Qol ppt
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The document discusses quality of life indices and how they relate to oral health. It provides background on concepts of health, quality of life, and oral health-related quality of life. It also describes several instruments that are used to measure oral health-related quality of life, including questionnaires, social indicators, and global self-ratings. Several case studies are summarized that examined how dental treatments and oral health conditions impacted patients' oral health-related quality of life scores.
Qol ppt
- 1. •QUALITY OF LIFE INDEX Dr Vikram Kumar
- 2. Content • Introduction • Oral health concept • Health • Quality of life • Health Related Quality of Life (HRQoL) • Oral Health Related Quality of Life (OHRQoL) • Instruments to assess OHRQoL •
- 3. • The Quality of Life Index covers various factors different of subcategories: • Health & Well-Being, • Safety & Security, • Personal Happiness, • Travel & Transportation, and • Digital Life.
- 4. Introduction • It is accepted and recognized by dental community that oral health status can cause considerable pain and suffering, if oral symptoms remain untreated would be a major source of diminished quality of life; disturbing people´s food choices or their speech, or may lead to sleep deprivation, depression, and multiple adverse psychosocial outcomes. I
- 5. • As in 1948 WHO expanded the definition of health to mean “a complete state of physical, mental, and social well-being, and not just the absence of infirmity”, • oral health concept followed this change aiming not minimized oral health as having or not caries.
- 6. Quality of life(QoL ) • QoL is a multidimensional construct that includes a subjective evaluation of the individual’s oral health, functional well-being, emotional well-being, expectations and satisfaction with care, and sense of self. • QoL is an integral part of general health and well-being. In fact, it is recognized by the World Health Organization (WHO) as an important segment of the Global Oral Health Program (2003) • Quality of Life is by itself multi-faceted, showing variation over time for each individual
- 8. Health Related Quality of Life (HRQoL) • HRQoL as “the subjective assessment of the influence of health status, health care and health promotion on an individual’s ability to maintain a level of functioning that allows him to perform activities that are important, and affect overall welfare.
- 9. • HRQoL is the quality of life that relates directly to the state of health of the individual. • The HRQoL assessment in a patient represents the impact that a disease and its subsequent treatment has on the patient’s perception of their well-being.
- 10. Oral health-related quality of life • Oral health-related quality of life was defined as a “self-report specifically pertaining to oral health–capturing both the functional, social and psychological impacts of oral disease” • There is another definition that conceptualizes OHRQoL mentioning that it “reflects people’s comfort when eating, sleeping and engaging in social interaction; their self-esteem; and their satisfaction with respect to their oral health
- 11. • Oral health related quality of life (OHRQOL) is a relatively new, but rapidly growing phenomenon, which has emerged over the past 2 decades. . • It is evident from the literature that the notion of OHRQOL appeared only in the early 1980s in contrast to the general HRQOL notion that started to emerge in the late 1960s • In the late 1970s, the OHRQOL concept started to evolve as more evidence grew of the impact of oral disease on social roles. • The concept of OHRQOL can become a tool to understand the state of clinical practice, dental research and dental education but also that of at community level. • There are different approaches to measure OHRQOL; the most popular one is multiple item questionnaires. • .
- 12. Associated factor Quality of Life (OHRQoL)
- 13. • We must keep in mind that OHRQoL deals with conditions that vary in intensity and importance, some of them are life-threatening (e.g. oral cancers) some chronic (caries, periodontitis, etc.) some other dealing with aesthetics (fluorosis, dental anomalies, etc) and other are related to oral pain (pulpitis, dental treatments etc.).
- 14. oral conditions impact on OHRQoL • An example is edentulism, condition that can affect masticatory function, dietary choice, and nutritional level. It has been reported that wearing dentures may interfere with the ability to eat satisfactorily, talk clearly, and laugh freely • Tooth loss is one of the worst types of damage to oral health, causing esthetic and functional problems. In addition to the biological causes of tooth loss, socioeconomic factors contribute to oral health associated with tooth loss. • Another alteration that affects quality of life is malocclusion. • Nigerian children aged 12-18 years, found a correlation between the malocclusion severity and the perception that children have about their dental appearance
- 15. • Some other common oral conditions, such as caries, periodontal disease, which are almost universal in prevalence, and which are chronic but with acute recurring episodes, also impact on QoL • There are several reports showing that dental caries has negative impacts but in severe condition it also affect Qol • Socioeconomic status is related to inequalities in health, and socioeconomically disadvantaged people have higher risks of disease and suffer more from health conditions.
- 16. Indices used to measure OHRQOL • Fundamentally, there are three categories of OHRQOL measure as indicated by Slade. • Social indicators • Global self-ratings of OHRQOL • Multiple items questionnaires of OHRQOL.
- 17. social indicators • Social indicators are used to assess the effect of oral conditions at the community level. • In large population surveys , Social indicators such as days of restricted activities, work loss, and school absence due to oral conditions. • For example, using work loss due to impact of oral diseases. • But it is not an appropriate indicator for those who are not working.
