Câncer bucal: voz e qualidade de vida pós mutilação / Oral cancer: voice and quality of life after mutilation / Cáncer oral: voz y calidad de vida después de la mutilación

Objetivo: investigar o impacto da deformidade bucal oncológica na comunicação oral e na qualidade de vida de adultos e idosos. Métodos: estudo observacional descritivo, transversal, com abordagem mista. Amostra de 41 pacientes, submetidos à cirurgia para retirada do câncer bucal, resultando em mutilação e inteligibilidade verbal. Instrumentos: Questionário sociodemográfico; Índice de Desvantagem Vocal; Questionário Qualidade de Vida da Universidade de Washington; Roteiro Semiestruturado para análise no software Iramuteq®.Resultado: a mutilação predominou em região de palato. Avaliação vocal mostrou o sexo masculino com pior qualidade de vida, expressivamente escala Social, enquanto, o feminino, escala Física. A análise lexical mostrou necessidades, frustrações e expectativas. Conclusão: o estudo revelou a vergonha, o medo, o isolamento social e, ao mesmo tempo, a esperança de voltar a, pelo menos, poder falar e ser compreendido pelas outras pessoas através do uso da prótese

Objective: to investigate the impact of oral cancer deformity on oral communication and the quality of life of adults and the elderly. Methods: descriptive, cross-sectional observational study with a mixed approach. Sample of 41 patients undergoing surgery to remove oral cancer, resulting in mutilation and verbal intelligibility. Instruments: Sociodemographic questionnaire; Voice Handicap Index; University of Washington Quality of Life Questionnaire; Semi-structured script for analysis in the Iramuteq® software. Result: mutilation predominated in the palate region. Vocal assessment showed the male sex with worse quality of life, significantly on the Social scale, while the female, Physical scale. Lexical analysis showed needs, frustrations and expectations. Conclusion:the study revealed shame, fear, social isolation and, at the same time, the hope of returning to at least being able to talk and be understood by other people through the use of the prosthesis

Objetivo: investigar el impacto de la deformidad del cáncer oral en la comunicación oral y la calidad de vida de adultos y ancianos. Métodos: estudio observacional descriptivo, transversal con enfoque mixto. Muestra de 41 pacientes sometidos a cirugía para extirpar el cáncer oral, lo que resulta en mutilación e inteligibilidad verbal. Instrumentos: cuestionario sociodemográfico; Índice de discapacidad de voz; Cuestionario de calidad de vida de la Universidad de Washington; Guión semiestructurado para análisis en el software Iramuteq®. Resultado: la mutilación predominó en la región del paladar. La evaluación vocal mostró el sexo masculino con peor calidad de vida, significativamente en la escala social, mientras que la hembra, la escala física. El análisis léxico mostró necesidades, frustraciones y expectativas. Conclusión: el estudio reveló vergüenza, miedo, aislamiento social y, al mismo tiempo, la esperanza de volver al menos a poder hablar y ser entendido por otras personas mediante el uso de la prótesis

Impact on the Quality of Life of Older Adults Who Use Inadequate Dental Prostheses: A Cross-Sectional Study

Abstract Objective: To investigate the impact of inadequate prostheses on older adult's quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in João Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher's exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p<0.05). Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85-4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14). Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual.

Impact of Dental Rehabilitation on Oral Health-related Quality-of-life in Healthy Children and Those with Special Health Care Needs.

Aim: The aim of this study is to compare the effect of dental rehabilitation on oral health-related quality-of-life (OHRQoL) in children with special health care needs (CSHCN) and healthy children. Materials and methods: The prospective study's sample consisted of 213 parents of caries-affected children, who were aged 6 years or younger and were scheduled for dental rehabilitation under general anesthesia (DRGA). The parent-child dyads were recruited from three public hospitals in Jeddah between October 2014 and May 2016. They comprised healthy children (n = 133) and CSHCN (n = 80). Parents self-completed the early childhood oral health impact scale (ECOHIS) before and 1 month after DRGA. The parents also rated the overall oral health status of their children by answering a global question before and after DRGA. Results: At baseline, the CSHCN had significantly worse OHRQoL in most of the scale domains at 25.9 [standard deviation (SD) 11.3] and 19.9 (SD 10.3) respectively. The OHRQoL significantly improved in both groups postoperatively (p = 0.005, Wilcoxon rank-sum test). The effect size of the improvement in the CSHCN group (+1.8) was greater than that in the healthy group (+1.5) in all domains, except for the family impact and parental distress sections. Conclusion: The DRGA markedly improves OHRQoL in children aged 6 years or younger, and the improvement is even greater in CSHCN. Clinical significance: The substantial improvement in OHRQoL after DRGA highlights the importance of oral health care in young children, which should receive higher priority than it has been done to date. Keywords: Children with special health care needs, Dental caries, Early childhood oral health impact scale, General anesthesia, Oral health-related quality-of-life.

