Psychosocial impact of dental aesthetics in adolescence: validity and reliability of a questionnaire across age-groups.

BACKGROUND: Dental malocclusion is a highly prevalent health condition in adolescence. Patients seek treatment primarily for aesthetic reasons. Therapy benefits are regarded, in the first place, to be psychosocial in nature. Therefore, it is mandatory to consider the perspective of the patient in treatment planning and control using a dental-aesthetics-related quality of life measure. The objective of this study was to investigate whether the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) developed in adult samples including the subscales Dental Self-Confidence, Social Impact, Psychological Impact and Aesthetic Concern is also applicable in adolescents aged 11 years and above. The psychometric properties were examined across three age-groups (11-12, 13-14, 15-17 year olds) with respect to factorial invariance, internal consistency, temporal stability, discriminant validity and gender- or age-associated scale mean differences and item response bias. METHOD: Participants were 1,112 adolescents recruited from 4 institutions: orthodontic and dental practices, schools, and youth clubs. They answered the 23 partially reformulated items of the PIDAQ. Subjective and dentist evaluations of dental occlusion were assessed using the Perception of Occlusion Scale and the Aesthetic Component of the Index of Orthodontic Treatment Need. Both indices were aggregated to one Malocclusion Index (MI-S and MI-D). RESULTS: The fit indices using confirmatory factor analyses suggested that the factor structure and factor loadings underlying the PIDAQ items were invariant across ages (comparative fit index = 0.91, root-mean-square error of approximation = 0.04). Internal consistency and temporal stability were adequate within the age-groupings (Alpha = 0.71-0.88; intra-class correlations = 0.82-0.96). Adolescents with severe compared to slight malocclusion according to both self-evaluation and dentist evaluation were found to differ in all PIDAQ subscales at a level of p < 0.001 for all ages. PIDAQ scale scores were not related to age and gender. On the item level, no evidence for gender or age bias has been found. CONCLUSION: The PIDAQ demonstrates to have good psychometric properties in adolescents, independent of their age. The instrument can be applied in making clinical decisions and in the assessment of psychosocial outcomes of orthodontic therapy.

Perception of occlusion, psychological impact of dental esthetics, history of orthodontic treatment and their relation to oral health in naval recruits.

OBJECTIVE: To investigate whether the oral health of young male adults was related to (1) the degree of self-perceived malocclusion, (2) the degree of experienced negative psychosocial impact of dental esthetics, and (3) the history of orthodontic treatment and its duration. MATERIALS AND METHODS: The study subjects were 470 male naval recruits undergoing a routine dental health checkup. They answered the Perception of Occlusion Scale (POS) and Negative Impact of Dental Aesthetics Scale (NIDAS). The Approximal Plaque Index (API), the Sulcus Bleeding Index (SBI), and the number of decayed teeth (DT) and missing teeth (MT) were examined by a staff dentist. Statistical procedures were one-way analyses of variance in the API and SBI and nonparametric Kruskal-Wallis, Mann-Whitney, and chi(2) tests in DT and MT as dependent variables. RESULTS: (1) The subjects ranging within the upper POS quartile scored higher on the SBI (contrast: P = .003) and DT (P = .002) than did those in the lower POS quartiles. (2) In contrast to the subjects reporting minor negative impacts in the NIDAS, those with strong impacts had higher scores on the API and MT (each P < .001). (3) In the subjects with a history of orthodontic treatment lasting 30 months and longer, lower API (P < .05), SBI and DT (each P = .002), and MT (P = .007) scores were found than in the subjects without previous orthodontic treatment. CONCLUSION: The results suggest that self-perceived dental irregularity and negative impact of dental esthetics might affect oral health, whereas previous extensive orthodontic treatment may have favorable effects by improving dental health compliance.

JProGO: a novel tool for the functional interpretation of prokaryotic microarray data using Gene Ontology information.

