Dentures and their impact on social and sexual activities.
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Comment↗
Biomedical subjects
Colman McGrath
Publications and source records attributed to Colman McGrath.
Patient-centred measures in dental practice: 1. An overview.
This paper explores the way that patient participation has increased in dentistry in recent years and introduces the two concepts of 'quality of life' and 'patient satisfaction' and examines their relevance to everyday clinical dental practice.
Attitude to Health↗
Application of an interactive computer program to manage a problem-based dental curriculum.
Managing the change from traditional to problem-based learning (PBL) curricula is complex because PBL employs problem cases as the vehicle for learning. Each problem case covers a wide range of different learning issues across many disciplines and is coordinated by different facilitators drawn from the school's multidisciplinary pool. The objective of this project was to adapt an interactive computer program to manage a problem-based dental curriculum. Through application of a commercial database software--CATs (Curriculum Analysis Tools)--an electronic database for all modules of a five-year problem-based program was developed. This involved inputting basic information on each problem case relating to competencies covered, key words (learning objectives), participating faculty, independent study, and homework assignments, as well as inputting information on contact hours. General reports were generated to provide an overview of the curriculum. In addition, competency, key word, manpower, and clock-hour reports at three levels (individual PBL course component, yearly, and the entire curriculum) were produced. Implications and uses of such reports are discussed. The adaptation of electronic technology for managing dental curricula for use in a PBL curriculum has implications for all those involved in managing new-style PBL dental curricula and those who have concerns about managing the PBL process.
Curriculum↗
Pilot survey of oral health-related quality of life: a cross-sectional study of adults in Benin City, Edo State, Nigeria.
BACKGROUND: Oral health studies conducted so far in Nigeria have documented prevalence and incidence of dental disease using traditional clinical measures. However none have investigated the use of an oral health-related quality of life (OHRQoL) instrument to document oral health outcomes. The aims of this study are: to describe how oral health affects and impacts quality of life (QoL) and to explore the association between these affects and the oral health care seeking behavior of adults in Benin City, Edo State, Nigeria. METHODS: A cross-sectional survey recruited 356 adults aged 18-64 years from two large hospital outpatient departments and from members of a university community. Closed-ended oral health questionnaire with "effect and impact" item-questions from OHQoL-UK instrument was administered by trained interviewers. Collected data included sociodemographic, dental visits, and effects and impact of oral health on QoL. Univariate and bivariable analyses were done and a chi-square test was used to test differences in proportions. Multivariable analyses using ANOVA examined the association between QoL factors and visits to a dentist. RESULTS: Complete data was available for 83% of the participants. About 62% of participants perceived their oral health as affecting their QoL. Overall, 82%, 63%, and 77% of participants perceived that oral health has an effect on their eating or enjoyment of food, sleep or ability to relax, and smiling or laughing, respectively. Some 46%, 36%, and 25% of participants reported that oral health impact their daily activities, social activities, and talking to people, respectively. Dental visits within the last year was significantly associated with eating, speech, and finance (P < 0.05). The summary score for the oral health effects on QoL ranged from 33 to 80 with a median value of 61 (95% CI: 60, 62) and interquartile range of 52-70. Multivariable modeling suggested a model containing only education (F = 6.5, pr>F = 0.0111). The mean of effects sum score for those with secondary/tertiary education levels (mean = 61.8; 95% CI: 60.6, 62.9) was significantly higher than those with less than secondary level of education (mean = 57.2; 95% CI: 57.2, 60.6). CONCLUSION: Most adults in the study reported that oral health affects their life quality, and have little/no impact on their quality of life. Dental visits within the last year were associated with eating, speech, and finance.
Journal Article↗
Photographs as a means of assessing developmental defects of enamel.
