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1.  Validity and reliability of OIDP and OHIP-14: a survey of Chinese high school students 
BMC Oral Health  2014;14:158.
To determine the impact of oral diseases on everyday life, measures of oral quality of life are needed. In complementing traditional disease-based measures, they assess the need for oral care to evaluate oral health care programs and management of treatment. To assess the reliability and validity of the Oral Impact of Daily Performance (OIDP) and the short-form Oral Health Impact Profile (OHIP-14) among high school students in Xi’an, the capital of Shanxi province, China.
Cross-sectional one-stage stratified random cluster sample using high schools as the primary sampling unit. Students completed self-administered questionnaires at school. The survey included the OHIP-14 and OIDP inventories, translated and culturally adapted for China, and global oral health and socio-behavioral measures.
A total of 5,608 students participated in the study, with a 93% response rate (mean age 17.2, SD 0.8, 52% females, 45.3% urban residents).The proportion experiencing at least one impact (at any frequency) during the previous six months was 62.9% for the OHIP-14 and 45.8% for the OIDP. Cronbach’s alpha measured internal consistency at 0.85 for OHIP-14 and 0.75 for OIDP while Cohen’s kappa varied between 0.27 and 0.58 for OHIP-14 items and between 0.23 and 0.65 for OIDP items. Kappa scores for the OHIP-14 and OIDP additive scores were 0.52 and 0.66, respectively. Both measures varied systematically and in the expected direction, with global oral health measures showing criterion validity. The correlation between OIDP and OHIP-14 was rs +0.65. That both measures varied systematically with socio-behavioral factors indicates construct validity.
Both the OIDP and OHIP-14 inventories had reasonable reliability and construct validity in relation to subjective global oral health indicators among adolescents attending high schools in China and thus appear to be useful oral health –related quality of life measures in this context. Overall, the OHIP-14 and OIDP performed equally well, although OHIP-14 had superior content validity due to its sensitivity towards less severe impacts.
PMCID: PMC4289589  PMID: 25527278
OIDP; OHIP-14; Adolescents; China
2.  Validation of a Greek version of the oral health impact profile (OHIP-14) for use among adults 
To test the validity of the short form of the Oral Health Impact Profile (OHIP-14) for use among adults in Greece.
The original English version of the OHIP-14 was translated using the forward-backward technique, pilot-tested, and then applied to 211 adults aged 35 years and above. The questionnaire was filled out during face-to-face interviews conducted by one dentist, while individuals were asked to undergo a clinical examination. The internal consistency of the questionnaire was evaluated using Cronbach's alpha (α) coefficient and inter-item and item-total correlations. Discriminant and convergent validities were assessed.
Cronbach's α was estimated to be 0.90. Inter-item correlations coefficients ranged from 0.10 to 0.83, while item-total correlations coefficients from 0.44 to 0.76. Significant associations were found between OHIP-14 and the decayed, missing and filled teeth (DMFT) and oral hygiene, supporting the ability of the questionnaire to discriminate between individuals with and without impacts. The OHIP-14 total score was highly associated with self-perceived oral health status (rs = 0.57; p = 0.01), as well as with self-assessment of oral satisfaction (rs = 0.55;p = 0.01). Similar results were observed by investigating the relationship between the latter questions and each domain score as well as in various sub-groups analyses.
The OHIP-14 is a reliable and valid questionnaire for the assessment of OHRQoL among adults in Greece.
PMCID: PMC3278380  PMID: 22244162
3.  Validation of the Spanish version of the Oral Health Impact Profile (OHIP-14Sp) in elderly Chileans 
BMC Oral Health  2014;14:95.
The OHIP-49 is widely used to assess oral health-related quality of life, but its length makes it time-consuming and difficult to use. An abbreviated version of the OHIP-49 with fourteen items has been validated for older adults, but not in Chile. The aim was to develop and validate the Spanish version of the OHIP-14 in an elderly Chilean population.
Two studies were conducted; a cross sectional to develop and a retrospective study to validate the OHIP-14Sp. The OHIP-49Sp was applied to 490 older adults and the fourteen questions with the higher impact on oral health-related quality of life were selected through linear regression. These items were applied on a retrospective dataset of 85 older adults to test internal consistency (Cronbach’s alpha). A discriminative validity analysis was performed along with the assessment of sociodemographic (age and gender, educational level) and clinical variables (number of teeth, caries lesions, CPITN, prosthetic needs and prosthetic functionality). Data were analyzed using Mann–Whitney U, Student’s t and one-way ANOVA tests with a 95% confidence level and finally were analyzed by a Multivariate Logistic Regression Model.
High internal consistency values were obtained for the OHIP-14Sp instrument (0.91). There was an association between the OHIP-14Sp scores and the presence of caries (p = 0.003), need for complex periodontal treatment (p = 0.002), prosthetic needs (p < 0.0001) and age younger than 70 years-old (p < 0.0001). Subjects with periodontal treatment need were more likely to report reduced oral health-related quality of life (PR = 2.10).
The OHIP-14Sp proved to be a consistent and valid tool to assess oral health-related quality of life when tested in Chilean older adults.
