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1.
J Oral Rehabil ; 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33300205

RESUMO

Dental patient-reported outcomes (dPROs) describe how dental patients suffer from oral diseases.1 Thus, dPROs are fundamental for evidence-based dentistry across dental disciplines.2 They are essential to evaluate treatment efficacy and to reduce research waste by addressing questions relevant to clinicians and capturing what matters most to patients.3 Doctor-patient communication centers around them,4 and they are necessary components for value-based oral health care, a concept that relates outcomes to costs.5 Oral health-related quality of life (OHRQoL) is the most important dPRO. Recent studies have demonstrated that OHRQoL has four main components, so called dimensions - Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact.6-8 These four dimensions, characterized by four scores, would allow to "map" all 1,323 oral diseases1 with one, single metric, thus describing oral disease impact with a standardized impact metric across all conditions in all settings. Meta-analytic statistical techniques are available to synthesize these multiple outcomes from differences sources.

2.
J Public Health Dent ; 2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33305385

RESUMO

OBJECTIVES: a) To evaluate the item and scale properties of the Oral Health Literacy Adults Questionnaire (OHL-AQ) in an adult general population. b) To determine precision or accuracy of the respondents' estimated scores along the Oral Health Literacy (OHL) spectrum using item response theory (IRT) modeling. METHODS: Survey data were collected from a convenience sample of 405 adult attendees of the 2014 Minnesota State Fair. We used the two-parameter logistic (2PL) model for the item response theory (IRT) analyses of OHL-AQ data and calibrated items to estimate model-based item difficulty and discrimination parameters. Item and scale properties were also assessed by plotting and interpreting item characteristic curves (ICCs), test characteristic curve (TCC), and test information function (TIF). RESULTS: Based on interpretation of model coefficients, statistical testing, and model fit criteria, we deemed the 2PL model superior and selected this model to examine item and scale properties. Scale reliability was shown to be good through the test information function (TIF). TIF from our analysis showed that higher levels of OHL were measured less precisely than lower levels of OHL. CONCLUSION: We demonstrated OHL-AQ as a whole has promising psychometric properties. However, for equiprecise measurement across the scale range, the scale needs more items for measuring higher levels of OHL.

3.
J Oral Rehabil ; 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33006787

RESUMO

OBJECTIVES: To investigate differential item functioning across the Spanish and English versions of the Orofacial Esthetic Scale (OES). METHODS: OES data were collected from a consecutive sample of a total of 622 adult dental patients (311 English- and 311 Spanish-speaking adults) from HealthPartners dental clinics in Minnesota. We inspected boundary characteristic curves (BCCs) based on item response theory (IRT) in English speakers and Spanish speakers to examine differential item functioning (DIF). Using the Samejima's graded response model, we used the item response theory log-likelihood ratio (IRTLR) approach to test whether DIF was statistically significant. RESULTS: Inspection of the BCCs did not reveal substantial differences in item difficulty and discrimination between English speakers and Spanish speakers. When IRTLR tests were performed for the seven OES items, no item was flagged with significant DIF after P-values were adjusted for multiple comparisons. CONCLUSIONS: Pooling of Orofacial Esthetic Scale (OES) data from English and Spanish-speaking dental patients for analysis and interpretation is supported by the absence of differential item functioning (DIF) across the two language groups.

4.
J Evid Based Dent Pract ; 20(3): 101459, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32921379

RESUMO

OBJECTIVE: The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. METHODS: Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated. RESULTS: For every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering. CONCLUSION: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.


Assuntos
Saúde Bucal , Qualidade de Vida , Odontólogos , Humanos , Inquéritos e Questionários , Organização Mundial da Saúde
5.
Zdr Varst ; 59(2): 65-74, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32952705

RESUMO

Objectives: To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population. Methods: A cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients' data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile-version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL. Results: Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52-0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51-0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47-0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit. Conclusions: OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients' general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients' OHRQoL as well as HRQoL.