OBJECTIVES: To evaluate the validity and reliability of photographic examinations for developmental defects of enamel (DDE) in maxillary and mandibular incisors and canines using a standardized process. METHODS: The anterior teeth of 257 children were examined 'wet', both clinically and photographically for DDE, using the modified Federation Dentaire Internationale (FDI) (DDE) Index. A series of five standardized photographs were taken for each child: a frontal view perpendicular to the four incisors; two lateral views, each showing the lateral incisors and canines on each side of the dental arch; and the superior and inferior views, retaking of the frontal view with the camera held at approximately 30 degrees above and below the horizontal plane. The photographs taken for each child were viewed as three different sets; the 'five-view' (frontal, two lateral views plus superior and inferior views), 'three-view' (frontal and two lateral views), and 'one-view' (frontal view only) slide sets. RESULTS: Using 'one view' slides, 91.7% of teeth could be examined photographically. Whereas using multiple views 99.9% of teeth could be assessed. At the subject level, agreements between clinical diagnoses (gold standard) and photographic examinations were substantial to almost perfect (k = 0.73-0.86). At the tooth level, agreement was best for incisors (k = 0.71 or higher). The intra-examiner reproducibility was high for the photographic assessments at both subject and tooth levels (k = 0.71-0.95). CONCLUSIONS: Multiple-view photographic slides of 'five-view' and 'three-view' are valid and reliable for assessing DDE on the 12 anterior teeth, while a 'one-view' (frontal) was acceptable to study only the incisors.
Child↗
The use of Traditional Chinese Medicine in managing oral health--Hong Kong: one country, two systems.
OBJECTIVES: To determine knowledge, use, and interest in traditional methods to manage oral health among Hong Kong adults. DESIGN: A cross sectional epidemiological survey. PARTICIPANTS: A random sample of 500 Hong Kong adults. METHODS: Telephone interviews about Traditional Chinese Medicine (TCM) approaches to mange oral health, employing a battery of 50 questions over a one month period in 2002. RESULTS: Most completed the interview (96%, 481/500). Over half (52%, 250/481) had some knowledge about using TCM to manage oral health. Approximately a third (32%, 155/481) reported using TCM to manage their oral health in the past, most frequently for oral mucosal lesions (65%, 101/155) or for periodontal reasons (62%, 96/155). TCM was used predominately in combination with western dentistry or as a last resort (55%, 86/155). Most (89%, 428/481) expressed an interest in TCM approaches to managing oral health, particularly if administered by their dentist (54%, 259/481), and expressed many reasons for such interest. Socio-demographic variations in knowledge, use and interest in the use of TCM to manage oral health were apparent (p<0.05). CONCLUSION: Knowledge, use and interest in traditional based approaches to managing oral health is widespread in Hong Kong, and is associated with age and educational attainment.
Adolescent↗
Why are we "weighting"? An assessment of a self-weighting approach to measuring oral health-related quality of life.
OBJECTIVE: To determine whether or not self-weighting at an item level contributes to the performance of an oral health-related quality-of-life measure. DESIGN: Data were collected in two national surveys conducted a month apart, one using the "weighted" measure and the other an "unweighted" version of the UK oral health-related quality-of-life measure. In addition, sociodemographic and self-reported oral health status were recorded. RESULTS: The UK oral health-related quality-of-life measure discriminated between groups based on age group (<65, 65 and older) and social class (higher and lower) irrespective of the version of the questionnaire used. Both versions also showed significant associations with self-reported oral health: denture status (P < 0.01) and number of teeth possessed (P < 0.01). In addition, both versions demonstrated predictive ability in identifying those in prosthetic need (<20 teeth and without recourse to a denture, P < 0.01). CONCLUSION: Weighting the UK oral health-related quality-of-life instrument does not improve the psychometric properties of the instrument and thus raises questions about the value of self-weighting at an item level.
Adolescent↗
Impact of oral health on the life quality of periodontal patients.