PMCID: PMC4128544  PMID: 25091189
Quality of life; Oral health; OHIP; Validation studies; Aging; Chile
4.  Validation of the chinese version of the oral health impact profile for TMDs (OHIP- TMDs-C) 
Objectives: The aim of this study was to evaluate the reliability and validity of the the Chinese version of the Oral Health Impact Profile for TMDs (OHIP-TMDs-C). Study Design: The OHIP-TMDs was initially translated and cross-culturally adapted to Chinese following international guidelines; then subsequently validated for the psychometric characteristics of reliability and validity. In total, 156 participants with temporomandibular disorders (TMDs) were recruited to complete the questionnaire. The reliability of the OHIP-TMDs-C was evaluated using internal consistency and test-retest methods. The validity of the OHIP-TMDs-C was analysed by construct validity and convergent validity. Construct validity was determined based on factor analysis, and convergent validity by analyzing the correlation between OHIP-TMDs-C subscale scores and the global rating of oral health question. Results: Cronbach’s alpha value (internal reliability) for the total OHIP-TMDs-C score was 0.917 and the intraclass correlation coefficient (ICC) value (test–retest reliability) was 0.899. Construct validity was determined by factor analysis, extracting five factors, accounting for 78.6% of the variance. All items had factor loadings above 0.40. In terms of convergent validity, the OHIP-TMDs-C subscale was significant correlated to the global oral health rating. Conclusions: The results suggest that the OHIP-TMDs-C has good reliability and validity and thus may be used as a valuable instrument for patients with TMDs in China.
Key words:Validation, TMDs, quality of life, questionnaire.
PMCID: PMC4393978  PMID: 25475781
5.  Validity and reliability of the Persian version of the oral health impact profile (OHIP)-14  
Background: The need for assessment of oral health related quality of life has been increased over the last decades. The aim of this study was to develop a Persian version of the Oral Health Impact Profile (OHIP)-14 and to evaluate its reliability and validity for its use in Persian-speaking communities.
Methods: The original version of the OHIP-14 was translated into the Persian language using the back-translation technique. To establish the reliability of the translated instrument, internal consistency and test-retest reliability trials were performed on 20 subjects (at 4-week intervals); Cronbach’s alpha was used. One hundred sixty adults over 50 years of age who attended Health Care Centers in Sari and Babol were recruited to fill out the questionnaires and received a clinical examination by a single dentist. The socio-demographic and oral health information was also collected.
Results: The test-retest reliability was excellent (Cronbach’s alpha = 0.095). In the main study, Cronbach’s reliability coefficient for all 14 questions in each dimension was more than 70%. The individuals in need of dental treatment showed significantly higher OHIP scores than the individuals not requiring treatment. The individuals with hopeless teeth, negative self-perceived oral had significantly higher OHIP scores.
Conclusion: The Persian version of the OHIP-14 is a comprehensive and accurate instrument with acceptable reliability and validity for measuring oral health–related quality of life.
PMCID: PMC3895829  PMID: 24551438
Quality of life; QOL questionnaire; OHIP-14
6.  Psychometric Properties of Croatian and Slovenian Short Form of Oral Health Impact Profile Questionnaires 
Croatian medical journal  2008;49(4):536-544.
To develop Croatian and Slovenian versions of the 14-item Oral Health Impact Profile (OHIP) Questionnaire.
The English original version of the OHIP questionnaire was translated into Croatian (OHIP-CRO14) and Slovenian (OHIP-SVN14) language by a forward-backward translation method. The psychometric properties of the OHIP-CRO14 and OHIP-SVN14 were tested. Concurrent validity was tested on 623 subjects (193 Croatian and 430 Slovenian), test-retest reliability on 115 subjects (55 Croatian and 60 Slovenian), internal consistency on 678 subjects (218 Croatian and 460 Slovenian), and responsiveness on 51 patients (21 Croatian and 30 Slovenian) in demand of treatment (toothache).
Concurrent validity was confirmed by the association between the OHIP summary scores and self-reported oral health (correlation coefficients ranged from 0.40 to 0.60, P<0.001). Test-retest reliability showed high intraclass correlation (correlation coefficients, 0.79-0.94). Internal consistency showed high Cronbach α (0.77-0.91). Responsiveness was confirmed by a significant difference between the mean OHIP score at baseline and follow-up (P<0.001 for both Croatian and Slovenian patients) and high effect size in Croatian and Slovenian patients in demand of treatment (3.00 and 0.57, respectively).
Psychometric properties of OHIP-CRO14 and OHIP-SVN14 render these instruments suitable for the assessment of Oral Health Related Quality of Life in Croatia and Slovenia.
PMCID: PMC2525826  PMID: 18717001
7.  Impact of oral disease on quality of life in the US and Australian populations 
The US National Health and Nutrition Examination Survey (NHANES 2003–2004) evaluated oral health quality of life for the first time using a previously untested subset of seven Oral Health Impact Profile (OHIP) questions, i.e. the NHANES-OHIP.
(i) To describe the impact of dental conditions on quality of life in the US adult population; (ii) to evaluate construct validity and adequacy of the NHANES-OHIP in NHANES 2003–2004 and a comparable Australian survey.
In the cross-sectional NHANES 2003–2004 survey of a nationally representative sample of US adults (n = 4907), prevalence was quantified as the proportion of adults who reported experiencing one or more impacts fairly often or very often within the past year. Construct validity was tested by comparing prevalence estimates across categories of sociodemographic, dental health and utilization characteristics known to vary in oral health. In 2002, Australian cross-sectional survey of a nationally representative sample of adults (n = 2644), adequacy of the NHANES-OHIP questions were tested with reference to a slightly modified version of the OHIP-14 questions.
