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1.  HIV/AIDS-related attitudes and oral impacts on daily performances: a cross-sectional study of Sudanese adult dental patients 
Background
Few studies have investigated the relationships between HIV-related knowledge, fear of contagion in dental environments and Oral Impacts on Daily Performance (OIDP) among dental patients. Our objectives were to investigate the associations between HIV-related knowledge and fear of contagion in dental environments and OIDP among dental patients, and to evaluate whether those associations were modified by the frequency of dental service attendance.
Methods
A total of 1262 patients (mean age 30.7 years, 56.5% females) were recruited from the Khartoum Dental Teaching Hospital and the University of Science and Technology during March–July 2008. The participants underwent a full-mouth oral clinical examination and completed an interview in a face-to-face setting.
Results
Of the study participants, 41.4% had visited a dentist at least twice during the last 2 years, 96.2% had caries experience (DT > 0) and 79.1% reported oral impacts (OIDP > 0). The most frequently reported oral impacts were problems eating, sleeping and cleaning teeth. In total, 26.3% of the participants had HIV transmission knowledge, 75.6% knew people with HIV/AIDS and 58.7% perceived a high risk of cross-infection in dental environments. After adjusting for sociodemographic characteristics, frequency of dental service attendance and caries experience, patients who had high HIV-related information exposure, a positive attitude toward people with HIV/AIDS and a high perceived risk of cross-infection were more likely to report oral impacts, whereas patients who knew people with HIV/AIDS were less likely to report oral impacts. The association between OIDP and HIV transmission knowledge was modified by frequency of dental service attendance.
Conclusions
Dental patients who were informed about HIV and had a high HIV/AIDS risk perception were more likely to report impaired oral health-related quality of life than their less informed counterparts and those who perceived a low risk of contagion. The effect of HIV transmission knowledge on oral impacts was influenced by frequency of dental service attendance.
doi:10.1186/1472-6963-13-335
PMCID: PMC3765642  PMID: 23971974
HIV; AIDS; Attitudes; Oral impacts on daily performance; Dental; Sudan
2.  Discriminative ability of the generic and condition-specific Child-Oral Impacts on Daily Performances (Child-OIDP) by the Limpopo-Arusha School Health (LASH) Project: A cross-sectional study 
BMC Pediatrics  2011;11:45.
Background
Generic and condition-specific (CS) oral-health-related quality-of-life (OHRQoL) instruments assess the impacts of general oral conditions and specific oral diseases. Focusing schoolchildren from Arusha and Dar es Salaam, in Tanzania, this study compared the discriminative ability of the generic Child OIDP with respect to dental caries and periodontal problems across the study sites. Secondly, the discriminative ability of the generic-and the CS Child OIDP attributed to dental caries, periodontal problems and malocclusion was compared with respect to various oral conditions as part of a construct validation.
Methods
In Arusha, 1077 school children (mean age 14.9 years, range 12-17 years) and 1601 school children in Dar es Salaam (mean age 13.0 years, range 12-14 years) underwent oral clinical examinations and completed the Kiswahili version of the generic and CS Child-OIDP inventories. The discriminative ability was assessed as differences in overall mean and prevalence scores between groups, corresponding effect sizes and odd ratios, OR.
Results
The differences in the prevalence scores and the overall mean generic Child-OIDP scores were significant between the groups with (DMFT > 0) and without (DMFT = 0) caries experience and with (simplified oral hygiene index [OHI-S] > 1) and without periodontal problems (OHI-S ≤ 1) in Arusha and Dar es Salaam. In Dar es Salaam, differences in the generic and CS Child-OIDP scores were observed between the groups with and without dental caries, differences in the generic Child-OIDP scores were observed between the groups with and without periodontal problems, and differences in the CS Child-OIDP scores were observed between malocclusion groups. The adjusted OR for the association between dental caries and the CS Child-OIDP score attributed to dental caries was 5.4. The adjusted OR for the association between malocclusion and CS Child-OIDP attributed to malocclusion varied from 8.8 to 2.5.
Conclusion
The generic Child-OIDP discriminated equally well between children with and without dental caries and periodontal problems across socio-culturally different study sites. Compared with its generic form, the CS Child-OIDP discriminated most strongly between children with and without dental caries and malocclusion. The CS Child OIDP attributed to dental caries and malocclusion seems to be better suited to support clinical indicators when estimating oral health needs among school children in Tanzania.
doi:10.1186/1471-2431-11-45
PMCID: PMC3118891  PMID: 21615892
3.  Evaluation of oral health-related quality of life among Sudanese schoolchildren using Child-OIDP inventory 
Background
Information on oral health-related quality of life, in addition to clinical measures, is essential for healthcare policy makers to promote oral health resources and address oral health needs.
Objectives
This paper aimed at evaluating the psychometric properties of the Arabic version of Child-OIDP, estimating the prevalence, severity and causes of oral impacts on daily performances in 12-year-old public and private school attendees in Khartoum State and to identify socio-demographic and clinical correlates of oral impacts as assessed by the Child-OIDP inventory.
Methods
The Child-OIDP questionnaire was translated into Arabic was administered to a representative sample of 1109 schoolchildren in Khartoum state. Clinical measures employed in this study included DMFT index, Gingival index, Plaque index and Dean's index. A food frequency questionnaire was used to study the sugar-sweetened snack consumption.
