Are Stage of Change constructs relevant for subjective oral health in a vulnerable population?

UNLABELLED: Stage of Change constructs may be proxy markers of psychosocial health which, in turn, are related to oral health. OBJECTIVE: To determine if Stage of Change constructs were associated with subjective oral health in a population at heightened risk of dental disease. METHODS: Stage of Change constructs were developed from a validated 18-item scale and categorised into 'Pre-contemplative', 'Contemplative' and 'Active'. A convenience sample of 446 Australian non-Aboriginal women pregnant by an Aboriginal male (age range 14-43 years) provided data to evaluate the outcome variables (self-rated oral health and oral health impairment), the Stage of Change constructs and socio-demographic, behavioural and access-related factors. Factors significant at the p < 0.05 level in bivariate analysis were entered into prevalence regression models. RESULTS: Approximately 54% of participants had fair/poor self-rated oral health and 34% had oral health impairment. Around 12% were 'Pre-contemplative', 46% 'Contemplative' and 42% 'Active'. Being either 'pre-contemplative' or 'contemplative' was associated with poor self-rated oral health after adjusting for socio-demographic factors. 'Pre-contemplative' ceased being significant after adjusting for dentate status and dental behaviour. 'Pre-contemplative' remained significant when adjusting for dental cost, but not 'Contemplative'. The Stages of Change constructs ceased being associated with self-rated oral health after adjusting for all confounders. Only 'Contemplative' (reference: 'Active') was a risk indicator in the null model for oral health impairment which persisted after adding dentate status, dental behaviour and dental cost variables, but not socio-demographics. When adjusting for all confounders, 'Contemplative' was not a risk indicator for oral health impairment. CONCLUSIONS: Both the 'Pre-contemplative' and 'Contemplative' Stage of Change constructs were associated with poor self-rated oral health and oral health impairment after adjusting for some, but not all, covariates. When considered as a proxy marker of psychosocial health, Stage of Change constructs may have some relevance for subjective oral health.

Does different wording of a global oral health question provide different results?

OBJECTIVE: Focusing on 70-year-old adults in Sweden and guided by the conceptual framework of International Classification of Impairments, Disabilities and Handicaps (ICIDH), the purpose of this study was to examine the extent to which socio-demographic characteristics, self-reported oral disease and social/psychological/physical oral health outcome variables are associated with two global measures of self-assessed satisfaction with oral health in Swedish 70-year-olds and if there is a degree of discordance between these global questions. BACKGROUND: It has become an important task to create a simple way to measure self-perceived oral health. In these attempts to find practical ways to measure health, the 'global oral health question' is a possible tool to measure self-rated oral health, but there is limited knowledge about how important the wording of this question is. MATERIALS AND METHODS: In 2012, a questionnaire was mailed to all persons born in 1942 in two Swedish counties, Örebro (T) and Östergötland (E). The total population of 70-year-olds amounted to 7889. Bivariate analyses were conducted by cross-tabulation and Chi-square statistics. Multivariate analyses were conducted using binary multiple logistic regression. RESULTS: The two global oral health question of 70-year-olds in Sweden was mainly explained by the number of teeth (OR=5.6 and 5.2), chewing capacity (OR=6.9 and 4.2), satisfaction with dental appearance (OR=19.8 and 17.3) and Oral Impact on Daily Performance (OIDP) (OR=3.5 and 3.9). CONCLUSION: Regardless of the wording, it seems that the concept of a global oral health question has the same main determinants.

Aspectos sociodemograficos e clinicos da qualidade de vida relacionada a saude bucal em adolescentes / Aspectos sociodemogragicos y clinicos de la calidad de vida relacionada con la salud bucal en adolescentes / Sociodemographic and clinical aspects of quality of life related to oral health in adolescents