NHANES-OHIP prevalence estimates were markedly similar in the United States (15.3%) and Australia (15.7%). In the US construct, validity was evidenced by higher NHANES-OHIP scores among groups with greater levels of tooth loss, perceived treatment need and problem-oriented visiting and with lack of private dental insurance and low income. In Australia, prevalence for the NHANES-OHIP closely resembled prevalence estimates of the modified OHIP-14. Both varied to a similar degree across levels of tooth loss, perceived treatment need, problem-oriented visiting, and private dental insurance and income, demonstrating adequacy of the NHANES-OHIP as a brief independent instrument.
There was acceptable construct validity and adequacy of the NHANES-OHIP questionnaire. In the United States, the impact of oral disease disproportionately affected disadvantaged groups, a finding that supports application of the US Healthy People 2010 major goals of improved quality of life and reduced health disparities.
PMCID: PMC3760707  PMID: 19175659
adults; health policy; health surveys; NHANES; population groups
8.  Quality of life measured by OHIP-14 and GOHAI in elderly people from Bialystok, north-east Poland 
BMC Oral Health  2014;14:106.
The Oral Health Impact Profile-14 (OHIP-14) and the Geriatric/General Oral Health Assessment Index (GOHAI) have never been compared for a group of the same subjects in the Polish population. The aim of the study was to compare the OHIP-14 and GOHAI measures.
178 independently living people over the age of 55 were included in the study. The GOHAI and OHIP-14 measures were used. Other variables included age, gender, self-ratings of oral general health, education, number of missing teeth, chewing problems and dry mouth.
The mean age of respondents was 70.8 years. The internal reliability (Cronbach’s alpha) showed a high internal consistency for both measures. Spearman’s rank correlation coefficient between the GOHAI and OHIP-14 scores was 0.81. Using the additive method of creating scores, 1.1% of respondents had the GOHAI score of zero, indicating no impact from oral conditions, while 13.5% of them had an OHIP-14 score of zero. Dental status, partial dentures, chewing problems, dry mouth and self-rated oral health were significantly associated with the results of the GOHAI and the OHIP-14 (Kruskal–Wallis test, Mann–Whitney U test). The numbers of preserved and missing teeth significantly correlated with the GOHAI and the OHIP-14, while DMF was significantly associated with the GOHAI only. 6 individuals with discrepant results were revealed. After the exclusion of the abovementioned patients, the internal reliability (Cronbach’s alpha) still showed a high internal consistency, and the correlation between the GOHAI and OHIP-14 scores using Spearman’s rank-correlation coefficient increased to 0.87. This phenomenon was identified as a “fatigue effect”.
There was a strong correlation between the GOHAI and the OHIP-14. Both instruments demonstrated good discriminant properties and helped capture the respondents’ oral health problems. The questionnaires should be randomly distributed to avoid the influence of “fatigue effect” on the results of a comparison of different measures.
PMCID: PMC4145358  PMID: 25141902
Oral health-related quality of life; OHIP-14; GOHAI; Quality of life; Elderly; Poland; “Fatigue effect”
9.  Oral health-related quality of life after prosthetic rehabilitation: a longitudinal study with the OHIP questionnaire 
Aspects of oral health related quality of life (OHRQoL) attracted an increased attention recently.
The aim of the study was to assess self-reported oral health related quality of life (OHRQoL) among patients requiring prosthetic rehabilitation and to determine the rate of improvement 1 month and 6–12 months after therapy. In addition, effect of age, gender, oral health indicators and denture types before treatment were assessed on OHRQoL as evaluated and reported by the patients.
Hungarian version of OHIP-49 (OHIP-49-H) questionnaire was completed before oral rehabilitation (T0-phase) by 389 patients undergoing prosthetic replacement. After 1 month (T1-phase) and 6–12 months (T2-phase) recall periods 235 and 92 patients completed the questionnaire. The median interquartile range (IQR) values of the total OHIP-49-H score were calculated for T0-, T1- and T2-phases. Reliability of the questionnaire was checked by Cronbach’s statistics. Age, gender, oral health indicators and denture types of patients before and after treatment were recorded and treatment-associated changes in OHRQoL were evaluated.
The study demonstrated the excellent reliability and internal consistency of OHIP-49-H by a high and narrow range of Cronbach’s alpha value (0.81-0.93). A median OHIP-49-H score of 52; IQR = 25-83 demonstrated a poor OHRQoL on first admission. Decreasing median total OHIP-49-H scores 1 month (24; IQR = 9-51; p < 0.001) and 6–12 months (20; IQR = 7-37; p = 0,055) after therapy indicated an improvement of OHRQoL. Patients’ age and CPI value assessed before treatment proved to be significant factors of OHRQoL.
Here we presented representative data about self-assessed OHRQoL of patients requiring prosthetic treatment from Hungary using OHIP-49-H questionnaire. The results demonstrated that the restoration of oral health was associated with an improvement in patients’ OHRQoL. According to the demographical and T0 phase clinical status, the treatment was more effective in the respect of OHIP-49-H score improvement among females (than among males), among younger (than among more aged), and among patients with more serious CPI assessed at T0. The type of prosthetic interventions did not exert a significant effect on total OHIP-49-H score, suggesting that the improvement in OHRQoL is independent from the type of denture applied.