A novel program suite was implemented for the functional interpretation of high-throughput gene expression data based on the identification of Gene Ontology (GO) nodes. The focus of the analysis lies on the interpretation of microarray data from prokaryotes. The three well established statistical methods of the threshold value-based Fisher's exact test, as well as the threshold value-independent Kolmogorov-Smirnov and Student's t-test were employed in order to identify the groups of genes with a significantly altered expression profile. Furthermore, we provide the application of the rank-based unpaired Wilcoxon's test for a GO-based microarray data interpretation. Further features of the program include recognition of the alternative gene names and the correction for multiple testing. Obtained results are visualized interactively both as a table and as a GO subgraph including all significant nodes. Currently, JProGO enables the analysis of microarray data from more than 20 different prokaryotic species, including all important model organisms, and thus constitutes a useful web service for the microbial research community. JProGO is freely accessible via the web at the following address: http://www.jprogo.de.

Anxiety sensitivity as predictor of pain in patients undergoing restorative dental procedures.

OBJECTIVES: The personality disposition to anxiety sensitivity refers to beliefs about negative consequences of bodily arousal. The concept has recently been successfully applied in research on chronic pain conditions. The present study investigated whether anxiety sensitivity interacts with dental fear to increase expected and experienced pain during routine dental treatment. METHODS: Subjects were 97 patients undergoing dental procedures of excavation and filling. Anxiety dispositions were measured by the Anxiety Sensitivity Index and the Dental Anxiety Scale. Expected and experienced pain were assessed by affective and sensory verbal descriptor scales and a numerical rating scale measuring pain intensity. RESULTS: Dentally fearful patients scoring high in anxiety sensitivity both expected and experienced more pain than low scorers did. Significant interactions were found predicting expected affective and intense pain and experienced pain intensity. CONCLUSION: The results lend support to the assumption that dentally fearful patients with a disposition to high anxiety sensitivity amplify pain anticipations when exposed to the critical situation. When dentally fearful patients are under treatment, their beliefs about negative consequences of bodily arousal may negatively influence their evaluation of treatment related pain.

Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults.

The aim of this study was to develop a psychometric instrument for assessment of orthodontic-specific aspects of quality of life. The study subjects, 194 young adults aged 18-30 years, were interviewed using a pool of 23 items dealing with the psychosocial impact of dental aesthetics. Self- and interviewer-rating of the dental aesthetic appearance of each subject were carried out using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Additionally, the Perception of Occlusion Scale and a modification of the Dental Aesthetic Index (DAI) were applied. Factorial analyses identified four measures within the item pool, namely Dental Self-Confidence, Social Impact, Psychological Impact, and Aesthetic Concern. The factor structure was confirmed in an independent sample of 83 subjects aged 18-33 years. The reliabilities of the factor analysis-derived scales were between alpha (alpha) 0.85 and 0.91. They differed between respondents with varying severity of malocclusion, as assessed by subject and interviewer ratings. The results suggest that the proposed instrument, termed the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ), meets the criteria of factorial stability across samples and criterion-related validity and reliability, and might be a promising tool for further research and clinical application in orthodontics.

Dental esthetics, orthodontic treatment, and oral-health attitudes in young adults.

INTRODUCTION: The aim of this study was to investigate whether young adults with varying dental esthetics and histories of orthodontic treatment also differ in oral-health attitudes, preventive behaviors, and self-perceived oral health. METHODS: The sample comprised 298 young adults, 18 to 30 years old, with at least 13 years of primary and secondary school education. The subjects were asked to complete questionnaires dealing with various measures related to oral-health attitudes, preventive behaviors, and perceptions of oral health. Dental esthetics were assessed by means of the aesthetic component of the index of orthodontic treatment need. Dental plaque accumulation was assessed in a subsample of respondents. RESULTS: Subjects with high dental-esthetics scores reported more favorable oral-health attitudes, such as internal control, dental awareness, value of occlusion, and preventive behavior expectations than subjects with lower scores. Subjects with previous orthodontic treatment showed greater internal control and dental awareness than those who had not previously been treated. Subjects ranking high in dental esthetics and those with previous orthodontic treatment reported stricter oral-hygiene adherence than others. Self-perceived oral health was better in high scorers on dental esthetics. Less plaque accumulation was found in subjects with higher dental esthetic scores and in those with previous orthodontic treatment. CONCLUSIONS: These findings suggest that favorable dental esthetics and previous orthodontic treatment might be important variables in explaining individual differences in oral-health attitudes and behaviors.