OBJETIVO: Estimar a prevalência e identificar fatores sociodemográficos e parâmetros bucais associados ao impacto negativo da condição bucal na qualidade de vida de adolescentes. MÉTODOS: Foram analisados dados de 5.445 adolescentes entre 15 e 19 anos que participaram do inquérito nacional de saúde bucal (SBBrasil 2010), considerando a complexidade do desenho amostral. O desfecho foi a qualidade de vida relacionada à saúde bucal, avaliada por meio do questionário Oral Impacts on Daily Performance e analisada de forma discreta. As variáveis de exposição foram sexo, cor da pele, escolaridade, renda familiar, idade, cárie não tratada, perda dentária, dor de dente, oclusopatias, sangramento gengival, cálculo dentário e bolsa periodontal. Foram conduzidas análises de regressão de Poisson e apresentadas as razões de médias (RM), com respectivos intervalos de 95% de confiança (IC95%). RESULTADOS: Dos pesquisados, 39,4% relataram pelo menos um impacto negativo na qualidade de vida. Após o ajuste, a média do impacto negativo foi de 1,52 (IC95%1,16;2,00) vez maior no sexo feminino e 1,42 (IC95% 1,01;1,99), 2,66 (IC95% 1,40;5,07) e 3,32 (IC95% 1,68;6,56) vezes maior nos pardos, amarelos e indígenas, respectivamente, em relação aos brancos. Quanto menor a escolaridade, maior a média de impacto negativo (RM 2,11, IC95% 1,30;3,41), assim como em indivíduos com renda familiar até R$ 500,00 (RM 1,84, IC95% 1,06;3,17) comparados aos de maior renda. Encontrou-se maior impacto na qualidade de vida entre adolescentes com quatro ou mais lesões de cáries não tratadas (RM 1,53, IC95% 1,12;2,10), uma ou mais perdas dentárias (RM 1,44, IC95%1,16;1,80), com dor de dente (RM 3,62, IC95% 2,93;4,46) e com oclusopatia grave (RM 1,52, IC95% 1,04;2,23) e muito grave (RM 1,32, IC95% 1,01;1,72). ...

OBJETIVO: Estimar la prevalencia e identificar factores sociodemográgicos y parámetros bucales asociados con el impacto negativo de la condición bucal en la calidad de vida de adolescentes. MÉTODOS: Se analizaron datos de 5.445 adolescentes entre 15 y 19 años que participaron de la pesquisa nacional de salud bucal (SBBrasil 2010), considerando la complejidad del diseño de muestreo. El resultado fue la calidad de vida relacionada con la salud bucal, evaluada por medio de cuestionario Oral Impacts on Daily Performance y analizada de forma discreta. Las variables de exposición fueron sexo, color de la piel, escolaridad, renta familiar, edad, caries no tratada, pérdida dentaria, dolor de diente, maloclusiones, sangramiento de encías, cálculo dentario y bolsa periodontal. Se efectuaron análisis de regresión de Poisson y se presentaron los cocientes de promedios (RM), con sus respectivos intervalos de 95% de confianza (IC95%), RESULTADOS: Entre los investigados, 39,4% relataron por lo menos un impacto negativo en la calidad de vida. Posterior al ajuste, el promedio del impacto negativo fue de 1,52 (IC95% 1,16;2,00) veces mayor en el sexo femenino y 1,42 (IC95% 1,01;1,99), 2,66 (IC95%1,40;5,07) y 3,32 (IC95%1,68;6,56) veces mayor en los pardos, amarillos e indígenas, respectivamente, con relación a los blancos. En la medida que disminuye la escolaridad, mayor el promedio del impacto negativo (RM 2,11, IC95%1,30;3,41), así como en individuos con renta familiar hasta R$ 500,00 (RM 1,84, IC95%1,06;3,17) en comparación con los de mayor renta. Se encontró mayor impacto en la calidad de vida entre adolescentes con cuatro o más lesiones de caries no tratadas (RM1,53, IC95%1,12;2,10), una o más pérdidas dentarias (RM1,44, IC95%1,16;1,80), con dolor de diente (RM3,62, IC95%2,93;4,46), y con maloclusión grave (RM1,52, IC95%1,04;2,23) y muy grave ...