PMCID: PMC4496854  PMID: 26156102
Quality of life; Prosthodontics; Oral health; Oral Health Impact Profile (OHIP) questionnaire
10.  Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon 
The respective abilities of the GOHAI and OHIP-14 to discriminate between aged patients with different levels of oral diseases have rarely been studied in developing countries. The aim of this study was to compare the discriminative abilities of the OHIP-14 and the GOHAI in an elderly Lebanese population, and particularly to identify persons with different masticatory function.
A sample of elderly, aged 65 years or more, living independently was recruited in two primary care offices in Beirut, Lebanon. Data were collected by means of personal interview and clinical examination. The Arabic OHIP-14 and GOHAI questionnaires were used after cultural adaptation for use in Lebanon. The internal consistency, reproducibility and concurrent validity were verified. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile respectively and logistic regressions were conducted using socio-demographic, clinical and subjective explanatory variables.
Two hundred and six participants were included; mean age was 72 years and 60% were women. Good psychometric properties were observed for both questionnaires for internal consistency (Cronbach’s alpha>0.88), reproducibility (ICC>0.86) and concurrent validity. Strong correlations were found between GOHAI and OHIP-14 scores but a high prevalence of subjects with no impact was observed using the OHIP-14. Both questionnaires were able to discriminate between participants according to age, perception of temporomandibular joint (TMJ) pain or functional status as represented by the number of dental Functional Units (FU). GOHAI was more discriminant since it identified participants with high dental care needs: high numbers of decayed teeth, low numbers of teeth and socially deprived status.
Lebanese elderly with high dental care needs and impaired oral health were identified more easily with the GOHAI. These results may guide the choice of dental indicators to use in a national geriatric survey.
PMCID: PMC3495839  PMID: 23110518
Oral health; Quality of Life; Lebanese elderly; Psychometric properties; Health status indicators; Dental health survey
11.  Impact of tooth loss related to number and position on oral health quality of life among adults 
The objective of this study was to evaluate the impact of tooth loss on oral health-related quality of life (OHRQoL) in adults with emphasis on the number of teeth lost and their relative position in the mouth.
The study population was a cross-sectional household probability sample of 248, representing 149,635 20–64 year-old residents in Piracicaba-SP, Brazil. OHRQoL was measured using the OHIP-14. Socioeconomic, demographic, health literacy, dental services use data and clinical variables were collected. Oral examinations were performed using WHO criteria for caries diagnosis, using the DMFT index; that is, the sum of decayed, missing and filled teeth (DMFT). An ordinal scale for tooth loss, based on position and number of missing teeth, was the main explanatory variable. The total OHIP score was the outcome for negative binomial regression and OHIP prevalence was the outcome for logistic regression at 5% level. A hierarchical modeling approach was adopted according to conceptual model.
OHIP score was 10.21 (SE 1.16) with 48.1% (n=115) reporting one or more impacts fairly/very often (OHIP prevalence). Significant prevalence rate ratios (PRRs) for OHIP severity were observed for those who had lost up to 12 teeth, including one or more anterior teeth (PRR=1.63, 95%CI 1.06–2.51), those who had lost 13–31 teeth (PRR=2.33, 95%CI 1.49–3.63), and the edentulous (PRR=2.66, 95%CI 1.55–4.57) compared with fully dentate adults. Other significant indicators included those who only sought dental care because of dental pain (PRR=1.67, 95%CI 1.11–2.51) or dental needs (PRR=1.84, 95%CI 1.24–2.71) and having untreated caries (PRR=1.57 95%CI 1.09–2.26). Tooth loss was not significantly associated with OHIP prevalence; instead using dental services due to dental pain (PR=2.43, 95%CI 1.01–5.82), having untreated caries (PR=3.96, 95%CI 1.85–8.51) and low income (PR=2.80, 95%CI 1.26–6.42) were significant risk indicators for reporting OHIP prevalence.
Our analyses showed OHRQoL gradients consistent with the number and position of teeth missing due to oral disease. These findings suggest that the quantity of teeth lost does not necessarily reflect the impact of tooth mortality on OHRQoL and that future studies should take this into consideration.
PMCID: PMC4263115  PMID: 25433483
Adults; Oral health; Quality of life; OHIP14; Regression analysis
12.  Oral health-related quality of life in diabetic patients: comparison of the Persian version of Geriatric Oral Health Assessment Index and Oral Health Impact Profile: A descriptive-analytic study 
Diabetes mellitus is one of the systemic disease which is show important oral manifestation and influence oral health. This study describes how diabetes mellitus affects oral health and oral health-related quality of life. The aim of this study was to evaluate the oral health and oral health-related quality of life of diabetic patients and compare the discriminative capability of Persian versions of two GOHAI and OHIP-14 questionnaires in these patients.
A total of 350 patients with Type II diabetes mellitus, referring to the Diabetes Clinic, were selected and data were collected by GOHAI and OHIP-14 questionnaires completed by patients and clinical examinations. Oral health parameters (CAL,BI,GI,PLI,DMFT and xerostomia) were measured, also concurrent validity and conformity of two questionnaires were assessed. In order to test Discriminant analysis capabilities of two questionnaires, ADD and SC scores of questionnaires were divided into two parts and a logistic regression model was designed, which included subjective and objective variables.
