Relationship of periodontal disease and domains of oral health-related quality of life.

OBJECTIVES: The aim of this study was to investigate the impact of periodontal disease on the domains of oral health-related quality of life (OHRQoL) of United Kingdom adults. METHODS: National representative data from the 2009 Adult Dental Health Survey, United Kingdom, were used in this study. Periodontal disease severity was measured using periodontal pocket depth and categorized into three groups: pocket depth up to 3.5, 3.5-5.5 and more than 5.5 mm. OHRQoL was measured using the Oral Health Impact Profile-14 (OHIP-14) scores. Bivariate and multivariable Zero-inflated Poisson regression analysis was used. RESULTS: A total of 6378 participants was analysed in this study. Periodontal pocketing was significantly associated with higher OHIP-14 scores. Participants with periodontal pocket depths >3.5 mm had a significantly higher prevalence for functional limitation, physical pain and social disability than participants with pocket depths of less than 3.5 mm. Participants with periodontal pocket depth(s) >5.5 mm had significantly higher OFOVO prevalence in all the domains of OHIP-14 except handicap domain than participants with pocket depth(s) <3.5 mm. CONCLUSION: This study showed that for a nationally representative sample of the United Kingdom population, periodontal disease was significantly associated with the domains of OHRQoL.

The relationship between oral health and oral health related quality of life among elderly people in United Kingdom.

OBJECTIVES: To identify the determinants of OHRQoL among older people in the United Kingdom. METHODS: A subset of elderly (≥65year) participants from the UK Adult Dental Health Survey 2009 data was used. OHRQoL was assessed by means of the OHIP-14 additive score. The number of missing teeth; presence of active caries, dental pain, root caries, tooth wear, periodontal pockets>4mm, loss of attachment>9mm; having PUFA>0 (presence of severely decayed teeth with visible pulpal involvement, ulceration caused by dislocated tooth fragments, fistula and abscess); and wearing a denture were used as predictor variables. Age, gender, marital status, education level, occupation and presence of any long standing illness were used as control variables. Multivariate zero-inflated Poisson regression analysis was performed using R-project statistical software. RESULTS: A total of 1277 elderly participants were included. The weighted mean(SE) OHIP-14 score of these participants was 2.95 (0.17). Having active caries (IRR=1.37, CI=1.25;1.50), PUFA>0 (IRR=1.17, CI=1.05;1.31), dental pain (IRR=1.34, CI=1.20;1.50), and wearing dentures (IRR=1.30, CI=1.17;1.44), were significantly positively associated with OHIP-14 score. Having periodontal pockets>4mm, at least one bleeding site, and anterior tooth wear were not significantly associated with the OHIP-14 score. CONCLUSION: Whereas previous research has suggested a moderate relationship between oral disease and quality of life in this large scale survey of older adults, the presence of active caries and the presence of one or more of the PUFA indicators are associated with impaired oral health related quality of life in older adults, but not indicators of periodontal status. The implication of this is that whilst focussing on prevention of disease, there is an ongoing need for oral health screening and treatment in this group.

Predictive model of oral cancer metastasis for different cancer sites and age groups.

AIM: The high incidence rates for oral cancer (excluding lip) are especially found in the South and South-East Asia. Therefore, the aim of the present study was to investigate the relationship between sex, age, site, and metastasis of a large sample with oral squamous cell carcinoma (OSCC). METHODS: A total of 989 OSCC treated with neck dissection were selected. All the relevant data were recorded from biopsy request forms. The patients were divided into seven groups, and there were nine different oral sites. RESULTS: The male-to-female ratio of the sample was 4:1. Most of the patients were aged between 30 and 60 years. Of the 989 patients, approximately 40% patients had metastasis. Age <30 years showed a higher probability of metastasis compared to higher age groups, but it was not statistically significant. Palate cancers had more than 14 times higher chance of metastasis, followed by maxilla (4.6 times) and tongue (2.8 times). CONCLUSION: The present study provides important information on the metastatic potential of OSCC in different oral sites, and identifies high-risk age groups for metastasis. This will be helpful in planning neck treatment for OSCC.