OBJECTIVES: To assess the impact of oral health on the life quality of a periodontal patient group. MATERIALS AND METHODS: Two hundred and five patients attending a private periodontal clinic completed a questionnaire incorporating the 16-item UK oral health-related quality-of-life measure (OHQoL-UK), a check list of questions about their periodontal health over the past year and a comprehensive periodontal examination. RESULTS: The effect of oral health on quality of life was considerable, with many individuals experiencing negative impacts across a broad range of physical, social and psychological aspects of life quality. OHQoL-UK(Copyright ) scores was associated with patient's self-reported periodontal health in the past year: experiences of "swollen gums" (p<0.01), "sore gums" (p<0.01), "receding gums" (p<0.01), "loose teeth" (p<0.01), "drifting teeth" (p<0.01), "bad breath" (p<0.01) and "toothache" (p<0.01). In addition, OHQoL-UK scores were correlated with the number of teeth with pocket depths of 5 mm or more (r(s)-0.42, p<0.01). New patients had poorer oral health-related quality of life compared with the treated maintenance group (p<0.01). CONCLUSIONS: Periodontal status impacts on life quality. This has implications in understanding the consequences of periodontal health and in the use of patient-centred outcomes in periodontal research.
Affect↗
The association between dental anxiety and oral health-related quality of life in Britain.
OBJECTIVE: The aim of this study was to identify associations between level of dental anxiety and the impact of oral health on quality of life (OHQOL) in Britain, controlling for sociodemographic and oral health status (self-reported) factors. METHODS: The basic research design included a cross-sectional study involving a random probability sample of 3000 UK residents. The outcome measures were: levels of dental anxiety, which were measured on the Corah Dental Anxiety Scale (DAS), and the impact of OHQOL, which was assessed using UK oral health-related quality of life instrument (OHQoL-UK (W)). RESULTS: DAS was correlated with OHQoL-UK (W) scores (P < 0.01). Having controlled for sociodemographic factors (age, gender and social class) and oral health status factors (self-reported number of teeth possessed and denture status), known confounding factors associated with OHQOL, those with high levels of dental anxiety (DAS > or = 15) were approximately two times as likely to be among those experiencing the poorest OHQOL (below the population median OHQoL-UK (W) score) in Britain (P < 0.001; OR = 1.93; 95% CI 1.41, 2.65). CONCLUSION: Dental anxiety is associated with the impact oral health has on life quality. Those experiencing high levels of dental anxiety are among those with the poorest oral health-related quality of life in Britain.
Adolescent↗
Assessing the impact of oral health on the life quality of children: implications for research and practice.
Traditionally, child oral health has been assessed using clinical parameters of disease and deformity. However, there is a growing interest in the psychosocial impact of oral health among children. This commentary outlines the value and need for assessing child oral health-related quality of life (COHQoL). COHQoL has implications for oral health needs assessment (at an individual and population level) and for evaluating outcomes from specific treatments, initiatives and dental services overall. In addition, it could prove to be a useful adjunct tool for evidence-based dentistry research and practice. Theoretical and practical considerations in assessing the complex psychosocial construct of oral health among children are discussed: the use of general versus oral health-specific measures, the development of tools for children, the use of generic versus condition-specific measures, and the measurement of 'positive' oral health. Recommendations for research and practice are presented.
Child↗
Patient-centred outcome measures in oral surgery: validity and sensitivity.
The performances of patient-centred outcome measures after oral surgery were evaluated in a prospective cohort study of 100 patients who had third molar extractions. Participants self-completed a questionnaire incorporating a general health (12-item short form health survey: SF-12) and two specific outcome scales to oral health (oral health impact profile: OHIP-14, and The United Kingdom Oral Health related Quality of Life measure: OHQoL-UK) preoperatively, daily during the immediate postoperative period, and at the review appointment (7-days later). Ninety-seven completed the study. History of 'taking time off' work/study because of pericoronitis during the past year was significantly associated with preoperative OHIP-14 and OHQoL-UK scores. There were significant differences in SF-12, OHIP-14, OHQoL-UK scores during the immediate postoperative period compared with preoperatively, when postoperative symptoms were prevalent. At the review appointment, OHIP-14 and OHQoL-UKscores were associated with clinical findings. The measures were valid and sensate in relation to oral surgery. However, those specific to oral health were more discerning than the general scale.
Adult↗
Can third molar surgery improve quality of life? A 6-month cohort study.
