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      Development of the Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life of young people with malocclusion: part 1 – qualitative inquiry

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          Abstract

          Objectives: To seek the views of adolescents with malocclusion about how the appearance and arrangement of their teeth affects their everyday life and to incorporate these views into a new Malocclusion Impact Questionnaire (MIQ). Methods: Semi-structured interviews were undertaken with a purposive sample of 30 young people (10–16 years) referred for orthodontic treatment to two dental teaching hospitals. The interviews were recorded, transcribed and analysed using framework analysis. Several themes and sub themes were identified and these were used to identify items to include in the new measure. Results: Three themes emerged which were: concerns about the appearance of their teeth, effect on social interactions and oral health/function. Participants expressed the view that their teeth did not look normal, causing them embarrassment and a lack of confidence, particularly when they were with their peers or having their photograph taken. Concerns regarding the potential effect of a malocclusion on oral health, in terms of food becoming stuck between crooked teeth, interferences when chewing and increased risk of damaging the teeth were also identified. The themes were used to generate individual items for inclusion in the questionnaire. Conclusions: Common themes relating to the impact of malocclusion on the lives of young people were identified and generated items for the new MIQ to measure the oral health-related quality of life of young people with malocclusion. Part 2 outlines the further development and testing of the MIQ.

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          Most cited references34

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          What do measures of 'oral health-related quality of life' measure?

          The terms 'health-related quality of life' and 'quality of life' are now in common use to describe the outcomes of oral health conditions and therapy for those conditions. In addition, there has been a proliferation of measures designed to quantify those outcomes. These measures, which were initially designated as socio-dental indicators or subjective oral health indicators are now more usually referred to as measures of oral health-related quality of life (OH-QoL). This is based on the assumption that the functional and psychosocial impacts they document must, of necessity, affect the quality of life. While this assumption has been subject to critical scrutiny in medicine, this is not the case with dentistry. Consequently, exactly what is being measured by indexes of OH-QoL is somewhat unclear. Based on the debate between Gill and Feinstein and Guyatt and Cook, we outline a number of criteria by means of which the construct addressed by measures of OH-QoL may be assessed. These are concerned with how the measures were developed and validated. These criteria are then used to appraise five of the many measures that have been developed over the past 20 years--the GOHAI, OHIP, OIDP, COHQoL and OH-QoL. The main conclusion is that while all document the frequency of the functional and psychosocial impacts that emanate from oral disorders they do not unequivocally establish the meaning and significance of those impacts. Consequently, the claim that oral disorders affect the quality of life has yet to be clearly demonstrated. Verifying this claim requires further qualitative studies of the outcomes of oral disorders as perceived by patients and persons, and the concurrent use of measures that more explicitly address the issue of quality of life.
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            Validity and reliability of a questionnaire for measuring child oral-health-related quality of life.

            Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.
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              Developing and evaluating an oral health-related quality of life index for children; the CHILD-OIDP.

              To develop an oral health-related quality of life index in Thai children and evaluate its psychometric properties. Cross-sectional study of children aged 11-12 years, attending the final year of primary school (grade-six). Development and evaluation process was conducted on non-random sample in U-thong District, Suphan-buri province, Thailand. Re-evaluation of the index included all target group children in a municipal area of Suphan-buri province, Thailand. The psychometric properites evaluated in this study refer to face, content and concurrent validity and internal and test-retest reliability. 513 children in the development process. 1,100 children in the re-evaluation. Throughout the development process, the OIDP index was modified and its psychometric properties evaluated. The final test revealed excellent validity and reliability. Weighted kappa was 0.93. There was no negative correlation between any item, corrected item-total correlation coefficients were between 0.4-0.7, Standardised Cronbach's alpha coefficient was 0.82. The index showed very significant associations with perceived oral treatment need (p < 0.001) and perceived oral health problems (p < 0.001). The validity and reliability of the index was confirmed by similar results in the re-evaluation study. This study has demonstated that the CHILD-OIDP index is a valid, reliable and practical measure of oral health-related quality of life in 12 year old Thai children.
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                Author and article information

                Journal
                J Orthod
                J Orthod
                YJOR
                yjor20
                Journal of Orthodontics
                Taylor & Francis
                1465-3125
                1465-3133
                2 January 2016
                8 January 2016
                : 43
                : 1
                : 7-13
                Affiliations
                [ a ]Eastman Dental Hospital, UCLH Foundation Trust , UK
                [ b ]Academic Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield , UK
                [ c ]Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield , UK
                [ d ]Orthodontic Department, University College London Eastman Dental Institute , UK
                Author notes
                Address for correspondence: Philip E. Benson, Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield , Sheffield S10 2TA, UK. E-mail: p.benson@ 123456sheffield.ac.uk
                Article
                1114712
                10.1080/14653125.2015.1114712
                4867848
                26747334
                aed25f91-c87e-4632-9cc6-56d8abf0d0d1
                © 2016 British Orthodontic Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 September 2015
                : 24 October 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 7
                Categories
                Article
                Scientific Section

                impact,malocclusion,oral health quality of life,orthodontics

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