Exploratory and confirmatory factorial analysis of the OHIP-Edent instrument

Abstract Several instruments have been used to measure oral health-related quality of life (OHRQoL). The Oral Health Impact Profile (OHIP) questionnaire was based on the concept that sequential events related to oral diseases can cause discomfort, functional limitations and consequently, result in dysfunctions and even disabilities. There are few studies in the literature that structurally analyze the instruments to verify whether they measure the requirements to which they were designed to. The objective of the study was to evaluate the internal structure of the OHIP-Edent questionnaire. The OHIP-Edent was administered to 54 edentulous patients' wearers of conventional complete dentures. For structural analysis, an exploratory factorial analysis (EFA) was carried out. After determining the internal consistency of the model (Cronbach's alpha = 0.88), the fit was checked using the root mean square error approach (value 0.04), the comparative fit index (value 0.982) and the Tucker-Lewis index (value 0.976). After analysis of the 19 questions and the seven domains proposed in the OHIP-Edent questionnaire, the hypothetical factorial model showed three dimensions denominated "Physical Impact", "Psychological Impact" and "Social Impact". In this sample of conventional complete denture wearers, the OHIP-Edent seems adequate to measure the "Physical Impact", "Psychological Impact", and "Social Impact" of the OHRQoL. The confirmatory factorial analysis confirmed the model and, through adjustment indexes, it was verified that the three dimensions have convergence and consistence adequate in order to characterize the OHRQoL construct with validity.

Percepción estética del paciente desdentado comparada con la opinión de expertos / The aesthetic self-perception of the edentulous patient compared to the opinion of experts

Objetivo Relacionar la autopercepción estética de pacientes desdentados rehabilitados protésicamente con la opinión de expertos en estética facial. Materiales y métodos A una muestra por conveniencia de 40 pacientes desdentados se les tomó 2 fotografías faciales 3D: sin prótesis y con prótesis nuevas, respectivamente. Posteriormente a cada paciente se le mostró sus imágenes y evaluó su satisfacción respecto al cambio facial mediante una pregunta en escala tipo Likert. A continuación se mostró las imágenes a 5 profesionales con especialidades relacionadas con estética facial, quienes evaluaron el cambio facial de cada paciente utilizando la misma escala tipo Likert. Finalmente, se procedió a comparar los resultados mediante el test no paramétrico de Wilcoxon para determinar diferencias estadísticas entre las preferencias de los pacientes y los expertos. Resultados Tanto las respuestas de los pacientes como de los expertos fueron positivas. Se encontró diferencia estadística al comparar las respuestas de ambos grupos, con un valor p = 0,00, siendo los expertos más críticos en su evaluación. Conclusión La autopercepción estética del paciente desdentado total rehabilitado con prótesis totales y la opinión del panel de expertos son concordantes, siendo ambas positivas. Cabe destacar que estos últimos fueron más críticos en sus apreciaciones.

Objective To determine the relationship between the aesthetic self-perception of edentulous patients rehabilitated with dentures and the opinion of facial aesthetics experts. Materials and methods Two facial 3D photographs, without dentures and with new dentures, respectively, were taken of a convenience sample of 40 edentulous patients. The images were subsequently shown to the patients, and they assessed their satisfaction of the facial change using Likert scale question. The photographs of the patients were also shown to 5 professionals with specialties related to facial aesthetics. Facial change was evaluated using the same Likert scale as the patients. Finally, the results were compared using the non-parametric Wilcoxon test to determine any statistical differences between the preferences of patients and the experts. Results The perception of patients and experts are positive. Significant statistical differences were found after comparing the responses of both groups, with p=.00, with the experts being more critical in their assessment. Conclusion The aesthetic perception of edentulous patients rehabilitated with complete dentures and the opinion of a panel of aesthetic experts are concordant, both being positive. It is important to note that experts were more critical in their assessment.

