Oral health‐related quality of life in patients receiving home‐care nursing: associations with aspects of dental status and xerostomia

doi:10.1111/j.1741‐2358.2009.00344.x
Oral health‐related quality of life in patients receiving home‐care nursing: associations with aspects of dental status and xerostomia Objective: To explore the differences in oral status, dental attendance and dry mouth problems between patients with long‐term disease with high and low scores on Oral Health Impact Profile 14 (OHIP 14) and how patients cope with oral problems such as xerostomia and a reduced ability to brush their teeth. Background: There has been a lack of studies of oral health and oral health‐related quality of life in the frail elderly within the community services. Materials and methods: A cross‐sectional questionnaire study was conducted with 137 patients receiving home‐care nursing. Structured interviews were conducted by student nurses using OHIP‐14, items from the Xerostomia Inventory and questions concerning dental visit habits, brushing of teeth and data from medical records. Results: Eighty‐three per cent of patients had natural teeth and 60% had only natural teeth. ‘Natural teeth only’ indicated a low score on OHIP‐14. Problems with brushing and items concerning xerostomia indicated a high score on OHIP‐14. Contrasts in the assessments concerning brushing of teeth and xerostomia indicated low priority from the patients themselves and the nursing staff. Conclusion: Community health services should focus upon oral health. Both patients and nurses should assess the need for regular brushing of teeth carried out by home‐care nurses. Assessment and treatment of dry mouth problems should have higher priority.     

Oral health‐related quality of life of older people from three South American cities

Objective: To describe subjective oral health status and its association with overall health conditions and socioeconomic factors in the elderly (60 years and older) living in the capital cities with the oldest average populations in South America. Background: Oral diseases are a public health problem, frequently neglected in older adults. In recent years, the subjective assessment of psychological and social consequences of the problems related to oral health has been valued. One of the instruments used to estimate the Oral Health‐Quality of Life is the Geriatric Oral Health Assessment (GOHAI). Material and methods: Representative samples from SABE study (1999–2000) of Santiago (n = 1301), Buenos Aires (n = 1043), and Montevideo (n = 1450) aged 60 and over community‐dwelling people. We assessed OH‐QoL (GOHAI), self‐reported missing teeth, denture use, and self‐rated‐health, among other indicators. Logistic regression models(GOHAI < 58) for each city, adjusted by sex and age, were applied. Results: GOHAI average scores were higher in Montevideo (54.8 ± 6.1) than in Buenos Aires (53.1 ± 7.4) and Santiago (49.9 ± 8.6). A pronounced gradient of the oral condition and GOHAI scores were observed within the three‐cities. Denture use ‐less prevalent in Santiago and more common among women‐ is a protective factor against a poor OH‐QoL. Conclusion: Socioeconomic inequalities in oral health status and OH‐QoL are observed in the three cities. The increasing life expectancy emphasizes the need to integrate prevention and treatment efforts, as a way to improve OH‐QoL over the course of a lifetime.     

Assessing changes in oral health‐related quality of life and its factors in community‐dwelling older Brazilians

doi: 10.1111/j.1741‐2358.2012.00656.x Assessing changes in oral health‐related quality of life and its factors in community‐dwelling older Brazilians Objective: To describe changes in oral health‐related quality of life and to evaluate the associations of these changes in community‐dwelling older people. Materials and methods: In this longitudinal study a representative sample of 872 older people, living in Brazil, was evaluated during 2004. The follow‐up was carried out during 2008, with 587 older persons evaluated. A questionnaire assessing socio‐demographic information, health history, oral health‐impact profile and number of natural teeth was used. Changes in oral health‐related quality of life were categorized as improvement or deterioration. Data analysis was performed using a hierarchical approach based in a conceptual framework. A hierarchal approach was carried out using Poisson regressions. Results: Older persons living in rural areas, those who reported brushing once a day or less and older persons with fewer natural teeth had an increased chance of reporting deterioration in oral health‐related quality of life. Women and participants who received a minimum wage of less than US$219.50 were more likely to report improvement in oral health‐related quality of life. Conclusion: The results of this study suggest that changes in the oral health‐related quality of life are influenced by many of the variables that were included in the conceptual framework.     