Results
The instrument showed acceptable psychometric properties and is considered as a valid, reliable (Cronbach's alpha 0.73) and practical inventory for use in this population. An impact was reported by 54.6% of the schoolchildren. The highest impact was reported on eating (35.5%) followed by cleaning (28.3%) and the lowest impacts were on speaking (8.6%) and social contact (8.7%). Problems which contributed to all eight impacts were toothache, sensitive teeth, exfoliating teeth, swollen gums and bad breath. Toothache was the most frequently associated cause of almost all impacts in both private and public school attendees. After adjusting for confounders in the 3 multiple variable regression models (whole sample, public and private school attendees), active caries maintained a significant association with the whole sample (OR 2.0 95% CI 1.4-2.6) and public school attendees (OR 3.5 95% CI 2.1-5.6), and higher SES was associated with only public school attendees' Child-OIDP (OR 1.9 95% 1.1-3.1).
Conclusion
This study showed that the Arabic version of the Child-OIDP was applicable for use among schoolchildren in Khartoum. Despite the low prevalence of the dental caries pathology (24%), a significant relationship, with an average moderate intensity was found with OHRQoL. Focus in this population should be on oral health education, improving knowledge of the prospective treatment opportunities and provision of such services.
doi:10.1186/1477-7525-8-152
PMCID: PMC3019139  PMID: 21182769
4.  Applicability of an abbreviated version of the Child-OIDP inventory among primary schoolchildren in Tanzania 
Background
There is a need for studies evaluating oral health related quality of life (OHRQoL) of children in developing countries.
Aim
to assess the psychometric properties, prevalence and perceived causes of the child version of oral impact on daily performance inventory (Child-OIDP) among school children in two socio-demographically different districts of Tanzania. Socio-behavioral and clinical correlates of children's OHRQoL were also investigated.
Method
One thousand six hundred and one children (mean age 13 yr, 60.5% girls) attending 16 (urban and rural) primary schools in Kinondoni and Temeke districts completed a survey instrument in face to face interviews and participated in a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child-OIDP frequency score, global oral health indicators and socio-demographic factors.
Results
The Kiswahili version of the Child-OIDP inventory preserved the overall concept of the original English version and revealed good reliability in terms of Cronbach's alpha coefficient of 0.77 (Kinondoni: 0.62, Temeke: 0.76). Weighted Kappa scores from a test-retest were 1.0 and 0.8 in Kinondoni and Temeke, respectively. Validity was supported in that the OIDP scores varied systematically and in the expected direction with self-reported oral health measures and socio-behavioral indicators. Confirmatory factor analyses, CFA, confirmed three dimensions identified initially by Principle Component Analysis within the OIDP item pool. A total of 28.6% of the participants had at least one oral impact. The area specific rates for Kinondoni and Temeke were 18.5% and 45.5%. The most frequently reported impacts were problems eating and cleaning teeth, and the most frequently reported cause of impacts were toothache, ulcer in mouth and position of teeth.
Conclusion
This study showed that the Kiswahili version of the Child-OIDP was applicable for use among schoolchildren in Tanzania.
doi:10.1186/1477-7525-5-40
PMCID: PMC1939836  PMID: 17631038
5.  A Malay version of the Child Oral Impacts on Daily Performances (Child-OIDP) index: assessing validity and reliability 
Background
The study aimed to develop and test a Malay version of the Child-OIDP index, evaluate its psychometric properties and report on the prevalence of oral impacts on eight daily performances in a sample of 11–12 year old Malaysian schoolchildren.
Methods
The Child-OIDP index was translated from English into Malay. The Malay version was tested for reliability and validity on a non-random sample of 132, 11–12 year old schoolchildren from two urban schools in Kuala Lumpur. Psychometric analysis of the Malay Child-OIDP involved face, content, criterion and construct validity tests as well as internal and test-retest reliability. Non-parametric statistical methods were used to assess relationships between Child-OIDP scores and other subjective outcome measures.
Results
The standardised Cronbach’s alpha was 0.80 and the weighted Kappa was 0.84 (intraclass correlation = 0.79). The index showed significant associations with different subjective measures viz. perceived satisfaction with mouth, perceived needs for dental treatment, perceived oral health status and toothache experience in the previous 3 months (p < 0.05). Two-thirds (66.7%) of the sample had oral impacts affecting one or more performances in the past 3 months. The three most frequently affected performances were cleaning teeth (36.4%), eating foods (34.8%) and maintaining emotional stability (26.5%). In terms of severity of impact, the ability to relax was most severely affected by their oral conditions, followed by ability to socialise and doing schoolwork. Almost three-quarters (74.2%) of schoolchildren with oral impacts had up to three performances affected by their oral conditions.
Conclusion
This study indicated that the Malay Child-OIDP index is a valid and reliable instrument to measure the oral impacts of daily performances in 11–12 year old urban schoolchildren in Malaysia.
doi:10.1186/1477-7525-10-63
PMCID: PMC3444407  PMID: 22682472
Oral health; Quality of life; Reliability; Schoolchildren; Validity
6.  Social and dental status along the life course and oral health impacts in adolescents: a population-based birth cohort 
Background
Harmful social conditions in early life might predispose individuals to dental status which in turn may impact on adolescents' quality of life.
Aims
To estimate the prevalence of oral health impacts among 12 yr-old Brazilian adolescents (n = 359) and its association with life course socioeconomic variables, dental status and dental services utilization in a population-based birth cohort in Southern Brazil.
Methods
Exploratory variables were collected at birth, at 6 and 12 yr of age. The Oral Impacts on Daily Performances index (OIDP) was collected in adolescence and it was analyzed as a ranked outcome (OIDP from 0 to 9). Unadjusted and adjusted multivariable Poisson regression with robust variance was performed guided by a theoretical determination model.
