Colman McGrath

Impact of orthognathic surgery on quality of life.

PURPOSEnTo determine changes in quality of life (QOL) following orthognathic surgery in patients with dentofacial deformity, using generic health, generic oral health, and condition-specific QOL approaches.nnnMATERIALS AND METHODSnThirty-six patients were evaluated at baseline presurgical (T(0)), 6 weeks postoperatively (T(1)), and 6 months postoperatively (T(2)). Generic health-related QOL was assessed using the 36-item Short Form Health Survey (SF-36), generic oral health-related QOL was assessed by the 14-item Short Form Oral Health Impact Profile (OHIP-14), and condition-specific QOL was assessed by the 22-item Orthognathic Quality of Life Questionnaire (OQLQ).nnnRESULTSnThere was a significant reduction (deterioration) in SF-36 summary physical (P < .01) and mental health scores (P < .001) at 6 weeks after surgery but no significant change in overall OHIP-14 or OQLQ scores. At 6 months after surgery, SF-36 summary scores returned to baseline levels and significant reduction (improvements) in OHIP-14 (P < .001) and OQLQ mean scores (P < .001) were observed.nnnCONCLUSIONSnSignificant changes in QOL occurred following orthognathic surgery. A marked but transient deterioration in many aspects related to general well being was noted in the early postoperative period and significant improvement was documented by 6 months. A comprehensive assessment of QOL using generic health, generic oral health, and condition-specific approaches proved useful in determining such changes.

A systematic review of the effectiveness of oral health promotion activities among patients with cardiovascular disease

AIMSnThis study aimed to review the effectiveness of oral health promotion activities conducted among patients with cardiovascular disease.nnnMETHODS AND RESULTSnThree electronic databases were searched for effective papers using standardized search methods, and key findings of effective studies were summarized. The initial search yielded 3101 papers but only 8 studies met the criteria for this review: 3 were randomized controlled studies, 3 were pre-/post group interventions, 1 was a randomized split-mouth study, and 1 was a quasi-experimental study. Studies retrieved concerned oral health promotion activities in patients with coronary heart disease, hypertension, heart transplantation, and stroke. Interventions comprised periodontal treatment performed by dental personnel, and oral hygiene interventions provided by nursing home care assistants. Outcomes included improvements in periodontal health, and modifications of systemic inflammatory markers. No studies, however, evaluated the effects of oral health promotion interventions on oral microflora.nnnCONCLUSIONnThere are limited studies on the efficacy of oral health promotion activities in patients with cardiovascular disease, particularly stroke patients. Oral health promotion activities appear to produce improvements in periodontal health, and also result in changes to systemic markers of inflammation and endothelial function (at least) in the short term. Whether these effects can ultimately lower the risk of secondary cardiovascular events has not yet been determined.

A review of the influences of oral health on the quality of life

AbstractQuality of life has emerged as the main focus of initiatives across a number of disciplines. With the growing recognition that health is of central importance to quality of life, there has been an explosion of interest in this factor in the medical context. This is equally true in dentistry and this, in turn, has led to advances in defining the concept of ‘oral health related quality of life’ and attempts to measure it. Along with other groups, oral health promoters have embraced this issue as a means of bringing about behavioural change. However, central to developing this area is an assessment of the tools available for measuring it.This paper explores the concepts of ‘quality of life’, health related quality of life ‘and’ oral health related quality of life. It explores how they have arisen and reviews the current oral health related quality of life indicators in the dental literature, their development, their content, their reliability and their validity.The point is made that these indicato...

Pilot Survey of Oral Health-related Quality of Life: A Cross-sectional Study of Adults in Benin City, Edo State, Nigeria

BackgroundOral health studies conducted so far in Nigeria have documented prevalence and incidence of dental disease using traditional clinical measures. However none have investigated the use of an oral health-related quality of life (OHRQoL) instrument to document oral health outcomes. The aims of this study are: to describe how oral health affects and impacts quality of life (QoL) and to explore the association between these affects and the oral health care seeking behavior of adults in Benin City, Edo State, Nigeria.MethodsA cross-sectional survey recruited 356 adults aged 18–64 years from two large hospital outpatient departments and from members of a university community. Closed-ended oral health questionnaire with effect and impact item-questions from OHQoL-UK© instrument was administered by trained interviewers. Collected data included sociodemographic, dental visits, and effects and impact of oral health on QoL. Univariate and bivariable analyses were done and a chi-square test was used to test differences in proportions. Multivariable analyses using ANOVA examined the association between QoL factors and visits to a dentist.ResultsComplete data was available for 83% of the participants. About 62% of participants perceived their oral health as affecting their QoL. Overall, 82%, 63%, and 77% of participants perceived that oral health has an effect on their eating or enjoyment of food, sleep or ability to relax, and smiling or laughing, respectively. Some 46%, 36%, and 25% of participants reported that oral health impact their daily activities, social activities, and talking to people, respectively. Dental visits within the last year was significantly associated with eating, speech, and finance (P < 0.05). The summary score for the oral health effects on QoL ranged from 33 to 80 with a median value of 61 (95% CI: 60, 62) and interquartile range of 52–70. Multivariable modeling suggested a model containing only education (F = 6.5, pr>F = 0.0111). The mean of effects sum score for those with secondary/tertiary education levels (mean = 61.8; 95% CI: 60.6, 62.9) was significantly higher than those with less than secondary level of education (mean = 57.2; 95% CI: 57.2, 60.6).ConclusionMost adults in the study reported that oral health affects their life quality, and have little/no impact on their quality of life. Dental visits within the last year were associated with eating, speech, and finance.

