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      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

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          Abstract

          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.

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          Most cited references17

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          Report of the Committee on the classification and diagnostic criteria of diabetes mellitus

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            Relationship between salivary flow rates and Candida counts in subjects with xerostomia.

            This study evaluated the relationship between salivary flow and Candida colony counts in the saliva of patients with xerostomia. Sialometry and Candida colony-forming unit (CFU) counts were taken from 112 subjects who reported xerostomia in a questionnaire. Chewing-stimulated whole saliva was collected and streaked in Candida plates and counted in 72 hours. Species identification was accomplished under standard methods. There was a significant inverse relationship between salivary flow and Candida CFU counts (P =.007) when subjects with high colony counts were analyzed (cutoff point of 400 or greater CFU/mL). In addition, the median sialometry of men was significantly greater than that of women (P =.003), even after controlling for confounding variables like underlying disease and medications. Sjögren's syndrome was associated with low salivary flow rate (P =.007). There was no relationship between the median Candida CFU counts and gender or age. There was a high frequency (28%) of mixed colonization. Candida albicans was the most frequent species, followed by C parapsilosis, C tropicalis, and C krusei. In subjects with high Candida CFU counts there was an inverse relationship between salivary flow and Candida CFU counts.
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              Assessing change in quality of life using the Oral Health Impact Profile.

              Traditionally, longitudinal studies of oral health have measured only disease progression and ignored improvements in health. This study examines methodological issues that arise in longitudinal assessment of change in oral health-related quality of life (OHRQOL). Baseline and 2-year follow-up data were used from an observational longitudinal study of 498 people aged 60 years or more living in South Australia. Oral health-related quality of life was measured using the Oral Health Impact Profile (OHIP). Three hypothesized risk predictors (tooth loss, problem-based dental visits and financial hardship) were selected to examine the effects of four methods of measuring change: categorical measures of improvement, deterioration and net change, and a quantitative measure of net change in OHIP scores. Some 31.7% of people experienced some improvement and 32.7% experienced some deterioration in OHRQOL. All three high-risk groups had approximately twice the rate of deterioration in OHRQOL compared with their corresponding low-risk groups. Surprisingly, high-risk groups also had higher rates of improvement. When measured categorically, these effects did not cancel one another, indicating that improvement and deterioration in OHRQOL can be experienced simultaneously. However, quantitative analyses cause improvements and deteriorations to cancel, and analysis of mean OHIP scores created a spurious impression that change in OHRQOL did not differ between dental visit groups. Furthermore, changes in mean OHIP scores were masked by regression to the mean. Oral health-related quality of life measures capture both improvement and deterioration in health status, creating new complexities for conceptualizing and analyzing change in longitudinal studies.
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                Author and article information

                Contributors
                Journal
                J Diabetes Metab Disord
                J Diabetes Metab Disord
                Journal of Diabetes and Metabolic Disorders
                BioMed Central
                2251-6581
                2014
                4 February 2014
                : 13
                : 32
                Affiliations
                [1 ]Faculty of Dentistry, Dentistry Student Research committee(DSRC), Babol University of Medical Sciences, Babol, Iran
                [2 ]Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
                [3 ]Dental Materials Research Center ,Department of Periodontology & Implantology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
                [4 ]Department of Social Health Medicine, Babol University of Medical Sciences, Babol, Iran
                [5 ]Cellular & Molecular Biology Research Center, Department of Oral Medicine, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
                Article
                2251-6581-13-32
                10.1186/2251-6581-13-32
                4015305
                24495383
                2ad4721b-ba66-4d79-831a-8b07052abbd9
                Copyright © 2014 Nikbin et al.; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 August 2013
                : 19 January 2014
                Categories
                Research Article

                diabetes mellitus,type 2,oral health,quality of life,gohai,ohip-14

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