OBJECTIVE: To estimate the prevalence and to identify sociodemographic and oral health factors associated with the negative impact of oral health conditions on the quality of life in adolescents. METHODS: Data from 5,445 adolescents aged 15-19, who took part in the Brazilian Oral Health Survey (SBBrasil 2010) were analyzed, using a multistage sampling design. The outcome was quality of life related to oral health, which was assessed using the Oral Impacts on Daily Performance questionnaire and analyzed as a discrete variable. The independent variables were sex, skin color, schooling, household income, age, untreated dental caries, malocclusion.,gingival bleeding, dental calculus, and periodontal pocket. Poisson regression analysis was carried out and mean ratios (MR) with their respective 95% confidence intervals (95%CI) were presented. RESULTS: Of the total, 39.4% reported at least one negative impact on their quality of life. After adjustment, the mean negative impact was 1.52 (95%CI 1.16;2.00) times higher in females and 1.42 (95%CI 1.01;1.99), 2.66 (95%CI 1.40;5.07) and 3.32 (95%CI 1.68;6.56) higher in those with brown, yellow, and indigenous skin color, respectively, when compared to those with white skin. The lower the level of schooling, the greater the negative impact (MR 2.11, 95%CI 1.30;3.41), likewise for individuals with household income below R$ 500.00 (MR 1.84, 95%CI 1.06;3.17) compared with those with higher incomes. The greatest impact on quality of life was found among adolescents with four or more teeth with untreated dental caries (MR 1.53, 95%CI 1.12;2.10), one or more missing teeth (MR 1.44. 95%CI 1.16;1.80). those with dental pain (RM 3.62, 95%CI 2.93;4.46) and with severe (MR 1.52, 95%CI 1.04;2.23) and very severe malocclusion (MR 1.32, 95%CI 1.01;1.72). CONCLUSIONS: Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken ...

[Sociodemographic and clinical aspects of quality of life related to oral health in adolescents]. / Aspectos sociodemográficos e clínicos da qualidade de vida relacionada à saúde bucal em adolescentes.

OBJECTIVE: To estimate the prevalence and to identify sociodemographic and oral health factors associated with the negative impact of oral health conditions on the quality of life in adolescents. METHODS: Data from 5,445 adolescents aged 15-19, who took part in the Brazilian Oral Health Survey (SBBrasil 2010) were analyzed, using a multistage sampling design. The outcome was quality of life related to oral health, which was assessed using the Oral Impacts on Daily Performance questionnaire and analyzed as a discrete variable. The independent variables were sex, skin color, schooling, household income, age, untreated dental caries, malocclusion.,gingival bleeding, dental calculus, and periodontal pocket. Poisson regression analysis was carried out and mean ratios (MR) with their respective 95% confidence intervals (95%CI) were presented. RESULTS: Of the total, 39.4% reported at least one negative impact on their quality of life. After adjustment, the mean negative impact was 1.52 (95%CI 1.16;2.00) times higher in females and 1.42 (95%CI 1.01;1.99), 2.66 (95%CI 1.40;5.07) and 3.32 (95%CI 1.68;6.56) higher in those with brown, yellow, and indigenous skin color, respectively, when compared to those with white skin. The lower the level of schooling, the greater the negative impact (MR 2.11, 95%CI 1.30;3.41), likewise for individuals with household income below R$ 500.00 (MR 1.84, 95%CI 1.06;3.17) compared with those with higher incomes. The greatest impact on quality of life was found among adolescents with four or more teeth with untreated dental caries (MR 1.53, 95%CI 1.12;2.10), one or more missing teeth (MR 1.44. 95%CI 1.16;1.80). those with dental pain (RM 3.62, 95%CI 2.93;4.46) and with severe (MR 1.52, 95%CI 1.04;2.23) and very severe malocclusion (MR 1.32, 95%CI 1.01;1.72). CONCLUSIONS: Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken into account when planning preventive, monitoring and treatment strategies for oral health problems in groups with the highest impact on their quality of life.

Developing a new self-reported scale of oral health outcomes for 5-year-old children (SOHO-5).