Oral health impact in patients wearing removable prostheses: relations to somatization, pain sensitivity, and body consciousness.

PURPOSE: Previous studies investigating associations between patient personality traits and complaints related to wearing dental prostheses have been inconclusive. From the perspective of cognitive behavioral theory, the current study investigated whether pain sensitivity, body consciousness, and somatization affected the oral health of patients wearing removable dentures. MATERIALS AND METHODS: Eighty-eight patients were supplied with removable partial and complete dentures. The Oral Health Impact Profile (OHIP), with six subscales measuring oral health impairment and disability during daily living, the Pain Sensitivity Index, the Private Body Consciousness scale, and the Somatization Scale of the SCL-90-R, were used. RESULTS: The variables pain sensitivity, body consciousness, and somatization correlated significantly with all six OHIP subscales in removable denture wearers. In multiple hierarchic regression analyses, patient personality accounted for 38.0% of functional limitation and 41.5% of physical pain. CONCLUSION: Pain sensitivity and bodily preoccupation might be important factors in explaining the subjective oral health effects of removable denture wearing.

Approximal plaque and gingival sulcus bleeding in routine dental care patients: relations to life stress, somatization and depression.

OBJECTIVES: Previous research on relations between life stress and periodontal conditions was often based on indicators of periodontal destruction history and stimulus-specific measures of life stress. The present study was undertaken to compare patients showing different degrees of gingival sulcus bleeding with patients without signs of bleeding, using an instrument measuring cognitive impacts of events and assessing reported symptoms of depression and somatization. Additionally the patient groups were compared with regard to dental status and dental visiting behaviour. Analog comparisons were conducted in patients with different degrees of approximal plaque. MATERIALS AND METHODS: 140 routine dental care patients attending a private dental practice were examined. Measurement devices were the sulcus bleeding index (SBI), the approximal plaque index (API), the Dental Avoidance Scale, the Life Experience Survey (LES), the Impact of Event Scale with the subtests cognitive intrusion and cognitive avoidance, and the SCL-90-R subscales somatization and depression. RESULTS: Patients with high API scores differed from their zero-score counterparts in dental avoidance and time since last visit only. By contrast, subjects scoring high in the SBI not only had more missing teeth and reported more dental avoidance than their zero-score counterparts but also had elevated scores in intrusive and avoidant thoughts related to a stressful event as well as in symptoms of somatization and depression. No difference was found for the measure of stimulus specific recent life events (LES). CONCLUSIONS: The results suggest that cognitive preoccupation with adverse events and the presence of somatization and depression symptoms might play a role in gingival inflammation.

Dental aesthetics, self-awareness, and oral health-related quality of life in young adults.

The aim of the present study was to explore the putative relationship between dental aesthetics and oral health-related quality of life (OHRQoL), taking into consideration the potential direct and moderating influence of private and public self-consciousness. The subjects of this cross-sectional survey were 148 university students. Dental aesthetics were assessed by means of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). OHRQoL was estimated using a modification of the scales 'social appearance concern' and 'appearance disapproval', and a novel dental self-confidence scale. In addition, the private and public self-consciousness scales were used. Two-factor analyses of variance were carried out with high and low levels of dental aesthetics and private and public self-consciousness as the independent variables and the OHRQoL scales as the dependent variables. It was found that dental aesthetics had a direct effect on all OHRQoL scale values. Private self-consciousness was related to social appearance concern, while public self-consciousness was associated with both social appearance concern and appearance disapproval. An interaction effect was identified which showed that the impact of dental aesthetics on social appearance concern was stronger in respondents with high private and public self-consciousness than in low scoring subjects. The findings of the study suggest that minor differences in dental aesthetics may have a significant effect on perceived OHRQoL. This effect was more significant in subjects with high self-consciousness.