PURPOSE: In this study, we evaluated patients' perceptions of changes in oral health-related quality of life (OHQOL) over a 6-month period after third molar surgery. PATIENTS AND METHODS: One hundred patients participated in this prospective study. Two specific OHQOL measures, the 14-item Oral Health Impact Profile (OHIP-14) and the 16-item UK Oral Health-Related Quality of Life measure (QHQoL-UK), were administered to the study group before surgery. Standardized surgical and analgesic protocols were used. Patients kept a diary of changes in life quality each postoperative day (POD) for 7 days and were contacted at 1, 3, and 6 months after surgery. RESULTS: Both measures identified a significant deterioration in quality of life in the immediate postoperative period (P <.01). However, there was an improvement in OHQOL compared with preoperative status at 1 (P <.05), 3 (P <.05), and 6 (P <.01) months after surgery. Patients perceived physical, social, and psychologic changes in life quality after surgery. Previous pericoronitis was associated with changes in quality of life (P <.05). CONCLUSION: The study concludes that third molar surgery is associated with changes in OHQOL. This has implications for understanding the value of third molar surgery from patients' perspectives and in assessing health gain.
Activities of Daily Living↗
Dental services and perceived oral health: are patients better off going private?
OBJECTIVE: The aim of this study is to determine associations between method of payment for dental services and perceived oral health in the UK. METHOD: A national UK study involving a random probability sample of 2718 adults. Respondents were interviewed in their homes about their method of payment for dental services (private or NHS), service use (time and reason for last dental visit), self-reported oral health status (number of teeth possessed and denture status) and the impact of their oral health on their quality of life (employing the 16-item OHQoL-UK( Copyright) measure). RESULTS: The response rate was 68% (1838/2718). Thirty one percent (575/1838) claimed they paid privately for dental services the last occasion they visited their dentist. This was associated with self-reported number of teeth possessed (P<0.01), denture status (P<0.01), WHO goal of retaining 20 teeth with and without a prosthesis (P<0.05), impact of oral health on life quality (P<0.01), and number of positive oral health influences experienced (P<0.01). However, these associations did not remain apparent having accounted for socio-demographic factors (age, gender, and social class background) and reported dental attendance pattern. CONCLUSION: Difference in perceived oral health exists between private and NHS dental service users. However, this is more likely to be attributed to socio-demographic factors and regular use of services rather than method of payment.
Adolescent↗
Measuring the impact of oral health on quality of life in Britain using OHQoL-UK(W).
OBJECTIVES: This study assessed the impact of oral health on quality of life (OHQoL) in Britain and identified disparities in OHQoL among subgroups of the population. METHODS: A national survey involved a random probability sample of 2,667 households. Participants were interviewed about their oral health status and sociodemographic information was collected. The impact of oral health on life quality was measured utilizing the OHQoL-UK(W). RESULTS: The response rate was 68 percent. Most people in Britain (73%) claimed their oral health did affect their life quality, most frequently through physical influences rather than social or psychological. Disparities in perceived influences of oral health on life quality among subgroups of the population were apparent by age, sex, and social class; OHQoL also was influenced by oral health status (self-reported). CONCLUSION: Most Britons claim their oral health affects their life quality and OHQoL was associated with sociodemographic and oral health factors.
Adolescent↗
Measuring the impact of oral health on life quality in two national surveys - functionalist versus hermeneutic approaches.
OBJECTIVES: This study compares a functionalist (quantitative) versus a hermeneutic (qualitative) approach to assessing the impact of oral health on life quality in two United Kingdom national surveys. METHODS: The vehicles for this study were two Office for National Statistics' Omnibus Surveys completed in 1998 and 1999. In both studies a random probability sample of 3000 household addresses was selected from the British Postcode Address File (PAF). The data were collected by face-to-face interviews with respondents in their homes about how their oral health status affected their quality of life employing a qualitative, hermeneutic approach (1998) and a functionalist, quantitative approach using a battery of questions (1999). RESULTS: Irrespective of study design, in both studies it was apparent that the majority of the public perceived their oral health as affecting their life quality (P > 0.05). Likewise, both approaches identified that oral health affected life quality most frequently through physical aspects of oral health rather than social or psychological. However, using the hermeneutic approach, respondents were less likely to cite that their oral health affected specific aspects of their oral health compared to when a battery of questions were used (P < 0.01). Furthermore, socio-demographic variations in oral health-related quality of life were more apparent when a battery of questions were employed compared to an open-ended approach. CONCLUSIONS: Different approaches to assessing oral health-related quality of life yield similar findings in terms of prevalence of oral health's impact and affected ways (domains). However, the different methods influenced the ability to identify socio-demographic disparities.