Results
The response rate was of 94.4% (n = 339). The prevalence of OIDP = 1 was 30.1% (CI95%25.2;35.0) and OIDP ≥ 2 was 28.0% (CI95%23.2;32.8). The most common daily activity affected was eating (44.8%), follow by cleaning the mouth and smiling (15.6%, and 15.0%, respectively). In the final model mother schooling and mother employment status in early cohort participant's life were associated with OIDP in adolescence. As higher untreated dental caries at age 6 and 12 years, and the presence of dental pain, gingival bleeding and incisal crowing in adolescence as higher the OIDP score. On the other hand, dental fluorosis was associated with low OIDP score.
Conclusion
Our findings highlight the importance of adolescent's early life social environmental as mother schooling and mother employment status and the early and later dental status on the adolescent's quality of life regardless family income and use of dental services.
doi:10.1186/1477-7525-7-95
PMCID: PMC2785763  PMID: 19930601
7.  Validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional study of adolescents in Uganda 
BMC Oral Health  2003;3:5.
Background
Assessing oral health related quality of life impact of mouth in adolescents is a relatively ignored area in dental research. This study aimed to examine reliability and validity of an abbreviated version of the oral impact of daily performance (OIDP) questionnaire and to analyse the interrelationship among OIDP scores, socio-demographic characteristics and oral health status in Uganda.
Method
1146 adolescents (mean age 15.8, response rate 87%) attending secondary schools in Kampala (urban) and Lira (rural) completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. A clinical examination was conducted among 372 students (mean age 16.3, response rate 72%) and caries was assessed following the World Health Organisation criteria (1997).
Results
62% of the students experienced at least one oral impact during the 6 months preceding the survey. Cronbach's alpha for the OIDP frequency items was 0.91 and the corrected item-total correlation ranged from 0.62 to 0.75. Discriminant and construct validity were demonstrated in that the OIDP scores varied systematically in the expected direction with missing teeth and self-report indicators of oral health status, respectively. Socio-demographics and dental attendance did not predict OIDP through interaction with clinical indicators but varied systematically and independently with OIDP frequency scores in the multivariate analysis.
Conclusion
the OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among Ugandan adolescents. Some evidence of the importance of social and personal characteristics in shaping adolescents' responses to oral disorders was provided.
doi:10.1186/1472-6831-3-5
PMCID: PMC212323  PMID: 12943555
adolescents; Uganda; OIDP; validity; reliability; caries experience; social factors
8.  Malocclusion, psycho-social impacts and treatment need: A cross-sectional study of Tanzanian primary school-children 
BMC Oral Health  2008;8:14.
Background
studies on the relationship between children's malocclusion and its psycho-social impacts are so far largely unexplored in low-income countries. This study aimed to assess the prevalence of malocclusion, reported dental problems and dissatisfaction with dental appearance among primary school children in Tanzania. The relationship of dissatisfaction with socio-demographic characteristics, clinically defined malocclusion and psychosocial impacts of dental anomalies was investigated. Orthodontic treatment need was estimated using an integrated socio-dental approach.
Method
One thousand six hundred and one children (mean age 13 yr) attending primary schools in the districts of Kinondoni and Temeke completed face to face interviews and a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child Oral Impact on Daily Performance (Child-OIDP) frequency score, reported dental problems, dissatisfaction with dental appearance/function and socio-demographic characteristics.
Results
The prevalence of malocclusion varied from 0.9% (deep bite) to 22.5% (midline shift) with a total of 63.8% having at least one type of anomaly. Moderate proportions of children admitted dental problems; ranging from 7% (space position) to 20% (pain). The odds ratio of having problems with teeth position, spaces, pain and swallowing if having any malocclusion were, respectively 6.7, 3.9, 1.4 and 6.8. A total of 23.3% children were dissatisfied with dental appearance/function. Children dissatisfied with their dental appearance were less likely to be Temeke residents (OR = 0.5) and having parents of higher education (OR = 0.6) and more likely to reporting problem with teeth position (OR = 4.3) and having oral impacts (OR = 2.7). The socio-dental treatment need of 12% was five times lower than the normative need assessment of 63.8%.
Conclusion
Compared to the high prevalence of malocclusion, psycho social impacts and dissatisfaction with appearance/function was not frequent among Tanzanian schoolchildren. Subjects with malocclusion reported problems most frequently and malocclusion together with other psycho-social impact scores determined children's satisfaction with teeth appearance- and function.
doi:10.1186/1472-6831-8-14
PMCID: PMC2413214  PMID: 18460198
9.  Dental caries prevalence, oral health knowledge and practice among indigenous Chepang school children of Nepal 
BMC Oral Health  2013;13:20.
Background
Chepang communities are one of the most deprived ethnic communities in Nepal. According to the National Pathfinder Survey, dental caries is a highly prevalent childhood disease in Nepal. There is no data concerning the prevalence of caries along with knowledge, attitude and oral hygiene practices among Chepang schoolchildren. The objectives of this study were to 1) record the prevalence of dental caries 2) report experience of dental pain 3) evaluate knowledge, attitude and preventive practices on oral health of primary Chepang schoolchildren.
Method
A cross sectional epidemiological study was conducted in 5 government Primary schools of remote Chandibhanjyang Village Development Committee (VDC) in Chitwan district. Ethical approval was taken from the Institutional Review Board within the Research Department of the Institute of Medicine (IOM) Tribhuvan University. Consent was obtained from parents for conducting clinical examination and administrating questionnaire. Permission was taken from the school principal in all schools. Data was collected using a pretested questionnaire on 131 schoolchildren aged 8-16-year- olds attending Grade 3–5. Clinical examination was conducted on 361 school children aged 5–16 –year-olds attending grade 1–5. Criteria set by the World Health Organization (1997) was used for caries diagnosis. The questionnaires, originally constructed in English and translated into Nepali were administered to the schoolchildren by the researchers. SPSS 11software was used for data analysis.
