Discomfort associated with fixed orthodontic appliances: determinant factors and influence on quality of life.

OBJECTIVE: To investigate the determinant factors of discomfort attributed to the use of fixed orthodontic appliance and the effect on the quality of life of adolescents. MATERIAL AND METHODS: Two hundred and seventy-two individuals aged between 9 and 18 years old, enrolled in public and private schools and undergoing orthodontic treatment with fixed appliance participated in this cross-sectional study. The participants were randomly selected from a sample comprising 62,496 individuals of the same age group. Data was collected by means of questionnaires and an interview. Discomfort intensity and bio-psychosocial variables were assessed using the Oral Impact on Daily Performance questionnaire. Self-esteem was determined using the Global Negative Self-Evaluation questionnaire. Statistical analysis involved the chi-square test and both simple and multiple Poisson regression analyses. RESULTS: Although most individuals did not present discomfort, there was a prevalence of 15.9% of impact on individuals' daily life exclusively due to the use of fixed orthodontic appliance. Age [PR: 3.2 (95% CI: 1.2-8.5)], speech impairment [PR: 2.2 (95% CI: 1.1-4.6)], poor oral hygiene [PR: 2.4 (95% CI: 1.2-4.8)] and tooth mobility [PR: 3.9 (95% CI: 1.8-8.1)] remained independently associated with a greater prevalence of discomfort (P ≤ 0.05). CONCLUSIONS: Discomfort associated with the use of fixed orthodontic appliances exerted a negative influence on the quality of life of the adolescents comprising the present study. The determinants of this association were age, poor oral hygiene, speech impairment and tooth mobility.

Discomfort associated with fixed orthodontic appliances: determinant factors and influence on quality of life

OBJECTIVE: To investigate the determinant factors of discomfort attributed to the use of fixed orthodontic appliance and the effect on the quality of life of adolescents. MATERIAL AND METHODS : Two hundred and seventy-two individuals aged between 9 and 18 years old, enrolled in public and private schools and undergoing orthodontic treatment with fixed appliance participated in this cross-sectional study. The participants were randomly selected from a sample comprising 62,496 individuals of the same age group. Data was collected by means of questionnaires and an interview. Discomfort intensity and bio-psychosocial variables were assessed using the Oral Impact on Daily Performance questionnaire. Self-esteem was determined using the Global Negative Self-Evaluation questionnaire. Statistical analysis involved the chi-square test and both simple and multiple Poisson regression analyses. RESULTS: Although most individuals did not present discomfort, there was a prevalence of 15.9% of impact on individuals' daily life exclusively due to the use of fixed orthodontic appliance . Age [PR: 3.2 (95% CI: 1.2-8.5)], speech impairment [PR: 2.2 (95% CI: 1.1-4.6)], poor oral hygiene [PR: 2.4 (95% CI: 1.2-4.8)] and tooth mobility [PR: 3.9 (95% CI: 1.8-8.1)] remained independently associated with a greater prevalence of discomfort (P ≤ 0.05). CONCLUSIONS: Discomfort associated with the use of fixed orthodontic appliances exerted a negative influence on the quality of life of the adolescents comprising the present study. The determinants of this association were age, poor oral hygiene, speech impairment and tooth mobility. .

OBJETIVO: investigar os fatores determinantes do desconforto atribuído ao uso do aparelho ortodôntico fixo e sua influência na qualidade de vida de adolescentes. MÉTODOS: participaram desse estudo transversal 272 indivíduos, com idades entre 9 e 18 anos, estudantes de escolas públicas e privadas, que usavam aparelhos ortodônticos fixos (braquetes). Os participantes foram selecionados aleatoriamente, entre 62.496 indivíduos da mesma faixa etária. A coleta de dados foi feita em forma de entrevista e questionário. A intensidade do desconforto e variáveis biopsicossociais foram avaliadas por meio do Oral Impact on Daily Performance (OIDP). A autoestima foi determinada pela Global Negative Self-Evaluation (GSE). A análise estatística envolveu o teste qui-quadrado e a análise de regressão de Poisson, simples e múltipla. RESULTADOS: embora a maioria dos indivíduos não apresentasse desconforto, observou-se uma prevalência de impacto na vida diária devido, exclusivamente, ao uso do aparelho ortodôntico fixo, de 15,9%. Variáveis idade de 15 a 18 anos [RP = 3,2 (IC 95% = 1,2-8,5)], dificuldade de falar [RP = 2,2 (IC 95% = 1,1-4,6)], dificuldade de limpar a boca [RP = 2,4 (IC95% = 1,2-4,8)] e mobilidade dos dentes [RP = 3,9 (IC 95% = 1,8-8,1)] permaneceram associadas, de forma independente, à maior prevalência de desconforto (p ≤ 05). CONCLUSÕES: desconforto associado ao uso de aparelhos ortodônticos fixos influenciou negativamente a qualidade de vida de adolescentes. Os fatores determinantes foram idade, dificuldade de limpar a boca, de falar e mobilidade dentária. .

