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1.  Validation of a Greek version of the oral health impact profile (OHIP-14) for use among adults 
Background
To test the validity of the short form of the Oral Health Impact Profile (OHIP-14) for use among adults in Greece.
Methods
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.
Results
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.
Conclusions
The OHIP-14 is a reliable and valid questionnaire for the assessment of OHRQoL among adults in Greece.
doi:10.1186/1477-7525-10-7
PMCID: PMC3278380  PMID: 22244162
2.  Validation of the Spanish version of the Oral Health Impact Profile (OHIP-14Sp) in elderly Chileans 
BMC Oral Health  2014;14:95.
Background
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.
Methods
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.
Results
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).
Conclusions
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.
doi:10.1186/1472-6831-14-95
PMCID: PMC4128544  PMID: 25091189
Quality of life; Oral health; OHIP; Validation studies; Aging; Chile
3.  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
4.  Psychometric Properties of Croatian and Slovenian Short Form of Oral Health Impact Profile Questionnaires 
Croatian medical journal  2008;49(4):536-544.
Aim
To develop Croatian and Slovenian versions of the 14-item Oral Health Impact Profile (OHIP) Questionnaire.
Methods
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).
Results
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).
Conclusion
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.
doi:10.3325/cmj.2008.4.536
PMCID: PMC2525826  PMID: 18717001
5.  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.
Objectives
(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.
Methods
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.
Results
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.
Conclusions
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.
doi:10.1111/j.1600-0528.2008.00457.x
PMCID: PMC3760707  PMID: 19175659
adults; health policy; health surveys; NHANES; population groups
6.  Quality of life measured by OHIP-14 and GOHAI in elderly people from Bialystok, north-east Poland 
BMC Oral Health  2014;14:106.
Background
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.
Methods
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.
Results
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”.
Conclusions
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.
doi:10.1186/1472-6831-14-106
PMCID: PMC4145358  PMID: 25141902
Oral health-related quality of life; OHIP-14; GOHAI; Quality of life; Elderly; Poland; “Fatigue effect”
7.  Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon 
Background
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.
Methods
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.
Results
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.
Conclusions
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.
doi:10.1186/1477-7525-10-131
PMCID: PMC3495839  PMID: 23110518
Oral health; Quality of Life; Lebanese elderly; Psychometric properties; Health status indicators; Dental health survey
8.  Impact of tooth loss related to number and position on oral health quality of life among adults 
Background
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.
Methods
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.
Results
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.
Conclusion
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.
doi:10.1186/s12955-014-0165-5
PMCID: PMC4263115  PMID: 25433483
Adults; Oral health; Quality of life; OHIP14; Regression analysis
9.  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 
Background
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.
Methods
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.
Results
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.
Conclusion
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.
doi:10.1186/2251-6581-13-32
PMCID: PMC4015305  PMID: 24495383
Diabetes mellitus; Type 2; Oral health; Quality of Life; GOHAI; OHIP-14
10.  How Valid are the Psychometric Properties of the Oral Health Impact Profile-14 Measure in Adult Dental Patients in Ibadan, Nigeria? 
Background
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.
Methods
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.
Results
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.
Conclusion
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
11.  Mapping oral health related quality of life to generic health state values 
Background
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.
Methods
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.
Results
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).
Conclusion
The findings enable health state values to be derived from OHIP-14 scores for populations where utility has not or cannot be measured directly.
doi:10.1186/1472-6963-6-96
PMCID: PMC1570134  PMID: 16893470
12.  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).
doi:10.4317/medoral.19061
PMCID: PMC4015039  PMID: 24121906
13.  Oral health-related quality of life in a birth cohort of 32-year olds 
Objectives
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.
Methods
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.
Results
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.
Conclusions
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%).
doi:10.1111/j.1600-0528.2007.00395.x
PMCID: PMC2288569  PMID: 18650957
adult; dental caries; oral health; Oral Health Impact Profile; periodontal diseases; prevalence; quality of life; tooth loss
14.  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 Desing: 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.
doi:10.4317/medoral.17498
PMCID: PMC3476106  PMID: 22143713
15.  Dimensions of oral health related quality of life measured by EQ-5D+ and OHIP-14 
Background
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.
Methods
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.
Results
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.
Conclusions
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.
doi:10.1186/1477-7525-2-35
PMCID: PMC479699  PMID: 15248893
16.  Interpreting one oral health impact profile point 
Background
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.
Methods
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.
Results
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.
Conclusions
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.
doi:10.1186/1477-7525-11-12
PMCID: PMC3598229  PMID: 23363450
OHIP; Response format; OHRQoL; Assessment
17.  How Do Age and Tooth Loss Affect Oral Health Impacts and Quality of Life? A Study Comparing Two State Samples of Gujarat and Rajasthan 
Objective:
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.
Results:
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.
Conclusion:
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
18.  Psychosocial aspects of temporomandibular disorders and oral health-related quality-of-life 
Acta Odontologica Scandinavica  2012;70(4):331-336.
Objective.
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.
Results.
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.
Conclusions.