Mean patients age was 55 years (with 75.4% female patients). The results showed that some oral conditions such as xerostomia, clinical attachment loss, number of missing teeth and plaque index were correlated to diabetes control level (HbA1c) and type of anti-diabetic medication. ADD and SC scores of two questionnaires were at high level. However, the effect of oral problems on decreasing OHRQoL was evident. Both questionnaires had acceptable concurrent validity and conformity. Moreover, there was a strong correlation between GOHAI and OHIP-14. OHIP-14 questionnaire had a higher discriminant analysis capability compared to GOHAI and better diagnosed patients who needed dental treatments: patients with higher GI, xerostomia and those wearing partial dentures.
Diabetic patients did not show acceptable oral health status and in some extent, oral problems affected oral health-related quality of life. Psychotherapy courses and solving oral problems of the patients can improve OHRQoL. OHIP-14 had higher discriminant analysis capability and was more effective in diagnosing oral problems.
PMCID: PMC4015305  PMID: 24495383
Diabetes mellitus; Type 2; Oral health; Quality of Life; GOHAI; OHIP-14
13.  How Valid are the Psychometric Properties of the Oral Health Impact Profile-14 Measure in Adult Dental Patients in Ibadan, Nigeria? 
The Oral Health Impact Profile (OHIP) is the most widely used quality of life (QoL) measure to evaluate the influence of oral diseases on individuals. QoL measures have been noted to be context and environment specific, and there is a need to cross-culturally adapt a scale before its introduction into any community. This study aimed to evaluate the psychometric properties, validity and internal consistency of the OHIP-14 measure in an adult patient population in Ibadan, Nigeria.
A cross-sectional study was conducted over a four-month period on 204 adult patients using OHIP-14 structured questionnaire, global self-report indicator of oral conditions and perceived treatment need. Oral examinations were performed to assess periodontal status, caries experience and attachment loss. Data were analyzed using SPSS and p-value for statistical significance was set at < 0.05.
A total of 204 patients participated in the study with a mean OHIP score of 11.2 (± 9.8). OHIP scores were not related to the sociodemographic characteristics. Perception of need for treatment was greater among those who reported impacts on their QoL (89.3% vs. 14.3%, p < 0.001). The OHIP scores correlated negatively with global self rating of oral health status (rho = −0.23, p < 0.01). Higher OHIP scores were associated with having carious teeth (p = 0.023). The Cronbach's alpha for the 14 inventory items ranged from 0.857 to 0.871.
The OHIP-14 measure showed good psychometric properties with satisfactory validity and internal consistency in adult patients in Ibadan, Nigeria.
PMCID: PMC4141227  PMID: 25183930
Oral health; quality of life; OHIP-14; validity; internal consistency
14.  Mapping oral health related quality of life to generic health state values 
A summary utility index is useful for deriving quality-adjusted life years (QALY) for cost analyses or disability weights for burden of disease studies. However, many quality of life instruments provide descriptive profiles rather than a single utility index. Transforming quality of life instruments to a utility index could extend the use of quality of life instruments to costs analyses and burden of disease studies. The aims of the study were to map a specific oral health measure, the Oral Health Impact Profile to a generic health state measure, the EuroQol, in order to enable the estimation of health state values based on OHIP data.
Data were collected from patients treated by a random sample of South Australian dentists in 2001–02 using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental conditions and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol (EQ-5D) and 14-item version of the Oral Health Impact Profile (OHIP-14) instruments. Data were available from 375 patients (response rate = 72%). A random two-thirds sample of patients was used in tobit regressions of EQ-5D health state values estimated using OHIP-14 in a model with categories of OHIP responses as indicator variables and in a model with OHIP responses as continuous variables. Age and sex were included as covariates in both models. The remaining one-third sample of patients was used to test the models.
The OHIP item 'painful aching in mouth' was significantly related to health state values in both models while 'life less satisfying' was also significant in the continuous model. Mean forecast errors relative to the mean observed health state value were higher when fitted to the categorical model (17.4%) compared to the continuous model (15.2%) (P < 0.05).
The findings enable health state values to be derived from OHIP-14 scores for populations where utility has not or cannot be measured directly.
PMCID: PMC1570134  PMID: 16893470
15.  Psychometric Properties of the Oral Health Impact Profile and New Methodological Approach 
Journal of Dental Research  2014;93(7):645-650.
Objective: Evaluate the validity, reliability, and factorial invariance of the complete Portuguese version of the Oral Health Impact Profile (OHIP) and its short version (OHIP-14). Methods: A total of 1,162 adults enrolled in the Faculty of Dentistry of Araraquara/UNESP participated in the study; 73.1% were women; and the mean age was 40.7 ± 16.3 yr. We conducted a confirmatory factor analysis, where χ2/df, comparative fit index, goodness of fit index, and root mean square error of approximation were used as indices of goodness of fit. The convergent validity was judged from the average variance extracted and the composite reliability, and the internal consistency was estimated by Cronbach standardized alpha. The stability of the models was evaluated by multigroup analysis in independent samples (test and validation) and between users and nonusers of dental prosthesis. Results: We found best-fitting models for the OHIP-14 and among dental prosthesis users. The convergent validity was below adequate values for the factors “functional limitation” and “physical pain” for the complete version and for the factors “functional limitation” and “psychological discomfort” for the OHIP-14. Values of composite reliability and internal consistency were below adequate in the OHIP-14 for the factors “functional limitation” and “psychological discomfort.” We detected strong invariance between test and validation samples of the full version and weak invariance for OHIP-14. The models for users and nonusers of dental prosthesis were not invariant for both versions. Conclusion: The reduced version of the OHIP was parsimonious, reliable, and valid to capture the construct “impact of oral health on quality of life,” which was more pronounced in prosthesis users.