6.
J Oral Rehabil ; 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-32658317

RESUMO

Oral health-related quality of life (OHRQOL) is the component of health-related quality of life that relates to the effects of oral diseases and dental interventions on patients. This article describes why OHRQOL is important and how it is measured. The conceptual basis for OHRQOL is discussed. A four-dimensional structure consisting of Oral Function, Orofacial Pain, Orofacial Appearance and Psychosocial Impact as the OHRQOL dimensions has emerged as psychometrically sound and clinically intuitive. Consequently, when the impact of oral diseases or the effects of dental interventions are measured, four dimension scores capturing these attributes need to be used.

7.
J Oral Rehabil ; 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32628288

RESUMO

BACKGROUND: Knowledge about the magnitude of Oral Health-Related Quality of Life (OHRQoL) impairment across dental patient populations is essential for clinical practice, public health and research. Within the project Mapping Oral Disease Impact with a Common Metric, this systematic review aimed to describe functional, pain-related, aesthetic and broader psychosocial impact of oral conditions with a single metric using OHRQoL dimensions Oral Function, Oro facial Pain, Oro facial Appearance and Psychosocial Impact. METHODS: A search using PubMed, EMBASE, Cochrane, CINAHL and PsycINFO was performed on 8 June 2017, and updated on 14 January 2019. Only publications in the English language were considered. To characterise the extent of available standardised and clinically relevant OHRQoL information, we determined the number of publications, dental patient populations, which are clinically similar, and patient samples within each population with four-dimensional OHRQoL information using the Oral Health Impact Profile (OHIP) questionnaire. A quality assessment and a publication bias assessment were performed. RESULTS: We identified 171 publications that characterised 199 dental populations and 329 patient samples with four-dimensional OHRQoL information. The vast majority of populations were only characterised by one patient sample. Study quality was not related to OHRQoL magnitude, and substantial publication bias could be excluded. CONCLUSIONS: Standardised and clinically relevant information using the four OHRQoL dimensions Oral Function, Oro facial Pain, Oro facial Appearance and Psychosocial Impact was available for a significant number of dental patient populations. Findings can provide a framework to interpret OHRQoL impairment of individual patients, or groups of patients, for clinical practice, public health and research.

8.
J Evid Based Dent Pract ; 20(1): 101403, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32381410

RESUMO

OBJECTIVES: Dental research typically targets multiple outcomes. Interdental cleaning devices such as interdental brushes (IB) and water jet devices (WJ) share a sizable portion of the medical device market. However, recommendations for device selection are limited by the conflicting evidence from multiple outcomes in available studies and the lack of an appropriate synthesis approach to summarize evidences taken from multiple outcomes. In particular, both pairwise meta-analyses and single-outcome network meta-analyses can give discordant results. The purpose of this multioutcome, Bayesian network meta-analysis is to introduce this innovative method to the dental research community using data from interdental cleaning device studies for illustrative purposes. METHODS: We reanalyzed a network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation, which included 22 trials assessing 10 interproximal oral hygiene aids. We focused on the primary outcome of gingival inflammation, which was measured by 2 correlated outcome variables, the Gingival Index (GI) and bleeding on probing (BOP). RESULTS: In our previous single-outcome analysis, we concluded that IB and WJ rank high for reducing gingival inflammation while toothpick and flossing rank last. In this multioutcome Bayesian network meta-analysis with equal weight on GI and BOP, the surface under the cumulative ranking curve was 0.87 for WJ and 0.85 for IB. WJ and IB remained ranked as the 2 best devices across different sets of weightings for the GI and BOP. CONCLUSION: In conclusion, multioutcome Bayesian network meta-analysis naturally takes the correlations among multiple outcomes into account, which in turn can provide more comprehensive evidence.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária , Teorema de Bayes , Pesquisa em Odontologia , Humanos , Metanálise em Rede , Escovação Dentária
9.
PeerJ ; 8: e8814, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32211245