Impact of oral rehabilitation on patients with head and neck cancer: A study using the Liverpool Oral Rehabilitation Questionnaire and the Oral Health Impact Profile-14.

STATEMENT OF PROBLEM: The treatment of oral cancers affects oral functions and quality of life (QOL). Dental rehabilitation is a major step toward enhancing quality of life after controlling the disease. The effects of the disease, treatment, and rehabilitation need to be evaluated to assess oral health-related QOL. The Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) and Oral Health Impact Profile-14 (OHIP-14) are specific assessment questionnaires of oral rehabilitation. PURPOSE: The purpose of this study was to assess the impact of oral rehabilitation on patients with head and neck cancer by using the LORQv3 and OHIP-14 questionnaires and to discover and document specific patient-derived problems related to the issues of oral rehabilitation. MATERIAL AND METHODS: The LORQv3 and OHIP-14 questionnaires were administered to 60 participants with oral cancer, who were in need of oral rehabilitation. They were asked to rate their dental problems on a Likert scale before fabrication of their prostheses (baseline) and at the 3-month follow-up visit after prosthetic rehabilitation. Paired comparison was done using the Wilcoxon signed rank test according to the distribution, and Cronbach alpha was used to assess internal consistency. Subscale scores were determined by mean value (α=.05). RESULTS: For the LORQv3 questionnaire, a 10% to 27% improvement was found in the domain of oral function, and a 20% improvement in orofacial appearance, with improvement in patient satisfaction with the prosthesis. Using the OHIP-14 questionnaire, a 45% to 67% improvement was generally seen in all domains. CONCLUSIONS: After assessment using the LORQv3 and OHIP-14 questionnaires, prosthetic rehabilitation was seen to contribute to the betterment of patients with head and neck cancer.

Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency.

The aim of this non-randomized controlled clinical trial was to evaluate the oral health-related quality of life and masticatory efficiency of patients rehabilitated with mandibular two-implant overdentures with immediate loading or conventional dentures. Fifty completely edentulous patients wearing bimaxillary conventional dentures, for at least one year, were recruited. The patients were then assigned to either two treatment groups: mandibular overdentures supported by two implants with bar-clip system and a maxillary conventional denture (n = 25), and new maxillary and mandibular conventional complete dentures (n = 25). Masticatory efficiency and oral health-related quality of life were assessed before and 3 months after denture insertion. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral health-related quality of life. Masticatory efficiency was evaluated with chewing capsules through a colorimetric method. The results revealed fewer oral health-related quality of life problems in patients wearing mandibular two-implant overdentures compared to the conventional dentures group. In addition, the implant overdenture group presented statistically significant improvement in masticatory efficiency (p = 0.001). There was no correlation between masticatory efficiency and OHIP in the implant group (p > 0.05), however a correlation was found in the conventional denture group (p < 0.05). Therefore, these short-term results suggest that mandibular overdenture retained by 2 implants with immediate loading combined with maxillary conventional dentures provide better masticatory efficiency and oral health-related quality of life than mandibular conventional dentures.

The Effect of Full-Mouth Rehabilitation on Oral Health-Related Quality of Life for Children with Special Health Care Needs.

