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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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... 14 Since oral health issues can have a negative influence on a person's physical functioning, social status, and wellbeing, OHRQoL becomes an indispensable part of overall health. 15 OHRQoL is a subjective assessment of the person's sense of self, expectations for and satisfaction with treatment, functional well-being, emotional well-being, and oral health. 15 Previously published studies report that PD and PsA have a significant negative impact on OHRQoL. ...
... 15 OHRQoL is a subjective assessment of the person's sense of self, expectations for and satisfaction with treatment, functional well-being, emotional well-being, and oral health. 15 Previously published studies report that PD and PsA have a significant negative impact on OHRQoL. [16][17][18][19] Based on these findings, it would be reasonable to assume that patients with coexisting PsA and PD would see a comparable or maybe synergistic effect on their OHRQoL. ...
Background: Since oral health issues can have a negative influence on a person's physical functioning, social status, and wellbeing, oral health-related quality of life (OHRQoL) becomes an indispensable part of overall health. Previous published studies report that periodontitis (PD) and psoriatic arthritis (PsA) have a significant negative impact on OHRQoL. Based on these findings, it would be reasonable to assume that patients with coexisting PsA and PD would see a comparable or maybe synergistic effect on their OHRQoL. Hence, the aim of the present study is to evaluate the OHRQoL and its impact among subjects with concurrent PsA and PD. Material and Methods: The present study was a comparative, cross-sectional investigation. A total of 200 participants were categorized into four groups-PD-PsA (n = 50), PsA (n = 50), PD (n = 50), and healthy controls (n = 50). Demographic data and periodontal parameters-plaque index, sites with gingi-val bleeding, probing pocket depth, gingival recession, and clinical attachment level were recorded for all the four groups. Number of mobile teeth due to peri-odontitis was recorded for the PSA-PD and PD groups. OHIP-14 questionnaire was administered to all the four groups. Collected data was then subjected to statistical analysis. Results: The severity of OHIP-14 summary scores was highest in the PsA-PD group (18.06 ± 11.22) followed by the PD group (17.02 ± 9.99) and lowest in the healthy group (6.32 ± 5.59) (p < .0001). The scores of all the domains-oral pain, oral function, orofacial appearance and psychological impact were highest among the PsA-PD group followed by the PD group (p < .0001). The combined interaction of PsA and PD on the OHRQoL was statistically significant (F = 6.33, p = .012). Results of the multiple linear regression analysis indicated that there was a moderate collective significant effect between age, past dental visit, frequency of daily tooth brushing, use of other oral hygiene aids, and OHIP-14 (F(3,196) = 13.08, p < .001, R 2 = 0.17, adjusted R 2 = 0.15).
... Oral diseases are related to a state of severe morbidity with physical, psychological and social repercussions. In this way they alter the general state of health of the individual, their well-being, and their quality of life (14). Oral health is crucial for an individual's quality of life and is variable depending on several factors, and some behaviors are modi able to the extent that their adoption means a reduction in oral pathology. ...
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Background High average life expectancy has caused an increase in the elderly population and with it the need to characterize this population regarding their health and in particular their oral health arises. The purpose of this study was to assess and characterize oral health, oral rehabilitation, oral health literacy and oral health perception and quality of life in a sample of elderly participants of a physical activity program. Methods An observational cross-sectional study was designed with a group of 206 individuals. All the individuals were clinically assessed, and a questionnaire was applied, in the form of a "face-to-face" interview with questions related to the quality of life related to oral health (GOHAI index and the REALD-30 scale). Results Of the 206 study participants, 90.3% admit brushing their teeth daily, 6.3% practice daily flossing, and 5.8% had a dental appointment in the last 12 months. Applying the REALD-30 scale, 22.7% have a low level (score 0–14), 43.7% a moderate level (score 15–22) and 33.6% a high level (score 23–29) of oral health literacy. The GOHAI scale reveals that 37.4% have a high self-perception of their oral health. Conclusions A considerable prevalence of the sample studied present a moderate level of oral health literacy. Therefore, educate each person about their oral health when participating in a specific health program and develop proposals for oral health promotion activities should be widely considered as a strategy towards primary prevention.