Adolescent↗
Influences of social support on the oral health of older people in Britain.
A national UK study involving a random sample of 876 non-institutionalized older people (aged 65 or older) were recruited, to identify the association between social support (living alone), self-reported oral health status and oral health behaviour (use of services). Home interviews were undertaken exploring oral health behaviour (time and reason for last dental visit) and oral health status measures (self-reported number of teeth possessed and denture status). In addition, socio-demographic characteristics were collected. Bivariate analysis identified that social support was associated with time since last dental visit (P < 0.01), reason for last dental visit (P < 0.01), self-reported number of teeth possessed (P < 0.01) and denture status (P < 0.01). In regression analysis, social support emerged as an important predictor of reason for last dental visit and denture status having accounted for other factors in the model (age, gender, social class and educational attainment). Social support is associated with oral health status and oral health behaviour of older people in Britain and is likely to influence both the decision making process of when to seek dental care and what type of treatment to opt for.
Aged↗
Oral health behind bars: a study of oral disease and its impact on the life quality of an older prison population.
OBJECTIVE: The principal aims of this study were to report on the prevalence of oral disease and its impact on the life quality of older (aged 60 and above) prisoners at Hong Kong SAR's elderly detention centre, China. DESIGN: A cross-sectional epidemiological survey involving clinical oral examinations and face-to-face interviews with 64 older prisoners at the centre. Clinical oral examinations were carried out following WHO criteria. The impact of oral health on life quality was assessed using the 14-item Oral Health Impact Profile measure, OHIP-14. RESULTS: The prevalence of oral disease was high, the mean DMFT was 22.5 (SD 10.6) and 40% (18) of the dentate prisoners had shallow or deep periodontal pockets. Most (75%, 48) were in need of prosthetic treatment. Over half the prisoners experienced one or more oral health impacts on life quality during the previous year. This was associated with socio-demographic factors: employment status prior to incarceration (P < 0.01), oral health behaviour: smoking habits (P < 0.01) and clinical oral health status: DMFT (P < 0.05) and prosthetic need (P < 0.05). CONCLUSION: Among inmates at Hong Kong's elderly detention centre, the prevalence of oral disease was high and the impact of oral health on their life quality was substantial. The impact of oral health on the life quality of the older prisoners was associated with prisoners socio-demographic background, oral health behaviour and oral health status.
Aged↗
Disparities in self reported oral health problems among a young Syrian adult population.
OBJECTIVE: To describe the prevalence of dental pain and other oral health problems among a young Syrian adult population and to identify socio-demographic factors associated with these experiences. SUBJECTS: An industrial sample of 400 men and women aged 18-34 years from Damascus, Syria. METHODS: Study participants were interviewed about their experience of oral health problems in the previous year (1998). Socio-demographic information was collected. RESULTS: 93% (369) of the interviews were completed. The prevalence of oral health problems was high, with 96% (353) of respondents claiming that they experienced one or more problems in the previous year. Two thirds of participants (65%, 239) claimed they had dental pain in the previous year. Analysis revealed that dental pain experience was significantly associated with age and gender. Analysis considering all factors revealed that the odds of experiencing dental pain were higher amongst the younger age group (18-24 compared to 25-34 year-olds). CONCLUSION: The prevalence of oral health problems was high among the population studied. Socio-demographic variations in experience of dental pain were apparent, with young men of lower education having the greatest odds of dental pain experience in the previous year.
Adolescent↗