BACKGROUND: Information on the impact of oral health on quality of life of children younger than 8 years is mostly based on parental reports, as methodological and conceptual challenges have hindered the development of relevant validated self-reported measures. This study aimed to develop and assess the reliability and validity of a new self-reported oral health related quality of life measure, the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5), in the UK. METHODS: A cross-sectional study of two phases. First, consultation focus groups (CFGs) with parents of 5-year-olds and review by experts informed the development of the SOHO-5 questionnaire. The second phase assessed its reliability and validity on a sample of grade 1 (5-year-old) primary schoolchildren in the Greater Glasgow and Clyde area, Scotland. Data were linked to available clinical oral health information and analysis involved associations of SOHO-5 with subjective and clinical outcomes. RESULTS: CFGs identified eating, drinking, appearance, sleeping, smiling, and socialising as the key oral impacts at this age. 332 children participated in the main study and for 296 (55% girls, mean d3mft: 1.3) clinical data were available. Overall, 49.0% reported at least one oral impact on their daily life. The most prevalent impacts were difficulty eating (28.7%), difficulty sleeping (18.5%), avoiding smiling due to toothache (14.9%) and avoiding smiling due to appearance (12.5%). The questionnaire was quick to administer, with very good comprehension levels. Cronbach's alpha was 0.74 and item-total correlation coefficients ranged between 0.30 and 0.60, demonstrating the internal consistency of the new measure. For validity, SOHO-5 scores were significantly associated with different subjective oral health outcomes (current toothache, toothache lifetime experience, satisfaction with teeth, presence of oral cavities) and an aggregate measure of clinical and subjective oral health outcomes. The new measure also discriminated between different clinical groups in relation to active caries, pulp involvement, and dental sepsis. CONCLUSIONS: This is the first study to develop and validate a self-reported oral health related quality of life measure for 5-year-old children. Initial reliability and validity findings were very satisfactory. SOHO-5 can be a useful tool in clinical studies and public health programs.

Validation of a Korean version of the Child Oral Health Impact Profile (COHIP) among 8- to 15-year-old school children.

OBJECTIVES: The purpose of this study was to assess reliability, discriminant validity, and convergent validity of the Oral Health Impact Profile (COHIP) Korean version in a representative community sample of 8- to 15-year-old Korean children. METHODS: A Korean version of COHIP was developed according to the standard procedure of cross-cultural adaptation of self-reported instruments. A representative community sample of 2236 schoolchildren was selected by cluster sampling method. RESULTS: Mean age of the participants was 11.8 years. Mean and median of the overall COHIP score were 103.3 (SD 13.3) and 106, respectively. Internal reliability and retest reliability were excellent with Chronbach's alpha 0.88 and intraclass correlation coefficient 0.88. Face validity was confirmed with 98% of participants reporting the COHIP questionnaire was easy to answer. Nonclinical factors such as self-rated oral health or satisfaction with oral health were significantly related with overall COHIP score and five subscale scores (P < 0.001) in a consistent manner. Children with carious permanent teeth and with orthodontic treatment need had highly significantly lower overall COHIP score (P < 0.01). CONCLUSION: The Korean version of the COHIP was successfully developed. The internal reliability, retest reliability, face validity, discriminant validity, and convergent validity of the COHIP Korean version were confirmed.

Relationship between patients' oral health-related quality of life, satisfaction with dentition, and personality profiles.

AIM: The aim of this study was to investigate the relationship between patients' oral health-related quality of life, satisfaction with their dentition, and their personality profiles. METHODS AND MATERIALS: Eighty-four patients (30 males and 54 females; mean age 31.9+/-12.7 years) seeking routine dental treatment were recruited for this study. A "Dental Impact on Daily Living" (DIDL) questionnaire was used to assess dental satisfaction and impact on daily living. An "Oral Health Impact Profile" (OHIP) was used to measure self-reported discomfort, disability, and dysfunction caused by oral conditions. Oral health-related quality of life was assessed using the "United Kingdom Oral Health Related Quality of Life" measure (OHQoL-U.K). A "NEO Five Factor inventory" (NEO-FFI) was used to assess personality profiles. RESULTS: The dentition has a measurable impact on daily living as well as with satisfaction with appearance, pain levels, oral comfort, general performance, and eating capability (p=0.000). Younger patients had more profound oral health impacts (p=0.045) and higher neuroticism scores (0.043). OHIP scores were significantly related to OHQoL-UK scores (p=0.000). DIDL scores had significant correlations with OHIP and OHQoL-UK scores (p<0.05). Significant correlations were established between neuroticism and satisfaction with oral comfort, extraversion and total satisfaction and satisfaction with general performance, and openness and satisfaction with appearance (p<0.05). OHIP and OHQoL-UK scores had no significant correlations with psychological profiles. CONCLUSION: The status of the oral cavity can have a definitive impact on patients' daily living and quality of life regardless age, gender, and level of education. Patients' satisfaction with their dentition has definitive impacts on daily living, quality of life, and dental perceptions. Personality profiles (neuroticism; extraversion, and openness) may influence dental perceptions, play a significant role in shaping satisfaction with dentition, and help with the prediction of the dental impact on daily living. CLINICAL SIGNIFICANCE: Since patients' satisfaction with their dentitions impacts their daily living and quality of life while affected by their psychological profiles, this should be considered when formulating a treatment plan for management for their dentition in order to obtain patient acceptance of the proposed treatment.