... Quality of life is subjective [11] and can be di cult to measure [7]. Therefore, different questionnaires have been developed and modi ed over the years to capture patients' perceptions about his or her health status [12]. The rst speci c instrument for the measurement of QoL following third molar surgery was developed by Shugars et al. (1996) [13] and later by Savin and Ogden [7]. ...
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Objectives: To evaluate and compare the effect of dexamethasone, ketoprofen and cold compress on the quality of life (QoL) following surgical removal of impacted lower third molar (ILTM). Materials and Methods: Eligible patients requiring ILTM extraction with modified Pederson difficulty index score of 5-6 were recruited. The patients were randomly allocated into Group A, B and C. The group A and C patients received pre-operatively, 100mg of ketoprofen and 8mg of dexamethasone per-oral respectively. Subjects in group B applied a pre-standardized ice pack over the angle of the mandible for 6 hours postoperatively. The QoL questionnaire was administered on postoperative day 1, 2 and 7. Results: In total, seventy-eight subjects completed the study: 46 (59%) were male and had a mean age of 27.8 ± 4.9 years. The groups were similar sociodemographically. The overall QoL and appearance domain score was significantly better in patients on oral dexamethasonein postoperative day 1 compared to other groups. Conclusions: Oral dexamethasone demonstrates better improvement in postoperative QoL and appearance on day 1 following ILTM surgery compared to ice packs and ketoprofen. Although ice packs are readily available, can be used repeatedly and are a low-cost option, more research is necessitated to determine its optimum therapeutic use in outpatient setting that will produce a result superior to a single dose of oral dexamethasone. Clinical Relevance: Oral dexamethasone is superior to ice pack compress and ketoprofen in improving the postoperative QoL in ILTM surgery.
... It is often defined as a multifaceted phenomenon which includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex. 31 When oral diseases manifest, the mouth and face can affect an individual's self-esteem as well as their wellbeing. 32 The participants in this study agreed with this phenomenon as they alluded that oral health had an overall effect and viewing patients holistically was just as important as identifying oral anomalies. ...
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Background The general and oral healthcare needs of communities far exceed the capacity of the current public health system of South Africa (SA). This results in patients deferring treatment or seeking alternative measures in the form of the traditional health practice. It is important for dental professionals in the health system to be aware of such oral health care seeking behaviour within rural communities to initiate joint corporate oral health education programmes and referral systems that resonate with these communities. Aims and objectivesThe study aimed to explore the knowledge, attitude and perceptions of dental professionals (16 dentists, 25 dental therapists, 4 oral hygienists and 3 dental assistants) regarding patients seeking oral health care from traditional healers. Methods This was an exploratory, cross-sectional study that evaluated dental professionals’ knowledge, attitude and perceptions on patients seeking oral health care from traditional healers. A purposive sampling technique using specific inclusion criteria was used to select 48 qualified dental professionals (oral hygienists, dentists, dental assistants and dental therapists) practising in rural KwaZulu-Natal. A self-administered questionnaire was used for data collection. Data related to sociodemographic variables and knowledge, attitudes and perceptions of dental professionals were recorded. ResultsMost (77.1%) dental professionals were aware that their patients were seeking oral health care from traditional healers. They further maintained that the traditional health practice included ideas and methods from which the oral health fraternity could benefit. Conclusion This study revealed most of the dental professionals in rural Kwa-Zulu Natal have encountered patients who have consulted traditional health practitioners for oral health care. The dental personnel were accepting of traditional healers and believed that traditional healers could contribute positively to rural oral health care.
... Oral health professionals may be valuable, not only in the diagnosis of the disease, but also by helping in the control of oral manifestations and, consequently, improving the Oral Health-Related Quality of Life (OHRQoL) of celiac patients. OHRQoL is a multidimensional concept that reflects the level of comfort that the individual experiences when performing daily activities, as well as their selfesteem and satisfaction regarding their oral health (Bennadi and Reddy 2013). In fact, oral manifestations can have a significant impact on the OHRQoL of CD patients (van Gils et al. 2017). ...
