (p<0.05). Conclusion. The study findings were in favor of the effectiveness of the theory-based educational intervention in improving the knowledge, literacy, and behavior related to oral health. Yet, further research is suggested to determine the effectiveness of such an intervention in male students as well as in populations with different socioeconomic and cultural statuses.
... Moreover, researchers had rejected the proposal that oral diseases could be related to general health till around 50 years ago. 11 In 1976, Davis P had asserted that only oral pain and life-threatening cancers had impact on social life of an individual and other oral conditions were only linked with cosmetic issues. 12 Similarly, other researchers have discussed that dental diseases were among others with frequent complaints such as headache, rash and burns and they were perceived to be unimportant that seldom contributed to the classic sickness and hence counted them not be a justification for exemption from work. ...
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Health is defined as "a complete state of physical, mental and social well-being and not merely the absence of disease or infirmity" by World Health Organization (WHO) in 1948. According to WHO, the determinants of health include the physical environment, the person's individual characteristics and behaviors and social and economic environment thus capturing both quantity and quality of life. The concept of Quality of Life was introduced in the medical literature in 1966 by Elkington, prior to that the disease was usually measured in quantity i.e. the prevalence of disease. With the advent of life-saving drugs and procedures, the life expectancy was increased and so did the side-effects for some of them. This impelled the physicians to assess the treatment on the basis of risk versus benefits, efficiency and efficacy. The concept of Oral Health Related Quality of Life was introduced by Locker D in 1988. Since then, numerous indices have been developed by various authors to measure the OHRQoL. In 2011, Sischo and Broder suggested the following purposes for growing importance of quality of life in dental practice. Firstly, the patient now a day has more active role in decision making regarding the various health care procedures as a treatment team member and has the freedom of thought, intention and action when making decisions. Secondly, there is a constant rise in the health care practices for evidence-based approaches and thirdly, the fact that many treatments for chronic diseases keep the underlying health condition under control but fail to cure the same. Thus, it is recommended that the assessment and impact of presenting dental disease on Oral Health Related quality of life should be part of diagnosis by the dentist to give holistic care to the patient.
... Oral health-related quality of life (OHRQoL) is "a multidimensional construct that reflects (among other things) people's comfort when eating, sleeping, and engaging in social interaction; their self-esteem; and their satisfaction with respect to their oral health" [13]. Older adults have more oral health problems, owing to their health burden and increased tooth retention. ...
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This study explored the relationship between depression, anxiety, stress, morbidity, and oral health-related quality of life (OHRQoL) in the migrant elderly following children (MEFC) in Weifang, China. A total of 613 MEFC were selected using multistage cluster random sampling. The GOHAI scale was used to evaluate oral health-related quality of life. The DASS-21 scale was used to assess levels of depression, anxiety, and stress. Univariate analysis and binary logistic regression were used to analyze the correlation between these indicators and oral health-related quality of life, of which 43.9% were classified as having poor oral health. Logistic regression analysis showed that the MEFC who were of older age (OR = 0.965, p = 0.039), with hypertension (OR = 0.567, p = 0.004), with gastroenteropathy (OR = 0.263, p = 0.007), had received an outpatient service in the past year (OR = 0.669, p = 0.048), were depressed (OR = 0.338, p = 0.012), and anxious (OR = 0.414, p = 0.026) were less likely to report good oral health status. On the other hand, the MEFC with a high school education or above (OR = 1.872, p = 0.020) were more likely to report good oral health than those with primary school education and below. In conclusion, with regard to depression, anxiety, and stress: the results indicated that the fewer morbidities, the lower the level of depression and anxiety and the better the OHRQoL of MEFC. Targeted measures for government, communities, and family members were given to improve the OHRQoL of MEFC.
... Various aspects of quality of life, such as physical and social functioning, are affected. In developing nations, the transition to this holistic philosophy of health occurred in the twentieth century, and Oral Health Related Quality of Life (OHRQOL) became a "silent movement" 5 Researchers have broadened their focus on the patho physiological assessment of clinical disease to incorporate a more holistic view of health thus improving the quality of life. There has been an increase in the motivation for measuring negative as well as positive changes in oral health status. ...
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Introduction: Oral diseases like dental caries, periodontal diseases, oral cancers, oral manifestations of HIV, oro-dental trauma, cleft lip and palate, though not life threatening constitute major public health problems worldwide. The Global burden of Disease Study 2017, estimated that oral diseases affect close to 3.5 billion people worldwide. Therefore, the aim of this study is to assess the oral health status, unmet oral health needs and oral impact of daily life among the permanent residents in Tiruvallur district. Materials and Methods: The WHO Oral health assessment form (2013) was used to record the oral health status. For assessing the quality of well-being among the patients, the Oral Impact on Daily Performances questionnaire was used (Sheiham A et al). After a brief introduction on the purpose and intent of the study, examination was conducted by a single examiner. Demographic information like age, gender, education, occupation were recorded. The oral health status was recorded after clinical examination of the oral cavity followed by Oral Impact on Daily Performance questionnaire. Descriptive statistics, chi square test were used. Mann Whitney U test was used to test the association between gender and OIDP scores.
