The terms 'health-related quality of life' and 'quality of life' are now in common use to describe the outcomes of oral health conditions and therapy for those conditions. In addition, there has been a proliferation of measures designed to quantify those outcomes. These measures, which were initially designated as socio-dental indicators or subjective oral health indicators are now more usually referred to as measures of oral health-related quality of life (OH-QoL). This is based on the assumption that the functional and psychosocial impacts they document must, of necessity, affect the quality of life. While this assumption has been subject to critical scrutiny in medicine, this is not the case with dentistry. Consequently, exactly what is being measured by indexes of OH-QoL is somewhat unclear. Based on the debate between Gill and Feinstein and Guyatt and Cook, we outline a number of criteria by means of which the construct addressed by measures of OH-QoL may be assessed. These are concerned with how the measures were developed and validated. These criteria are then used to appraise five of the many measures that have been developed over the past 20 years--the GOHAI, OHIP, OIDP, COHQoL and OH-QoL. The main conclusion is that while all document the frequency of the functional and psychosocial impacts that emanate from oral disorders they do not unequivocally establish the meaning and significance of those impacts. Consequently, the claim that oral disorders affect the quality of life has yet to be clearly demonstrated. Verifying this claim requires further qualitative studies of the outcomes of oral disorders as perceived by patients and persons, and the concurrent use of measures that more explicitly address the issue of quality of life.

What do measures of ‘oral health-related quality of life’ measure?

http://public-files.prbb.org/publicacions/12060e10-c44a-012b-a7a8-000c293b26d5.pdf

Health-Related Quality of Life Measurement in Children and Adolescents: A Systematic Review of Generic and Disease-Specific Instruments

Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families. Twenty-two health professionals evaluated a pool of 45 items that assess the impact of oral health problems on 6-14-year-old children and their families. The health professionals identified 36 items as relevant to preschool children. Thirty parents rated the importance of these 36 items to preschool children; 13 (9 child and 4 family) items were considered important. The 13-item ECOHIS was administered to 295 parents of 5-year-old children to assess construct validity and internal consistency reliability (using Cronbach's alpha). Test-retest reliability was evaluated among another sample of parents (N = 46) using the intraclass correlation coefficient (ICC). ECOHIS scores on the child and parent sections indicating worse quality of life were significantly associated with fair or poor parental ratings of their child's general and oral health, and the presence of dental disease in the child. Cronbach's alphas for the child and family sections were 0.91 and 0.95 respectively, and the ICC for test-retest reliability was 0.84. The ECOHIS performed well in assessing OHRQL among children and their families. Studies in other populations are needed to further establish the instrument's technical properties.

/pdf/parental-perceptions-of-children-s-oral-health-the-early-4kzh75ml7l.pdf

Parental perceptions of children's oral health: The Early Childhood Oral Health Impact Scale (ECOHIS)

Objective: The aim of the study is to evaluate the measurement properties of the Brazilian version of the short form of the Oral Health Impact Profile (OHIP14).



Methods:  Data were obtained from a cross-sectional study designed to assess the impact of toothache on quality of life during pregnancy. The sample consisted of 504 postpartum women (mean age 24 years; SD 6.2), most of whom had unsolved dental problems and belonged to low-income families. The questionnaire was administered in the form of interviews by two trained interviewers who also performed clinical examinations. Reliability was assessed in terms of internal consistency and stability. Construct validity was evaluated based on comparison of the total scores among groups according to: self-perceived and normative oral health care needs, self-perceived general and oral health status, presence of carious lesions and tooth loss. It was also hypothesized that the scores of OHIP14 and Oral Impacts on Daily Performances (OIDP) would correlate with each other.



Results:  Both test–retest stability and internal consistency, as measured by the intra-class correlation coefficient (0.87) and by Cronbach's alpha (0.91), proved to be adequate. Construct validity was confirmed as the correlation between OHIP14 scores with self-perceived general and oral health were in the expected direction, and the differences in scores of the groups formed according to the selected attributes were significant at values of P ≤ 0.05 (Mann–Whitney test). Moreover, the correlation coefficient between OIDP and OHIP14 was 0.76 (rs).



Conclusion:  The Brazilian version of OHIP14 has good psychometric properties, which are similar to those of the original instrument.

Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form.

BACKGROUND

The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well-being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age.

OBJECTIVE

To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors.

METHODS

Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children's OHRQoL and socioeconomic conditions. Two calibrated dentists (κ>0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0=caries free; 1-5=low severity; ≥6=high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome.

RESULTS

In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (P 0.05). The increase in the child's age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (P<0.05). The multivariate adjusted model showed that the high severity of ECC (RR=3.81; 95% CI=2.66, 5.46; P<0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR=0.93; 95% CI=0.87, 0.99; P<0.001).

CONCLUSIONS

The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents.

Impact of oral diseases and disorders on oral health-related quality of life of preschool children.

Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.

M. Stephens

Papers

Validity and Reliability of a Questionnaire for Measuring Child Oral-health-related Quality of Life