Title: Quantifying Oral Health Related Quality of Life Hans Gjrup Aarhus University Hospital
1Quantifying Oral Health Related Quality of
LifeHans GjørupAarhus University Hospital
The 4th Nordic Conference on Orofacial Therapy
2Aarhus University HospitalÅrhus Sygehus
3Oral health and quality of life- any relation?
4Quality of life (QoL)
- QoL is related to health
- Health and ability to function
- Vital functions in the orofacial area
- Oral Health Related Quality of life
5WHO definition of health
- WHO Constitution 1946
- Health is a state of complete physical, mental
and social wellbeing and not merely the absence
of disease or infirmity
6WHO definition of health
- WHO 1998
- Health is a ressource for everyday life, not the
object of living. It is a positive concept
emphasizing social and personal ressources as
well as physical capabilities.
7Theoretical referenceHolistic theories
- Disease or sickness
- Physical changes of organs in the body
- Lack of an organ or part of the body
- Malfunction of organs
- Lack of function
8Theoretical referenceHolistic theories
- Health is the ability of the individual to
achieve vital aims in daily life - Acceptabel health
- An individual definition
9Disease versus illness
- Diseased or sound
- Objective
- Biomedical items
- Functional limitations
- Impairment
- Disease
- Death
- Illness or wellbeing
- Subjective
- Sociomedical items
- Discomfort
- Incompetence
- Handicap
10Lockers model for Oral HealthREFLocker D.
Measuring oral health a conceptual framework.
Community Dent Health 1988 53-18
Functional limitation
- Disability
- Physical
- Psychological
- Social
Disease
Impairment
Handicap
Discomfort pain
11Quantifying oral health
- Biomedical items
- DMFS/T
- Gingival index, Löe and Silness 1963
- PAR index, Richmond 1992
- Research diagnostic criteria, Dvorkin and LeReche
1992
12Quantifying oral health
- Sociomedical items
- Research diagnostic criteria, Dvorkin and LeReche
1992 - OHQoL indices
- Oral Health related Quality of Life
13www.qolid.org/proqolid
14OHQoL for adults
- GOHAI. General Oral Health Assessment Index,
Atchinson and Dolan, 1990 - Dental Impact Profile, Strauss and Hunt 1993
- OHIP, Oral Health Impact Profile, Slade and
Spencer 1994 - DIDL Dental Impact on Daily Living, Leao and
Sheiham 1996 - OIDP, Oral Impacts on Daily Performances,
Adulyanon and Sheiham 1997
15OHQoL for children
- Child Health Questionnaire
- Landgraf et al 1996
- Childhood Asthma Questionnaires
- French and Christies 1996
- Child-OIDP, Child Oral Impact on Daily
Performances - Gherunpong, Tsakos, Sheiham 2004
- COHQoL, Child Oral Health related Quality of Life
- Jokovic, Slade et al 2002
16Pub MED searchAdults/adolescents Quality of
Life - and
- DIDL 3 hits
- GOHAI 19 hits
- OIDP 23 hits
- OHIP 101 hits
17OHIP translated into
- English / American
- Hungarian
- Brazil
- German
- Portugese
- Swedish
- Hebrew
- Spanish
- Malaysian
- Sri Lanka
- Chinese
- Japanese
- Danish
18Translation procedures
Translation english to danish
Backtranslation danish to english
Comparing the 2 english versions
Adjustment of the danish version
19Pub MED searchChildren Quality of Life and
- Child - OIDP 8 hits (2004-2007)
- CPQ 12 hits (2002-2007)
20Quantifying the impact of oral health on quality
of life
- OHIP (Slade 1994)
- Oral Health Impact Profile
- COHQoL (Jokovic 2002)
- Child Oral Health Quality of Life
- Standardized questionnaires
- Frequency of symptoms or experiences
- Score 0 4
- 0 never
- 4 daily / always
- Validation studies performed
21OHIP(Slade Spencer 1994)
- 49 questions
- 7 domaines
- Functional limitations
- Physical pain
- Psychological discomfort
- Physical disability
- Psychological disability
- Social disability
- Handicap
22Questions
- Functional limitations
- Have you felt that your sense of taste was
worsened because of problems with your teeth,
mouth or denture? - Physical pain
- Have you had toothache?