Results
Caries prevalence for 5–6 –year-old was above the goals recommended by WHO and Federation of Dentistry international (FDI) of less than 50% caries free children. Caries prevalence in 5-6-year-olds was 52% and 12-13-year-olds was 41%. The mean dmft/DMFT score of 5–6 –year-olds and 12 -13-year -olds was 1.59, 0.31 and 0.52, 0.84 respectively. The DMFT scores increased with age and the d/D component constituted almost the entire dmft/DMFT index. About 31% of 8-16-year-olds school children who participated in the survey reported having suffered from oral pain. Further, the need for treatment of decayed teeth was reported at 100%. About 76% children perceived teeth as an important component of general health and 75% reported it was required to eat. A total 93% children never visited a dentist or a health care service. Out of 56% children reporting cleaning their teeth daily, only 24% reported brushing their teeth twice daily. About 86% of the children reported using toothbrush and toothpaste to clean their teeth. Although 61% children reported to have received oral health education, 82% children did not know about fluoride and its benefit on dental health. About 50% children reported bacteria as the main cause of tooth decay and 23% as not brushing teeth for gingivitis. Frequency of sugar exposure was low; 75% of children reported eating sugar rich food once daily.
Conclusions
Caries prevalence of 5–6 –year- old Chepang school children is above the recommended target set by FDI/WHO. The study reported 31% schoolchildren aged 8-16-year old suffered oral pain and decayed component constituted almost the entire dmft/DMFT index. The brushing habit was reportedly low with only 24% of the children brushing twice daily. A nationwide scientifically proven, cost effective school based interventions is needed for prevention and control of caries in schoolchildren in Nepal.
doi:10.1186/1472-6831-13-20
PMCID: PMC3655880  PMID: 23672487
Dental caries; School children; Oral hygiene
10.  Psychometric properties and the prevalence, intensity and causes of oral impacts on daily performance (OIDP) in a population of older Tanzanians 
Background
The objective was to study whether a Kiswahili version of the OIDP (Oral Impacts on Daily Performance) inventory was valid and reliable for use in a population of older adults in urban and rural areas of Tanzania; and to assess the area specific prevalence, intensity and perceived causes of OIDP.
Method
A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. A two-stage stratified cluster sample design was utilized. Information became available for 511 urban and 520 rural subjects (mean age 62.9 years) who were interviewed and participated in a full mouth clinical examination in their own homes.
Results
The Kiswahili version of the weighted OIDP inventory preserved the overall concept of the original English version. Cronbach's alpha was 0.83 and 0.90 in urban and rural areas, respectively, and the OIDP inventory varied systematically in the expected direction with self-reported oral health measures. The respective prevalence of oral impacts was 51.2% and 62.1% in urban and rural areas. Problems with eating was the performance reported most frequently (42.5% in urban, 55.1% in rural) followed by cleaning teeth (18.2% in urban, 30.6% in rural). More than half of the urban and rural residents with impacts had very little, little and moderate impact intensity. The most frequently reported causes of impacts were toothache and loose teeth.
Conclusion
The Kiswahili OIDP inventory had acceptable psychometric properties among non-institutionalized adults 50 years and above in Tanzania. The impacts affecting their performances were relatively common but not very severe.
doi:10.1186/1477-7525-4-56
PMCID: PMC1579214  PMID: 16934161
11.  Oral health of visually impaired schoolchildren in Khartoum State, Sudan 
BMC Oral Health  2013;13:33.
Background
Although oral health care is a vital component of overall health, it remains one of the greatest unattended needs among the disabled. The aim of this study was to assess the oral health status and oral health-related quality of life (Child-OIDP in 11-13-year-old) of the visually challenged school attendants in Khartoum State, the Sudan.
Methods
A school-based survey was conducted in Al-Nour institute [boys (66.3%), boarders (35.9%), and children with partial visual impairment (PVI) (44.6%)]. Two calibrated dentists examined the participants (n=79) using DMFT/dmft, Simplified Oral Hygiene Index (OHI-S), dental care index, and traumatic dental injuries (TDI) index. Oral health related quality of life (C-OIDP) was administered to 82 schoolchildren.
Results
Caries experience was 46.8%. Mean DMFT (age≥12, n=33) was 0.4 ± 0.7 (SiC 1.6), mean dmft (age<12, n=46) was 1.9 ±2.8 (SiC 3.4), mean OHIS 1.3 ± 0.9. Care Index was zero. One fifth of the children suffered TDI (19%). Almost one third (29%) of the 11–13 year old children reported an oral impact on their daily performances. A quarter of the schoolchildren (25.3%) required an urgent treatment need. Analysis showed that children with partial visual impairment (PVI) were 6.3 times (adjusted) more likely to be diagnosed with caries compared to children with complete visual impairment (CVI), and children with caries experience were 1.3 times (unadjusted) more likely to report an oral health related impact on quality of life.
Conclusions
Visually impaired schoolchildren are burdened with oral health problems, especially caries. Furthermore, the 11-13 year olds' burden with caries showed a significant impact on their quality of life.
doi:10.1186/1472-6831-13-33
PMCID: PMC3720199  PMID: 23866155
Visually impaired children; Oral health; Oral health-related quality of life
12.  Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: a cross-sectional study 
Background
An important aim of antenatal care is to improve maternal health- and well being of which oral health is an important part. This study aimed to estimate the prevalence of oral impacts on daily performances (OIDP) during pregnancy, using a locally adapted OIDP inventory, and to document how periodontal status, tooth-loss and reported periodontal problems are related to oral impacts.
