Development of the Chinese version of the Dentine Hypersensitivity Experience Questionnaire.

The aim of this study was to evaluate the reliability and the validity of the Chinese version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ). After translation and cross-cultural adaptation following international guidelines, 110 patients with dentine hypersensitivity were recruited to complete the questionnaire. The reliability of the Chinese version of the DHEQ was evaluated using internal consistency and test-retest methods. Construct validity was determined based on factor analysis, discriminative validity (by comparing the subscale scores difference in the degree of sensitivity being investigated), and convergent validity (by analyzing the correlation between DHEQ subscale scores and the global rating of oral health question). Cronbach's alpha value (internal reliability) for the total DHEQ score was 0.95 and the intraclass correlation coefficient (ICC) value (test-retest reliability) was 0.85. Construct validity was determined by factor analysis, extracting eight factors, accounting for 74% of the variance. All items had factor loadings of >0.40. In addition, the Chinese version of the DHEQ was found to be valid for distinguishing patients with varying degrees of dentine hypersensitivity. In terms of convergent validity, the impact scale was significantly highly correlated to the global oral health rating. The results suggest that the Chinese version of the DHEQ has satisfactory psychometric properties and is applicable for patients with dentine hypersensitivity in China.

Rasch analysis of the Geriatric Oral Health Assessment Index.

The aim of this study was to perform a psychometric analysis on the Geriatric Oral Health Assessment Index (GOHAI) using Rasch analysis, a modern statistical approach for examining rating scale data. Eighty-five subjects, long-term residents of a nursing home, were analysed using the GOHAI. The mean GOHAI score (range 0-48) was 11. Two of the five rating categories (1 = seldom; 3 = often) did not comply with the Rasch criteria for category functioning. After collapsing rating categories into a three-level rating scale (0 = never; 1 = sometimes; 2 = often/always), the new model met the set criteria. Item 12 'sensitivity to hot, cold or sweets' was misfitting. Rasch analysis showed both the unidimensionality of (at least) 11 of the 12 items of GOHAI, and the possibility of simplifying the structure of its rating scale.

Patients' experiences of the impact of periodontal disease.

AIM: To examine critically patients' experiences of the impact of periodontal disease on their daily lives. MATERIAL AND METHODS: Semi-structured interviews of a purposive sample of patients with periodontal conditions were conducted using a flexible evolving topic guide. Data collection and analysis were an inductive, iterative process that occurred concurrently. The data were organized in a framework and recurrent themes identified. Interviews occurred until it was felt that no new themes or ideas were being expressed by respondents (n=14). RESULTS: Effects of periodontal disease on patients' daily lives included impairment, functional limitation, discomfort and disability (including physical, psychosocial and social disability). A large number of the emergent themes from the analysis were relevant to the domains of Locker's conceptual model of oral health. The domain within Locker's model that had no data relevant to it in the context of periodontal disease was death. Two additional themes emerged that appeared unrelated to Locker's model, these were stigma and retrospective regret. CONCLUSION: Periodontal disease reportedly affects patients' lives in a negative manner in a variety of ways. This is of relevance in the management of patients with periodontitis.

Oral health-related quality of life in patients seeking care for dentin hypersensitivity.

The aim of the present study was to evaluate oral health-related quality of life (OHRQoL) impairment in patients seeking care for their hypersensitive teeth in comparison with general population subjects and to investigate the influence of gender and age on OHRQoL in these populations. Study participants were 656 patients without removable prosthodontics who sought treatment for their hypersensitive teeth in German dental offices. These patients were asked to complete the German form of the Oral Health Impact Profile (OHIP-G) prior to treatment. The sum of OHIP-G item responses (OHIP-G49, 0-196) characterized the OHRQoL impairment. Patients' OHIP summary scores were compared with those in a sample of the German general population (n = 1541). The influence of population (patients vs. general population subjects), gender and age was investigated using a multivariable linear regression model. Age presented a curvilinear association with OHRQoL, with lower OHIP scores associated with younger and older adults and higher OHIP scores (indicating impaired OHRQoL) associated with middle-aged adults in both the patient and general populations. Gender influence depended on the population, i.e. female general population subjects had lower OHIP scores than male general population subjects and female patients had higher OHIP scores than male patients. Mean OHIP summary scores indicated that patients with hypersensitive teeth reported considerably more impaired OHRQoL (approximately 22 OHIP units) than subjects in the general population. The present study suggests that the oral condition of hypersensitive teeth is significantly associated with impaired OHRQoL.

A pilot assessment of alternative methods of quantifying dental pain with particular reference to dentine hypersensitivity.

OBJECTIVE: The overall aim of this pilot study was to establish the usefulness and comparability of selected verbal and non-verbal methods in the quantification of sensory and affective aspects of dental pain associated with dentine hypersensitivity (DH). DESIGN: The assessment of dental pain was conducted during an eight week clinical study. Patients were asked to rate their perception of dental pain using selected methods of quantification following tactile (Yeaple Probe-an electronic pressure-sensitive probe) and evaporative (cold air from a dental air syringe) stimulation; together with an overall assessment of perception to daily stimuli (e.g., cold air/water, toothbrushing, sweet and sour foods). The assessment methods used to quantify pain arising from DH were a continuous visual analogue scale (VAS), a 0-10 numerical rating VAS scale (NRS), and a separate intensity verbal descriptor (IVD) and unpleasantness verbal descriptor (UVD) word scales. SETTING: A specialist department at a postgraduate dental institute and hospital in London, UK. SUBJECTS: Twenty-five adult patients (8M + 17F) with a mean age of 42.6 years (95 per cent C.I. 38.8 to 46.4 years) attending the department for a clinical study evaluating the efficacy of a desensitising toothpaste agreed to participate. OUTCOME MEASURES: The study compared a continuous visual analogue scale (VAS), a 0-10 numerical rating visual analogue scale (NRS), and a separate intensity (IVD) and unpleasantness verbal descriptor (UVD) scales to quantify sensory and affective aspects of pain. An unweighted moving average technique was used to construct graphs of the relative frequency of reported severity gradings over a range of 0-10. RESULTS: The results of the study indicated that cold air appeared to cause greater discomfort to the patient than tactile sensitivity, with the air intensity curve for both IVD and 0-10 VAS peaking at a severity score of 5 while continuous VAS peaked at a score of 3-4. All methods peaked at score 2 for tactile sensitivity. The UVD scale peaked at score 2-3 and again at 6 for air sensitivity, but conformed to the other scales by peaking at score 2 for tactile sensitivity. NRS and IVD scales therefore appeared to provide acceptable alternatives to continuous VAS, but the UVD scale, probably because of the imprecise nature of the words used in the scale, did not. CONCLUSIONS: This study partially confirms previous conclusions that both verbal and non-verbal techniques quantify sensory and affective aspects of pain. However, the imprecise nature of UVD words provided misleading information in terms of both accuracy and sensitivity (except at very low levels of discomfort), when assessing pain arising from dentine hypersensitivity. In view of the highly subjective data arising from studies of this nature, the use of a moving average technique may be considered a more pragmatic method of analysis.