Within-Family Discussion on Harmful Effects of Smoking and Intention to Initiate Smoking Among European Adolescents.

OBJECTIVE: The main objective of this study was to determine the impact of discussion within family about the harmful effects of smoking on intention to initiate smoking in the long term among nonsmoking adolescents. METHODS: Data from Global Youth Tobacco Survey for 25 European countries were used. The outcomes of interest were, therefore, the intention to initiate smoking 1 and 5 years after the survey. Discussion within family about harmful effect of smoking was the main predictor with age, sex, and smoking status of parents, friends, and classmates as covariates. The association between predictors and outcomes was assessed through multiple regression analysis. RESULTS: A total of 118,703 nonsmoking adolescents were included. Within-family discussion significantly reduced the odds of intention to initiate smoking 1 and 5 years later. Intention to initiate smoking also was significantly associated with the smoking status of friends, classmates, and parents, except for father's smoking status, which was not associated with intention to initiate 1 year later. CONCLUSIONS: This study demonstrated that within-family discussion about the harmful effects of smoking may contribute to reduce the intention to start smoking among adolescents in the long term. Such a discussion was associated with reduced intention to smoke even when adjusting for parent/friend and classmate smoking.

Development of a conceptual model of oral health for malocclusion patients.

OBJECTIVES: To provide an empirical test of the applicability of Locker's conceptual model of oral health for malocclusion patients, and to suggest alternative models of the effect of malocclusion on well-being. MATERIALS AND METHODS: Data from a survey of 323 adolescents attending for orthodontic treatment were analyzed to develop a new oral health model for malocclusion patients. Oral health-related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile; malocclusion was measured using the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN). Using structural equation modeling, the relationship between conceptual domains in Locker's model was explored and three models of their interrelationship tested for goodness of fit. RESULTS: Fit indexes for Locker's model indicated that it did not fit the data well. Therefore, a modified model was developed to incorporate additional paths between other levels to better fit the data. The best fit was provided by a model in which the direct effects of malocclusion on pain, discomfort, and handicapping-and the direct effect of pain on disability-were removed. A direct effect of functional limitation on disability was allowed. The modified Oral Health Impact Profile model proved to be a good fit to the data (root mean square error of approximation  =  0.069). CONCLUSION: The pathways identified in Locker's (1988) conceptual model of oral health may not be appropriate for describing the relationships between OHRQoL constructs in individuals with malocclusion. An alternative model is proposed.

Role of miRNA in head and neck squamous cell carcinoma.

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Evidence suggests that miRNAs play an important role in progression, recurrence, metastasis and postoperative survival of HNSCC. Studies have investigated the utility of miRNAs as diagnostic/prognostic tools and as potential therapeutic targets and biomarkers that may improve the management and outcomes of HNSCC. The aim of this article is to review the current literature on aberrant expression profiles of miRNAs in biopsy samples of HNSCC and their role in cancer development, metastasis, prognosis and survival of these patients. This review gives an overview that miRNAs deregulation play major role in the development of HNSCC. They offer the potential to be used as biomarkers or novel therapeutic targets. Future research is required to test their use in both of these fields.

Need of minimal important difference for oral health-related quality of life measures.

Demand and use for oral health-related quality of life (OHRQoL) instruments have increased in recent years in both research and clinical settings. These instruments can be used to measure patient's health status or detect changes in a patient's health status in response to an intervention or changes in disease trajectory. Ensuring universal acceptance of these measures requires easy interpretation of its scores for clinicians, researchers, and patients. The most important way of describing and interpreting this significance of changes in OHRQoL is through the establishment of minimal important difference (MID). The minimally important difference represents the smallest improvement considered worthwhile by a patient. A comprehensive search of published literature identified only 12 published articles on establishment of MID for OHRQoL measures. This scarcity of published studies on MID encourages the need of appropriate interpretation and describing patient satisfaction in reference to that treatment using MID. Anchor- and distribution-based methods are the two general approaches that have been proposed and recommended to interpret differences or changes in OHRQoL. Both of these methods of determining the MID have specific shortcomings; therefore, it is proposed to adopt triangulation approaches in which the methods are combined. The objective of this review is to summarize the need for, importance of, and recommendations for methods of establishing MID for OHRQoL measures.