Methods
Pregnant women at about 7 months gestational age who were members of a community based multi-center cluster randomized community trial: PROMISE EBF: Safety and Efficacy of Exclusive Breast feeding in the Era of HIV in Sub-Saharan Africa, were recruited in the district of Mbale, Eastern Uganda between January 2006 and June 2008. A total of 877 women (participation rate 877/886, 98%, mean age 25.6, sd 6.4) completed an interview and 713 (participation rate 713/886, 80.6%, mean age 25.5 sd 6.6) were examined clinically with respect to tooth-loss and according to the Community Periodontal Index, CPI.
Results
Seven of the original 8 OIDP items were translated into the local language. Cronbach's alpha was 0.85 and 0.80 in urban and rural areas, respectively. The prevalence of oral impacts was 25% in the urban and 30% in the rural area. Corresponding estimates for CPI>0 were 63% and 68%. Adjusted ORs for having any oral impact were 1.1 (95% CI 0.7-1.7), 1.9 (95% CI 1.2-3.1), 1.7 (1.1-2.7) and 2.0 (0.9-4.4) if having respectively, CPI>0, at least one tooth lost, tooth loss in molars and tooth loss in molar-and anterior regions. The Adjusted ORs for any oral impact if reporting periodontal problems ranged from 2.7(95% CI 1.8-4.2) (bad breath) through 8.6(95% CI 5.6-12.9) (chewing problem) to 22.3 (95% CI 13.3-35.9) (toothache).
Conclusion
A substantial proportion of pregnant women experienced oral impacts. The OIDP impacts were most and least substantial regarding functional- and social concerns, respectively. The OIDP varied systematically with tooth loss in the molar region, reported chewing-and periodontal problems. Pregnant women's oral health should be addressed through antenatal care programs in societies with limited access to regular dental care facilities.
doi:10.1186/1477-7525-7-89
PMCID: PMC2770560  PMID: 19828031
13.  Oral health related quality of life among dental students in a private dental institution in India 
Background:
The compartmentalization involved in viewing the mouth separately from the rest of the body must cease. This is because oral health affects general health by causing considerable pain and suffering; and, by changing what people eat and their speech, can bring about a change in their quality of life and well-being. There are several instruments for measuring oral health related quality of life, and, OIDP (Oral Impact on Daily Performance) is one among them.
Aim:
The aim of this study is to assess the OIDP among dental students and to know whether students in different stages of the dental course had any difference in impact on their daily performance.
Materials and Methods:
372 students of Bachelor of Dental Sciences’ (BDS) course at Manipal College of Dental Sciences, Manipal, Karnataka, India, from the first to final year, and interns answered a structured questionnaire recording their demographic characteristics, behavioral characteristics and eight items of OIDP.
Results:
The mean OIDP Additive scores (ADD) and OIDP Simple count scores (SC) scores were 7.02 (sd = 3.3, range 8 - 40) and 2.16 (sd = 1.55, range 0 - 8), repectively. A total of 36.6%, 12.9% and 12.9% of the dental students confirmed difficulties with eating, enjoying contact with other people and carrying out major college work, respectively. Logistic regression analysis revealed that compared with the first BDS dental students, the Odds ratio (OR) for the second, third, fourth year and intern dental students for being without oral impacts, despite reporting poor oral health, were 0.21 (95% CI: 0.24 – 1.9), 0.61 (95% CI: 0.06 – 6.2), 0.70 (95% CI: 0.61 – 8.2) and 0.54 (95% CI: 0.3 – 9.3), respectively.
Conclusion:
The study reported the OIPD among dental students and provided evidence of importance of social and behavioral characteristics in shaping the response by dental students.
doi:10.4103/2231-0762.97708
PMCID: PMC3894072  PMID: 24478957
Dental students; oral health; oral health related quality of life; Oral Impact on Daily Performance; socio – demographic factors
14.  Socio-demographic and behavioural correlates of oral hygiene status and oral health related quality of life, the Limpopo - Arusha school health project (LASH): A cross-sectional study 
BMC Pediatrics  2010;10:87.
Background
Promoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours.
Methods
Cross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI).
Results
44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females.
Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders.
Conclusion
Disparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health.
doi:10.1186/1471-2431-10-87
PMCID: PMC3001697  PMID: 21118499
15.  Perceived dental treatment need among older Tanzanian adults – a cross-sectional study 
BMC Oral Health  2007;7:9.
Background
Need perceptions for dental care play a key role as to whether people in general will seek dental care. The aim was to assess the prevalence of perceived need of problem based dental care, dental check-ups and any type of dental care. Guided by the conceptual model of Wilson and Cleary, the relationship of perceived need for dental care with socio-demographic characteristics, clinically defined dental problems and self-reported oral health outcomes was investigated. Partial prosthetic treatment need was estimated using a socio-dental approach.
Method
A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. Information from interviews and clinical examination became available for 511 urban and 520 rural adults (mean age 62.9 yr).
Results
51.7% (95% CI 46.2, 57.0) urban and 62.5 % (95% CI 53.1, 70.9) rural inhabitants confirmed need for dental check-up, 42.9% (95% CI 36.9, 48.9) urban and 52.7% (95% CI 44.5, 60.6) rural subjects confirmed need for problem oriented care and 38.4% (95% CI 32.4, 44.6) urban versus 49.6% (95% CI 41.8, 57.4) rural residents reported need for any type of dental care. Binary and ordinal multiple logistic regression analyses revealed that adults who reported bad oral health and broken teeth were more likely to perceive need for dental care across the three outcome measures than their counterparts. Socio-demographic factors and clinically defined problems had less impact. Based on a normative and an integrated socio-dental approach respectively 39.5% and 4.7% were in need for partial dentures.
Conclusion
About half of the participants confirmed need for problem oriented care, dental check-ups and any type of dental care. Need perceptions were influenced by perceived oral health, clinically assessed oral problems and socio-demographic characteristics. Need estimates for partial denture was higher when based on clinical examination alone compared to an integrative socio-dental approach.
doi:10.1186/1472-6831-7-9
PMCID: PMC1939845  PMID: 17625014
16.  Validation of a Persian version of the OIDP index 
BMC Oral Health  2007;7:2.