- 18. Global self-ratings • Global self-ratings of OHRQOL, also known as single-item ratings, refer to asking individuals a general question about their oral health. • Response options to this global question can be in a categorical or visual analog scale (VAS) format. • For example, a global question asking: “How do you rate your oral health today?” can have categorical responses ranging from “Excellent” to “Poor”
- 20. Multiple items questionnaires • Multiple items questionnaires are the most widely used method to assess OHRQOL. • Researchers have developed QOL instruments specific to oral health. OHRQOL instruments vary widely in terms of the number of questions (items), and format of questions and responses
- 23. • Few example taken which are commonly used in day today life • Geriatric (General) Oral Health Assessment Index (GOHAI • The Dental Impact Profile (DIP) • Oral Health Impact Profile (OHIP) • Oral Impacts on Daily Performance
- 24. Geriatric (General) Oral Health Assessment Index (GOHAI • The GOHAI is one of the most commonly used scales in assessment of OHRQoL in the USA for use with elderly populations. • five options,for scoring as often’, always’, ‘seldom ’or ‘sometimes’ and ‘never’ reflecting the aspects that are considered to have an impact upon the quality of life of the older population. • Physical functions like eating, chewing, speech, swallowing; psychosocial functions like worry, limitations and discomfort with social contacts, dissatisfaction with appearance; and self- consciousness about oral health, pain or discomfort including the use of medication or discomfort from the mouth.
- 25. The Dental Impact Profile (DIP) • It consist in twenty-five items • respondents are offered three ordinal response choices (good effect, bad effect, no effect) eg. about whether teeth or dentures have had an effect on various aspects of life • A response of “good effect” was seen as likely to be most socially acceptable • Responses of “no effect” are seen as indication of no dental impact. The OHIP responses, “never”, “hardly ever”, “occasionally”, “fairly often”, and “very often”, were codified from 0 to 4, respectively. Oral Health Impact Profile (OHIP)
- 26. Oral Impacts on Daily Performance • The OIDP aims to provide an alternative sociodental indicator which focuses on measuring the serious oral impacts on the person's ability to perform daily activities.
- 27. Importance of QOL measurement • Clinical indicators were constructed and tested in epidemiological studies on different populations to build a more concrete relationship between subjective and objective oral health measures, which would help to estimate the real population needs. • In public health, QOL measurement is a useful tool to plan welfare policies because it is possible to determine the population needs, priority of care, and evaluation of adopted treatment strategies; thus helping in the decision making process • OHRQOL to refocus dental education . • Research on OHRQOL: Current status and future directions
- 28. • OHRQOL considerations can serve as a tool for bringing about these changes in the perspective of future clinician. • Dental education aims at training future clinician, researchers, and administrators as well as future dental educators. • Research on QOL has gained interest and visibility in recent decades internationally. “How” we live and not just “how long” we live has increasingly become recognized as a central issue in health-care and health research. • Current objectives of this initiative are to increase quality and years of healthy life and to eliminate health disparities.
- 29. Case -1
- 30. Assessment of Quality of Life After Implant-Retained Prosthetically Reconstructed Maxillae and Mandibles Postcancer Treatments Purpose: The aim of this prospective study was to assess treatment outcome and impact on quality of life with implant-retained prosthesis in reconstructed jaws in head and neck cancer patients. MATERIALS AND METHODS A total of 12 patients were selected for the study on the basis of the following inclusion criteria. 1. Patients in whom the jaws including the alveolar process are subjected to resection, followed by reconstruction (primary or secondary) with free fibular grafts. These included total and partial edentulous patients in need of dental rehabilitation. 2. Patients who are disease-free for more than 1 year after completion of surgery, radiation, and chemotherapy were selected. 3. Good general condition to withstand surgical insertion of implant under local anesthesia/general anesthesia
- 31. • A total of 35 implants were inserted in 12 patients with reconstructed jaw. One patient died due to reasons beyond the scope of this project. One patient had recurrence after first stage surgery. Despite the observation, improvement seen in some patients, the statistical analysis of speech, swallowing parameters, and quality of life were not significant. • There was no improvement in the symptoms scale scores.
- 32. Case-2
- 33. The Responsiveness of Patients' Quality of Life to Dental Caries Treatment The objective of this study was to determine the responsiveness of oral health related quality of life (OHRQoL) in dental caries restoration treatment A total of 126 patients (aged 16±40 years) received dental caries restoration treatment with a 2-week follow-up and pre- and post treatment interviews by questionnaire. Stepwise multiple qutionanarie analysis was used to examine the association with the responsiveness of all outcome measurements This study suggests that dental caries treatment moderately improves OHRQoL, but is less related to HRQoL. Furthermore, the number of dental caries and restoration are important factors affecting the improvement of patients quality of life
- 34. Case-3
- 35. Oral health-related quality of life among institutionalized patients after dental rehabilitation • The aim of the present study was to determine the changes in oral health- related quality of life before and 3 months after dental rehabilitation among geriatric patients residing in a state-owned nursing home, using the General Oral Health Assessment Index (GOHAI). • In this study, Data collected from 40 patients were collected through the administration of a structured questionnaire, as well as from medical records and intraoral examinations. . • The GOHAI questionnaire was completed before and 3 months after dental rehabilitation by the same examiner. Mean GOHAI scores increased from 41.275 (low) to 53.100 (moderate) 3 months after dental rehabilitation.