RESUMO

Background: The Orofacial Esthetic Scale (OES) is an instrument to assess an individual's perception of their Orofacial Appearance (OA). However, its translation and evaluation of psychometric properties is necessary for its use in Brazilian individuals. Objectives: To develop the Portuguese version of OES (OES-Pt), estimate its psychometric properties (validity, measurement invariance and reliability) when applied to Brazilian individuals aged 18-40 years, and estimate the relationship between sociodemographic characteristics and OA. Methods: This was a cross-sectional study using a convenience sample. The sample consisted of 1,072 Brazilian individuals (70.1% female, 25.1% dental patients; mean ± SD age: 25.7 ± 5.7 years). After cross-cultural adaptation of OES-Pt, factorial validity was evaluated by confirmatory factor analysis. Convergent validity (average variance extracted (AVE)) and reliability (Cronbach's alpha coefficient (α) and Composite Reliability (CR)) were also estimated. Concurrent validity was assessed (Pearson's correlational analysis (r) between OES-Pt total score and item eight of the OES which refers to global assessment of OA). Measurement invariance of the factorial model (multigroup analysis using ΔCFI) was evaluated for independent samples (sample randomly split into two: "Test Sample" and "Validation Sample" and according to sex: male and female, age range: 18-30 and 31-40 years, and whether the individual is undergoing dental treatment or not). A Structural Equation Model estimated the relationship between sociodemographic characteristics and OA. Results: OES-Pt presented adequate fit to the sample. Convergent validity (AVE ≥ 0.56) and reliability (α and CR ≥ 0.89) were adequate. Concurrent validity was adequate (r = 0.88; p-value < 0.001). OES-Pt presented strict invariance for independent samples. Age, sex, and socioeconomic status (SES) were related to OA, indicated by standardized beta coefficients (standardized ß) of 0.036 (standard error: 0.007), 0.001 (0.094) and 0.196 (0.061), respectively on OA. These three relationships were either weak or not statistically significant. Conclusions: When measuring OA in Brazilian individuals, the OES-Pt was valid, reliable and invariant for independent samples. Age, sex and SES were weak or not statistically significantly related to OA.

10.
Int Dent J ; 70(2): 127-135, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31750546

RESUMO

OBJECTIVE: To test validity and reliability of the Spanish version of the 5-item Oral Health Impact Profile (OHIP-Sp5). METHODS: Spanish-speaking dental patients (n = 331, response rate = 61%, age: 42.9 + 12.3 years, 59% female) with a scheduled appointment at HealthPartners dental clinics in Minnesota, USA, were investigated. To assess score reliability, we computed Cronbach's alpha, expecting 'good' reliability (alpha > 0.70). To assess score validity, we correlated the OHIP-Sp5 summary score with five OHRQoL measures [49- and 14-item OHIP-Sp, the Spanish version of the General Oral Health Assessment Index (GOHAI-Sp), the Spanish version of the Oral Impacts on Daily Performances (OIDP-Sp) and a Global Oral Health Assessment]. We expected a pattern of 'very large' (r > 0.70) correlation coefficients for OHIP-Sp5 relationships with the two longer OHIP-Sp versions and 'large' (r > 0.50) correlation coefficients for the other three measures. RESULTS: Patients had a mean OHIP-Sp5 score of 3.7 (SD = 4.0). The Instrument's reliability was, as expected, 'good', according to the Cronbach's alpha statistic of 0.83. The Instrument's validity was supported by the expected pattern of validity coefficients. OHIP-Sp5 summary scores correlated with OHIP-Sp14 as well as with OHIP-Sp49 (both r = 0.95: 'very large' effect) and with GOHAI-Sp, OIDP and the Global Oral Health Assessment with r = -0.80, 0.73, and -0.56 (absolute effect magnitude all 'very large' or 'large'), respectively. CONCLUSIONS: The Spanish version of OHIP-5 is a brief and psychometrically sound instrument to measure oral health-related quality of life (OHRQoL) in Spanish-speaking populations. It can effectively replace longer OHIP instruments and would be applicable across all settings of clinical practice and research.


