Although common oral diseases are not life threatening, their outcomes may influence the overall wellbeing of individuals and populations. Oral health-related quality of life (OHRQoL) characterizes a person's perception of how oral health influences an individual's life quality and overall well being. This concept has received a lot of attention in the past two decades from sociologists, psychologists and the health professions, [1
] with different instruments been developed to measure quality of life (QoL) and OHRQoL.
Cohen & Jago [2
] first recognized the lack of data on the psycho-social impact of oral health problems. [3
] To address this, several authors developed socio-dental indicators to measure the social impact of oral health problems. [5
] In addition, other generic and disease-specific measures were developed based on the conceptual framework of the World Health Organization's (WHO) International Classification of Impairments, Disabilities and Handicaps (ICIDH). [1
] However, some concerns have been raised about the instruments so far developed, because of their use of older adults in testing the reliability and validity of the instruments, the use of non-random samples, and some have mostly professionally dominated opinions. [13
] Other concerns also include measuring of positive and or negative effects related to QoL and the varied number of item questions or domains in each instrument. [13
Most of the OHRQoL instruments developed so far measure either the "effect" or the "impact" of oral health on life quality and others measure the "effect and "impact" together. The "effect" dimension examines the physical, psychological and social effects of oral health attributes, and the "impact" dimension examines the impact of oral health attributes on daily activities, chewing ability and talking to people. It also examines the impact of the effects on individuals' overall quality of life. This "effect" and "impact" domains of oral health are better assessed using OHRQoL measures rather than the traditional clinical disease status measures. Slade & Spencer [8
] and Adulyanon et al
] instruments for the most part focused on the negative effects of how oral health affects quality of life, but that developed by McGrath & Bedi [13
] included the positive "effects" dimensions which reflected the concept of health beyond the mere absence of disease-impairment-disability-handicap. [13
] Developing this idea further, Locker [17
] suggested an extension of the ICIDH scope to include certain feeling states (e.g., pain and psychological discomfort) which are prominent consequences of oral disease.
The instrument (OHQoL-UK©
) developed by McGrath & Bedi used a random probability sampling method. [13
] It is based on the public's perceptions in the United Kingdom of how oral health affects life quality. [13
] It consists of 16 key questions relating to 16 key areas of oral health-related quality of life, such as comfort, speaking, and social life, and each of the 16 key questions are also rated for their 'impact' on overall quality of life. [13
has been tested for reliability and validity and found to be a valid and reliable measure for assessing OHRQoL, and have also been reported to have good psychometric properties. [13
and other oral health-related quality of life instruments have been used to explore a relationship between sociodemographic factors in different populations, [18
] from different countries including Tanzania, Greece, Thailand, Germany, Syria, Egypt, Saudi Arabia, and Uganda. [12
] This has lead to a paradigm shift from the use of only traditional assessment of oral health with a focus on disease to a more comprehensive community measure of health service provision. [1
] This shift gives healthcare providers the opportunity to move from the concept of just treating disease, to a holistic model of caring for the patient as a productive member of the society under the "socio-environmental-medical model" of caregiving that encompasses a broader definition of oral health.
Studies show that OHRQoL is related to age, gender, and socioeconomic factors. [6
] A study of secondary school students conducted in Nigeria found that participants perceived their teeth to be important for their appearance [23
] and self esteem. [24
] Overall, their perception of the importance of dental health was similar to those reported from the United States. [25
] In a recently published study conducted in Nigeria we demonstrated that being younger, being female, and being employed were associated with visiting a dentist in the past 12 months. [26
] Other studies have documented prevalence of dental caries and periodontal disease in Nigeria, [27
] and described oral health care practice among physicians, [28
] as well as oral health knowledge and attitudes of Nigerian school teachers. [29
Despite these studies there is a paucity of information on how oral health affects and impacts quality of life of persons from sub-Saharan African countries (e.g., Nigeria) which have multiple tribes, varied cultural beliefs, high levels of unemployment and poverty. The specific aims of this study were: 1) to describe the effect and impact of OHRQoL factors, and 2) to explore the association between these effects and oral health care seeking behavior of adults in Benin City, Edo State, Nigeria. This study used oral health related quality of life measures patterned after OHQoL-UK©
]. The questions of how oral health is related to quality of life were described in two dimensions: "effects" and "impacts". The effect dimension included three domains (physical effects, psychological effects and social effects), and the impact dimension included three domains (impact on daily activities, chewing ability and talking to people). We believe that this study will fill a gap in OHRQoL on Benin City, Edo State, Nigeria and will serve as an impetus for more research in this area.