OBJECTIVES: Changes in oral health-related quality of life (OHRQoL) among 40 children with special health care needs (CSHCN) aged 5-14 years before and 12 months after full-mouth rehabilitation (FMR) under general anesthesia (GA) in two hospitals in Jeddah city were assessed. STUDY DESIGN: The questionnaire was delivered to the parents/caregivers at baseline (pre-operative) and at the 12-month post-operative follow-up visit. Medical and dental histories and clinical findings were correlated accordingly. RESULTS: The follow-up response rate was 87.5% with 35 children completing a 12-month follow-up visit. The age range was from 5 to 12 years with a mean of 7.3 ± 2.4 years. More than half of the study sample was boys (63%) in the 5-8 year age-group (69%). The impact on OHRQoL was reportedly negative before FMR under GA, with overall scores ranging from 12 to 68 and a mean of 43.34 ± 14.83. OHRQoL improved significantly in all aspects evaluated (P<0.05) following FMR under GA with overall scores ranging from 4 to 41 and a mean of 18.86 ± 8.54. CONCLUSIONS: Treating CSHCN under GA, with 3-month recall visits for the patients, had a significant long-term effect on their OHRQoL extending up to 12 months postoperatively.

Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency

Abstract The aim of this non-randomized controlled clinical trial was to evaluate the oral health-related quality of life and masticatory efficiency of patients rehabilitated with mandibular two-implant overdentures with immediate loading or conventional dentures. Fifty completely edentulous patients wearing bimaxillary conventional dentures, for at least one year, were recruited. The patients were then assigned to either two treatment groups: mandibular overdentures supported by two implants with bar-clip system and a maxillary conventional denture (n = 25), and new maxillary and mandibular conventional complete dentures (n = 25). Masticatory efficiency and oral health-related quality of life were assessed before and 3 months after denture insertion. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral health-related quality of life. Masticatory efficiency was evaluated with chewing capsules through a colorimetric method. The results revealed fewer oral health-related quality of life problems in patients wearing mandibular two-implant overdentures compared to the conventional dentures group. In addition, the implant overdenture group presented statistically significant improvement in masticatory efficiency (p = 0.001). There was no correlation between masticatory efficiency and OHIP in the implant group (p > 0.05), however a correlation was found in the conventional denture group (p < 0.05). Therefore, these short-term results suggest that mandibular overdenture retained by 2 implants with immediate loading combined with maxillary conventional dentures provide better masticatory efficiency and oral health-related quality of life than mandibular conventional dentures.

Validation of the Geriatric Oral Health Assessment Index in complete denture wearers.

To perform a validation of the Geriatric Oral Health Assessment Index (GOHAI) for complete denture wearers and present a proposal for estimation of perceived oral health. This is a cross-sectional study with non-probabilistic sampling. A total of 211 subjects with a mean age of 62·5 (s.d. = 11·4) years participated, being 169 female. The GOHAI was applied in a personal interview. The construct/convergent/discriminant validity was tested using structural equation modelling. Confirmatory factor analysis was used to verify the fit of three proposals of the GOHAI: three-factor, one-factor and second-order hierarchical models. The stability of the models was evaluated in independent samples. The three-factor model presented an inadequate fit, and items 3, 4 and 9 were removed. The new structure presented an acceptable fit and strong invariance in independent samples. The convergent, discriminant validity and internal consistency were below adequate. The one-factor model presented an adequate fit to the sample. Convergent validity was compromised. A strong invariance of the one-factor model was observed. To calculate the overall scores of the GOHAI factors (three-factor model) or of the oral health perception (one-factor model), a matrix of regression weights for each item in the model was presented as a suggestion. We found an adequate fit of the both structures of the GOHAI for denture wearers, but the three-factor structure was more parsimonious. We suggested considering the weights of the regression model to calculate the overall score of perceived oral health or of its factors in different samples.