TMD associate with OHRQoL through multiple ways, linked with depression and somatization. These findings emphasize the importance of early and effective treatment of TMD.
doi:10.3109/00016357.2011.654241
PMCID: PMC3793272  PMID: 22300221
temporomandibular disorders; oral health-related quality-of-life; Oral Health Impact Profile; psychosocial factors
19.  Validation of a Persian Version of the Oral Health Impact Profile (OHIP-14) 
Iranian Journal of Public Health  2010;39(4):135-139.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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
20.  The Dutch version of the Oral Health Impact Profile (OHIP-NL): Translation, reliability and construct validity 
BMC Oral Health  2008;8:11.
Background
The purpose of this study was to make a cross-culturally adapted, Dutch version of the Oral Health Impact Profile (OHIP), a 49-item questionnaire measuring oral health-related quality of life, and to examine its psychometric properties.
Methods
The original English version of the OHIP was translated into the Dutch language, following the guidelines for cross-cultural adaptation of health-related quality of life measures. The resulting OHIP-NL's psychometric properties were examined in a sample of 119 patients (68.9 % women; mean age = 57.1 ± 12.2 yrs). They were referred to the clinic of Prosthodontics and Implantology with complaints concerning their partial or full dentures or other problems with missing teeth. To establish the reliability of the OHIP-NL, internal consistency and test-retest reliability (N = 41; 1 – 2 weeks interval) were examined, using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. Further, construct validity was established by calculating ANOVA.
Results
Internal consistency and test-retest reliability were excellent (Cronbach's alpha = 0.82 – 0.97; ICC = 0.78 – 0.90). In addition, all associations were significant and in the expected direction.
Conclusion
In conclusion: the OHIP-NL can be considered a reliable and valid instrument to measure oral health-related quality of life.
doi:10.1186/1472-6831-8-11
PMCID: PMC2329613  PMID: 18405359
21.  The impact of burning mouth syndrome on health-related quality of life 
Background
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.
Methods
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.
Results
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).
Conclusions
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.
doi:10.1186/1477-7525-9-57
PMCID: PMC3158539  PMID: 21801374
Burning Mouth Syndrome; Quality of life; epidemiology
22.  Translation and Cross-Cultural Adaptation of the Manchester Orofacial Pain Disability Scale 
ABSTRACT
Objectives
The purpose of the present study was to translate and perform a cross-cultural adaptation of Manchester Orofacial Pain Disability Scale to the Portuguese language.
Material and Methods
A synthesis of two independent translations done by bilingual translators whose mother tongue was the Portuguese language began the process of translation. From the synthesis of the translated version and totally blind to the original version, two different non-native English language teachers without dental knowledge translated the questionnaire back to English. The pre-final version was done by an Expert committee: the researchers, two other non-native English language teachers and one native English language speaker. The new questionnaire was then piloted among 8 patients from the target setting that were interviewed to probe it on their perceived meaning of each question. The Manchester Orofacial Pain Disability Scale (MOPDS) thus translated was called Brasil-MOPDS and was validated in 50 patients with Orofacial pain from TMJ and Occlusion clinic ambulatory of São Paulo University School of Dentistry. The Brasil-MOPDS was administered twice by an interviewer (15 - 20 day interval) and once by a second independent interviewer. The Brazilian version of the short form oral health impact profile (OHIP-14) questionnaire and the visual analogue pain scale (VAS) were applied on the same day.
Results
Internal consistency (Cronbach's α = 0.9), inter-observer (ICC = 0.92) and intra-observer (ICC = 0.98) correlations presented high scores. Validity of Brasil-MOPDS compared to OHIP-14 (r = 0.85) and VAS (r = 0.75) shown high correlations.
Conclusions
Brasil-MOPDS was successfully translated and adapted to be applied to Brazilian patients, with satisfactory internal and external reliability.
doi:10.5037/jomr.2012.3403
PMCID: PMC3886098  PMID: 24422021
orofacial pain; oral health; quality of life; visual analogue pain scale.
23.  Oral health-related quality of life in complete denture wearers depending on their socio-demographic background, prosthetic-related factors and clinical condition 
Objectives: To investigate the differences in impact on oral health-related quality of life (OHRQoL) among complete denture wearers depending on their socio-demographic characteristics, prosthetic-related factors and oral status. Study Design: 51 patients aged 50-90 years treated, from 2005 to 2010, with at least one complete denture at the Department of Buccofacial Prostheses of the Complutense University (Madrid) were enrolled in this cross-sectional study. All of the participants answered the Oral Health Impact Profile (OHIP-14sp) questionnaire. The additive scoring method was used. The prevalence of impacts was calculated by using the occasional threshold (OHIP-14sp score≥2). Socio-demographic and prosthetic-related variables were gathered. Patients underwent clinical examination to assess their oral condition. Descriptive probes and Chi-Square tests were run (p≤0.05). Results: The predominant participants’ profile was that of a man with a mean age of 69 years wearing complete dentures in both the maxilla and the mandible. The prevalence of impact was 23.5%, showing an average score of 19±9.8. The most affected domains were “functional limitation” and “physical pain”, followed by “physical disability”. Minor impacts were recorded for the psychological and social subscales (“psychological discomfort”, “psychological disability”, “social disability” and “handicap”). The prosthesis’ location significantly influenced the overall patient satisfaction, the lower dentures being the less comfortable. Having a complete removable denture as antagonist significantly hampered the patient satisfaction. Patients without prosthetic stomatitis and those who need repairing or changing their prostheses, recorded significantly higher OHIP-14sp total scores. Conclusions: The use of conventional complete dentures brings negative impacts in the OHRQoL of elderly patients, mainly in case of lower prostheses that required reparation or substitution, with a removable total denture as antagonist. The prosthetic stomatitis in this study was always associated to other severe illness, which may have influenced the self-perceived discomfort with the prostheses, as those patients were daily medicated with painkillers.