Homeless who accessed a healthy living centre in Swansea, South Wales: an assessment of the impact of oral ill-health.

AIM: To quantify the way that oral diseases affect the lives of homeless and vulnerable people in Swansea, using the short-form Oral Health Impact Profile (OHIP-14). METHOD: A convenience sample of people using the services of a healthy living centre for the homeless was surveyed using a questionnaire and the short-form OHIP-14. RESULTS: One hundred subjects were recruited to the study. The mean score for the OHIP-14 was 21.8 (SD 17.0). The most commonly reported impacts experienced were problems with toothache, discomfort, ability to relax, and feeling ashamed regarding the appearance of teeth. Of the different categories of homeless people, rough sleepers experienced higher levels of impact (P=0.004). Those having more than 20 teeth were more likely to experience lower levels of impact (P=0.001). CONCLUSION: The survey highlighted an increased prevalence of oral health impacts in this special needs group. In addition to physical factors, psychosocial factors must be considered, particularly with regard to appearance and psychological disability and discomfort, in the development of services.

A novel decision-making process for tooth retention or extraction.

BACKGROUND: Implant-supported restorations have become the most popular therapeutic option for professionals and patients for the treatment of total and partial edentulism. When implants are placed in an ideal position, with adequate prosthetic loading and proper maintenance, they can have success rates >90% over 15 years of function. Implants may be considered a better therapeutic alternative than performing more extensive conservative procedures in an attempt to save or maintain a compromised tooth. Inadequate indication for tooth extraction has resulted in the sacrifice of many sound savable teeth. This article presents a chart that can assist clinicians in making the right decision when they are deciding which route to take. METHODS: Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed. Book sources were also searched. Individual tooth- and patient-related features were thoroughly analyzed, particularly when determining if a tooth should be indicated for extraction. RESULTS: A color-based decision-making chart with six different levels, including several factors, was developed based upon available scientific literature. The rationale for including these factors is provided, and its interpretation is justified with literature support. CONCLUSION: The decision-making chart provided may serve as a reference guide for dentists when making the decision to save or extract a compromised tooth.

Dynamics of satisfaction with dental appearance among dentate adults: 24-month incidence.

INTRODUCTION: Dental appearance comprises an important aspect of oral health and oral health-related quality of life (OHRQoL). However, no study has investigated the dynamics of satisfaction with dental appearance and other aspects of oral health using a longitudinal study design. The current study aimed to: (i) quantify longitudinal patterns of change in satisfaction with dental appearance, and (ii) identify the dynamic relationships between the changes in satisfaction with dental appearance and other dimensions of oral health (oral disease/tissue damage and oral disadvantage), taking sociodemographic factors into account. METHODS: Data were taken from the Florida Dental Care Study (FDCS), a population-based longitudinal cohort study of oral health and OHRQoL. The sample included at baseline 873 subjects. Patterns of change in satisfaction with dental appearance during 24 months of follow-up were quantified. The dynamic relationships between the changes in satisfaction with dental appearance and other dimensions of oral health were evaluated. RESULTS: During follow-up, 19-22% of the subjects were dissatisfied with dental appearance, depending on the time point of the interview. Onset of a certain oral health problem/condition or constantly having the problem/condition was associated with a lower likelihood of satisfaction improvement and a higher likelihood of deterioration. In comparison, recovery from a certain oral health problem/condition or not having the problem/condition was associated with a higher likelihood of improvement and a lower likelihood of deterioration. CONCLUSION: Change in satisfaction with dental appearance was substantially influenced by the dynamic changes in other aspects of oral health.

