ASSESSMENT OF IMPACT OF ORAL HEALTH PARAMETERS ON ORAL HEALTH-RELATED QUALITY OF LIFE IN FUTURE DENTISTS
WHO estimates health as complete physical, mental and social well-being. Clinical indicators of oral diseases are not entirely suitable to capture this concept of health. Standardized questionnaires have been developed to evaluate the physical, psychological, and social impact of oral conditions on an individual. Oral health-related quality of life (OHRQoL) identifies the impact of oral health on aspects of everyday life in terms of a person’s functional, social, and psychological well-being. The oral health impact profile (OHIP) is widely used to measure OHRQoL in adults, its short version includes 14 items (OHIP-14).
The aim was to investigate how self-reported and clinically-assessed parameters of oral health are related to OHRQoL measured by OHIP-14 in dental students of UMSA.
101 third- and fourth-year dental students aged 19–26 years attending UMSA in Poltava, Ukraine, took a questionnaire in Ukrainian. The first part of the questionnaire includes information on age, sex, self-assessed oral health, self-assessed dental aesthetic, satisfaction with mouth and teeth, and oral health behaviour. Questions on oral health behaviour included regularity of dental visits and frequency of tooth brushing. All these items were categorized into different groups. The question on dental aesthetic had the response option “difficult to answer”. When that response was chosen (n = 2 questionnaires), this data was considered missing and the students were excluded from the analysis.
The second part of the questionnaire included the OHIP-14 to measure OHRQoL. There were seven dimensions of negative impact on OHRQoL: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. There were two items for each dimension, which added up to a total of 14 items. Participants rated the frequency with which they experienced each of these items in the last 12 months using a 5-point Likert scale (“never” = 0, “hardly ever” = 1, “occasionally” = 2, “fairly often” = 3, and “very often” = 4). In addition, each item had the response option “I do not know”. When a student missed one answer or chose the option “I do not know” (for at least one item), the data was considered missing, and the student was excluded from the analysis (n=2).
A clinical dental examination was performed. All permanent teeth were taken into consideration to measure dental caries experience using the DMF index. The Green-Vermillion index was applied for oral hygiene estimation. To assess the extent of gingivitis, the PMA index was used. The chi-square test was applied to compare the percentage of students with low and high OHRQoL between categories of self-reported oral health characteristics, and oral health behaviour. When comparing data on clinically-assessed oral health (the DMF, Green-Vermillion, and PMA indices), the Mann–Whitney U test was used for the two independent groups (with low and high OHRQoL). p-values<0.05 were considered as statistically significant.
A total of 97 students were included in the statistical analysis, 43 of which were males and 54 were females. The highest mean scores in OHIP-14 were observed for the dimensions of physical pain (39,17%). Students with poor self-assessed oral health, poor self-assessed dental aesthetic, and who reported dissatisfaction with mouth and teeth more frequently fell into the group with low OHRQoL (p<0,05). The mean DMF was 5,41, Green-Vermillion hygienic index was 0,54, and РМА – 4,48%. However, a higher DMF index score, high Green-Vermillion index, and high PMA in students were not associated with low OHRQoL (р>0,5).
In this study, the self-reported assessment of oral health affects the dental students' quality of life, while the clinical characteristics do not. Physical pain was the most frequently reported OHIP-14 dimension with an impact on OHRQoL. Poor self-assessed dental aesthetic and dissatisfaction with mouth and teeth were the strongest factors associated with low OHRQoL.
The line of research pertaining to other parameters of oral health in youth that impact dental aesthetic and oral health, and thus oral health-related quality of life, is considered promising.
2. Leus PA, Homenko LO, Smoljar NІ, Kas'kova LF. Evropejskie indikatory v ocenke vlijanija povedencheskih faktorov riska. Stomatologicheskij zhurnal. 2016; 3: 164-170.(Russian)
3. Locker D, Allen F. What do measures of ‘oral health-related quality of life’ measure? Community Dent Oral Epidemiol. 2007; 35: 401–11.
4. Allen PF. Assessment of oral health related quality of life. Health Qual Life Outcomes. 2003; 1: 40.
5. Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997; 25: 284-90.
6. Yamane-Takeuchi M, Ekuni D, Mizutani S, Kataoka K, Taniguchi-Tabata A, Azuma T, et al. Associations among oral health-related quality of life, subjective symptoms, clinical status, and self-rated oral health in Japanese university students: A cross-sectional study. BMC Oral Health. 2016; 16: 127.
7. Drachev SN, Brenn T, Trovik TA. Oral health related quality of life among young adults: A Survey of Russian Undergraduate Students. Acta Odontol. Scand. 2002; 60: 353–9.
8. Lu HX, Wong M, Lo E, McGrath C. Oral health related quality of life among young adults. Appl Res Qual Life. 2015; 10: 37–47.
9. Kaskova LF, redaktor. Profіlaktika stomatologіchnih zahvorjuvan. Poltava: TOV «ASMІ»; 2018. 403 s.(Ukrainian)
10. Parma C. Parodontopathien. Leipzig: I.A.Verlag; 1978, 203 p.
11. medcalc.org [Internet]. [updated 2019 Dec 14; cited 2020 March 14]. Available from: https://www.medcalc.org/calc/comparison_of_proportions.php.
12. Mann-Whitney U Test Calculator [Internet]. [updated 2019 Sep 23; cited 2020 March 14]. Available from: https://www.socscistatistics.com/tests/mannwhitney/ default2.aspx.
13. Oscarson N, Kallestal C, Lindholm L. A pilot study of the use of oral health-related quality of life measures as an outcome for analysing the impact of caries disease among Swedish 19-year-olds. Caries Res. 2007; 41: 85–92.
14. Carr AJ, Gibson B, Robinson PG. Is quality of life determined by expectations or experience? BMJ. 2001; 322: 1240–3.
15. Slade GD, Sanders AE. The paradox of better subjective oral health in older age. J Dent Res. 2011; 90: 1279–85.
16. Vodorіz JaJu, Lemeshko AV, Marchenko ІJa, Shundrik MA, Tkachenko ІM, Kovalenko VV. Ocіnka jakostі zhittja u pacієntіv іz potreboju u lіkuvannі zubіv frontal'noї grupi. Vіsnik problem bіologії і medicini. 2019; 4 (1): 296-300. (Ukrainian)
This work is licensed under a Creative Commons Attribution 4.0 International License.