Assuntos
Saúde Bucal , Qualidade de Vida , Adulto , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Perfil de Impacto da Doença , Inquéritos e Questionários
11.
J Evid Based Dent Pract ; 19(1): 53-70, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30926102

RESUMO

OBJECTIVES: Patient-reported outcomes (PROs) are used beside disease-oriented outcomes (eg, number of teeth, clinical attachment level) to better capture the impact of diseases or interventions. To assess PROs for dental patients (dPROs), dental PRO measures (dPROMs) are applied. The aim of this systematic review was to identify generic dPROMs for adult patients and the dPROs. METHODS: This systematic review searched the MEDLINE, Embase, and PsycINFO databases along with hand searching, through December 2017, to identify English-language, multi-item dPROMs that are oral health generic, that is, they are applicable to a broad range of adult patients. RESULTS: We identified 20 questionnaires that contained 36 unique dPROs. They were measured by 53 dPROMs. dPRO names (N = 36) suggested they could be grouped into four dPRO categories: (1) Oral Function (N = 11), Orofacial Pain (N = 7), Orofacial Appearance (N = 3), and Psychosocial Impact (N = 14), as well as an additional dPRO that represented perceived oral health in general. Only eight questionnaires had a specific recall or reference period. dPROM's score dimensionality was only investigated in 13 of the 20 questionnaires. CONCLUSIONS: The identified 36 dPROs represent the major aspects of an adult dental patient's oral health experience; however, four major dPRO categories, that is, Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, summarize how patients are impacted. If multi-item, oral health-generic dPROMs are to be used to measure patients' suffering, the 53 dPROMs represent current available tools. Limitations of the majority of these dPROMs include incomplete knowledge about their dimensionality, which affects their validity, and an unspecified recall period, which reduces their clinical applicability.


Assuntos
Assistência Odontológica , Saúde Bucal , Medidas de Resultados Relatados pelo Paciente , Adulto , Diagnóstico Bucal , Humanos , Qualidade de Vida , Inquéritos e Questionários
12.
J Am Dent Assoc ; 150(4): 278-286, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30922458

RESUMO

BACKGROUND: This study aimed to determine the psychometric properties of the English-language version of the Orofacial Esthetic Scale (OES-E) in a population of dental patients. METHODS: In this cross-sectional study, 1,784 English-speaking, adult dental patients (mean age, 56.7 [standard deviation, 15.8] years; 60.0% women) were included. The 8-item OES-E was used to assess orofacial appearance. Dimensionality of the OES was investigated through an analysis of the items' correlation matrix, a parallel analysis, and an exploratory factor analysis. Convergent validity was determined by means of several correlations between the OES and items of the Oral Health Impact Profile measuring orofacial appearance. Reliability of the OES was assessed as the instrument's internal consistency by means of computing Cronbach α and average interitem correlation. RESULTS: All analyses for dimensionality revealed that the OES is sufficiently represented by a single factor. Convergent validity was supported by means of the correlations of the OES summary score with the other measures of the construct with Pearson product moment and Spearman rank correlation coefficients of the expected size and direction. Cronbach α (lower boundary of 95% confidence interval, 0.94) and average interitem correlation (0.70) revealed that the scale's internal consistency was excellent. CONCLUSION: This study found that the OES-E has sufficient psychometric properties to characterize dental patient's global assessment of orofacial appearance. PRACTICAL IMPLICATIONS: The brevity and the easy application make the OES a pragmatic tool to clinically appraise the important construct of orofacial appearance in dental patients.


