OHIP-14 appeared to be responsive to change. However, the magnitude of change that it detected in the context described here was modest, probably because it was designed primarily as a discriminative measure. The psychometric properties of the global transition judgements that often provide the "gold standard" for responsiveness studies need to be established.

Numerous studies have demonstrated that many older adults have problems chewing, pain, difficulties in eating, and problems in social relationships because of oral disorders. However, it is not clear if these functional and psychosocial outcomes affect broader psychological well-being and life satisfaction. Consequently, this paper begins to address the question, 'Does poor oral health compromise the quality of life?'. Initial cross-sectional analyses used data derived from the seven-year follow-up of the Ontario Study of the Oral Health of Older Adults. As at baseline and three-year follow-up, oral health was measured by self-ratings of oral health and five oral health indices. Psychological well-being and life satisfaction were assessed according to the Morale Index, the Perceived Life Stress Questionnaire, The Life Satisfaction Scale, and the General Health Questionnaire. All oral health variables were significantly associated with scores from the first three of these measures in the expected direction. These associations remained after we controlled for other potential influences on the quality of life. In addition, prospective analysis indicated that self-perceived oral health at three years had a significant independent effect on psychological well-being and life satisfaction at seven years. These results suggest that poor self-perceived oral health and relatively poor quality of life co-exist in the same subgroup of older adults.

In a study of tooth extractions in general dental practices in Ontario, Canada, 165 dental practitioners provided information on 6134 patients attending during a reference week. Of these, 11.6 per cent of patients had one or more permanent teeth extracted. Periodontal disease was given as the reason for 35.9 per cent of these extractions and caries for 28.9 per cent. Analysis by tooth type showed that third molars were the most common tooth type extracted. However, there were differences in the types of teeth extracted by age. Posterior teeth were most frequently lost by the younger age groups and anterior teeth by older subjects. There were also differences in the reasons for the loss of different tooth types. A comparison of these results with those of a similar study in Scotland suggests that age and tooth type does not account for the excess of extractions due to periodontal disease in this Canadian population. Differences in practice patterns and attitudes towards the retention of teeth may be contributing factors.

Studies from a number of countries, including Canada, have demonstrated that the oral health status of immigrants is worse than that of their native-born counterparts and that they make less use of dental services. To date, however, little information is available which documents changes in immigrant oral health following immigration. This paper reports the results of a study conducted in the City of North York, Ontario, that examined the oral health status of Canadian-born and immigrant adolescents aged 13 and 14 years. The former had better oral health than the latter on all parameters assessed and made more use of dental services. Within the immigrant population, there was a significant association between oral health and time since immigration. Those who had been in Canada 6 or more years were significantly healthier than those who had arrived within the preceding 2 years. While changing patterns of immigration may account for part of these differences, the data suggest that access to dental public health programs, delivered to students between the ages of 4 and 14 years, have been effective in improving the oral health of those born outside Canada. Since these programs cease at age 13 or 14 years, barriers to accessing the private dental care sector may mean that the residual inequities and inequalities evident in the data widen as these individuals age.

Varnish applications were found to take less time and resulted in fewer signs of discomfort. These results support the use of fluoride varnish in caries prevention programs, especially for younger children.