Opciones de tratamiento prótésico en niños con oligodoncias por displasia ectodérmica hidrótica / Prosthetic treatment options for children with oligodontia due to hidrotic ectodermal dysplasia

La reposición de los dientes no solamente influye en la adecuada alimentación y fonética, sino que también mejora la sonrisa y la apariencia personal, además del aspecto positivo que produce en el estado de salud psicológico y emocional de los niños afectados. Se presentan tres casos clínicos de niños con oligodoncias asociadas a displasia ectodérmica hidrótica, atendidos en la consulta de prótesis de la Clínica Estomatológica de Especialidades de Cienfuegos. Fueron rehabilitados con prótesis parcial removible acrílica, sobredentadura y prótesis parcial fija, respectivamente. Estas constituyen opciones de tratamiento efectivas, que solucionan el problema estético y funcional de los pacientes, y por tanto, mejoran su calidad de vida(AU)

Replacement of teeth not only contributes to adequate nutrition and phonetics, but also improves the smile and appearance, in addition to its positive impact on the psychological and emotional health of the affected children. Three cases of children with oligodontias associated with hidrotic ectodermal dysplasia who were treated at the prosthetics consultation of the Specialized Dental Clinic in Cienfuegos are presented. They were rehabilitated through acrylic removable partial dentures, overdenture and fixed partial denture, respectively. These are effective treatment options that solve the aesthetic and functional problems of the patients, and therefore improve their quality of life(AU)

Impact of rehabilitation with metal-ceramic restorations on oral health-related quality of life.

Dental ceramics present excellent ability to reproduce the natural teeth regarding esthetic and biomechanics. Recently, due to the advancement of ceramic technology, metal-free restorations were developed. However, the traditional metal-ceramic restorations still present the requirements of high strength, long survival in the oral environment and favorable aesthetics. In this context, it is essential to know the specificity of each ceramic system available in order to apply it properly to various clinical situations. This report describes an integrated rehabilitation using metal-ceramic restorations of a patient at 50 years of age, who presented edentulous spaces, and previous unsatisfactory composite and amalgam restorations, and indirect metallic restorations, leading to compromised quality of life in both functional and psychosocial aspects. The impact on quality of life was measured using a generic instrument, OHIP-14, validated for the World Health Organization, which covers both the biological and the psychosocial dimensions. This instrument was applied to the patient before and after treatment. The patient had an overall OHIP-14 score of 28 before the treatment and after treatment the score decreased to 0, showing that dental and oral health conditions are factors that do impact on the quality of life. Rehabilitation has provided functional and aesthetic restorations, harmony of the stomatognathic system and improvement of life quality.

Impact of rehabilitation with metal-ceramic restorations on oral health-related quality of life

Dental ceramics present excellent ability to reproduce the natural teeth regarding esthetic and biomechanics. Recently, due to the advancement of ceramic technology, metal-free restorations were developed. However, the traditional metal-ceramic restorations still present the requirements of high strength, long survival in the oral environment and favorable aesthetics. In this context, it is essential to know the specificity of each ceramic system available in order to apply it properly to various clinical situations. This report describes an integrated rehabilitation using metal-ceramic restorations of a patient at 50 years of age, who presented edentulous spaces, and previous unsatisfactory composite and amalgam restorations, and indirect metallic restorations, leading to compromised quality of life in both functional and psychosocial aspects. The impact on quality of life was measured using a generic instrument, OHIP-14, validated for the World Health Organization, which covers both the biological and the psychosocial dimensions. This instrument was applied to the patient before and after treatment. The patient had an overall OHIP-14 score of 28 before the treatment and after treatment the score decreased to 0, showing that dental and oral health conditions are factors that do impact on the quality of life. Rehabilitation has provided functional and aesthetic restorations, harmony of the stomatognathic system and improvement of life quality.

As cerâmicas dentais são conhecidas pela excelência em reproduzir artificialmente dentes naturais. Recentemente, devido ao aprimoramento da tecnologia cerâmica, surgiram as restaurações livres de metal. Entretanto, as tradicionais metalocerâmicas ainda preenchem adequadamente os requisitos de alta resistência, longa sobrevida em meio bucal e estética favorável. Neste contexto, é fundamental conhecer a especificidade de cada sistema cerâmico a fim de indicá-lo adequadamente às diversas situações clínicas. Este artigo relata um caso de reabilitação integral e integrada de paciente de 50 anos de idade, portador de espaços edêntulos, restaurações protéticas posteriores e restaurações diretas anteriores insatisfatórias, resultando em comprometimento da qualidade de vida nos âmbitos funcional e psicossocial, utilizando coroas metalocerâmicas. O impacto na qualidade de vida foi mensurado utilizando um instrumento genérico, OHIP-14, validado pela Organização Mundial de Saúde, que abrange tanto a dimensão biológica, como a dimensão psicossocial. Este instrumento foi aplicado à paciente antes e após o tratamento, obtendo pontuação total de 28 e 0 respectivamente, o que mostra que a condição de saúde oral representa fator de grande impacto sobre a qualidade de vida. A reabilitação oral proporcionou restabelecimento funcional e estético, harmonia do sistema estomatognático e melhoria da qualidade de vida da paciente.