Oral health-related quality of life: a critical appraisal of assessment tools used in elderly people

Objective: The purpose of this study was to undertake a critical appraisal of oral health‐related quality of life (OHRQoL) measurements used for research in the elderly. Background: A variety of OHRQoL measurements have been developed in the past 20 years as a result of increased concern about the impact of oral conditions on a person’s quality of life. There is need for an assessment aimed at prioritising the recommended measurements to be used for different purposes in the elderly. Materials and methods: Original English language papers using measurements to assess OHRQoL in the elderly were identified from Web of Science, EMBASE, PubMed, Medline and Lilacs databases. The search included all papers published from 1985 to February 2007. The criteria of assessment were: (i) measurement criteria (number of items and domains, and classification of the results found for each measurement); (ii) quantitative–qualitative criteria (frequency, acceptability, reproducibility, reliability, sensitivity and capability of being reproduced in other language versions). Results: In a total of 152 papers selected, 20 measurements were identified. However, only seven fulfilled all the measurement and quantitative–qualitative criteria. Conclusion: Geriatric Oral Health Assessment Index, Subjective Oral Health Status Indicators, Oral Health Impact Profile‐49, Dental Impact on Daily Living, Oral Health Impact Profile‐14, Oral Impact on Daily Performances and German Version of the Oral Heath Impact Profile were considered as instruments of choice to assess OHRQoL in the elderly. The other 13 instruments identified require further research aimed at a validation process and the use of a language other than English.     

Oral health‐related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City,India

doi: 10.1111/j.1741‐2358.2012.00651.x Oral health‐related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India Objective: To assess whether oral health–related quality of life (OHRQoL) is associated with nutritional status in the institutionalised elderly population of Mysore. Background: Malnutrition in the elderly has an evident impact on their general health and quality of life. Analysis of data of the Geriatric Oral Health Assessment Index (GOHAI) and their association with the Mini Nutritional Assessment (MNA) results improves our understanding of the complex relationship between oral health and malnutrition. Materials and methods: The study was conducted among the institutionalised elderly population in Mysore city, Karnataka. Data on socio‐demographic, oral health status were gathered. OHRQoL was evaluated using GOHAI, and malnutrition risk using MNA. Results: Out of 141 elderly, 41.1% were men and 58.9% were women with mean age of 72.2 ± 7.5 years. Mean GOHAI score was 47.03 ± 9.2, with 69.5% had low perception of oral health. Mean MNA score was 9.91 ± 2.4, 15.6% were malnourished, 52.5% were at risk of malnutrition and 31.9% were adequately nourished. A strong association was found between the mean GOHAI and MNA scores. Conclusion: Oral health–related quality of life was associated with nutritional deficit, and it requires a greater integration between dentistry and nutrition in the health promotion of older adults.     

Investigation of factor affecting health‐related quality of life in head and neck cancer patients

doi: 10.1111/j.1741‐2358.2012.00662.x Investigation of factor affecting health‐related quality of life in head and neck cancer patients Objectives: Head and neck cancer (HNC) patients have profound illness of physical, social and psychological factors that affects quality of life (QOL). The purpose of this study is to investigate the factors affecting HRQL in patients with intra‐oral prostheses. Background: Some cross‐sectional studies have been performed to investigate HRQL in patients with HNC, but these studies did not report in detail how factors affect the HRQL of maxillectomy and mandibulectomy and/or glossectomy patients. Materials and Methods: The University of Washington Quality of Life version 4 questionnaires (Japanese version) was administered to 50 maxillectomy and 50 mandibulectomy and/or glossectomy patients with intra‐oral prostheses who were selected according to inclusion and exclusion criteria. Gathered data were statistically analyzed to investigate how a number of factors, namely, age, sex, pathologic diagnosis, neck dissection, resection size, radiotherapy and dental condition affect HRQL. Results: In the maxillectomy patients, there were no significant differences between malignant and benign tumor in pathological diagnosis or between dentate and edentulous in dental condition. Age, sex, neck dissection and radiotherapy affected HRQL. In the mandibulectomy and/or glossectomy patients, there was no significant difference between dentate and edentulous in dental condition. Age, sex, glossectomy, neck dissection and radiotherapy affected HRQL. Conclusions: The factors affecting HRQL in the maxillectomy patients were different from those in the mandibulectomy and/or glossectomy patients. Though they wore stable prostheses; we were still able to show that resection size, radiotherapy and neck dissection affected HRQL.     