Background
Measuring the impacts of oral conditions on quality of life is an important part of oral health needs assessment. For this purpose a variety of oral health-related quality of life instruments have been developed. To use a scale in a new context or with a different groups of people, it is necessary to re-establish its psychometric properties. The objectives of this study are to develop and test the reliability and validity of the Persian version of Oral Impacts on Daily Performances (OIDP) index.
Methods
The Persian version of OIDP index was developed through a linguistic translation exercise. The psychometric properties of the Persian version of OIDP were evaluated in terms of face, content, construct and criterion validity in addition to internal and test-retest reliability. A convenience sample of 285 working adults aged 20–50 living in Mashad was recruited (91% response rate) to evaluate the Persian version.
Results
The Persian version of OIDP had excellent validity and reliability charactersitics. Weighted Kappa was 0.91. Cronbachs alpha coefficient was 0.79. The index showed significant associations with self-rated oral and general health status, as well as perceived dental treatment needs, satisfaction with mouth and prevalence of pain in mouth (P < 0.001). 64.9% of subjects had an oral impact on their daily performances. The most prevalent performance affected was eating, followed by major work or role and sleeping.
Conclusion
The Persian version of OIDP index is a valid and reliable measure for use in 20 to 50 year old working Iranians.
doi:10.1186/1472-6831-7-2
PMCID: PMC1797167  PMID: 17257407
17.  Influence of oral mucosal lesions and oral symptoms on oral health related quality of life in dermatological patients: a cross sectional study in Sudan 
BMC Oral Health  2012;12:19.
Background
There are only few studies considering the impact of oral mucosal lesions (OML) on the oral quality of life of patients with different dermatological conditions. This study aimed to assess the relationship between oral health-related quality of life (OHRQoL) and OML and reported oral symptoms, perceived general and oral health condition and caries experience in adult skin diseased patients attending an outpatient dermatologic clinic in Sudan.
Methods
A cross-sectional survey was carried out with 544 diagnosed skin diseased patients (mean age 37.1 years, 50 % females), during the period October 2008 to January 2009. The patients were orally examined and OML and caries experience was recorded. The patients were interviewed using the Sudanese Arabic version of the OIDP. OHRQoL was evaluated by socio-demographic and clinical correlates according to number of types of OML diagnosed (no OML, one type of OML, > one type of OML) and number and types of oral symptoms.
Results
An oral impact (OIDP > 0) was reported by 190 patients (35.6 %) (mean OIDP total score 11.6, sd = 6.7). The prevalence of any oral impact was 30.5 %, 36.7 % and 44.1 %, in patients with no OML, one type of OML and more than one type of OML, respectively. Number of types of OML and number and types of oral symptoms were consistently associated with the OIDP scores. Patients who reported bad oral health, patients with ≥ 1 dental attendance, patients with > 1 type of OML, and patients with ≥ 1 type of oral symptoms were more likely than their counterparts in the opposite groups to report any OIDP. The odds ratios (OR) were respectively; 2.9 (95 % CI 1.9-4.5), 2.3 (95 % CI 1.5-3.5), 1.8 (95 % CI 1.1-3.2) and 6.7 (95 % CI 2.6-17.5). Vesiculobullous and ulcerative lesions of OML disease groups associated statistically significantly with OIDP.
Conclusion
OIDP was more frequently affected among skin diseased patients with than without OML. The frequency of the impacts differed according to the number of type of OML, oral symptoms, and OML disease groups. Dentists and dermatologists should pay special attention to skin diseased patients because they are likely to experience oral impacts on daily performances.
doi:10.1186/1472-6831-12-19
PMCID: PMC3461441  PMID: 22768994
dermatology; oral mucosal lesions; oral impact on daily performance; quality of life
18.  Validation of two complementary oral-health related quality of life indicators (OIDP and OSS 0-10 ) in two qualitatively distinct samples of the Spanish population 
Background
Oral health-related quality of life can be assessed positively, by measuring satisfaction with mouth, or negatively, by measuring oral impact on the performance of daily activities. The study objective was to validate two complementary indicators, i.e., the OIDP (Oral Impacts on Daily Performances) and Oral Satisfaction 0–10 Scale (OSS), in two qualitatively different socio-demographic samples of the Spanish adult population, and to analyse the factors affecting both perspectives of well-being.
Methods
A cross-sectional study was performed, recruiting a Validation Sample from randomly selected Health Centres in Granada (Spain), representing the general population (n = 253), and a Working Sample (n = 561) randomly selected from active Regional Government staff, i.e., representing the more privileged end of the socio-demographic spectrum of this reference population. All participants were examined according to WHO methodology and completed an in-person interview on their oral impacts and oral satisfaction using the OIDP and OSS 0–10 respectively. The reliability and validity of the two indicators were assessed. An alternative method of describing the causes of oral impacts is presented.
Results
The reliability coefficient (Cronbach's alpha) of the OIDP was above the recommended 0.7 threshold in both Validation and Occupational samples (0.79 and 0.71 respectively). Test-retest analysis confirmed the external reliability of the OSS (Intraclass Correlation Coefficient, 0.89; p < 0.001) Some subjective factors (perceived need for dental treatment, complaints about mouth and intermediate impacts) were strongly associated with both indicators, supporting their construct and criterion validity. The main cause of oral impact was dental pain. Several socio-demographic, behavioural and clinical variables were identified as modulating factors.