- Psychological impact
- Have you felt uncomfortable about the appearance
of your teeth, mouth or denture?
23Questions
- Physical disability
- Have you been unable to brush your teeth
properly due to problems with your teeth, mouth
or denture? - Psychological disability
- Have you felt depressed because of problems with
your teeth, mouth or dentures? - Social disability
- Have you had difficulty doing your usual jobs
because of problems with your teeth, mouth or
dentures?.
24Reliability and validity of a Sweedish version of
Oral Health Impact Profile Larson P, List T, et
al 2004Acta Odontol Scand 62 148-152
- OHIP-S
- 5 groups
- TMD (n30)
- Sjøgren Syndrom (n30)
- Oral mucosal pain (n28)
- Skeletal malocclusion (n27)
- Healthy controls (n30)
- Mean OHIP total-score
- 61,0
- 42,4
- 45,6
- 41,3
- 9,3
25 Larson P 2004Acta Odontol Scand 62 148-152
- Conclusions
- The reliability of the OHIP-S appears to be good
- The validity of the OHIP-S is acceptable
- OHIP-S can differentiate between groups of
patients with different kinds of functional
limitations and healthy individuals - The use of OHIP-S in future studies is recommended
26COHQoL(Jokovic Locker 2002)
- 4 types
- CPQ 6 7 (child perception questionnarie)
- CPQ 8 10 (child perception questionnarie)
- CPQ 11 14 (child perception questionnarie)
- PPQ (parental perception
questionnarie) - 29 49 questions
- 4 domaines
- Oral symptoms
- Functional limitations
- Psychological well-being
- Social well.being
27Validity and reliability of a questionnaire for
measuring Child Oral-helath-related Quality of
Life Jokovic A et al. 2002 J Dent Res,
81(7)459-463
- CPQ 11-14
- 3 groups
- Pedodontic (n32)
- Orthodontic (n52)
- Orofacial (n39)
- Mean CPQ total-scores
- 23,3 (SD 18,4)
- 24,3 (SD 14,5)
- 31,4 (SD 17,1)
28Jokovic A et al. 2002J Dent Res, 81(7)459-463
- Conclusions
- CPQ 11-14 is valid
- CPQ 11-14 has excellent reliability
- Orofacial conditions have substantial impact on
functional and psychosocial well-being - Psychometrically acceptabel accounts of the
impact can be achieved - CPQ 11-14 performs well as a discriminant measure
29Boy, 14 year, AIImpact upon QoL ?
30AI-boy, 14 yearCPQ 11-14
31CPQ profile, AI-boy
32CPQ_5 boys with HEDPedo and ortho group_Jokovic
2002
33Male, 20 year, AMCImpact upon QoL ?
34OHIP, male, 20 years, AMCSweedish control
groupLarsson P, List T, Lundström I, Marcusson
A, Ohrbach R. Reliability and validity of a
Sweedish version of the Oral Health Impact
Profile (OHIP-S). Acta Odontol Scand 2004
62147-152.
35OHIP, male, 20 year, AMCSweedish control
groupLarsson P, List T, Lundström I, Marcusson
A, Ohrbach R. Reliability and validity of a
Sweedish version of the Oral Health Impact
Profile (OHIP-S). Acta Odontol Scand 2004
62147-152.
36Female, 59 years, Ehlers Danloss syndrome
37Oral Health Impact ProfilesEDS-pt vs TMD group
(30)
38Impact of oligodontia on OoL?
- Patients referred to the Centre for Oral Health
in Rare Diseases - Agenesis of 13 teeth or more
- 9 patients answered the OHIP questionnaire in
2006-2007 - 16 37 years of age
- 3 females
- 6 males
39OHIP 9 individuals with agenesis
40Agenesis group (N9) vs.3 groups in the OHIP-S
study
41OHQoL indices- conclusions
- A diagnostic tool in treatment planning
- Complement to objective needs assessment
- Evaluate outcome of treatment
- The ultimate parameter in evaluation of quality
of treatment - Part of population studies
- An issue in national population surveys and
public health care planning
42Thank you for your attention