Patients' and dentists' perception of dental appearance.

The purpose of this study was to compare the patients' and dentists' perception of dental appearance. Based on internationally accepted guidelines about dental esthetics, a questionnaire was developed to measure "dental appearance" (QDA). Eleven items defined a QDA sum score (0 = "absolutely satisfied", 44 = "absolutely dissatisfied"). The QDA was completed by 16 patients (eight women, eight men, mean age 63 ± 9 years) before and after a complete oral rehabilitation. Forty-two dentists evaluated the esthetics before and after rehabilitation on a visual analog scale (VAS, 0 = "absolutely unesthetic", 100 = "absolutely esthetic"). The patients' quoting showed a significant esthetic improvement (QDA sum score) from 22 before treatment to 3.5 after treatment (P ≤ 0.001). Although most of the dentists judged an improvement in most of the patients dental appearances, no significant correlation could be found between patients' and dentists' judgment regarding dental appearance (r = -0.13-0.53, P > 0.05). When evaluating the influence of age, gender, and experience on rating dental appearance, no significant differences (P > 0.05) could be found.

Implantes com carga imediata / Immediate load system implants

A carga imediata é usada para definir os implantes que sofrem carga mastigatória em seguida, consecutivamente após a realização dos estágios cirúrgicos e protéticos. O protocolo cirúrgico de um só passo envolve a aplicação de carga imediata nos implantes dentais, ou seja, a colocação de uma prótese provisória logo após o procedimento cirúrgico, representando uma alternativa viável para a reabilitação de pacientes com perda parcial ou total dos dentes. Essa técnica oferece aos profissionais e pacientes, muitas vantagens, pois possibilita a diminuição dos custos, evita uma segunda intervenção e diminui o tempo de tratamento, restabelecendo a estética e a função.

The immediate load system is used to define the implants suffering masticatory load then consecutively after both surgical and prosthetic stages. The surgical protocol of one step involves the application of immediate load dental implants or the placement of a temporary prosthesis immediately after surgery, representing a viable alternative for the rehabilitation of patients with partial or total loss of teeth. This technique offers professionals and patients, many advantages because it enables the reduction of costs, avoids a second surgical procedure and reduces the treatment time, restoring aesthetics and function.

A national survey of oral and maxillofacial surgeons' attitudes towards the treatment and dental rehabilitation of oral cancer patients.

AIMS: To investigate the attitudes of maxillofacial surgeons in the treatment and dental rehabilitation of oral cancer patients in the UK. MATERIAL AND METHODS: The survey was conducted by postal questionnaires with 17 close-ended questions. A total of 229 questionnaires were sent to members of the British Association of Oral and Maxillofacial Surgeons over a one week period. A follow-up was sent if a reply was not received within 12 weeks. These results were compared to a similar study that was carried out approximately 15 years ago. RESULTS: The response rate was 65.5% (150/229). Overall 62% of respondents (92/150) carried out maxillary resections, which represents a decline of 23% on the previous study. There has been an increase in surgeons reconstructing the maxillary defect from 38% in the 1995 study to 91% in the present study. Ninety-eight percent of respondents had their patients seen in a multidisciplinary team (MDT) clinic, but in only 30% of the cases was a restorative dentist present on these clinics. There has been an improvement in the accessibility of a restorative dentist for this patient cohort, from 65% to 90%. The use of implants for dental rehabilitation post-cancer surgery has increased from 43% to 93%. CONCLUSION: This study highlights the changes in the dental and oral rehabilitation of patients undergoing resective surgery for oral cancer and especially those undergoing a maxillectomy procedure. It illustrates the increased use of implants for post-surgery rehabilitation and shows the different trends in which these implants are placed. An important aspect of this study is the input of the dental team. Current national guidelines state that a consultant restorative dentist needs to be a member of the MDT; this survey shows that this was the case in only 30% of responses.