Dental services and perceived oral health: are patients better off going private?

Objective. The aim of this study is to determine associations between method of payment for dental services and perceived oral health in the UK. n nMethod. A national UK study involving a random probability sample of 2718 adults. Respondents were interviewed in their homes about their method of payment for dental services (private or NHS), service use (time and reason for last dental visit), self-reported oral health status (number of teeth possessed and denture status) and the impact of their oral health on their quality of life (employing the 16-item OHQoL-UK© measure). n nResults. The response rate was 68% (1838/2718). Thirty one percent (575/1838) claimed they paid privately for dental services the last occasion they visited their dentist. This was associated with self-reported number of teeth possessed (P<0.01), denture status (P<0.01), WHO goal of retaining 20 teeth with and without a prosthesis (P<0.05), impact of oral health on life quality (P<0.01), and number of positive oral health influences experienced (P<0.01). However, these associations did not remain apparent having accounted for socio-demographic factors (age, gender, and social class background) and reported dental attendance pattern. n nConclusion. Difference in perceived oral health exists between private and NHS dental service users. However, this is more likely to be attributed to socio-demographic factors and regular use of services rather than method of payment.

Effect of oral hygiene interventions on opportunistic pathogens in patients after stroke

BACKGROUNDnDespite the role of the oral cavity as a reservoir of opportunistic pathogens for infection in patients following stroke, the evaluation of the effects of oral hygiene interventions has been largely neglected.nnnMETHODSnThis randomized clinical trial included 102 patients undergoing hospital-based rehabilitation for stroke. Patients were randomized to one of 3 groups: oral hygiene instruction (OHI) only; OHI and 0.2% chlorhexidine mouth rinse twice daily; or OHI, 0.2% chlorhexidine mouth rinse twice daily, and assisted brushing twice weekly. Oral samples were obtained at baseline and after 3 weeks for detection of Staphylococcus aureus, aerobic and facultatively anaerobic gram-negative bacilli, and yeasts.nnnRESULTSnAlmost three-quarters (72.8%) of the patients harbored oral anaerobic gram-negative bacilli at baseline, and more than half had detectable S aureus (56.8%) and yeasts (59.3%). Percentage frequencies and viable counts of pathogens remained relatively stable during the course of the clinical trial, and no significant differences were observed among the 3 patient groups.nnnCONCLUSIONSnIn our study cohort, there was no significant difference in the effectiveness of the 3 different oral hygiene interventions on the prevalence or viable counts of oral opportunistic pathogens.

The Relation Between Caregivers' Multiliterate Reading Habits and Their Children's Oral Health Status.

Background Caregivers’ oral health literacy (OHL) assessment results have been found to be related to their children’s oral health status. A further aspect of this relationship may be the role of caregivers’ reading habits. Objective Our goal was to describe the relationship between caregivers’ multimodal (digital and print) and multilingual (English and Chinese) reading habits, their OHL, and their child’s oral health status in Hong Kong. Methods A random sample of 301 child-caregiver dyads was recruited from kindergartens in Hong Kong. Data included sociodemographic information and caregivers’ self-reported digital print and reading habits across two languages (Chinese and English). Caregivers’ OHL levels were assessed by two locally developed and validated oral health literacy assessment tasks: Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) and the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry (HKOHLAT-P). Children’s oral health status was assessed using two measures: dental caries experience (number of decayed, missing, and filled teeth) and oral hygiene status (Visible Plaque Index). Results Bivariate variations revealed significant differences in mean OHL scores between caregivers with different reading habits (P<.01). Correlations revealed significant associations between caregivers’ practices of reading multimodal (print/digital) and multilingual (English/Chinese) texts, their literacy levels, and their children’s oral health status (P<.01). Adjusting for sociodemographics and all other reading habits in the regression analysis, the caregivers habit of reading digital and print texts was significantly retained in the final model. Regression analysis revealed significant associations between caregivers’ reading habits (digital Chinese) and their OHL word recognition scores: OR 5.00, 95% CI 1.10-3.65, P=.027. Significant associations were also evident for their OHL comprehension scores (digital Chinese: OR 2.30, 95% CI 1.30-4.20, P=.004; print Chinese: OR 2.50, 95% CI 1.40-4.30, P=.001). However, no significant associations were found between caregivers reading habits and child’s oral health status (P>.05). Conclusions Caregivers’ habits of reading print and digital Chinese texts are significantly associated with their OHL scores. Their reading habits, however, do not affect their children’s oral health status.