Cross-bite and oral health related quality of life in young people.

OBJECTIVES: This study sought to assess the impact of posterior cross-bite on OHRQoL in young people aged 15-25 and to determine whether the impact on higher domains of Oral Health Impact Profile-14 (physical disability, psychological disability, social disability and handicap) is a direct function of the cross-bite or mediated through the lower domains of OHIP-14 (functional limitation, pain and discomfort). METHODS: One hundred and forty-five young adults [72 cross-bite cases and 73 controls] aged 15-25 years, attending orthodontic clinics at the Faculty of Dentistry, Universiti Teknologi MARA participated in this study. Participants completed the OHIP-14 and had a clinical examination for cross-bite. Data analyses included descriptive statistics, t-test and bivariate and multivariate regression modelling. RESULTS: There was no significant difference between the case and control groups in gender, age and education level. The mean scores (±SD) for OHIP-14 total and all domains were significantly higher in cross-bite patients as compared to controls. The bivariate and multivariate regression analyses showed functional limitation was significantly associated with all the higher domains in all four models, whereas pain was only significantly associated with the psychological domain and discomfort was only significantly associated with the physical disability domain. CONCLUSION: The possession of a posterior cross bite has a significant association with OHRQoL especially on the functional limitation and psychological disability domains, among 15-25 years old young people. The relationship of cross-bite and lower domains of OHIP-14 with higher domains of OHIP-14 was in agreement with the relationships proposed by Locker's conceptual model of oral health. CLINICAL SIGNIFICANCE: Patients with a cross bite were more limited in their oral functions and experienced greater psychological discomfort than did controls. It is possible that part of patients' rationale for seeking treatment would be to alleviate such impacts on their oral health related quality of life.

Impact of malocclusion on oral health related quality of life in young people.

BACKGROUND: The objectives for this study were to assess Oral Health Related Quality of Life (OHRQoL) in young people aged 15-25 who sought orthodontic treatment, and to measure the association between orthodontic treatment need (using the IOTN), sex, age and education level, and oral health related quality of life (OHRQoL). METHODS: Survey of a consecutive series of 323 young adults aged 15 to 25 years, attending orthodontic clinics at the Faculty of Dentistry, Universiti Teknologi MARA. Participants completed the Oral Health Impact Profile-14 (OHIP-14) and had a clinical examination including the Index of Orthodontic Treatment Need- Dental Health Component (IOTN-DHC). Data analyses included descriptive statistics, One-way ANOVA and bivariate and multivariate regression models. RESULTS: The mean overall score (± SD) for OHIP-14 in young people aged 15-25 was 22.6 ± 12.5. The psychological discomfort domain was the domain where highest impact was recorded with a mean (± SD) of 4.0 ± 1.9. The regression analyses showed a significant association of IOTN-DHC with overall OHIP-14 score (p<0.05). Although females reported a slightly higher impact than males, this was not significant in both bivariate and multivariate analyses. Age group had a significant negative association with overall OHIP-14 score (p<0.05). The 15-18 year old group showed the highest impact on their quality of life due to malocclusion. Participants with a university education report a significantly higher impact on OHRQoL as compared to participants with only secondary education. CONCLUSION: Malocclusion has a significant negative impact on OHRQoL and its domains. This is greatest for the psychological discomfort domain. Younger people and those with a university education report higher levels of impact. There was no reported difference in impact between male and females.

Methods of qualitative research in dentistry: a review.

UNLABELLED: Over the last decade, researchers in health services research started using qualitative research methods. This has led to a corresponding rise in the reporting of the qualitative research studies in medical and related journals, including dental journals. Qualitative research is often contrasted with quantitative research as a set of 'non quantitative methods', since it does not deal with numbers and enumerate phenomena. It interprets the information people bring to research, which helps us to understand social phenomena in natural settings like their own territory, in their own language and on their own terms, giving emphasis to the meaning, experience and view of all the participants. CLINICAL RELEVANCE: This article will help the clinician to understand the importance of in-depth knowledge of behaviour and social phenomena around the patient.