A preliminary investigation into tooth care, dental attendance and oral health related quality of life in adult stroke survivors in Tayside, Scotland

Objective: The aim of this study was to investigate patterns of oral care, dental attendance and oral health‐related quality of life among adults who had suffered a stroke. Background: Stroke is the most common cause of adult disability in the UK. Seventy per cent of strokes occur in adults over 65 years of age. A mild stroke may leave little residual disability but in cases of moderate or severe stroke the disability may be significant and may impact on oral health and function. Materials and methods: A cross‐sectional survey was conducted among adults surviving 1 year after stroke, between January and July 2001. A medical screening was carried out which included an assessment of disability and handicap using the modified Rankin scale. A structured interview was conducted to identify normal patterns of oral care and dental attendance and to elicit if since suffering a stroke any changes had occurred or were likely to occur. The Short Form Oral Health Impact Profile (OHIP‐14) was administered prior to an oral examination. Analysis used SPSS 11.0 for Windows. Parametric and nonparametric tests were undertaken (t‐tests and chi‐squared tests with Yates correction where appropriate). Results: Forty‐one adults were recruited into the study comprising 21 female and 20 male. They ranged in age from 50 to 87 years and the mean age was 69 years (SD = 9.8). Forty per cent of participants experienced moderate disability or greater following their stroke. Thirty‐seven per cent had difficulty with tooth cleaning. The most frequently reported problem was being unable to use one hand properly as a result of the stroke. There was a significant association between the degree of disability following stroke and difficulty with tooth cleaning (P = 0.015). Disability as a result of the stroke was cited as the main reason for reported or projected attendance pattern change. The most frequently experienced OHIP‐14 dimension was functional limitation (39%). Conclusion: Individuals who have been left disabled after a stroke may require help with or advice on oral care and information on how to access dental services in a setting appropriate to their disability. Further research is needed to identify the dental needs of adults with stroke and to identify appropriate interventions to meet these needs.     

The oral health‐related quality of life in edentulous patients treated with Conventional complete dentures

Objective: To compare the oral health‐related quality of life (OHRQoL) between patients with both maxillary and mandibular complete denture and those with either the maxillary or the mandibular complete denture. Background: Satisfaction of denture wearers can be estimated using the OHRQoL questionnaires like the OHIP‐EDENT and the Geriatric Oral Health Assessment Index (GOHAI). Methods: Two questionnaires were used to compare the OHRQoL between edentulous patients who had conventional removable complete denture on both jaws and those who had on either one of the jaws. Result: The age of the participants ranged from 42 to 75 years, with the mean age of 58 ± 8.12 years. The mean OHIP‐EDENT scores were significantly high among those who wore conventional dentures in both jaws (54.12 ± 5.21), compared with the participants who only had denture either on upper or lower jaw (46.52 ± 7.35). It was noticed that the mean GOHAI score was significantly lower (p < 0.05) among participants who had conventional denture on both upper and lower jaw (28.25 ± 3.67), as compared to those who had conventional denture only on one arch (35.12 ± 2.11). Conclusion: Patients with complete dentures in both jaw (Group I) were less satisfied than patients with single complete denture (Group II). The result obtained in this study shows dissatisfaction with conventional dentures among edentulous patients.     

Exploring the quality of life after denture-wearing within elders in Kaohsiung

doi: 10.1111/j.1741‐2358.2012.00614.x
Exploring the quality of life after denture‐wearing within elders in Kaohsiung Objective: The objective of the research is to investigate whether the elderly people’s quality of life get improved after denture wearing. Material and methods: About 1600 elderly persons, over 65 years old, were sampled as the research target. The overall response rate was 71.62%. The tool of research is a structural questionnaire Oral Health Impact Profile (OHIP) that was used to measure the oral health–related quality of life. Individual’s satisfaction of denture wearing divides into three groups: edentulous individuals who are satisfied with denture wearing, edentulous individuals who are not satisfied with denture wearing and dentulous individuals. Results: The result shows the eight variables, which are oral health condition, frequency of snacks‐eating, age, frequency in participation in social activities, instrumental activities of daily living (IADL), vision, satisfaction with life and physical functions, have significant influence on total OHIP score. Conclusions: Although being edentulous, if the elderly are satisfied with their denture, the quality of life can be maintained and not affected by oral health problems. It is suggested that the further researches can include more relevant factors when in a discussion on the oral health–related quality of life, especially, the subjective perception of individual’s feeling.     

