Measuring the symptomatic, physical, emotional and social impacts of dry mouth: A qualitative study.

OBJECTIVE: To explore the impacts of dry mouth in order to develop a comprehensive condition-specific OHRQoL measure. BACKGROUND: Dry mouth has been shown to have significant, if not more severe impacts on OHRQoL, than dental caries. Yet there remain few studies reporting on how to develop a comprehensive measure of the impact of dry mouth on OHRQoL. METHODS: This study was a qualitative study using semi-structured interviews. Data were collected from a purposive sample of 17 people with dry mouth (14 women, three men). The sample was drawn to capture a comprehensive range of impacts of dry mouth. These interviews were analysed using a framework approach informed by existing functionalist approaches to OHRQoL. RESULTS: Participants reported a huge range of symptoms associated with perceived dry mouth resulting in extensive impacts on physical, emotional (psychological) and social functioning. Dry mouth could also result in restrictions in social participation which, under some conditions, could be disabling. These impacts were modified by psychological, social and environmental factors. CONCLUSIONS: If we are to measure the impacts of oral conditions, it is important that this is done systematically and with reference to existing conceptual models of health. Current measures of the impact of dry mouth cover symptoms, discomfort and physical impacts along with some aspects of how people cope with the condition. This study proposes a more comprehensive approach that includes the full range of impacts people experience. Such an approach may enable us to focus on "downstream" and "upstream" interventions for dry mouth.

Impairment effects, disability and dry mouth: Exploring the public and private dimensions.

Existing accounts of dry mouth concentrate on the medical dimensions and almost completely neglect to consider its social dimensions. Simultaneously, debates on disability have highlighted an apparent split between the individual (medical) and social models of disability. The concept of 'impairment effects' aims to address this dichotomised approach. Impairment effects consider the everyday impact of people's impairments on their lives in conjunction with the disabling impacts encountered through their relations with society, and society's relations with them. This study indicates that identity and self became entangled with impairment effects and a form of disablism. The authors argue that impairment effects are, at times, a useful concept, but in some instances may actually overcomplicate things. By analysing the public and private dimensions of a chronic condition such as dry mouth, we have been enabled to explore the boundary between public and private lives. As a consequence, using public and private accounts may assist us to better locate the point where impairment ends and disability begins.