Patterns of impaired oral health‐related quality of life dimensions

Abstract

Background How dental patients are affected by oral conditions can be described with the concept of oral health-related quality of life (OHRQoL). This concept intends to make the patient experience measurable. OHRQoL is multidimensional and Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were suggested as its four dimensions and consequently four scores are needed for comprehensive OHRQoL assessment. When only the presence of dimensional impact is measured, a pattern of affected OHRQoL dimensions would describe in a simple way how oral conditions’ influence the individual. Objective By determining which patterns of impact on OHRQoL dimensions (Oral Function-Orofacial Pain-Orofacial Appearance-Psychosocial Impact) exist in prosthodontic patients and general population subjects, we aimed to identify in which combinations oral conditions’ functional, painful, aesthetical, and psychosocial impact occurs. Methods Data came from the Dimensions of OHRQoL Project with OHIP-49 data from 6,349 general population subjects and 2,999 prosthodontic patients in the Learning Sample (N=5,173) and the Validation Sample (N=5,022). We hypothesized that all 16 patterns of OHRQoL dimensions should occur in these individuals who suffered mainly from tooth loss, its causes and consequences. A dimension was considered impaired when at least one item in the dimension was affected frequently. Results The 16 possible patterns of impaired OHRQoL dimensions were found in patients and general population subjects in both Learning and Validation Samples. Conclusions In a four-dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, oral conditions’ impact can occur in any combination of the OHRQoL dimensions.

Integration of oral health-related quality of life instruments

“…This finding might be interpreted as evidence for indirect effects from oral conditions that we previously hypothesized [28]. Whereas most oral conditions have a primary effect on one of those three dimensions Oral Function , Orofacial Pain , and Orofacial Appearance (e.g., TMD on Orofacial Pain , tooth loss on Oral Function and/or Orofacial Appearance ), conditions are often associated with a substantial psychosocial influence, i.e., they have simultaneous or, more likely, subsequent Psychosocial Impact .…”

“…We believe that this sequence – that primary functional, painful, and aesthetical problems have subsequent psychosocial impacts – represents a typical situation when the primary influence is strong. While this is a frequent scenario, an isolated primary influence on Psychosocial Impact can also occur, as demonstrated before [28]. …”

The Spanish Language 5-Item Oral Health Impact Profile

“…Finally, regarding interpretation of the results obtained for reliability of OHIP‐Sp5, the four‐dimensional OHRQoL structure with a strong general factor also provides the basis for understanding the validity results. In this situation, correlations of OHIP‐Sp5 with longer OHIP versions should follow a pattern that higher coefficients are observed for correlations with longer instruments, but representation of the four dimensions in other OHRQoL instruments should also affect correlation results.…”

Prevalence and normative values for jaw functional limitations in the general population in Sweden

“…Our findings for Jaw Functional Limitation can be compared with the most widely used dPRO, oral health‐related quality of life. This dPRO has four dimensions: Oral Function, Orofacial Pain, Orofacial Appearance and Psychosocial Impact (John, Feuerstahler, et al, ; John, Reissmann, et al, ; John, Rener‐Sitar, et al, ). Oral Function, together with the other three dimensions, was investigated for the Oral Health Impact Profile (Slade & Spencer, ); however, the four dimensions were found to be applicable also to other oral health‐related quality of life instruments (John, Reissmann, et al, ).…”