Mapping oral health related quality of life to generic health state values.

BACKGROUND: A summary utility index is useful for deriving quality-adjusted life years (QALY) for cost analyses or disability weights for burden of disease studies. However, many quality of life instruments provide descriptive profiles rather than a single utility index. Transforming quality of life instruments to a utility index could extend the use of quality of life instruments to costs analyses and burden of disease studies. The aims of the study were to map a specific oral health measure, the Oral Health Impact Profile to a generic health state measure, the EuroQol, in order to enable the estimation of health state values based on OHIP data. METHODS: Data were collected from patients treated by a random sample of South Australian dentists in 2001-02 using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental conditions and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol (EQ-5D) and 14-item version of the Oral Health Impact Profile (OHIP-14) instruments. Data were available from 375 patients (response rate = 72%). A random two-thirds sample of patients was used in tobit regressions of EQ-5D health state values estimated using OHIP-14 in a model with categories of OHIP responses as indicator variables and in a model with OHIP responses as continuous variables. Age and sex were included as covariates in both models. The remaining one-third sample of patients was used to test the models. RESULTS: The OHIP item 'painful aching in mouth' was significantly related to health state values in both models while 'life less satisfying' was also significant in the continuous model. Mean forecast errors relative to the mean observed health state value were higher when fitted to the categorical model (17.4%) compared to the continuous model (15.2%) (P < 0.05). CONCLUSION: The findings enable health state values to be derived from OHIP-14 scores for populations where utility has not or cannot be measured directly.

Perceptions of dental care need among African-American elders: implications for health promotion.

The aim of this study was to assess perceived dental care need, actual clinical need and the relationship between these variables and care-seeking behavior among community residing African-American elders. A convenience sample of 146 elders responded to a survey and participated in oral screenings at six senior centers. Elders were categorized as needing routine dental care, some dental care, or urgent dental care. Most (61%) required dental care with one-fourth having urgent dental care needs. Elders reporting a problem tended to seek dental care more often within a year (38%) than those not reporting a problem (27%). Sixty-four percent did not currently have a dental provider. The majority (83%) rated their general health as being fair or good and few (9%) reported oral pain. These findings suggest developing health promotion programs that emphasize non-painful oral signs and symptoms, accompanied by associated general health implications that may compromise overall health.

Application of short-form oral health impact profile on elderly Japanese.

OBJECTIVES: The purpose of this study was to use the oral health impact profile (OHIP-14) to evaluate the impact of oral disease on the quality of life of a group of independently-living elderly persons in an urban area of Japan. SUBJECTS: A total of 1244 participants of the Senior Citizen's College, who attended the lectures once a week. They were community-dwelling, independently-living people over 60 years of age. MEASUREMENTS: Japanese version of the short-form OHIP-14. RESULTS: Internal reliability for the 14 items overall was very high (Cronbach's alpha = 0.95). Report of 'painful aching' and 'uncomfortable to eat' were the two most highly scored items using the mean sum OHIP-14 score. A multiple logistic regression analysis indicated that the sum OHIP-14 score had significant associations with self-assessment of general health, dental status, and a perceived need for dental treatment. However, age, gender, dissatisfaction with financial status or education level was not significantly associated with the sum OHIP-14. Compared with that of other countries, the items were ranked similarly, whereas the perceived magnitudes of the problems were quite different from other population. CONCLUSIONS: The OHIP-14 in Japanese had a high internal reliability, was significantly associated with dental status and comparable ranking for items when compared with studies from other countries.

Dimensions of oral health related quality of life measured by EQ-5D+ and OHIP-14.