Knowledge of periodontitis and self-perceived oral health: a survey of periodontal specialist patients.

The aim of this study was to investigate changes in knowledge of periodontal disease among patients referred to periodontal specialist clinics. A further aim was to investigate the patients' self- perceived oral health before the treatment. Patients referred to five specialist clinics in periodontology for comprehensive periodontal treatment were consecutive sampled. The study was based on a questionnaire in a before and after design. The first questionnaire was sent to the patients before visiting the specialist clinic and the second was sent after six months. Four questions were analysed, two to measure knowledge about periodontitis and two to measure the patients self- perceived oral health. The first questionnaire was sent by post to 273 patients with a response rate of 31%. The second questionnaire was sent to 85 patients with a response rate of 73%. The results of the study showed a statistically significant improvement of correct answers on the knowledge questions after six months was found for scaling (p = 0.006), X-ray examination (p = 0.001) and increased space between the teeth (p = 0.001). The most frequent self-perceived trouble from the mouth was bleeding gum (70%) and sensitive teeth (51%). In conclusion knowledge of periodontitis improved after visiting the specialist clinic of periodontology. Many of the patients experienced some problems of the mouth.

A cross-sectional study of oral health and oral health-related quality of life among frail elderly persons on admission to a special oral health care programme in Copenhagen City, Denmark.

AIM: To describe the oral health and the oral-health-related quality of life (OHRQoL) of citizens in Copenhagen City on admission to a specific oral health-care programme for disabled elderly persons. Further, to analyse how various factors influence the oral health and the OHRQoL among these patients. METHODS: A cross-sectional study of 189 persons (average 85 years) consecutively admitted to a special oral health-care programme. Clinical data and data from interviews comprising social factors, life-style, dental visit habits, oral hygiene practices and self-perceived oral health were collected. A modified index on perceived dysfunction, discomfort and disability due to oral disorders was used. RESULTS: Sixty-eight per cent had natural teeth, among those 57% had decayed teeth and two out of three wore dentures. Smoking habits influence the number of teeth present and the OHRQoL (p < 0.05) of the patients. Edentulousness, decayed teeth, and presence of dentures did not seem to cause OHRQoL problems, while higher OHRQoL scores (more problems) were reported by those with 1-9 teeth and tooth mobility. CONCLUSION: OHRQoL of these patients can be increased by removal of loose teeth and provision of dentures to those with very few teeth rather than focus on traditional caries treatment.

Relationship between dental status and Oral Impacts on Daily Performances in older Southern Chinese people.

OBJECTIVE: The objective of this study was to assess the relationship between different clinical indicators of dental status and an Oral Health-Related Quality of Life (OHRQoL) measure, the Oral Impacts on Daily Performances (OIDP) index, using different scoring formats, among older Southern Chinese people. METHODS: A total of 1,196 dentate people aged 55 years and older, attending routine annual health checkups at Guangxi Medical University Hospital Health Centre in Guangxi, China, participated in the study. They had a face-to-face structured interview and a clinical dental examination. The OIDP index was used to assess the impacts of oral conditions on quality of life. Spearman and Pearson as well as partial correlation coefficients were used to assess, respectively, the unadjusted and adjusted associations of 14 clinical indicators with the overall OIDP score, OIDP intensity, and OIDP extent. RESULTS: All clinical indicators, except number of filled teeth, were significantly correlated with the OIDP index, after controlling for covariates. However, correlations were weak, ranging between 0.07 and 0.26. The strongest correlation was for the relationship between the number of natural plus replaced teeth and the OIDP index, irrespective of whether the overall OIDP score, OIDP intensity, or OIDP extent was used to measure OHRQoL. CONCLUSIONS: Clinical dental status indicators were related to OIDP, regardless of the scoring format used to calculate the OIDP index. Clinical indicators that included natural plus replaced teeth were more strongly associated with the OIDP index than their corresponding indicators that included only natural teeth.

Factors affecting oral health-related quality of life among pregnant women.