Assuntos
Estética Dentária , Idioma , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários
13.
Int Dent J ; 69(3): 207-213, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30525199

RESUMO

OBJECTIVES: The Oral Health Literacy Adults Questionnaire (OHL-AQ) was designed to test functional oral health literacy in general populations. Exploratory analyses suggested a unidimensional structure rather than the four constructs proposed (reading comprehension, numeracy, listening and decision-making). The purpose of this study was to conduct a confirmatory analysis of the OHL-AQ. METHODS: A cross-sectional study design used a stratified multistage sampling strategy in 22 districts of Tehran, Iran. The OHL-AQ was administered verbally in its original Persian language. Confirmatory analyses replicated the previous exploratory analyses to determine dimensionality and internal consistency. Data were then randomly assigned to two data sets and item analyses were performed to test reliability. RESULTS: Evidence of unidimensionality was confirmed as the exploratory factor analysis could replicate previous results in a different population. In a confirmatory factor analysis, model fit indicators were mixed because chi-square results were statistically significant and the standard root mean square residual (SRMR) neared guideline values. The comparative fit index (CFI) and the Tucker-Lewis index (TLI) did not meet recommended values but the root mean square error of approximation (RMSEA) was well within standards. Both score validity and reliability were adequate. CONCLUSIONS: While findings overall support that OHL measured using the OHL-AQ can be considered unidimensional and therefore OHL can be characterised with one score, further dimensionality studies are needed to investigate populations in which OHL is low.


Assuntos
Letramento em Saúde , Adulto , Estudos Transversais , Humanos , Irã (Geográfico) , Saúde Bucal , Reprodutibilidade dos Testes , Inquéritos e Questionários
14.
J Dent ; 80: 55-62, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30355509

RESUMO

OBJECTIVES: To compare oral health-related quality of life (OHRQoL) in patients with either molar replacement by partial removable dental prostheses (PRDP) or with restored shortened dental arches (SDA) over a period of 10 years. METHODS: In this multi-center RCT, a consecutive sample of 215 patients with bilateral molar loss in at least one jaw was initially recruited in 14 prosthodontic departments. Of those patients, 150 could be randomly allocated to the treatment groups (SDA: n = 71; PRDP: n = 79), received the allocated treatment, and were available for follow-up assessments. OHRQoL was assessed using the 49-item version of the Oral Health Impact Profile (OHIP) before treatment (baseline) and at follow-ups after treatment (4-8 weeks and 6, 12, 24, 36, 48, 60, 96, and 120 months). To investigate the course of OHRQoL over time, we longitudinally modelled treatment and time effects using mixed-effects models. RESULTS: OHRQoL substantially improved from baseline to first follow-up in both groups indicated by a mean decrease in OHIP scores of 20.0 points (95%-CI: 12.5-27.5). When compared to the SDA group, OHRQoL in the PRDP group was not significantly different (-0.6 OHIP points; 95%-CI: -7.1 to 5.9) during the study period when assuming a constant time effect. OHRQoL remained stable over the 10 years with a statistically insignificant time effect (p = 0.848). CONCLUSIONS: For patients requesting prosthodontic treatment for their lost molars, treatments with SDA or PRDP improve clinically relevantly OHRQoL and maintain it over a period of 10 years with no option being superior to the other. CLINICAL SIGNIFICANCE: Since there was no significant difference between the two treatment options over the observation period of 10 years, and since results have stayed stable over time, patients can be informed that both treatment concepts are equivalent concerning OHRQoL.


Assuntos
Arco Dental , Prótese Parcial Removível , Humanos , Saúde Bucal , Qualidade de Vida , Inquéritos e Questionários
15.
Oral Dis ; 25(2): 580-587, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30447172

RESUMO

OBJECTIVES: For jaw functional limitations measured by the Jaw Functional Limitation Scale (JFLS), (a) determining prevalence in the Swedish general adult population, (b) investigating the influence of demographic factors and self-reported dental status and (c) deriving normative values. METHODS: A random sample of the general adult population in Sweden was approached (response rate: 46%, N = 1,372). Prevalence was determined for the JFLS summary score and individual items. The influence of age, gender and dental status was investigated with regression analyses and normative values presented. RESULTS: The JFLS median score was 0, and all items had prevalences ≤30%. Age and gender did not influence jaw functional limitations but dental status did. Normative JFLS scores were 1, 9 and 28 for the 7th, 8th and 9th deciles, respectively. In dental status-stratified norms, 9th deciles were 20, 43 and 100, for subjects with natural teeth only, removable and complete dentures, respectively. CONCLUSIONS: The Swedish general adult population had excellent jaw function, but dental status was major determinant. In the absence of information linking JFLS scores to important patient concerns, the score distribution can serve as a reference with the 9th decile as threshold for functional limitation.