PMCID: PMC4293727  PMID: 24782438
quality of life; oral health; validation studies; weights and measures; dental prosthesis; scales
16.  Application of an oral health-related quality of life questionnaire in primary care patients with orofacial pain and temporomandibular disorders 
Objectives: To examine whether patients who report orofacial pain (OP) and temporomandibular disorders (TMD) have a poorer perception of their oral health-related quality of life and, if so, to what extent, and to analyze the association between oral health perception, sociodemographic variables and reported pain duration. Study Design: 407 patients treated at the OP and TMD units in the Healthcare District of Cordoba, Spain, diagnosed following the standard criteria accepted by the scientific community – the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) – were administered the Spanish version of the Oral Health Impact Profile questionnaire (OHIP-14). Bivariate and logistic regression analyses were performed to determine the degree of association between the patients’ OHIP-14 score and pain duration, pain intensity, and various sociodemographic variables. Results: The observed distribution was 89.4% women and 10.6% men. The mean OHIP-14 score was 20.57 ± 10.73 (mean ± standard deviation). A significant association (p<0.05) was found for gender, age, marital status, chronic pain grade, self-perceived oral health status and pain duration. Conclusions: The analysis of self-perceived oral health status in patients with OP and TMD, as measured by the OHIP-14, showed that oral health is perceived more negatively by women. Moreover, a one-point increase in the Chronic Pain Grade indicator increases the OHIP-14 indicator by 4.6 points, while chronic pain, defined as pain suffered by patients for one year or more, increases the OHIP-14 indicator by 3.2 points.
Key words:Orofacial pain, temporomandibular disorders, Oral Health Impact Profile, sociodemographic variables, primary care, Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).
PMCID: PMC4015039  PMID: 24121906
17.  Oral health-related quality of life in a birth cohort of 32-year olds 
To describe oral health-related quality of life (OHRQoL) among New Zealand adults and assess the relationship between clinical measures of oral health status and a well-established OHRQoL measure, controlling for sex, socioeconomic status (SES) and use of dental services.
A birth cohort of 924 dentate adults (participants in the Dunedin Multidisciplinary Health and Development Study) was systematically examined for dental caries, tooth loss, and periodontal attachment loss (CAL) at age 32 years. OHRQoL was measured using the 14-item Oral Health Impact Profile questionnaire (OHIP-14). The questionnaire also collected data on each study member’s occupation, self-rated oral health and reasons for seeing a dental care provider. SES was determined from each individual’s occupation at age 32 years.
The mean total OHIP-14 score was 8.0 (SD 8.1); 23.4% of the cohort reported one or more OHIP problems ‘fairly often’ or ‘very often’. When the prevalence of impacts ‘fairly/very often’ was modeled using logistic regression, having untreated caries, two or more sites with CAL of 4+ mm and 1 or more teeth missing by age 32 years remained significantly associated with OHRQoL, after adjusting for sex and ‘episodic’ dental care. Multivariate analysis using Poisson regression determined that being in the low SES group was also associated with the mean number of impacts (extent) and the rated severity of impacts.
OHIP-14 scores were significantly associated with clinical oral health status indicators, independently of sex and socioeconomic inequalities in oral health. The prevalence of impacts (23.4%) in the cohort was significantly greater than age- and sex-standardized estimates from Australia (18.2%) and the UK (15.9%).
PMCID: PMC2288569  PMID: 18650957
adult; dental caries; oral health; Oral Health Impact Profile; periodontal diseases; prevalence; quality of life; tooth loss
18.  Validation of the oral health impact profile (OHIP-20sp) for Spanish edentulous patients 
Objectives: The purposes of this study are to validate the indicator of Oral Health Impact Profile for edentulous patients (OHIP-20sp) in the Spanish population and to analyze the factorial construct of the prosthetic well-being. Study Design: A total of twenty-one (n=21) edentulous patients wearing mandibular implant-over dentures on Locator® (LO) and twenty (n=20) with complete dentures (CD) were retrospectively evaluated in this study. All participants were recruited consecutively and were treated in the previous academic year 2009-2010 by professors of the University of Salamanca. Reliability analyses and validity tests were performed in order to evaluate the psychometric properties of OHIP-20sp employing two different total score methods (additional and simple count). A retrospective evaluation of the impact of the prosthetic treatment was captured with an evaluative instrument derived from OHIP-20, and named POST-OHIP-13. Results: The reliability coefficient (Cronbach’s alpha = 0.91) has shown a high internal consistency. Item-total correlations coefficients ranged from 0.46 and 0.81. Five factors, named as disability, functional comfort, psychosocial impact, pain-discomfort and functional limitations were identified as principal components of the construct, explaining almost 85% of the variance. The 48% of the sample felt at least one impact in an occasional or more frequently manner (generally food packing). The global transition judgment of the prosthetic treatment using the POST-OHIP-13 was significantly higher in group LO than in the CD group. Conclusions: OHIP-20 seems to be a reliable and valid indicator to measure oral impact and satisfaction in the Spanish edentulous population. The underlying construct is comprised by 5 factors named as disability, functional comfort, psychosocial impact, pain-discomfort and functional limitations.