Assessing weight-related quality of life in adolescents

Objective : The development of a new weight‐related measure to assess quality of life in adolescents [Impact of Weight on Quality of Life (IWQOL)‐Kids] is described. Research Methods and Procedures : Using a literature search, clinical experience, and consultation with pediatric clinicians, 73 items were developed, pilot tested, and administered to 642 participants, 11 to 19 years old, recruited from weight loss programs/studies and community samples (mean z‐BMI, 1.5; range, ?1.2 to 3.4; mean age, 14.0; 60% female; 56% white). Participants completed the 73 items and the Pediatric Quality of Life Inventory and were weighed and measured. Results : Four factors (27 items) were identified (physical comfort, body esteem, social life, and family relations), accounting for 71% of the variance. The IWQOL‐Kids demonstrated excellent psychometric properties. Internal consistency coefficients ranged from 0.88 to 0.95 for scales and equaled 0.96 for total score. Convergent validity was demonstrated with strong correlations between IWQOL‐Kids total score and the Pediatric Quality of Life Inventory (r = 0.76, p < 0.0001). Significant differences were found across BMI groups and between clinical and community samples, supporting the sensitivity of this measure. Participants in a weight loss camp demonstrated improved IWQOL‐Kids scores, suggesting responsiveness of the IWQOL‐Kids to weight loss/social support intervention. Discussion : The present study provides preliminary evidence regarding the psychometric properties of the IWQOL‐Kids, a weight‐related quality of life measure for adolescents. Given the rise of obesity in youth, the development of a reliable and valid weight‐related measure of quality of life is timely.     

Enhancing the quality of life in elderly women through a programme to improve the condition of salivary hypofunction

doi: 10.1111/j.1741‐2358.2011.00594.x Enhancing the quality of life in elderly women through a programme to improve the condition of salivary hypofunction Objective: The purposes of this study were to examine the effects of oral exercise intended to improve the function of the oral cavity in the elderly and their quality of life to pave the way for the development of oral‐health promotion programmes geared towards the elderly. Methods: The subjects were 78 female Koreans who resided in Seoul and were aged 65 years and older. During a 3‐month period, an oral function promotion programme was conducted twice a week, between 10.00 am and 12.00 pm , applying oral exercise suggested by a Japanese public health centre. A survey was conducted by interviewing the selected women to determine the state of their subjective dry mouth, quality of life related to oral health and jaw functional limitation. Their opening, unstimulated whole saliva and pronunciation speed were measured before and after the oral function exercise programme. Results: The subjects showed a significant improvement in subjective dry mouth symptoms, relevant behaviour, the level of discomfort caused by dry mouth and subjective jaw functional limitation during mastication and swallowing and emotional expression after receiving the oral exercise. After the oral exercise, there was a significant increase in mouth opening, unstimulated whole saliva and speaking speed (‘patakala’ pronunciation) after oral exercise. There was also significant progress in their quality of life related to oral health. Overall improvement in subjective dry mouth symptoms and relevant behaviour over time after oral exercise had a positive correlation with the level of improvement in discomfort triggered by dry mouth and mastication. The level of improvement in OHIP‐14 had a positive correlation with the level of overall improvement in dry mouth symptoms and behaviour, the level of improvement in discomfort by dry mouth and that in mastication and swallowing. Conclusion: This study showed the effects of the oral function promotion programme and correlation of oral condition and oral health‐related quality of life. It is suggested that this oral function promotion programme has positive effects on both objective and subjective oral conditions. It is strongly recommended that this programme, along with other oral health promotion programmes, be implemented to improve oral function and oral health‐related quality of life for the elderly.     

A cross-sectional analysis of the prevalence of dental anxiety and its relation to the oral health-related quality of life in patients with dental treatment needs at a university clinic in Switzerland

doi: 10.1111/j.1741‐2358.2011.00465.x A cross‐sectional analysis of the prevalence of dental anxiety and its relation to the oral health‐related quality of life in patients with dental treatment needs at a university clinic in Switzerland Objectives: The aim of this observational, cross‐sectional study was to analyse the relationship between dental anxiety (DA) and health‐related quality of life aspects associated with oral conditions of a population with dental treatment needs in Switzerland. Methods: The measurements of DA were collected by means of two questionnaires, the Dental Anxiety Scale (DAS) and a Visual Analogue Scale (VAS). Oral health‐related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP). The sample included 223 patients enrolled at a university clinic which specialises in oral prosthetic rehabilitation and temporomandibular disorders. Of them, 78.9% were at or above the age of 50. Results: No gender or age dependencies were observed. A comparison of answers regarding OHRQoL and DA revealed a significant interdependence (p = 0.0118); highly anxious patients were 3.55 times more likely to suffer from poor quality of life compared with less anxious ones. Conclusion: This cross‐sectional study of mostly elderly patients seeking dental treatment in Switzerland found that increased DA was associated with an impaired OHRQoL. The average DA was slightly higher than the results of other industrialised countries and the average OHRQoL was reduced.