The responsiveness of the Liverpool Oral Rehabilitation Questionnaire (LORQ): a pilot study.

This study aimed to evaluate the responsiveness of denture patients to the Liverpool Oral Rehabilitation Questionnaire (LORQ). Changes in scores for 20 core items completed from 2000 to 2005 by 16 patients both before and after oral rehabilitation were assessed. The median age of respondents was 68 years and the median time between questionnaires was 2.6 years. Results indicated that masticatory efficiency impacted both food choice (P = .03) and social life (P = .06). After rehabilitation there was less worry about maxillary prostheses falling out (P = .07), less embarrassment while conversing (P = .02), and less worry about losing self-confidence from embarrassment caused by dentures (P = .06). Also, drooling problems deteriorated (P = .03). This exploratory study reports encouraging findings, but a larger prospective multicenter study is required to determine the responsiveness of the current version of the LORQ (version 3).

[Characteristics of the esthetic and functional rehabilitation of elderly and old patients in case of dental implants application].

The article presents the data of long-term application of one of the methods for effective rehabilitation of old and oldest-old patients with complete adentia accompanied by marked atrophy of jawbones alveolar crest. Peculiarities of the clinical stages of implant installation, clinical and laboratory stages of production of removable metal-acryl prostheses fixed to mesostructures on implants with a help of lock-attachment elements are described.

The further development and validation of the Liverpool Oral Rehabilitation Questionnaire: a cross-sectional survey of patients attending for oral rehabilitation and general dental practice.

BACKGROUND: Since the first version of the Liverpool Oral Rehabilitation Questionnaire (LORQ) was first published in 2004, the questionnaire has been modified to include more detail on chewing and appearance, and also details of denture, dental and implant status. AIM: The aim of this study is to report the ongoing development and validation of the LORQ version3. METHODS: A postal survey of the LORQv3 and OHIP-14 questionnaires was performed in April 2004 of 164 patients who had attended the oral rehabilitation clinic from February 2000. In addition The LORQv3 was administered to 349 patients attending six General Dental Practices, based in Liverpool, attending for routine care. RESULTS: Patients attending GDP scored appreciably better on most items in the LORQv3. The questionnaire discriminated between cancer and non-cancer oral rehabilitation patients in items such as swallowing, chewing, trismus, drooling and food clearance. There was no significant difference between rehabilitation groups for any of the seven OHIP-14 domains. The LORQv3 demonstrated good criterion validity when compared to the OHIP-14 with social items in the LORQv3 correlating well with items of the OHIP-14. Conversely various LORQv3 items did not have strong correlates within the OHIP-14 thus endorsing the additional items in the LORQv3.

Parental perceptions of oral health-related quality of life for children with special needs: impact of oral rehabilitation under general anesthesia.

PURPOSE: The purposes of this study were to: (1) describe the symptoms, daily life problems and parental concerns related to oral health for children with special health care needs; and (2) examine the effectiveness of oral rehabilitation under general anesthesia at improving quality of life (QOL). METHODS: A single-group design measuring change over time was used. Family caregivers of 107 children with special needs, for whom oral rehabilitation under general anesthesia was recommended, completed a QOL survey upon dental examination. RESULTS: Seventy-three children underwent oral rehabilitation, and 50 completed a follow-up survey. The most frequent survey responses before oral rehabilitation were: (1) spontaneous toothache and pain with hot/cold temperatures (oral symptoms); (2) difficulty eating and sleeping (daily life problems); and (3) worrying about eating and nutrition (parental concerns). Severity ratings for oral symptoms, daily life problems, and parental concerns were significantly lower (P<.001), and scores for oral well-being were significantly higher (P<.001) following oral rehabilitation. CONCLUSIONS: Family caregivers of special health care needs patients report a variety of oral symptoms, daily life problems, and concerns attributable to their child's oral health that impact QOL. Oral rehabilitation under general anesthesia is effective at improving QOL for special health care needs children and their families.