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Purpose Celiac Disease (CD) presents a wide variety of clinical signs and symptoms, including oral manifestations. This study pretended to characterize Oral Health-Related Quality of Life (OHRQoL) and reported oral manifestations in children with CD. Methods Target-population were children with CD. An online questionnaire, applied to children’s parents, collected information about OHRQoL (using the Early Childhood Oral Health Impact Scale—ECOHIS), oral health behaviours, and history of oral manifestations. Data analysis included descriptive statistics, Mann–Whitney, Kruskall-Wallis, and Spearman correlation tests (α = 0.05). Results The sample included 146 celiac patients, with a mean age of 10.5 years (sd = 4.1). Mean ECOHIS score was 5.2 (sd = 6.8). The most frequently reported oral manifestations were recurrent aphthous stomatitis (46.6%), dental caries (45.2%) and dental opacity (39%). About one third of the participants mentioned improvements in oral health when a gluten-free diet was introduced. Most of the reported oral manifestations had a significant association with the ECOHIS score ( p < 0.05). Conclusions The OHRQoL of children was good, however oral manifestations had a negative impact on OHRQoL. The most reported oral manifestations were recurrent aphthous stomatitis, dental caries, and dental opacities. Oral health professionals must be aware about the heterogeneity of the disease, to recognize oral manifestations associated and their importance in the early diagnosis to reduce complications and to an improvement in the OHRQoL of these patients.
... The idea that oral health is closely tied to overall quality of life started to gain traction in the early '80s [8]. Since then, a variety of instruments have been developed to gauge how oral health affects the Oral Health Impact Profile (OHIP). ...
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In strict accordance with PRISMA 2020 guidelines, our research team conducted a comprehensive systematic literature review (SLR) to explore the treatment and preventive strategies for Sjögren's Syndrome (SS). Leveraging a meticulous search strategy, we scoured reputable databases such as PubMed, PubMed Central, Google Scholar, Web of Science, and The Cochrane Library. Our analysis zeroed in on 10 seminal articles that met our stringent inclusion criteria, providing a holistic view of the existing treatment landscape for SS, along with emerging diagnostic tools and associated biomarkers indicative of lymphoma risk. From a clinical standpoint, our findings unequivocally highlight the detrimental effects of SS on patients' overall well-being. Of particular interest is the growing body of evidence that underscores the effectiveness of natural remedies and over-the-counter supplements rich in antioxidants as viable therapeutic interventions. Contrary to expectations, no single laboratory marker emerged as highly sensitive for the diagnosis of SS. On a promising note, dental implants have been demonstrated to offer lasting benefits with minimal side effects, emphasizing their potential utility in enhancing the oral health of individuals affected by SS. Given the evolving nature of treatment approaches for SS, our review strongly calls for further investigations. Such research endeavors are imperative for validating the effectiveness of these treatment options, whether they serve as primary or preventive care solutions, with the overarching aim of improving the quality of oral health among those suffering from SS.
... Examples of why drug-induced xerostomia can have such a negative impact on both mental and physical health include the negative impact of dentures fitting, leading to pain and discomfort, dysarthria, dysphagia, low self-esteem and social withdrawal [10][11][12]. ...
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Background: Many medications utilized in the United States (US) cause xerostomia (dry mouth); however, the costs and Quality Of Life (QOL) reduction associated with this side effect remains to be determined. Objective: To estimate the annual dental expenditures and quality of life burden attributable to chronic use of medications that cause xerostomia in the US adult population. Methods: This was a cross-sectional retrospective analysis evaluating prescribed medications in 2019 as reported by the Medical Expenditure Panel Survey. Medications were organized in 2 groups: medications with and without documentation of xerostomia. The treatment group included the US non-institutionalized adult population with chronic use of xerostomia causing medications. The control group included the rest of the US non-institutionalized adult population. Dental visits per year, total annual dental expenditures, and annual self-pay (out-of-pocket) dental expenditures were compared between treatment and control populations. Health related physical and mental quality of life scores were also compared. Results: Those in the treatment group exhibited a 33.3% higher expected rate of dental visits per year. Treatment populations also incurred higher dental expenditures $523.830/year vs. $315.78/year (p<0.001), and self-expenditures $266 vs. $131/year (p<0.001). Importantly, the treatment arm has lower physical and mental health, are older and sicker, thus, an adjusted analysis was necessary. Following the adjusted analysis, the difference of 1.3 (p<0.001) for physical and 2.0 (p<0.001) for mental summary scores remained. Conclusion: This study shows that medications that cause xerostomia result in higher dental costs and have a negative impact on physical and mental health