Key words:Oral health-related quality of life, edentulous, satisfaction, validation.
PMCID: PMC3476106  PMID: 22143713
19.  Dimensions of oral health related quality of life measured by EQ-5D+ and OHIP-14 
The aims of the study were to compare the dimensions of oral-health-related quality-of-life measured by a generic health state measure, the EuroQol, and a specific oral health measure, the Oral Health Impact Profile.
Data were collected in 2001–02 from a random sample of South Australian dentists using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental problems and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol (EQ-5D+) and 14-item version of the Oral Health Impact Profile (OHIP-14) instruments.
Data were available from 375 patients (response rate = 72%). The EuroQol items of mobility, self care and usual activities formed a separate cluster of variables, as did anxiety/depression and cognition, while pain clustered with items from the OHIP physical pain subscale. OHIP items tended to form clusters consistent with the subscales of social disability, physical disability, physical pain, functional limitation and psychological discomfort. The OHIP handicap items clustered between the OHIP social disability and physical disability subscales. The OHIP psychological disability items split between the social disability and psychological discomfort subscales.
The observed clusters of variables empirically supported most of the conceptual dimensions of the OHIP. Both instruments covered symptom experience of pain indicating overlapping domains. However there was partial separation of the generic and specific items, EuroQol covered daily activities such as self-care and usual activities and OHIP covered oral health-specific aspects of functional limitation and physical disability as well as psychological and social aspects of disability and handicap.
PMCID: PMC479699  PMID: 15248893
20.  Interpreting one oral health impact profile point 
Interpretation of scores from oral health-related quality of life (OHRQoL) instruments, such as the Oral Health Impact Profile (OHIP) is challenging. It was the aim of this study to determine how many oral impacts correspond to one point of the 49-item OHIP using a new approach which translates numeric problem counts into the traditionally used ordinal OHIP response categories.
A sample of 145 consecutively recruited prosthodontic patients seeking treatment or having a routine examination completed the German version of the 49-item OHIP with the original ordinal response format as a self-administered questionnaire. In addition, the numerical frequencies of impairment during the previous month were requested in personal interviews. Based on a multilevel mixed-effects linear regression, we estimated the mean difference with 95% confidence interval (CI) in numerical frequency between two adjacent ordinal responses.
A numerical frequency of 15.2 (CI: 14.8 – 15.7) impacts per month corresponded to one OHIP point. This translates to approximately one impact every other day in the past month.
The oral problem count per day that corresponds to one OHIP-49 point can be used to interpret this instrument’s scores in cross-sectional and longitudinal studies. This number can help to better understand OHRQoL burden for patients, clinicians, and researchers alike.
PMCID: PMC3598229  PMID: 23363450
OHIP; Response format; OHRQoL; Assessment
21.  How Do Age and Tooth Loss Affect Oral Health Impacts and Quality of Life? A Study Comparing Two State Samples of Gujarat and Rajasthan 
Age and tooth loss are expected to have a complex relationship with oral health-related quality of life. So the purpose of this study was to explain the impact of age and tooth loss on oral health-related quality of life using the short form 14-item oral health impact profile (OHIP-14) among two population samples of Gujarat and Rajasthan.
Materials and Methods:
A cross-sectional questionnaire-based survey was conducted among 1441 subjects collected from two major cities of Gujarat and Rajasthan. Both questionnaire approaches using OHIP-14 scale and clinical examination were conducted in accordance with WHO criteria using type III procedure on the same day. Chi square test, ANOVA and stepwise multiple regression analysis were applied using SPSS software version 15.0.
With the increase of age, OHIP mean score in both states increased, but that among Rajasthan state was higher, depicting poor oral health. Whereas, in the remaining 23–27 number of teeth both states showed higher OHIP mean, however again the score was much higher among Rajasthan subjects showing worse oral hygiene. Hence, overall all mean OHIP score for Gujarat was lower indicating good oral health; whereas, that among Rajasthan was higher indicating poor oral health-related quality of life.
Both age and tooth loss are associated with each other, but they have an independent effect on the oral health-related quality of life. Thus, all studied populations with complete natural dentition showed good oral health-related quality of life.
PMCID: PMC3466767  PMID: 23066478
Age Distribution; Tooth Loss; Oral Health; Quality of Life
22.  Psychosocial aspects of temporomandibular disorders and oral health-related quality-of-life 
Acta Odontologica Scandinavica  2012;70(4):331-336.
The aim of the study was to evaluate the association between psychosocial aspects of temporomandibular disorders (TMD) and oral health-related quality-of-life (OHRQoL) and, secondly, to investigate the gender differences in these associations using patient and non-patient groups.
Materials and methods.
The sample of the study consisted of 79 patients with TMD and 70 non-patients. The data was collected by Finnish versions of the RDC/TMD Axis II profile and Oral Health Impact Profile (OHIP-14) questionnaires. The associations between Axis II profile sub-scales and OHIP prevalence were evaluated using chi-square tests, as stratified by group status (TMD patients and non-patient controls) and by gender. The association between OHIP prevalence and Axis II profile sub-scales were evaluated using logistic regression analysis, adjusted by age, gender and group.