OBJECTIVES: To assess oral health status and to describe the possible factors that could affect the oral health-related quality of life (OHRQoL) among a group of pregnant rural women in South India. MATERIALS AND METHODS: A total of 259 pregnant women (mean age 26 +/- 5.5 years) who participated in the cross-sectional study were administered the Oral Health Impact Profile (OHIP-14) questionnaire and were clinically examined for caries and periodontal status. RESULTS: The highest oral impact on quality of life was reported for 'painful mouth' (mean: 1.7) and 'difficulty in eating' (mean: 1.1). On comparing the mean OHIP-14 scores against the various self-reported oral problems, it was seen that the mean OHIP-14 scores were significantly higher among those who reported various oral problems than those who did not. Those with previous history of pregnancies had more severe levels of gingivitis than those who were pregnant for the first time. Also gingival index scores, community periodontal index of treatment needs scores and previous pregnancies was associated with poorer OHRQoL scores. CONCLUSION: Increased health promotion interventions and simple educational preventive programmes on oral self-care and disease prevention during pregnancy can go a long way in improving oral health and lessening its impact on the quality of life in this important population.

Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India.

BACKGROUND: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. MATERIALS AND METHODS: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth), which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. CONCLUSION: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in.

Reproducibility and validity of self-perceived oral health conditions.

The reproducibility and validity of self-perceived periodontal, dental, and temporomandibular joint (TMJ) conditions were investigated. A questionnaire was applied in interview to 200 adults aged from 35 to 44, who were attending as casual patients at Araraquara School of Dentistry, São Paulo State University, São Paulo, Brazil. Clinical examination was based on the guidelines of the World Health Organization manual. The interview and the clinical examination were performed in two occasions, by a calibrated examiner. Reproducibility and validity were, respectively, verified by kappa statistics (kappa) and sensitivity (Sen) and specificity (Spec) values, having clinical examination as the validation criterion. The results showed an almost perfect agreement for self-perceived TMJ (kappa = 0.85) and periodontal conditions (kappa = 0.81), and it was substantial for dental condition (kappa = 0.69). Reproducibility according to clinical examination showed good results (kappa = 0.73 for CPI index, kappa = 0.96 for dental caries, and kappa = 0.74 for TMJ conditions). Sensitivity and specificity values were higher for self-perceived dental (Sen = 0.84, Spec = 1.0) and TMJ conditions (Sen = 1.0, Spec = 0.8). With regard to periodontal condition, specificity was low (0.43), although sensitivity was very high (1.0). Self-perceived oral health was reliable for the examined conditions. Validity was good to detect dental conditions and TMJ disorders, and it was more sensitive than specific to detect the presence of periodontal disease.

Oral health-related quality of life and periodontal status.

BACKGROUND: As patient-centered approaches become more popular, increasing attention is being given to assess the effects of various human health situations on an individual's overall quality of life (QoL). Measures have been used in dentistry to study the effects of orthodontic treatment and oral surgery, but so far little has been reported about the effects of periodontal disease. OBJECTIVE: This study assessed the impact of periodontal health status on QoL. METHODS: A subsample of 767 subjects were selected from a community study (n=1000) which investigated the association between psychological factors and clinical periodontal attachment level (CAL). The sample included subjects with full-mouth mean CAL3 mm (high/severe periodontal attachment loss group). The subjects were requested to complete the Chinese short-form version of Oral Health Impact Profile (OHIP-14S) and a checklist of self-reported periodontal symptoms during the previous 12 months. RESULTS: A total of 727 subjects (95%) completed the questionnaire. The OHIP-14S and subscale scores were significantly associated with six of seven of the self-reported periodontal symptoms. A comparison of the mean OHIP-14S scores of the healthy/low and the high/severe periodontal attachment loss groups revealed significant differences in respect of the subscales of functional limitation, physical pain, psychological discomfort, physical and psychological disabilities. CONCLUSION: This study demonstrates a significant association between oral health-related QoL and periodontal disease.

Perceived need for dental care among dentate older individuals in Sri Lanka.

The authors assessed the perceived need for dental care among 585 older individuals, of whom 235 received a clinical oral examination. Of the 235 participants, only 171 were dentate. The present analysis is limited to this group. Of these 171 dentate adults, 43 percent perceived a need for dental care. Of this sample section, 53 percent perceived a need for dentures. Age, perceived oral health status, presence of mobile teeth, three impact items of the Oral Health Impact Profile-14 (OHIP-14) scale--namely "had a painful aching in the mouth, had difficulty in eating and that the diet had been unsatisfactory due problems with teeth, mouth or dentures"--and the total OHIP-14 score showed significant associations with perceived need for dental care in bi-variate analysis. Poor perceived oral health status emerged as the strongest predictor of perceived need for dental care in logistic regression.

