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The association of subjective orthodontic treatment need with oral health-related quality of life.

ABSTRACT: The existing body of evidence reports an inconsistent association between subjective and objective orthodontic treatment need. The concept of oral health-related quality of life (OHRQoL) might help to explain the differences in subjective and objective orthodontic treatment need. Our aim was to investigate the association of subjective orthodontic treatment with OHRQoL in children.This cross-sectional study was embedded in the Generation R Study, a population-based prospective cohort study. OHRQoL and subjective orthodontic treatment need were assessed by parental questionnaires. Questionnaire items were individually compared among children with no, borderline and definite subjective orthodontic need. The association between subjective orthodontic treatment need and OHRQoL was investigated in multivariate regression analysis with weighted least squares. Differences by sex and levels of objective orthodontic treatment need were evaluated.In total, 3774 children were included in the analysis. Children with borderline subjective orthodontic treatment need and those with definite subjective orthodontic treatment need had significantly poorer OHRQoL based on the fully adjusted model (adjusted regression coefficient (a?)=-0.49, 95% CI: -0.75, -0.30; (a?)=-1.58, 95% CI: -1.81, -1.58, respectively). The association between subjective orthodontic treatment need and OHRQoL was stronger in girls than in boys and stronger in children with objective orthodontic treatment need than in those with none.Oral health-related quality of life is poorer in children with subjective orthodontic treatment need. This has not been investigated before in such a large-population-based study and clearly offers an explanation for the lack of concurrence between objective and subjective orthodontic treatment need.

SUBMITTER: Kragt L

PROVIDER: S-EPMC5501354 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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The association of subjective orthodontic treatment need with oral health-related quality of life.

Kragt Lea L Jaddoe Vincent V Wolvius Eppo E Ongkosuwito Edwin E

Community dentistry and oral epidemiology 20170331 4

<h4>Objectives</h4>The existing body of evidence reports an inconsistent association between subjective and objective orthodontic treatment need. The concept of oral health-related quality of life (OHRQoL) might help to explain the differences in subjective and objective orthodontic treatment need. Our aim was to investigate the association of subjective orthodontic treatment with OHRQoL in children.<h4>Methods</h4>This cross-sectional study was embedded in the Generation R Study, a population-b ...[more]

PMID: 28370341

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Project description:ObjectiveTo evaluate the association between oral health-related quality of life (OHRQoL) and oral health indicators including dental status, total occlusion force (TOF), number of natural and rehabilitated teeth (NRT), number of natural teeth (NT), and to explore the effect modification on the association by gender among Korean elders.MethodsA total of 675 participants aged 65 or above recruited by a cluster-based stratified random sampling were included in this cross-sectional study. The 14-items Korean version of the Oral Health Impact Profile (OHIP) was used to measure OHRQoL. The responses about OHIP were dichotomized by the cut-off point of 'fairly often' to determine the 'poor' versus 'fair' OHRQoL. Age, gender, education level, alcohol drinking, smoking, metabolic syndrome, frailty, and periodontitis were considered as confounders. Multiple multivariable logistic regression analyses were applied to assess the adjusted association between oral health indicators and OHRQoL. Gender stratified analysis was also applied to explore the effect modification of the association.ResultsThe prevalence of poor OHRQoL was 43.0%, which was higher in women, less-educated elders, alcohol non-drinkers and frailty elders (p < 0.05). Elders with poor OHRQoL also showed lower values of oral health indicators than elders with fair OHRQoL (p < 0.05). Those with NRT ≤ 24, NT ≤ 14, and TOF < 330 N increased the risk of poor OHRQoL by 2.3 times (OR = 2.26, confidence interval [CI] 1.54-3.31), 1.5 times (OR = 1.45, CI 1.02-2.07), and 1.5 times (OR = 1.47, CI 1.06-2.04), respectively. In women, the association of NRT ≤ 24 with poor OHRQoL increased from OR of 2.3 to OR of 2.4, while, in men, the association of TOF < 330 N with poor OHRQoL increased from OR of 1.5 to OR of 3.2.ConclusionOral health indicators consisting of TOF, NRT, and NT were independently associated with poor OHRQoL among Korean elders. Gender modified the association of TOF and NRT. Preventive and/or curative management for keeping natural teeth and the rehabilitation of missing teeth to recover the occlusal force may be essential for reducing poor OHRQoL.

Project description:OBJECTIVES:To integrate items from two widely used oral health-related quality of life (OHRQoL) questionnaires, the General Oral Health Assessment Index (GOHAI) and the Oral Impacts on Daily Performances (OIDP), as well as culturally-specific items of the Oral Health Impact Profile (OHIP) into a four-dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. METHODS:Subjects came from an ancillary study of the Dimensions of Oral Health-Related Quality of Life Project (N=267 patients, mean age±SD: 54.0±17.2years, 58% women.) Patients filled in the original 49 items of OHIP and 22 additional OHRQoL items in a cross-sectional study. These additional items consisted of 7 culturally specific OHIP items and 15 GOHAI or OIDP items with unique content not covered in OHIP-49. Before data collection, three experts hypothesized to which of the four OHRQoL dimensions these items belong. Hypotheses were tested in correlation analyses between the 22 items and the four dimension scores that were derived from OHIP-49. RESULTS:Five of the 22 items did not provide sufficient information to which dimension they belong. In 16 of the remaining 17 items, the pattern of correlation coefficients fitted experts' a priori hypotheses. Acceptance of 16 of the 17 hypotheses was interpreted as evidence that additional (not in OHIP-49 contained) OHRQoL items can be assigned to Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. CONCLUSION:Items of three OHRQoL instruments can be integrated into a dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. CLINICAL SIGNIFICANCE:Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact can serve as a simple and clinically appealing set of oral health-related quality of life (OHRQoL) dimensions and therefore provide an opportunity for simpler, but psychometrically improved OHRQoL measurement in the future.

Project description:Several measures of oral health-related quality of life have been developed for children. The most frequently used are the Child Perceptions Questionnaire (CPQ), the Child Oral Impacts on Daily Performances (C-OIDP) and the Child Oral Health Impact Profile (COHIP). The aim of this study was to assess the methodological quality of the development and testing of these three measures.A systematic search strategy was used to identify eligible studies published up to December 2012, using both MEDLINE and Web of Science. Titles and abstracts were read independently by two investigators and full papers retrieved where the inclusion criteria were met. Data were extracted by two teams of two investigators using a piloted protocol. The data were used to describe the development of the measures and their use against existing criteria. The methodological quality and measurement properties of the measures were assessed using standards proposed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) group.The search strategy yielded 653 papers, of which 417 were duplicates. Following analysis of the abstracts, 119 papers met the inclusion criteria. The majority of papers reported cross-sectional studies (n?=?117) with three of longitudinal design. Fifteen studies which had used the original version of the measures in their original language were included in the COSMIN analysis. The most frequently used measure was the CPQ. Reliability and construct validity appear to be adequate for all three measures. Children were not fully involved in item generation which may compromise their content validity. Internal consistency was measured using classic test theory with no evidence of modern psychometric techniques being used to test unidimensionality of the measures included in the COSMIN analysis.The three measures evaluated appear to be able to discriminate between groups. CPQ has been most widely tested and several versions are available. COHIP employed a rigorous development strategy but has been tested in fewer populations. C-OIDP is shorter and has been used successfully in epidemiological studies. Further testing using modern psychometric techniques such as item response theory is recommended. Future developments should also focus on the development of measures which can evaluate longitudinal change.

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The association of subjective orthodontic treatment need with oral health-related quality of life.

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The association of subjective orthodontic treatment need with oral health-related quality of life.

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