OHIP prevalence (those reporting at least one problem) was 90.9% in the patient group and 33.3% in the non-patient group (p < 0.001, chi-squared test). OHIP prevalence was higher among those scoring higher on all RDC/TMD Axis II profile sub-scales, i.e. graded chronic pain status, depression and non-specific physical symptoms with pain items included and with pain items excluded. The associations were significant in the non-patient group. Women showed statistically significant associations of OHIP prevalence with all Axis II sub-scales. Among men, OHIP prevalence associated with GCPS and somatization. The logistic regression analysis showed that OHIP prevalence associated significantly with somatization and depression.
TMD associate with OHRQoL through multiple ways, linked with depression and somatization. These findings emphasize the importance of early and effective treatment of TMD.
PMCID: PMC3793272  PMID: 22300221
temporomandibular disorders; oral health-related quality-of-life; Oral Health Impact Profile; psychosocial factors
23.  Validation of a Persian Version of the Oral Health Impact Profile (OHIP-14) 
Iranian Journal of Public Health  2010;39(4):135-139.
The oral health-related quality of life indicators are increasingly used to measure the impact of the oral conditions on quality of life. One of the most used indicators is the Oral Health Impact Profile (OHIP-14), but it has never been applied in Iran. The aim of this study was to validate the usage of OHIP-14 among Iranians.
A cross-sectional study was performed in Kerman (Iran). A consecutive sample (n= 400) of the Kerman Dental School Clinics attending patients participated in this study. All participants self-completed the translated OHIP-14. Reliability analyses, validity tests, and responsiveness were carried out to evaluate the psychometric properties of the OHIP-14.
The reliability coefficient (Cronbach’s alpha) of the OHIP-14 was above the recommended 0.7 threshold and considered excellent (alpha: 0.85). The coefficient of the test-retest reliability measured by ICC was 0.88 (CI 95%: 0.80–0.93). Poorer oral condition was strongly associated with OHIP scores of the patients, supporting construct validity. Moreover, for evaluation of responsiveness, the ES was measured to be 0.43 and the SRM was 0.67.
The Persian version of OHIP-14 is a precise, valid and reliable instrument for assessing oral health-related quality of life among Persian population.
PMCID: PMC3481693  PMID: 23113047
Oral health; Quality of life; Validity; Iran
24.  Translation and validation of Hindi version of Oral Health Impact Profile-14 
Title of the Study:
Validation of Hindi Version of Oral health Impact Profile (OHIP-14).
To validate the Hindi version of OHIP-14.
Settings and Design:
The study was carried out in K.M. Shah Dental College & Hospital, Vadodara.
Materials and Methods:
OHIP-14 was translated into Hindi language.102 participants were given English as well as Hindi versions of OHIP-14.
Statistical Analysis Used:
Individual question were analyzed using Pearson Chi-Square test, Likelihood Ratio test and Linear-by-Linear Association test. The entire questionnaire in English and Hindi language were comparatively analyzed using Unpaired T test & Pearson correlation coefficient test.
All the 14 questions showed no statistically significant difference between the English OHIP-14 and the translated Hindi version of OHIP-14. Results of Unpaired T test (P = 0.61) were statistically insignificant. Pearson Correlation coefficient test was 0.963 suggesting that the translated Hindi version was highly correlated to the original English version.
The translated Hindi version of OHIP-14 is hence established as a valid tool for conduction of oral health related & quality of life surveys in Hindi language which is the most commonly used language in the Indian subcontinent.
PMCID: PMC4439633  PMID: 26015674
Hindi version Oral Health Impact Profile-14; Oral Health Impact Profile-14; oral health quality of life; translation; validation
25.  The impact of burning mouth syndrome on health-related quality of life 
Burning mouth syndrome is a chronic disorder that is characterized by a burning sensation and a normal clinical appearance of the oral mucosa. This condition often affects the health-related quality of life in patients. As such, the aim of this study was to compare the health-related quality of life of patients with BMS and healthy controls, using the validated Portuguese versions of the SF-36 and OHIP-49 questionnaires.
A calculated sample of Brazilian patients with BMS (n = 26) was compared with a control group (n = 27), paired for gender and age. Sociodemographic information and clinical characteristics were obtained, and interviews were conducted using the SF-36 and OHIP-49. To evaluate the normality of the variables, we used the Kolmogorov-Smirnov test. The chi-square test, Fisher exact test and Mann-Whitney U-Test were used to compare sociodemographic and clinical characteristics of individuals with BMS and controls Mann-Whitney U-test were carried out to compare SF-36 and OHIP-49 between BMS patients and controls. The significance level was set at 0.05. To compare the dimensions of the SF-36 and OHIP-49 between BMS patients and controls, we considered Bonferroni correction. So for comparison of the dimensions, the significance level was set at 0.00625 for SF-36 and at 0.00714 for OHIP-49.
The clinical and demographic data were similar in both groups (P > 0.05). SF-36 scores were significantly lower in all domains for patients with BMS (P < 0.00625). OHIP-49 scores were higher for individuals with BMS (P < 0.00714).
BMS has a negative impact on the health-related quality of life of individuals, as can be shown by instruments such as the SF-36 and OHIP-49. So, the evaluation of quality of life might be useful for more information about the nature and severity of BMS, to evaluate the effects of treatment protocols, in order to improve their outcomes by means a humanized clinical practice.
PMCID: PMC3158539  PMID: 21801374
Burning Mouth Syndrome; Quality of life; epidemiology

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