Conclusion
OIDP and OSS are valid and reliable subjective measures of oral impacts and oral satisfaction, respectively, in an adult Spanish population. Exploring simultaneously these issues may provide useful insights into how satisfaction and impact on well-being are constructed.
doi:10.1186/1477-7525-6-101
PMCID: PMC2631008  PMID: 19019208
19.  Associations between oral health-related impacts and rate of weight gain after extraction of pulpally involved teeth in underweight preschool Filipino children 
BMC Public Health  2013;13:533.
Background
Severe dental caries in young children is associated with underweight and failure to thrive. One possible mechanism for severe caries affecting growth is that the resulting pain and discomfort influences sleeping and eating, and that affects growth and weight. The objective of this study was to assess whether rate of weight gain after extraction of severely decayed teeth in underweight preschool Filipino children was related to reductions in oral health-related impacts and dental pain from severe dental caries affecting eating and sleeping.
Methods
Data are from the Weight Gain Study, a stepped wedge cluster randomized clinical trial where underweight Filipino children with severe dental decay had their pulpally involved teeth extracted. Day care centers were randomly divided into two groups; A and B. Group A children received treatment first and Group B children were treated four months after Group A. Clinical oral examinations used WHO criteria and the pufa-index. Self-reported oral health-related impacts and anthropometric measurements were collected for both groups at baseline, four months after treatment of Group A children and four months after treatment of Group B children. Weight-for-age z-scores were calculated using 2006 and 2007 WHO standards. Data were converted to a one-group pre-test post-test study design, where all children received treatment. Associations between changes in oral health-related impacts and weight-for-age z-scores after dental treatment were assessed.
Results
Data on 145 children (mean age 61.4 months) were analyzed. There was a significant association between oral health-related impacts and rate of weight gain after extraction of pulpally involved teeth (p=0.02). Children free of impacts on sleeping related to having severely decayed teeth extracted gained significantly more weight compared to children who reported sleeping problems after dental treatment (p<0.01).
Conclusions
After extraction of severely decayed teeth in underweight Filipino children, levels of oral health-related impacts were associated with rate of weight gain. Decreases in oral health impacts on sleeping appeared to be most strongly associated with weight gain.
Trial registration
ISRCTN: ISRCTN90779069
doi:10.1186/1471-2458-13-533
PMCID: PMC3679996  PMID: 23731717
Dental caries; Dental decay; Tooth extraction; Oral impacts; Sleeping; Eating; Dental pain; Underweight; Weight gain; Growth
20.  Child-OIDP index in Brazil: Cross-cultural adaptation and validation 
Background
Oral health-related quality of life (OHRQoL) measures are being increasingly used to introduce dimensions excluded by normative measures. Consequently, there is a need for an index which evaluates children's OHRQoL validated for Brazilian population, useful for oral health needs assessments and for the evaluation of oral health programs, services and technologies. The aim of this study was to do a cross-cultural adaptation of the Child Oral Impacts on Daily Performances (Child-OIDP) index, and assess its reliability and validity for application among Brazilian children between the ages of eleven and fourteen.
Methods
For cross-cultural adaptation, a translation/back-translation method integrated with expert panel reviews was applied. A total of 342 students from four public schools took part of the study.
Results
Overall, 80.7% of the sample reported at least one oral impact in the last three months. Cronbach's alpha was 0.63, the weighted kappa 0.76, and the intraclass correlation coefficient (ICC) 0.79. The index had a significant association with self-reported health measurements (self-rated oral health, satisfaction with oral health, perceived dental treatment needs, self-rated general health; all p < 0.01).
Conclusion
It was concluded that the Child-OIDP index is a measure of oral health-related quality of life that can be applied to Brazilian children.
doi:10.1186/1477-7525-6-68
PMCID: PMC2553067  PMID: 18793433
21.  Perceived oral health status and treatment needs of dental auxiliaries 
The Libyan Journal of Medicine  2010;5:10.3402/ljm.v5i0.4859.
Objective
To determine the perceived oral health status and treatment needs of Nigerian dental therapists in training and dental technology students.
Methods
A descriptive cross-sectional study of students from Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted using self-administered questionnaire to obtain information on demography, self-reported oral health status, knowledge of impact of oral health on daily life activity, dental attendance and perceived dental need.
Results
The perception of oral health status and treatment need of the two groups of dental auxiliaries was the same. Fewer respondents (27.3%) rated their oral health as excellent, while 50.4% rated their oral health as good. Majority (95.5%) agreed that oral health is a part of general health and 94.6% agreed that oral health has a role in daily life.
Out of 81.4% that had previous dental treatment, scaling and polishing accounted for 66.1%. Presently, 48.8% think they need dental treatment ranging from scaling and polishing (33.9%), tooth restoration (10.3%), to extraction (1.2%).
Conclusion
This survey revealed that most of the students are aware that oral health is a component of general health and that it has an impact on an individual's daily life. More than half of the students perceived their oral health as good, but only a few knew that there is a need for a preventive approach to oral health as evident by the percentage that perceived scaling and polishing as a treatment need.
doi:10.3402/ljm.v5i0.4859
PMCID: PMC3071173  PMID: 21483589
oral health; status; dental auxiliaries
22.  Influence of an Intervention to Prevent Early Childhood Caries Initiated before Birth on Children’s Use of Dental Services up to 7 Years of Age 
The Open Dentistry Journal  2014;8:104-108.
Background :
In a previously reported randomised controlled trial, advising first time mothers on the prevention of early childhood caries from before their child was born, decreased the prevalence of early childhood caries at 20 months of age 5-fold.
Objective:
We examined the effect of the intervention on the frequency and nature of dental visits up to 7 years of age.
Methods:
Of 649 expectant mothers who participated in the trial, 277 completed a “Child Oral Health Survey” 7 years later. Their answers were compared with those of a comparison group of 277 mothers selected at random among those living in the same area with a first child born in the same year enrolled with the South Australian School Dental Services (SA SDS).