Dental trait anxiety and pain sensitivity as predictors of expected and experienced pain in stressful dental procedures.

A prevailing hypothesis suggests that exaggerated pain expectations in dentally anxious and pain-sensitive patients might usually be disconfirmed by a lower level of pain experienced during treatment. The present study was conducted to investigate whether this contention also holds during stressful dental procedures. Patients reporting high and low levels of dental fear and of pain sensitivity were compared in their expected and experienced pain and in the concordance between the two measures. Participants were 97 patients undergoing extraction and root canal treatment. The measuring instruments used were the Dental Anxiety Scale (DAS), the Pain Sensitivity Index (PSI), affective and sensory pain descriptor scales, and a numerical pain-intensity scale. The results demonstrated that patients, in general, expected more pain than they subsequently experienced. Subjects with a high DAS score both expected and experienced more pain than those with a low DAS score. Within the group of subjects with a high DAS score, those indicating high pain sensitivity expected and experienced more pain than their counterparts; additionally, only those reporting low pain sensitivity disconfirmed their high pain expectancies. The results suggest that during stressful dental procedures, patients indicating dental anxiety and pain sensitivity above median levels are especially at risk of stabilizing exaggerated pain expectations and dental fear.

[Irrational attitudes and social stress in outpatient behavior therapy: changes, prognostic and mediating influences]. / Irrationale Einstellungen und soziale Belastung bei Patienten in ambulanter Verhaltenstherapie: Verlauf, prognostische und mediierende Einflüsse auf den Behandlungserfolg.

UNLABELLED: Various studies suggest that social stress and cognitive dysfunction contribute to the development of psychiatric disorders. Their roles as moderators and mediators of recovery have rarely been studied. Aim of the present research was to investigate 1. the change of irrational attitudes and perceived social stress during outpatient behavioral treatment and their contribution to 2. the prediction and 3. mediation of success in patients with heterogeneous diagnoses. METHODS: A diagnostically unselected sample of 62 outpatients participated in a questionnaire study at the beginning and at the end of treatment. Success of treatment was assessed by the Symptom Check-List-90-R. Cognitive dysfunction was measured by the Irrational Attitudes Questionnaire (IAQ). Instruments for the assessment of perceived social stress were the Scale of Recent Life Events (SRL), the Contractual Conditions-Scale (CCS) and the Impact of Event-Scale (IES). RESULTS: 1. Psychological symptoms, irrational attitudes and perceived social stress decreased during therapy, while the number of life events remained constant. 2. Clinically reliably changed patients scored higher in Self-Blame (IAQ) than non-responders at the beginning of therapy. 3. The reduction of Negative Self-Evaluation (IAQ) was stronger in patients with clinical change than in unchanged patients. DISCUSSION: The results were disputed with reference to the literature and to limitations of the study.

Thermal regulation of membrane fluidity in Escherichia coli. Effects of overproduction of beta-ketoacyl-acyl carrier protein synthase I.

Multicopy plasmids bearing the structural gene (fabB) for beta-ketoacyl-acyl carrier protein (ACP) synthase I were constructed in vitro and transformed into various Escherichia coli strains. Introduction of these plasmids into fabB strains resulted in a fabB+ phenotype and a large (8- to 10-fold) overproduction of synthase I activity. Strains carrying these plasmids were also unusually resistant to cerulenin (an antibiotic that specifically inhibits beta-ketoacyl-ACP synthase activity) and overproduced cis-vaccenic acid. Strains (fabF-) lacking beta-ketoacyl-ACP synthase II are deficient in both cis-vaccenic acid synthesis and thermal regulation. Introduction of the fabB plasmids into these strains resulted in the restoration of cis-vaccenic acid synthesis. However, the plasmid-engendered cis-vaccenic acid synthesis of these strains was unaffected by temperature. These results demonstrate that synthase II, the product of the fabF gene, is the sole enzyme regulating the temperature-dependent composition of the membrane phospholipid acyl chains.