... Graphs were prepared on Microsoft Excel. One way [8][9][10] Results of the present study stated that Mean DMFT score was found to be significantly different among study groups. The mean DMFT score of Group 2 (Bronchial Asthma) was found to be significantly more than that of Group 1 (Cardiac patients) which was further significantly more than that among Group 3 (Control). ...
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... Oral-health-related quality of life (OHRQoL) questionnaires are used to obtain patientbased outcomes that refer to the individual's self-evaluation of the perception of a disease, and determine its perceived impact on quality of life [1]. In this context, OHRQoL measures tend to focus on the functional, psychological, and social impacts of the oral conditions on the life of the patient [2], and each of these instruments has its specific focus, purpose, and length [3]. ...
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Objectives: To shorten the 24-item Arabic Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ(A)) for adolescents in Yemen. Material and methods: Two shortening methods derived six-item and nine-item versions: the item impact method selected items with the highest impact scores as rated by 30 participants in each subscale; and the regression method was applied using data of 385 participants from the PIDAQ(A) validity study, with the total PIDAQ(A) score as the dependent variable, and its individual items as the independent variables. The four derived versions were assessed for validity and reliability. Results: The means of the six-item and nine-item short versions of both methods were close. Cronbach's alpha values extended from 0.90 to 0.92 (intra-class correlations = 0.85-0.88). In criterion validity, strong significant correlations were detected between scores of all short versions and the 24-item PIDAQ(A) score (0.96-0.98; p < 0.001). Construct validity displayed significant associations among all short versions and self-perceived dental appearance rank and self-perceived need for orthodontic braces rank (p < 0.05). Mean scores of all short versions were significantly different between adolescents with severe malocclusion and those with slight malocclusion in discriminant validity tests. In conclusion, all PIDAQ(A) short versions are valid and reliable.
... date, and the number only continues to grow rapidly to comply with the demand for more specific measures. [4] Known examples include the Dental Impact on Daily Living (DIDL), Oral Health Impact Profile (OHIP), World Health Organization Quality of Life, OHIP-14, United Kingdom Oral Health-related Quality of Life, Oral Impacts on Daily Performance, and EuroQoL. [5] The DIDL is one of the tools created by Leao and Sheiham made to measure oral perceptions of health and the correlation with quality of life. ...
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Objective: The need to assess oral health-related quality of life (OHRQoL) has grown increasingly in the healthcare sector over the past few decades. The Dental Impact on Daily Living (DIDL) assessment is a tool created to measure OHRQoL. The aim of this study was to complete a cross-cultural adaptation of the DIDL to yield a valid and reliable Indonesian version for use as an official instrument to assist in further OHRQoL research in Indonesia. Materials and Methods: The original English version of the DIDL was translated and validated. Content validity and face validity were considered. Psychometric testing for test-retest reliability was analyzed among 32 subjects, while internal consistency using Cronbach's alpha and clinical oral health status using the DMF-T index to obtain convergent validity of the questionnaire were checked among 278 subjects. Results: The study subjects showed a good understanding of how to complete the Indonesian language version of the DIDL questionnaire, and conceptual and semantic equivalence (content and face validity) were noted. Further, test-retest reliability was noted (intraclass correlation coefficient range: 0.975-1 and Cronbach's alpha: 0.942), whereas convergent validity suggested a correlation between DMF-T and DIDL questionnaire of −0.502 with significance at alpha of 5% (P = 0.00), which means that decreasing the DMF-T outcome will increase the satisfaction using the DIDL among research subjects. Conclusion: Cross-cultural adaptation of the DIDL yielded a valid and reliable Indonesian version. The DIDL questionnaire is a promising questionnaire that can be applied to measure OHRQoL in Indonesians.
The introduction of a removable partial denture onto the dental arch significantly influences the mechanical stress characteristics of both the jawbone and oral mucosa. The aim of this study was to analyze the stress state caused by biting forces upon insertion of partial dentures into the assembly, and to understand the influence of the resulting contact pressure on its retention behavior. For this purpose, a numerical model of a removable partial denture is proposed based on 3D models developed using computer tomography data of the jawbone and the removable partial denture. The denture system rests on the oral mucosa surface and three abutment teeth. The application of bite forces on the denture generated a stick condition on the loaded regions of the denture‐oral mucosa interface, which indicates positive retention of the denture onto the oral mucosa surface. Slip and negative retention were observed in the regions of the contact space that were not directly loaded. The contact pressures observed in the regions of the oral mucosa in contact with the denture were below the clinical pressure pain threshold value for soft tissue, which potentially lowers the risk of pain being experienced by denture users. Further, the variation of the retention behavior and contact pressures across different regions of the denture assembly was observed. Thus, there is a need for adhesives or restraining mechanisms for the denture system in order to avoid bending and deformation of sections of the denture as a consequence of the applied bite force. This article is protected by copyright. All rights reserved.