Treatment seeking behaviour in southern Chinese elders with chronic orofacial pain: a qualitative study

BackgroundChronic orofacial pain (OFP) is common in general adult populations worldwide. High levels of psychological distress and impaired coping abilities are common among Western people with chronic OFP but limited information was found in southern Chinese people. This study aimed to explore the perceptions and experiences of community dwelling elderly people with chronic OFP symptoms and their treatment seeking behaviour in Hong Kong.MethodsAn exploratory qualitative interview study was conducted. Elderly people experiencing chronic OFP symptoms were invited to take part in an individual semi-structured interview. A total of 25 semi-structured interviews were performed for 25 participants.ResultsPertinent issues relating to the treatment seeking behaviour emerged from the interviews, many of which were inter-related and overlapping. They were organized into three major themes: (i) Impact of chronic OFP on daily life; (ii) Personal knowledge and feeling of chronic OFP; (iii) Management of chronic OFP. The participants were found to have the intention to seek professional treatment, but there were barriers which discouraged them continuing to seek professional treatment. They also received complementary treatment for chronic OFP, such as acupuncture, massage and “chi kung”. Moreover, a wide range self-management techniques were also mentioned. On the other hand, those who did not seek professional treatment for the chronic OFP claimed that they had accepted or adapted to the pain as part of their lives.ConclusionsThis qualitative study observed that elderly people affected by chronic OFP symptoms in Hong Kong sought many different ways to manage their pain including traditional and complementary approaches. The role of the dentist in dealing with chronic OFP is unclear. Multiple barriers exist to accessing care for chronic OFP. The findings may be used to inform future chronic OFP management strategies in Hong Kong.

Factors influencing dental service utilisation: findings from a UK household survey

Abstract This study was designed to determine factors associated with and levels of dental service utilisation in the United Kingdom. A random probability sample of 2668 addresses was selected from the British Postcode Address File (PAF) and 1865 adults (70%) were interviewed in their own home. Information on use of dental services, dental anxiety and socio-demographic characteristics was collected. The data were analysed using the statistical package CHAID to identify significant factors in the use of services when age, gender, social class, level of income, level of education, area of residency, work pattern and dental anxiety were examined. 64% (1185) reported to have attended the dentist within the past year. Level of education was identified as the most important factor in determining services use (p<0.01), with 75% (312) of those with a high level of education reporting that they attended within the past year. For those who had a low level of education only 31% (75) reported attending the dentist within the past year. For those who had a low or high level of education, age was identified as the next most important factor in determining service use (p<0.01). Among those who had an intermediate level of education, dental anxiety was identified as the next most important determining factor in service utilisation (p<0.01). These findings may have implications for those involved in promoting the use of dental services and suggests the importance of targeting oral health promotion programmes at people who have lower levels of educational achievement, and especially older people in this category.

Can dentures improve the quality of life of those who have experienced considerable tooth loss

OBJECTIVESnThe aim of this study was to identify variations in the impact of oral health on quality of life (OHQOL) among UK residents in relation to self-reported number of teeth possessed and denture status. In addition, to determine whether recourse to a removable prosthesis for those who claimed that they had experienced considerable tooth loss (having <20 teeth) was associated with quality of life.nnnMETHODSnThe vehicle for this was the Office for National Statistics Omnibus survey in Great Britain. A random probability sample of 2667 addresses was selected in a multistage sampling process. Participants were interviewed about their oral health status. The impact of oral health on quality of life was measured utilising the OHQoL-UK(W) measure.nnnRESULTSnThe response rate was 68%. Variations in OHQoL-UK(W) scores were apparent in relation to self-reported number of teeth possessed (P < 0.001) and denture status (P < 0.001). Moreover, disparities in OHQOL were apparent among those who experienced considerable tooth loss who didnt have recourse to a denture (P < 0.001). In regression analysis, those who claimed that they had <20 natural teeth but had no recourse to a denture were less than half as likely to enjoy enhanced oral health related quality of life compared to others in the population (OR = 0.46, 95% Cl 0.30, 0.71), controlling for socio-demographic factors.nnnCONCLUSIONSnExperience of considerable tooth loss without recourse to a removable dental prosthesis is an important predictor of oral health related quality of life, as captured by OHQoL-UK(W), and associated with reduced quality of life.