Satisfação com saúde bucal de idosos brasileiros: um estudo de gênero com modelo hierárquico / Oral health satisfaction among Brazilian elderly: a gender study using a hierarchical model / Satisfacción con la salud bucal en adultos mayores brasileños: un estudio de género con el modelo jerárquico

Os objetivos do presente estudo foram identificar as diferenças de gênero em relação aos fatores associados à satisfação com saúde bucal de idosos e estimar a prevalência de edentulismo por gênero e faixa etária. Foram incluídos 2.052 idosos com 60 anos e mais de idade, residentes em Sete Lagoas, Minas Gerais, Brasil. A regressão de Poisson foi utilizada para estimar a prevalência de edentulismo. A associação entre satisfação bucal e as variáveis independentes foi realizada por meio da regressão ordinal com modelo hierárquico multidimensional. A prevalência de edentulismo nos gêneros masculino e feminino foi de 63% e 68,8%, respectivamente. A maioria dos idosos do gênero masculino (63%) e feminino (57%) estava satisfeita com a saúde bucal. O modelo final ajustado, para ambos os gêneros, foi formado por variáveis referentes ao ambiente externo, comportamentos de saúde e condições de saúde bucal. Conclui-se que a satisfação com a saúde bucal é influenciada fortemente pelas condições de saúde bucal e por comportamentos de saúde, e que os fatores associados são diferentes para cada gênero.

The objectives of this study were to identify gender differences in relation to factors associated with oral health satisfaction among the elderly and to estimate the prevalence of edentulism by gender and age. The study included 2,052 elderly (≥ 60 years) residing in Sete Lagoas, Minas Gerais State, Brazil. Poisson regression was used to estimate prevalence of edentulism. The association between oral health satisfaction and independent variables was estimated using ordinal regression with a hierarchical multidimensional model. Prevalence rates for edentulism in males and females were 63% and 68.8%, respectively. Most elderly males (63%) and females (57%) were satisfied with their oral health. The final adjusted model for both genders consisted of variables related to environmental characteristics, health behaviors, and oral health conditions. The study concludes that oral satisfaction is heavily influenced by oral health status and health behaviors, while the associated factors differ by gender.

Los objetivos de este estudio fueron identificar las diferencias de género, en relación con factores asociados a la satisfacción con la salud bucal de ancianos, con el fin de estimar la prevalencia de edentulismo por género y edad. Se incluyó a 2.052 personas mayores de 60 años y más que residen en Sete Lagoas, Minas Gerais, Brasil. La regresión de Poisson se utilizó para estimar la prevalencia de edentulismo. La asociación entre la satisfacción bucal y las variables independientes se realizó mediante el modelo de regresión ordinal multidimensional jerárquico. La prevalencia de edentulismo en hombres y mujeres era de un 63% y un 68,8%, respectivamente. La mayoría de los hombres de edad avanzada (63%) y mujeres (57%) estaban satisfechos con su salud bucal. El modelo ajustado final, para ambos sexos, fue desarrollado por variables relacionadas con el ambiente externo, las conductas de salud y las condiciones de salud bucal. Se concluye que la satisfacción con la salud bucal está fuertemente influenciada por el estado de salud oral y las conductas de salud, asimismo, los factores asociados son diferentes para cada género.

Factors related to poor self-perceived oral health among community-dwelling elderly individuals in São Paulo, Brazil / Fatores associados à autopercepção de saúde bucal ruim entre idosos não institucionalizados do Município de São Paulo, Brasil

The present study investigated the prevalence of poor self-perceived oral health and its association with oral health, general health and socioeconomic factors among elderly individuals from São Paulo, Brazil. The sample consisted of 871 elderly individuals enrolled in the Health, Wellbeing and Aging cohort study. Self-perceived oral health was measured by the question: "How would you rate your oral health?". Most subjects self-rated their oral health as good. Among dentate individuals, poor oral health was related to depression, poor self-rated health, dental treatment, dental checkups and the psychosocial subscale scores of the Geriatric Oral Health Assessment Index. Edentulous individuals were more likely to report poor oral health, whereas those with higher psychosocial scores were less likely to report poor self-rated oral health. Poor self-rated oral health is associated with general health factors and the psychosocial impact of oral health on quality of life, regardless of socioeconomic and clinical health measures.