- 36. • Patients with poor oral hygiene and those who had been using dentures and patients younger than 70 years-of-age all three type patient provided higher GOHAI scores after dental rehabilitation • Dental rehabilitation of institutionalized geriatric patients resulted in a significant improvement in quality of life • GOHAI scores, indicating an improvement in oral health-related quality of life after receiving proper dental care
- 37. Case -4
- 38. Effect of treatment with fixed and removable dental prostheses. An oral health-related quality of life study • The aim of the study was to evaluate patient-reported effects of treatment with fixed dental prostheses (FDP) and removable dental prostheses(RDP) and relate the change in Oral Health Related Quality of Life (OHRQoL) to the type of treatment and objective dental variables of aesthetics and mastication • Fixed dental prostheses treatment was performed in 200 patients and RDP treatment in 107 patients. Gender, age, region of replacement, and number of teeth present and replaced were obtained • The improvement was higher for the RDP group than the FDP group. • Removable dental prostheses that replaced only masticatory teeth did not improve the OHRQoL significantly
- 39. • The improvement in OHRQoL for both the FDP and RDP groups was not at the level of the control group. • Higher age was associated with lower improvement in OHRQoL. Higher age, being a woman and having teeth replaced in the aesthetic zone were associated with deterioration in OHRQoL. • Fixed dental prostheses and RDP treatments improved OHRQoL and reduced the number of problems. The RDP participants improved more than the FDP participant
- 40. Case -5
- 41. Oral health-related quality of life in patients seeking care for dentin hypersensitivity • To evaluate oral health-related quality of life (OHRQoL) impairment in patients seeking care for their hypersensitive teeth in comparison with general population subjects and to investigate the influence of gender and age on OHRQoL in these population • Study participants were 656 patients who sought treatment for their hypersensitive teeth in German dental offices. • These patients were asked to complete the German form of the Oral Health Impact Profile (OHIP) prior to treatment
- 42. • Age presented a curvilinear association with OHRQoL, with lower OHIP scores associated with younger and older adults and higher OHIP scores associated with middle-aged adults in both the patient and general populations. • Gender influence depended on the population, i.e. female general population subjects had lower OHIP scores than male general population subjects and female patients had higher OHIP scores than male patients • The present study suggests that the oral condition of hypersensitive teeth is significantly associated with impaired OHRQoL.
- 43. Case-6
- 44. Impact of mandibular implant prostheses on the oral health-related quality of life in partially and completely edentulous patients • To assess the oral health-related quality of life (OHRQoL) of patients provided with mandibular implant fixed partial prostheses (IFPP) for rehabilitation of two adjacent missing posterior teeth and complete denture patients provided with mandibular implant-supported overdenture (ISOD). • In this prospective study, 20 IFPP (mean age 47yr) and 28 ISOD (mean age 61.5 years) patients received 2 mandibular implants. • Metal ceramic non splinted fixed prostheses were provided in IFPP group, while in ISOD group, the mandibular overdentures were retained by nonsplinted attachments. • Patients rated their oral health-related quality of life using OHIP • Malaysian version at baseline (T0), 2–3 months (T1) and 1 year (T2) post implant treatment
- 45. • The total OHIP and domain scores before implant treatment were significantly higher (lower OHRQoL) in IFPP than in ISOD groups. • Post-implant scores between groups at T1 and T2 showed no significant difference. • The mean score changes at T0–T1 and T0–T2 for total OHIP and domains were significantly greater in IFPP except in the domains of physical pain and disability which showed no difference. • Improvement in OHRQoL occurred following both mandibular implant- supported overdentures and implant fixed partial prostheses.
- 46. References • E. B. O¨ ZHAYAT & K. GOTFREDSEN .Effect of treatment with fixed and removable dental prostheses. An oral health-related quality of life study Journal of Oral Rehabilitation .2012 39; 28–36 • Betül ˙lhan, Ebru Çal, Nesrin Dündar,Pelin Güneri and Safak Dag˘han .Oral health-related quality of life among institutionalized patients after dental rehabilitation. Geriatr Gerontol Int 2015; 15:1151–1157 • K. BEKES, M. T. JOHN, H-G.Oral health-related quality of life in patients seeking care for dentin hypersensitivity. Journal of Oral Rehabilitation 2009 36; 45–51 • The Effect of Full-Mouth Rehabilitation on Oral Health-Related Quality of Life for Children with Special Health Care NeedsThe Journal of Clinical Pediatric Dentistry 2016:40(1) • L. Sischo and H.L. Broder Oral Health-related Quality of Life What, Why, How, and Future Implications.J Dent Res. 2011 ; 90(11): 1264–1270.
- 47. THANKU