Assuntos
Doenças Maxilomandibulares/epidemiologia , Arcada Osseodentária/fisiologia , Estudos Transversais , Dentição Permanente , Prótese Total , Prótese Parcial Removível , Feminino , Humanos , Doenças Maxilomandibulares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Valores de Referência , Suécia/epidemiologia
16.
J Evid Based Dent Pract ; 18(4): 332-335, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30514446

RESUMO

To assess the impact of care on patients, patient-reported outcomes (PROs) are essential because they characterize patients' suffering. Patient-reported outcome measures (PROMs) are the instruments to assess PROs. Any report of the patient's oral health condition that comes directly from the patient is a dental patient-reported outcome (dPRO). Similar to oral health being a component of health in general, dPROs are a part of PROs. dPROs target four major areas of patients' suffering because dental patients typically seek care to improve oral function and orofacial appearance as well as to decrease pain and psychosocial impact related to oral conditions. dPROs capture what matters to dental patients. They characterize the specific influences of oral health on patients' lives. Dental patient-reported outcome measures (dPROMs) capture this influence and express it numerically in a score. Consequently, dPROs in general and Oral Function, Orofacial Appearance, Orofacial Pain, as well as Psychosocial Impact (related to oral conditions) in particular are the major targets for dental interventions in clinical practice as well as for oral health research.


Assuntos
Assistência Odontológica , Saúde Bucal , Humanos , Qualidade de Vida
17.
J Health Care Poor Underserved ; 29(3): 1135-1152, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30122688

RESUMO

This study explored the acceptability of dental therapists by respondents' socioeconomic factors and oral health status. METHODS: Data were collected from 405 adults during the 2014 Minnesota State Fair through completion of an electronic questionnaire and a modified Basic Screening Survey (BSS). RESULTS: This study found no relevant and statistically significant relationships between a respondent's various socioeconomic factors and their acceptability of care provided by a dental therapist. It also demonstrated no association between participants' perceived or physical oral health status and their acceptability of care provided by a dental therapist. CONCLUSIONS: The acceptability of care provided by a dental therapist is neither related to socioeconomic characteristics nor perceived or physical oral health. PRACTICAL IMPLICATIONS: While advancing the acceptability of dental therapists faces many challenges, the patient's socioeconomic profile and his/her oral health status are not among them.


Assuntos
Auxiliares de Odontologia , Assistência Odontológica/estatística & dados numéricos , Disparidades em Assistência à Saúde/economia , Saúde Bucal/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Minnesota , Fatores Socioeconômicos , Inquéritos e Questionários
18.
J Prosthodont Res ; 62(4): 456-461, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29866446

RESUMO

PURPOSE: To develop a Spanish version of the Orofacial Esthetic Scale (OES-Sp) and to determine its psychometric properties in dental patients. METHODS: We performed a validation study for OES development and validation into Spanish. In the development phase, eight individuals participated in the translation process (cross-cultural adaptation) following the PROMIS methodology. In the validation phase, 331 dental patients (age mean±sd: 42.9±12.3years, 59 % female) from the HealthPartners dental clinics in Minnesota, USA responded to a survey of Spanish speaking patients (n=540, response rate: 61 %). We first explored dimensionality by means of exploratory factor analysis and scree plot, and then we computed reliability measures with the Cronbach's alpha statistic. Finally, we assessed convergent validity by computing Pearson/Spearman rank correlations between OES-Sp and Oral Health Impact Profile (OHIP)-based orofacial appearance measures. All statistical procedures were performed using Stata v.13 for Windows (StataCorp). RESULTS: Exploratory factor analysis provided evidence that a single factor represents the Spanish OES version. Score reliability was high with Cronbach's alpha statistic of 0.95 (lower limit of the 95 % CI: 0.94). Score validity was sufficient indicated by Pearson and Spearman rank correlations between -0.53 and -0.69 (all 95 % confidence intervals: less than ± 0.10). CONCLUSIONS: OES is a valuable instrument to measure the orofacial appearance construct for Spanish-speaking populations. OES was concluded to be unidimensional with excellent score reliability and sufficient convergent score validity when compared with other Orofacial Appearance measures. Our results suggest that OES could be used in Spanish-speaking patients, an important and growing population around the globe.