Este estudo avaliou a prevalência de autopercepção de saúde bucal como ruim em idosos de São Paulo, Brasil, e investigou sua relação com a saúde bucal, saúde geral e fatores socioeconômicos. A amostra foi composta por 871 idosos do estudo de coorte Saúde, Bem-Estar e Envelhecimento. A autopercepção da saúde bucal foi medida pela pergunta: "Como você classifica a sua saúde bucal?". A maioria dos idosos apresentou autoavaliação de saúde bucal boa. A autopercepção de saúde bucal como ruim, entre indivíduos dentados, foi relacionada à depressão, autoavaliação de saúde ruim, check-up odontológico, tratamento dentário e dimensão psicossocial do Geriatric Oral Health Assessment Index. Desdentados com autoavaliação de saúde ruim apresentaram maior probabilidade de relatar saúde bucal ruim, enquanto aqueles com maior pontuação na dimensão psicossocial tiveram menor chance de autoavaliação ruim. A autoavaliação de saúde bucal ruim foi associada com fatores de saúde geral e com o impacto psicossocial da saúde bucal na qualidade de vida, independentemente de medidas socioeconômicas e clínicas de saúde bucal.

Experiencia y significado del proceso de edentulismo de adultos mayores, atendidos en un consultorio del servicio público chileno / Experience and significance of the edentulous process of older adults who attended a chilean public service office

En Santiago de Chile la prevalencia de desdentados totales en individuos mayores de 65 años es de 33.84 por ciento, es decir uno de cada tres santiaguinos de la 3° edad, es portador de prótesis totales. Prevalencia similar a la encontrada en países desarrollados. A partir de esta investigación se pretende comprender cual es la experiencia, significados y valoración del proceso de edentulismo de adultos mayores, tratados en un servicio de salud público, y sus familiares más cercanos; para entender cuales son sus vivencias y padecimientos; para poder entregarle una atención más completa, significativa y eficiente, orientada a lo que las personas perciben como importante. Tipo de estudio: El presente trabajo de investigación se desarrolló dentro de un paradigma naturalista cualitativo, por cuanto está interesado en conocer el fenómeno desde el propio marco de referencia del actor social; fundamentado en la realidad, de carácter exploratorio y enfoque fenomenológico. Selección de participantes: Se seleccionó a 11 hombres y 9 mujeres; adultos mayores, desdentados totales del Centro de Salud Familiar Garín, y a un familiar directo. Se consideró para esta investigación la aplicación de entrevistas semi estructuradas y grupo focal. Resultados: El presente estudio de investigación cualitativa, entregó relevante información, en la forma como piensa siente y vivencia el problema del edentulismo el propio actor social; la que pude ser considerada en la elaboración de nuevos proyectos y programas desarrollados especialmente para esta población; así como también, en el campo educacional.

In Santiago, Chile the prevalence of Edentulous in individuals over 65 years of age is 33.84 percent; this is to say that one third of Santiago s senior citizens wear dentures. Prevalence similar to this can be found in developed countries. From this research, the aim is to understand the experience, significance and assessment of the Edentulous process of senior citizens that are treated in public health service and to also understand the experiences and sufferings of their immediate families; To be able to give fuller, meaningful, and efficient attention by focusing on what people perceive as important. Type of study: This research work was developed within a qualitative naturalistic paradigm, to know the phenomenon from the interest point of the framework itself, the social actor; based on reality, exploratory and phenomenological approach. Selection of participants: 11 men and 9 women were selected; Elderly, all edentulous patients (and their immediate families) from the Garín Family Health Center. The application of semi-structured interviews and focus groups were considered for this research. Results: The qualitative research study delivered relevant information in the way that the Edentulous social actor himself thinks, feels and experiences the problem. This could be considered in the development of new projects and programs developed specifically for this population. As well as in the educational field.

Aproveitamento de dentes naturais anteriores superiores e inferiores em dentaduras completas: caso clínico, descrição / Use of natural anterior, upper and lower teeth in complete dentures: clinical case, description

Os autores descrevem o uso dos dentes anteriores naturais superiores e inferiores de um paciente, na confecção de uma dentadura dupla. Também são observados os fatores estéticos e a aceitação do paciente em relação a esse tipo de trabalho