Impact of oral health on the life quality of periodontal patients.

OBJECTIVES: To assess the impact of oral health on the life quality of a periodontal patient group. MATERIALS AND METHODS: Two hundred and five patients attending a private periodontal clinic completed a questionnaire incorporating the 16-item UK oral health-related quality-of-life measure (OHQoL-UK), a check list of questions about their periodontal health over the past year and a comprehensive periodontal examination. RESULTS: The effect of oral health on quality of life was considerable, with many individuals experiencing negative impacts across a broad range of physical, social and psychological aspects of life quality. OHQoL-UK(Copyright ) scores was associated with patient's self-reported periodontal health in the past year: experiences of "swollen gums" (p<0.01), "sore gums" (p<0.01), "receding gums" (p<0.01), "loose teeth" (p<0.01), "drifting teeth" (p<0.01), "bad breath" (p<0.01) and "toothache" (p<0.01). In addition, OHQoL-UK scores were correlated with the number of teeth with pocket depths of 5 mm or more (r(s)-0.42, p<0.01). New patients had poorer oral health-related quality of life compared with the treated maintenance group (p<0.01). CONCLUSIONS: Periodontal status impacts on life quality. This has implications in understanding the consequences of periodontal health and in the use of patient-centred outcomes in periodontal research.

The relationship between clinical dental status and oral impacts in an elderly population.

PURPOSE: To investigate the relationship between oral health-related quality of life and clinical dental measures in an elderly Greek population. MATERIALS AND METHODS: A cross-sectional survey was carried out of adults aged 65 years or older living independently in Athens. Data were collected through clinical examination and interviews. Oral health-related quality of life was assessed through the Oral Impacts on Daily Performance (OIDP) indicator. The sample consisted of 681 participants. Data analysis used non-parametric tests (Mann-Whitney, Kruskal-Wallis and multiple logistic regressions). RESULTS: The response rate was 87.8%. Dentate participants with 1-10 teeth were 2.05 (1.25, 3.35) times and those with 11-20 teeth were 1.81 (1.11, 2.95) times more likely to report oral impacts than subjects with 21 or more teeth. Participants with anterior tooth spaces were 2.86 (1.70, 4.80) times more likely to report oral impacts than those without anterior spaces. Participants with 0-8 natural occluding pairs (NOPs) were 1.72 (1.14, 2.58) times and those with 0-3 posterior occluding pairs (POPs) were 1.57 (1.04, 2.36) times more likely to experience oral impacts than subjects with 9-16 NOPs and 4-10 POPs respectively. Decayed teeth were not significantly related to the presence of oral impacts. Edentulous participants with inadequate denture adaptation were 2.59 (1.46, 4.59) times, those with inadequate denture retention 2.41 (1.39, 4.17) times and those with denture overextension 2.51 (1.10, 5.74) times more likely to report oral impacts than subjects without the respective denture deficiencies. CONCLUSION: Clinical indicators of oral health status were significantly related to measures of oral health-related quality of life.

Relationship of dental status, sociodemographic status, and oral symptoms to perceived need for dental care.

OBJECTIVE: Previous studies have noted a discrepancy between clinically determined oral health status (normative need), patients' perceptions, and perceived significance of dental signs and symptoms. Our objective was to quantify the relationships between normative need and self-reports to improve our understanding of the factors that contribute to perceived need for care. METHODS: Clinical examination and questionnaire data were derived from the Florida Dental Care Study, a study of oral health and dental care, in a representative sample of community-dwelling adults aged > or = 45 years. The questionnaire provided information about presence of signs and symptoms, self-ratings of oral health, perceived need for dental care, and sociodemographic status (SDS). Perceived need was measured on a 4-point nominal scale. RESULTS: Self-reported broken filling, broken denture, cavities, loose tooth, teeth that look bad, and toothache were strongly associated with self-reported perceived need for dental care. Satisfaction with dental health was also associated with perceived need, but self-rated oral health was not. Most measures of SDS were associated with perceived need. However, in a single multiple regression, with self-reported signs and symptoms accounted for, race, age group, sex, and educational attainment were not significantly associated with a currently perceived dental problem. CONCLUSIONS: Certain dental signs and symptoms were significantly associated with perceived need for dental care, as were certain aspects of SDS; even once differences in dental signs and symptoms had been taken into account. Disaggregating measurement of perceived need from a single dichotomous ('yes/no') scale to a 4-point nominal scale was elucidative.