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The objective of the present study was to assess the oral-health-related quality of life (OHRQoL) of oral submucous fibrosis (OSMF) patients before and after standard treatment. A convenient sampling technique was used to recruit the clinically diagnosed patients of OSMF (n = 130). Based on the medical treatment, the patients were randomly divided into two study groups (group A and B). The group A patients received submucosal intralesional injections of dexamethasone (2 mL; 4 gm/mL), while group B patients received hyaluronidase (1500 IU). Both the group A and B patients received respective medical therapy biweekly for a period of five weeks. At the follow up visit (6 months), the impact of treatment on OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Data were analyzed by a chi-square test for quantitative variables and an independent t-test for qualitative variables. The comparison of all clinical parameters before and after treatment was performed by a paired t-test. The results after treatment showed that there was a significant improvement in all domains of OHIP-14 (p = 0.001) except psychological disability (p = 0.243). In addition, the OHRQoL of patients was significantly improved following the treatment.
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O conceito qualidade de vida tem suscitado pesquisas e cresce a sua utilização nas práticas desenvolvidas nos serviços de saúde, por equipes profissionais que atuam junto a usuários acometidos por enfermidades diversas. O presente artigo tem como objetivo descrever a evolução histórica e tecer algumas considerações sobre aspectos conceituais e metodológicos do conceito qualidade de vida (QV) no campo da saúde. Baseando-se na revisão da literatura, dois aspectos do termo são destacados no plano conceitual: subjetividade e multidimensionalidade. Quanto aos aspectos metodológicos, uma tendência significativa tem sido a construção e/ou adaptação de instrumentos de medida e de avaliação da QV. Conclui-se que os esforços teórico-metodológicos têm contribuído para a clarificação e relativa maturidade do conceito. Trata-se de um construto eminentemente interdisciplinar, o que implica a contribuição de diferentes áreas do conhecimento para o seu aprimoramento conceitual e metodológico. Sua utilização, portanto, pode contribuir para a melhoria da qualidade e da integralidade da assistência na perspectiva da saúde como direito de cidadania.
Abstract A sociodental investigation was carried out among 254 elderly people living at home in Nottinghamshire. The aim of the inquiry was to ascertain whether this group of people were handicapped by their dental conditions. The dental status of the sample was generally poor. 74% were edentulous and the condition of the full dentures worn by many of the subjects was unsatisfactory. A high proportion (59%) of the subjects had lesions of the oral mucosa. Many members of the sample were orally handicapped, either functionally or socially. 32% complained of oral pain and 30% claimed to have difficulty chewing. Also, subjects were embarrassed by the appearance of their teeth and by their dentures dropping during social contact. The perception of handicap, however, was not strongly related to dental status.
The paper discusses the social organization of dental health and the delivery of dental care within the dual conceptual focus of the sociology of deviance and the sociology of work. Established models of illness and health care are discussed and modifications suggested in the light of the special conceptual requirements of dentistry. In particular, emphasis is laid on the social regulatory and compliance aspects of the therapeutic system. Specific empirical hypotheses that follow from the model are outlined, particular attention being paid to the applicability of the model in the New Zealand setting.
The bases for the construction of sociodental indicators is discussed in the paper, considering several available indexes of oral health status (dental caries, periodontal disease, malocclusion, oral hygiene, and other oral conditions) as well as measures of quality of services. Very little research exists relating any of the above measures to social indicators such as personal life-style or cultural and ecological factors. Such expansion would enable dental indicators to be useful for purposes of policy decisions. Combining any dental indicators or set of indicators with a potential global social health index is discussed in terms of potential problems obscuring dentistry's cost to society. Dentistry, in addition, is offered as a system in microcosm-one which can be useful for purposes of polishing methodology for the social health indicator movement.
This paper reports the results of a study to evaluate the performance of a battery of subjective oral health status indicators originally developed for use in large scale surveys of older adults. The aim was to assess their generalizability, efficiency, reliability, and validity when used in a study of adults aged 18 years and over and to compare their performance with respect to younger and older adults. Data were collected by means of a mail survey and self-complete questionnaire of a random sample of the population aged 18 years and older. The results suggested that the measures were sensitive to the oral health concerns of adults of all ages and that item nonresponse was within acceptable limits. Test-retest and internal consistency reliability statistics were good and all hypotheses designed to assess concurrent and construct validity were confirmed. The results confirm an earlier, but more limited, evaluation and suggest that these indicators are useful for descriptive oral health surveys of general populations.