Oral health-related quality of life of elderly Germans--comparison of GOHAI and OHIP-14.

OBJECTIVE: To obtain information about the subjective oral health status of non-clinical elderly populations of urban regions of Germany, one in the East and one in the West, by using OHIP-14 and, for first time, the GOHAI, and, furthermore, to compare the results obtained by use of both instruments. BASIC RESEARCH DESIGN: Cross-sectional. CLINICAL SETTING: Randomly chosen, non-clinical elderly population in urban regions of Germany. PARTICIPANTS: 197 participants (51% male) born in the years 1930-1932. MAIN OUTCOME MEASURES: GOHAI, OHIP-14. RESULTS: Median GOHAI score was 54; median OHIP-14 score was 2. Scores indicative of severely impaired oral health were rare. The effect of living in eastern or western Germany was of minor significance. Although the internal consistency of both measures was comparable and the same positive association with psychological wellbeing, absence of dry mouth, burning mouth, and removable dentures (p < 0.05) was observed, differences occurred. In simultaneous analysis of all items, factor analysis revealed only partial overlap of the items in extracted factors. Furthermore, the extreme score indicating no impairment was five times more frequent for OHIP-14. Of those who scored zero in OHIP-14, only 20% had the GOHAI equivalent score of 60, and for some GOHAI items the answer category for highest impairment was obtained. CONCLUSIONS: GOHAI scores for this randomly chosen non-clinical group enable comparison with scores for Germany measured in the future. The differences between GOHAI and OHIP-14 make it necessary to select the most appropriate instrument for a planned purpose and study population.

Self-rating of satisfaction with dental appearance in an elderly German population.

OBJECTIVE: To assess data on satisfaction with dental appearance in old age. DESIGN: Cross-sectional study of an elderly non-patient group born from 1930 to 1932. SETTING: Two urban regions of Germany. PARTICIPANTS: 225 subjects (73-75 years, 49.3% male). METHODS: A questionnaire was completed. Descriptive analysis and bivariate analysis of gender differences, and a regression model for multivariate analysis were performed. MAIN OUTCOMES: Satisfaction with overall dental appearance, tooth/denture colour, shape, and position, and importance of dental appearance to overall appearance. RESULTS: Importance of dental appearance to overall appearance was rated high (7.5 +/- 2.0, where 10 denotes most important), as was overall satisfaction with dental appearance (7.2 +/- 1.8, where 10 denotes best possible). Up to 12% were not at all satisfied with tooth/denture colour, shape, or position, however. Women were more critical when judging overall satisfaction with dental appearance (p = 0.02). A significant positive association was obtained between overall dental appearance and position of teeth (p < 0.001). CONCLUSIONS: Satisfaction with dental appearance was high, as was the importance of dental appearance to elderly patients. Both aesthetic and functional aspects should therefore receive special attention in dental treatment. In this context the position of teeth should be regarded as of special importance.

Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values.

The nationwide multicenter trials of the German Research Network on Neuropathic Pain (DFNS) aim to characterize the somatosensory phenotype of patients with neuropathic pain. For this purpose, we have implemented a standardized quantitative sensory testing (QST) protocol giving a complete profile for one region within 30 min. To judge plus or minus signs in patients we have now established age- and gender-matched absolute and relative QST reference values from 180 healthy subjects, assessed bilaterally over face, hand and foot. We determined thermal detection and pain thresholds including a test for paradoxical heat sensations, mechanical detection thresholds to von Frey filaments and a 64 Hz tuning fork, mechanical pain thresholds to pinprick stimuli and blunt pressure, stimulus/response-functions for pinprick and dynamic mechanical allodynia, and pain summation (wind-up ratio). QST parameters were region specific and age dependent. Pain thresholds were significantly lower in women than men. Detection thresholds were generally independent of gender. Reference data were normalized to the specific group means and variances (region, age, gender) by calculating z-scores. Due to confidence limits close to the respective limits of the possible data range, heat hypoalgesia, cold hypoalgesia, and mechanical hyperesthesia can hardly be diagnosed. Nevertheless, these parameters can be used for group comparisons. Sensitivity is enhanced by side-to-side comparisons by a factor ranging from 1.1 to 2.5. Relative comparisons across body regions do not offer advantages over absolute reference values. Application of this standardized QST protocol in patients and human surrogate models will allow to infer underlying mechanisms from somatosensory phenotypes.

The impact of positive and negative feedback on reaction time in brain-damaged patients.

Little is known about the impact of feedback on the reaction times (RTs) of brain-damaged (BD) patients. The authors therefore investigated the effect of positive and negative feedback on these patients, using a 4-choice RT task. Participants were 107 BD patients with different etiologies and 50 orthopedic (OG) control patients. Patients were assigned to 3 groups in which performance-independent negative, positive, and no feedback were given. Statistical analysis showed that negative feedback led to significantly shorter RTs in BD patients. Even BD patients with high depression scores were affected by negative feedback. In contrast, negative feedback had no impact on the RTs of the OG controls, and positive feedback had no influence on the RTs of any group. These results raise some interesting questions about motivational processes in BD patients.