Background The concept of oral health related to quality of life involves the impact that oral health has on an individual’s well-being. The Early Childhood Oral Health Impact Scale (ECOHIS) was developed to measure the impact of oral health problems on the lives of children and their families. Objective To evaluate the psychometric properties of ECOHIS applied to mothers of preschool children and estimate the influence of demographic characteristics, caries experience, and plaque index on the ECOHIS score. Methods The fit of ECOHIS to the data was assessed by confirmatory analysis. Chi-square for degrees of freedom ratio ( χ ² /df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) were used. Reliability was estimated by the ordinal coefficients alpha ( α ) and omega ( ω ). The factorial invariance was estimated by the difference in CFI (ΔCFI). Comparisons of the ECOHIS mean scores according to the demographic characteristics, caries experience, and plaque index was performed using analysis of variance (ANOVA). Results A total of 371 children participated in the study. Mothers’ mean age was 33.0 (SD = 7.04) years. The ECOHIS presented a good fit to the data ( χ ² /df = 4.31; CFI = 0.95; TLI = 0.94; RMSEA = 0.09) and a strict model invariance. Children without caries and from higher income class had lower oral health impact. Conclusion The data obtained with the ECOHIS were valid, reliable, and invariant. Children with caries experience and from lower income families had a greater impact of oral problems.
Purpose The purpose of this study was to assess the differences in functional, psychosocial, and pain-related consequences of oral health among older men and women at two Midwest senior centers. Method The Geriatric Oral Health Assessment Index (GOHAI) was used to assess self-reported oral health–related quality of life (OHRQoL) among older men and women at two Midwest senior centers. Researchers also collected demographic information, including age, gender, marital status, level of education, annual income, and ethnicity. Results Older women reported significantly lower overall OHRQoL than men did, and this difference was not better explained as being due to differences in annual income or marital status. Furthermore, women scored significantly lower on the Physical Functioning and Psychosocial Functioning subscales of the GOHAI, while women also had lower average scores on the Pain/Discomfort subscale. This difference did not reach statistical significance. Conclusions Older women were reportedly more negatively impacted by OHRQoL issues than older men. Women reported significantly lower levels of physical and psychosocial functioning due to oral health problems. Data regarding gender differences in oral health related pain and discomfort were inconclusive. Further research is needed to examine this question, as well as to determine the reasons why women seem to experience lower OHRQoL than men do in old age.
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Objectives With the aging United Kingdom population, oral diseases are expected to increase. Exploring credible projections is fundamental to understanding the likely impact of emerging population-level interventions on oral disease burden. This study aims at providing a credible, evidence-based projection of the adult population in the United Kingdom with dental caries and periodontal diseases. Methods We developed a multi-state population model using system dynamics that disaggregates the adult population in the United Kingdom into different oral health states. The caries population was divided into three states: no caries, treated caries, and untreated caries. The periodontal disease population was disaggregated into no periodontal disease, pocketing between 4 and < 6 mm, 6 and < 9 mm, and 9 mm or more. Data from the 2009 dental health survey in the United Kingdom was used to estimate age and gender-specific prevalence rates as input to the multi-state population model. Results Of the population 16 years and older, the number with carious teeth is projected to decrease from 15.742 million in the year 2020 to 15.504 million by the year 2050, representing a decrease of 1.5%. For individuals with carious teeth, the older adult population is estimated to constitute 62.06% by 2050 and is projected to increase 89.4% from 5.079 million in 2020 to 9.623 million by 2050. The adult population with periodontal pocketing is estimated to increase from 25.751 million in 2020 to 27.980 million by 2050, while those with periodontal loss of attachment are projected to increase from 18.667 million in 2020 to 20.898 million by 2050. The burden of carious teeth and periodontal diseases is anticipated to shift from the adult population (16–59 years) to the older adult population. The older adult population with carious teeth is estimated to rise from 32.26% in 2020 to 62.06% by 2050, while that for periodontal disease is expected to increase from 42.44% in 2020 to 54.57% by 2050. Conclusion This model provides evidence-based plausible future demand for oral health conditions, allowing policymakers to plan for oral health capacity to address growing needs. Because of the significant delay involved in educating and training oral health personnel, such projections offer policymakers the opportunity to be proactive in planning for future capacity needs instead of being reactive.
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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.