Key words:Oral Health Impact Profile (OHIP), oral health-related quality of life (OHRQoL), patient satisfaction, complete denture, elderly patients.
doi:10.4317/medoral.18648
PMCID: PMC3668860  PMID: 23385509
24.  The internal responsiveness of the Oral Health Impact Profile-14 to detect differences in clinical parameters related to surgical third molar removal 
Quality of Life Research  2011;21(7):1241-1247.
Purpose
The present study examined the internal responsiveness of the short-form Oral Health Impact Profile (OHIP-14) and its ability to differentiate between patients with and without pre- and postoperative complaints as well as other clinical variables.
Methods
The sample consisted of 97 patients undergoing surgical third molar removal. The OHIP-14 was filled in preoperatively, on each postoperative day for a week and once more after 1 month. In addition, pre- and postoperative status was measured along with other clinical variables.
Results
The OHIP-14 is able to differentiate between the first preoperative day (M = 16.85, SD = 5.35) and all the days within the postoperative week (first day M = 29.46, SD = 9.32). One month postoperatively, mean OHIP scores are reduced to preoperative levels. In addition, differences could be shown between patients with and without pre- (M = 18.9, SD = 8.1 vs. M = 16.2, SD = 3.9) and postoperative complaints (M = 18.9, SD = 8.1 vs. M = 16.2, SD = 3.9), partial (preop; M = 17.8, SD = 6.8, postoperative; M = 27.4, SD = 7.7) and complete mucosa coverage (preop; M = 15.9, SD = 3.2, postoperative; M = 29.5, SD = 10.6) and the level of impaction (Pell and Gregory classification) of the third molar (3B showing the highest increase in the mean OHIP score).
Conclusions
The OHIP-14 can be considered internally responsive to changes in impacts of oral conditions as a result of surgical third molar removal and is able to differentiate the effect of several clinical variables.
doi:10.1007/s11136-011-0022-5
PMCID: PMC3427486  PMID: 21964947
Impact of oral conditions; Third molar surgery; Internal responsiveness
25.  Level of oral health impacts among patients participating in PEARL: a dental practice-based research network 
Objectives
To determine whether participants of a dental practice-based research network (PBRN) differ in their level of oral health impact as measured by the Oral Health Impact Profile (OHIP) questionnaire.
Methods
A total of 2410 patients contributed 2432 OHIP measurements (median age = 43 years; interquartile range = 28) were enrolled in four dental studies. All participants completed the Oral Health Impact Profile (OHIP-14) during a baseline visit. The main outcome of the current study was the level of oral health impact, defined as follows: no impact (“Never” reported on all items); low (“Occasionally” or “Hardly ever” as the greatest frequency score reported on any item); and high (“Fairly often” or “Very often” as the greatest frequency reported on any item). Polychotomous logistic regression was used to develop a predictive model for the level of oral health impact considering the following predictors: patient’s age, gender, race, practice location, type of dentist, and number of years the enrolling dentist has been practicing.
Results
A high level of oral health impacts was reported in 8% of the sample; almost a third (29%) of the sample reported a low level of impacts, and 63% had no oral health impacts. The prevalence of impacts differed significantly across protocols (P<0.001). Females were more likely to be in the high oral impact group than the no impact group compared to males (OR=1.46; 95% CI= 1.06–1.99). African-Americans were more likely to report high oral impacts when compared to other racial/ethnic groups (OR=2.11; 95% CI = 1.26–3.55). Protective effects for being in the high or in the low impact groups were observed among patients enrolled by a solo practice (P<0.001) or by more experienced dentists (P=0.01). A small but highly significant statistical association was obtained for patient age (P<0.001). In the multivariate model, patient’s age, practice size and gender were found to jointly be significant predictors of oral health impact level.
Conclusions
Patients’ subjective report of oral health impact in the clinical setting is of importance for their health. In the context of a dental PBRN, the report of oral health-related quality of life (OHRQoL) was different across four dental studies. The observed findings validate the differential impact that oral health has on the patients’ perception of OHRQoL particularly among specific groups. Similar investigations to elucidate the factors associated with patient’s report of quality of life are warranted.
doi:10.1111/j.1600-0528.2012.00676.x
PMCID: PMC3380181  PMID: 22390788
Oral-Health Impact; OHRQoL; Dental PBRN; OHIP-14; Patient Reported Outcomes; Subjective Health

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