Assuntos
Estética Dentária , Hispano-Americanos/psicologia , Idioma , Psicometria , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
19.
J Periodontol ; 89(5): 558-570, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29520910

RESUMO

BACKGROUND: A wide selection of Interdental Oral Hygiene (IOH) aids is available to consumers. Recommendations for selection are, however, limited by the lack of direct comparisons in available studies. We aimed to assess the comparative efficacy of IOH aids using Bayesian Network Meta-Analysis (BNMA). METHODS: Two independent reviewers performed a systematic literature review of randomized clinical trials assessing IOH aids, based on a focused question. Gingival inflammation (Gingival Index (GI), Bleeding-on-probing (BOP)) was the primary outcome and plaque and probing depth were secondary outcomes A random-effects arm-based BNMA model was run for each outcome; posterior medians and 95% credible-intervals (CIs) summarized marginal distributions of parameters. RESULTS: A two-phase selection process identified 22 trials assessing 10 IOH aids as brushing adjuncts. Interdental brushes (IB) yielded the largest reduction in GI (0.23 [95% CI: 0.09, 0.37]) as toothbrushing adjuncts, followed by water-jet (WJ) (0.19 [95% CI: 0.14, 0.24]). Rankings based on posterior probabilities revealed that IB and WJ had the highest probability of being "best" (64.7% and 27.4%, respectively) for GI reduction, whereas the probability for toothpick and floss being the "best" IOH aids was near zero. Notably, except for toothpicks, all IOH aids were better at reducing GI as compared with control. CONCLUSIONS: BNMA enabled us to quantitatively evaluate IOH aids and provide a global ranking of their efficacy. Interdental brushes and water-jets ranked high for reducing gingival bleeding, whereas toothpicks and floss ranked last. The patient-perceived benefit of IOH aids is not clear because gingival inflammation measures are physical indicators of periodontal health.


Assuntos
Gengivite , Higiene Bucal , Teorema de Bayes , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Humanos , Inflamação , Escovação Dentária
20.
J Oral Facial Pain Headache ; 31(4): 299­305, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28973051

RESUMO

AIMS: To explore whether awake and sleep bruxism interact in their associations with painful temporomandibular disorders (TMD) and whether the interaction is multiplicative or additive. METHODS: In this case-control study, all participants (n = 705) were part of the multicenter Validation Project and were recruited as a convenience sample of community cases and controls and clinic cases. Logistic regression analyses were applied to test for the association between self-reported bruxism (sleep and/or awake) and the presence of painful TMD, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were computed. Regression models included an interaction term to test for multiplicative interaction, and additive interaction was calculated as the relative excess risk due to interaction (RERI). RESULTS: Based on logistic regression analyses adjusted for age and gender, the main effects for both awake (OR = 6.7; 95% CI: 3.4 to 12.9) and sleep (OR = 5.1; 95% CI: 3.1 to 8.3) bruxism were significant. While the multiplicative interaction (OR = 0.57; 95% CI: 0.24 to 1.4) was not significant, the results indicated a significant positive additive interaction (RERI = 8.6; 95% CI: 1.0 to 19.7) on the OR scale. CONCLUSION: This study has demonstrated that awake and sleep bruxism are associated with an increased presence of painful TMD, and that both types of bruxism are not independently associated, but interact additively. As such, the presence of each factor amplifies the effect of the other.

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