BACKGROUND: The aims of the study were to compare the dimensions of oral-health-related quality-of-life measured by a generic health state measure, the EuroQol, and a specific oral health measure, the Oral Health Impact Profile. METHODS: Data were collected in 2001-02 from a random sample of South Australian dentists using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental problems and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol (EQ-5D+) and 14-item version of the Oral Health Impact Profile (OHIP-14) instruments. RESULTS: Data were available from 375 patients (response rate = 72%). The EuroQol items of mobility, self care and usual activities formed a separate cluster of variables, as did anxiety/depression and cognition, while pain clustered with items from the OHIP physical pain subscale. OHIP items tended to form clusters consistent with the subscales of social disability, physical disability, physical pain, functional limitation and psychological discomfort. The OHIP handicap items clustered between the OHIP social disability and physical disability subscales. The OHIP psychological disability items split between the social disability and psychological discomfort subscales. CONCLUSIONS: The observed clusters of variables empirically supported most of the conceptual dimensions of the OHIP. Both instruments covered symptom experience of pain indicating overlapping domains. However there was partial separation of the generic and specific items, EuroQol covered daily activities such as self-care and usual activities and OHIP covered oral health-specific aspects of functional limitation and physical disability as well as psychological and social aspects of disability and handicap.

Dental abnormalities in children of fathers with substance use disorders.

Very little is known about whether parental substance-use disorders (SUDs) affect the prevalence of dental abnormalities among their offspring. This study examined the prevalence of various dental abnormalities in sons of fathers with SUDs (the high average risk, or HAR, group) versus the prevalence of these abnormalities among sons of fathers without SUDs (the low average risk, or LAR, group). A total of 385 sons and their families were comprehensively assessed at five different ages, 10-12, 12-14, 16, 19, and 22. All of these participants were participating in an ongoing longitudinal NIDA-funded center study (CEDAR) evaluating the etiology of SUDs, in collaboration with the University of Pittsburgh Dental School. The data from this study provide evidence that paternal SUDs (HAR vs. LAR status) is associated with poor dental condition, poor oral hygiene, a greater need for dental treatment, and inadequate levels of dental treatment utilization.

Oral health: perceptions of need in a rural Iowa county.

Several studies have shown that oral health problems impact the quality of life of older adults. However, few data are available to describe the oral health status, barriers to care, and patterns of care for adults and older populations living in rural areas. The purpose of this study was to evaluate the perceived need for treatment of oral health problems by adult residents in a rural county in Iowa. The oral health component was part of a larger longitudinal health study of the residents. The sample was stratified into three groups by residence, that is, farm households, rural non-farm households and town households. The sample was subsequently post-stratified by gender and age group into young elderly, 65-74 years old, and old elderly, 75 years and older. Dentition status varied according to age and was related to the perception of treatment needs. Edentulous persons had fewer perceived treatment needs and utilized a dentist less frequently. Place of residence, education, and marital status were not associated with the subjects' perceived problems with eating and chewing. However, persons with difficulty chewing were more likely to have some missing upper teeth, have a perceived need to have denture work, and have smoked for a number of years. The results suggest that this rural population is retaining more teeth and consequently may need and may seek dental services more often than previous more edentulous cohorts.

Chronic oral disadvantage, a measure of long-term decrements in oral health-related quality of life.

UNLABELLED: Few studies have investigated the relation between oral health-related quality of life (HRQL) and key demographic, socioeconomic, and oral health decrements. METHODS: Data were taken from 873 participants from the Florida Dental Care Study. Chronic oral disadvantage was defined from incident oral disadvantage, a measure of oral HRQL, reported for a minimum of two consecutive 6-month intervals. Patterns of chronic oral disadvantage over the 24-month period were described. Associations between the dependent variable, chronic oral disadvantage, and demographic variables, socioeconomic variables, oral health decrements, and dental services were evaluated. RESULTS: During 24 months of follow-up, 30% of subjects reported chronic oral disadvantage. Chronic oral disadvantage was significantly associated with approach to dental care, area of residence, situation if faced with an unexpected dollars 500 dental bill, teeth that are stained or look bad, cavities, sore or infected gums, loose tooth or cap, toothache or abscess, dental sensitivity, and chewing difficulty. A recent dental visit was associated with reduced progression to chronic oral disadvantage. CONCLUSION: A large proportion of subjects avoided certain daily activities due to oral health decrements for longer than 6 months. Recent dental visits were significantly associated with limitation of long-term progression of oral disadvantage.