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Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder.

ABSTRACT: BACKGROUND: Oral health-related quality of life (OHRQoL) in children and adolescents with signs and symptoms of temporomandibular disorder (TMD) has not yet been measured. This study aimed to evaluate the validity and reliability of OHRQoL measure for use in children and preadolescents with signs and symptoms of TMD. METHODS: Five hundred and forty-seven students aged 8-14 years were recruited from public schools in Piracicaba, Brazil. Self-perceptions of QoL were measured using the Brazilian Portuguese versions of Child Perceptions Questionnaires (CPQ)8-10 (n = 247) and CPQ11-14 (n = 300). A single examiner, trained and calibrated for diagnosis according to the Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD), examined the participants. A self-report questionnaire assessed subjective symptoms of TMD. Intraexaminer reliability was assessed for the RDC/TMD clinical examinations using Cohen's Kappa (?) and intraclass correlation coefficient (ICC). Criterion validity was calculated using the Spearman's correlation, construct validity using the Spearman's correlation and the Mann-Whitney test, and the magnitude of the difference between groups using effect size (ES). Reliability was determined using Cronbach's alpha, alpha if the item was deleted and corrected item-total correlation. RESULTS: Intraexaminer reliability values ranged from regular (? = 0.30) to excellent (? = 0.96) for the categorical variables and from moderate (ICC = 0.49) to substantial (ICC = 0.74) for the continuous variables. Criterion validity was supported by significant associations between both CPQ scores and pain-related questions for the TMD groups. Mean CPQ8-10 scores were slightly higher for TMD children than control children (ES = 0.43). Preadolescents with TMD had moderately higher scores than the control ones (ES = 0.62; p < 0.0001). Significant correlation between the CPQ scores and global oral health, as well as overall well-being ratings (p < 0.001) occurred, supporting the construct validity. The Cronbach's alphas were 0.93 for CPQ8-10 and 0.94 for CPQ11-14. For the overall CPQ8-10 and CPQ11-14 scales, the corrected item-total correlation coefficients ranged from 0.39-0.76 and from 0.28-0.73, respectively. The alpha coefficients did not increase when any of the items were deleted in either CPQ samples. CONCLUSIONS: The questionnaires are valid and reliable for use in children and preadolescents with signs and symptoms of temporomandibular disorder.

SUBMITTER: Barbosa TS

PROVIDER: S-EPMC3115836 | biostudies-other | 2011

REPOSITORIES: biostudies-other

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Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder.

Barbosa Taís S TS Leme Marina S MS Castelo Paula M PM Gavião Maria Beatriz D MB

Health and quality of life outcomes 20110512

<h4>Background</h4>Oral health-related quality of life (OHRQoL) in children and adolescents with signs and symptoms of temporomandibular disorder (TMD) has not yet been measured. This study aimed to evaluate the validity and reliability of OHRQoL measure for use in children and preadolescents with signs and symptoms of TMD.<h4>Methods</h4>Five hundred and forty-seven students aged 8-14 years were recruited from public schools in Piracicaba, Brazil. Self-perceptions of QoL were measured using the ...[more]

PMID: 21569403

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Project description:BackgroundThere are very few studies of the association between temporomandibular dysfunction (TMD) and oral health-related quality of life (OHRQoL) in a representative sample from the Asia-Pacific region. Accordingly, we aimed to quantify the association of TMD with OHRQoL dimensions and overall measurement scores in a representative sample of Australian adults while accounting for a range of confounders, and statistically estimating whether TMD experience is meaningfully associated with OHRQoL.MethodAustralia's National Survey of Adult Oral Health 2004-2006 data were used. The outcome variables were the Oral Health Impact Profile (OHIP-14) domains and overall scores while the main exposure was self-reported Diagnostic Criteria Question for TMD. The analysis accounted for confounders including oral health status obtained from the oral examination, demographics, socioeconomics, health behaviours and health including perceived stress subscales of the PSS-14. We conducted complex samples analysis while using Cohen's f2 effect size to estimate whether the association is meaningful.ResultsTMD prevalence was 9.9% (95% CI: 8.4-11.6%) among 4133 Australian adults. TMD experience was associated with impairments to the seven OHIP-14 OHRQoL domains (P < .05) with higher impairments observed in physical pain (B = 0.82, 95% CI: .45-1.20, P < .001), psychological discomfort (B = 0.68, 95% CI: .29-1.06, P = .001) and psychological disability (B = 0.52, 95% CI: .20-.84, P = .001) in adjusted multivariate analyses. The difference in the mean OHIP-14 scores for those reporting TMD (Mean = 13.1, 95% CI: 12.0-14.0) and those who did not (Mean = 6.6, 95% CI: 6.0-6.8) was significant (t = 7.51, P < .001). In an adjusted multivariable model for OHIP-14 scores, TMD experience was associated with higher OHIP-14 scores (B = 3.34, 95% CI: 1.94-4.75, P < .001) where the Cohen's f2 was .022. Further, perceived stress subscales: perceived distress and perceived control were associated with TMD experience and OHIP-14 scores (P < .05).ConclusionLower OHRQoL was observed in Australian adults who reported TMD experience but with small clinical importance which might support considering TMD in regular dental care. The higher impairments observed in physical pain, psychological discomfort and psychological disability domains of OHRQL can help clinicians and researchers focus their attention on these domains. The confounding effect exhibited by the perceived stress subscale might support their inclusion in future TMD and OHRQoL research.

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.

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Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder.

Publications

Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder.

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