Results:
Only 1.5% of children had a dental visit before 12 months of age and only 4% before 2 years of age unless a dental problem had arisen. The age at the first visit did not differ among groups, but the reasons for the visit did as did the number of visits and the need for treatment under sedation or anaesthesia. In the trial group, 34% of first visits were for pain, 29% for injury, and 29% for concern with appearance. In the comparison group, pain was the main concern in 49%, injury in 9.5%, and appearance in 25% (p=0.019). Over time, children in the trial had an average of 2.2 visits compared with 3.1 in the comparison group. In the intervention group of the trial, no child had required treatment under sedation or general anaesthesia compared with 2.9% in the control group, and 6.5% in the comparison group. Only 15% of mothers reported that they had received any information on caries prevention from health care professionals other than dental care practitioners.
Conclusion:
Providing first-time mothers with guidance on the prevention of childhood caries decreased the use of dental services to deal with problems in preschool children.
doi:10.2174/1874210601408010104
PMCID: PMC4062931  PMID: 24949107
Dental care; early childhood caries; health promotion; preschool children; randomised controlled trial.
23.  Oral health-related quality of life after dental general anaesthesia treatment among children: a follow-up study 
BMC Oral Health  2014;14:81.
Background
Many young paediatric patients with severe dental caries receive dental treatment under general anaesthesia. Oral health-related quality of life (OHRQoL) can be evaluated to assess the outcome of dental general anaesthesia (DGA) treatment. The aim of our study was to examine the OHRQoL of young Lithuanian children in need of DGA treatment and analyse the impact of DGA treatment on children’s OHRQoL.
Methods
We carried out a prospective clinical follow-up study on OHRQoL among all young Lithuanian child patients who received DGA treatment at the Lithuanian University of Health Sciences Hospital during 2010–2012. The study consisted of clinical dental examinations of patients younger than six years, data collected from their patient files, and an OHRQoL survey completed by their parents prior to the child’s dental treatment. We conducted a follow-up OHRQoL survey one month after the DGA treatment. The Early Childhood Oral Health Impact Scale (ECOHIS) and its effect size (ES) served to evaluate children’s OHRQoL, and the Wilcoxon signed-rank test served for statistical analyses.
Results
We obtained complete baseline and follow-up data for 140 and 122 participants, respectively (84.7% follow-up rate). Pain and eating problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. The parents reported greater impacts on boys than on girls. The ECOHIS score decreased significantly (69.5%, p < 0.001) after DGA treatment, revealing a large ES for the child (1.6) and family (2.4) sections of the ECOHIS.
Conclusions
The OHRQoL of young Lithuanian children requiring DGA treatment is seriously impaired. Dental general anaesthesia treatment results in significant improvement of the children’s OHRQoL. The children’s parents also greatly appreciate this treatment modality for its positive impact on the family’s quality of life.
doi:10.1186/1472-6831-14-81
PMCID: PMC4090347  PMID: 24984901
Dental general anaesthesia; Oral health-related quality of life; Children; Follow-up
24.  The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear 
BMC Oral Health  2007;7:1.
Background
Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored.
Methods
The study used a telephone interview survey with interviews predominantly conducted in 2002. A random sample of 6,112 Australian residents aged 16 years and over was selected from 13 strata across all States and Territories. Data were weighted across strata and by age and sex to obtain unbiased population estimates.
Results
People with higher dental fear visited the dentist less often and indicated a longer expected time before visiting a dentist in the future. Higher dental fear was associated with greater perceived need for dental treatment, increased social impact of oral ill-health and worse self-rated oral health. Visiting patterns associated with higher dental fear were more likely to be symptom driven with dental visits more likely to be for a problem or for the relief of pain. All the relationships assumed by a vicious cycle of dental fear were significant. In all, 29.2% of people who were very afraid of going to the dentist had delayed dental visiting, poor oral health and symptom-driven treatment seeking compared to 11.6% of people with no dental fear.
Conclusion
Results are consistent with a hypothesised vicious cycle of dental fear whereby people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear.
doi:10.1186/1472-6831-7-1
PMCID: PMC1784087  PMID: 17222356
25.  Assessment of oral self-care in patients with periodontitis: a pilot study in a dental school clinic in Japan 
BMC Oral Health  2009;9:27.
Background
Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models.
Methods
A cross-sectional study design was used. The study population consisted of sixty-five patients (age range 23-77) with chronic periodontitis. The pre-tested 19-item questionnaire comprised 3 domains; 1) oral hygiene, 2) dietary habits and 3) perception of oral condition. The questionnaire was used as a part of the comprehensive assessment.
Results
Analyses of the assessment data revealed no major problems with the respondents' perceived oral hygiene habits, although their actual plaque control levels were not entirely adequate. Most of the respondents acknowledged the importance of prevention of dental caries and periodontal diseases, but less than one third of them were regular users of the dental care system. Twenty-five percent of the respondents were considered to be reluctant to change their daily routines, and 29% had doubts about the impact of their own actions on oral health. Analyzing the relationships between patient responses and oral hygiene status, factors like 'frequency of tooth brushing', 'approximal cleaning', 'dental check-up' and 'compliance with self-care advice' showed statistically significant associations (P < 0.05) with the plaque scores.
Conclusion
The clinical utilization of the present questionnaire facilitates the inclusion of multiple aspects of patient information, before initiation of periodontal treatment. The significant associations that were found between some of the self-care behaviors and oral hygiene levels document the important role of patient-centered oral health assessment in periodontal care.
doi:10.1186/1472-6831-9-27
PMCID: PMC2774664  PMID: 19874626

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