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      Impact of removable dentures on oral health-related quality of life among elderly adults in Taiwan

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          Abstract

          Background

          Although the use of removable dentures can improve oral function and esthetics for elderly people, compared to those who do not wear removable dentures, those wearing removable dentures could have worse oral health related-quality of life (OHRQoL). Additional information is required to assess which factors related to denture wearing influence the OHRQoL of elderly individuals. The purpose of this study is to evaluate the association between denture wearing and OHRQoL in a sample of elderly individuals in Taiwan.

          Methods

          The study population included 277 elderly people wearing removable dentures (mean age = 76.0 years). Using face-to-face interviews, we collected data on the participants’ socio-demographic characteristics, dental care service usage (regular dental checkups, treatment during toothache, dental visits in the last year), and factors related to denture wearing (perceived oral pain, perceived loose denture, perceived oral ulcer, perceived halitosis, perceived dry mouth, and perceived total denture satisfaction scores). OHRQoL was measured using the Taiwanese version of the Geriatric Oral Health Assessment Index (GOHAI-T). The location and number of remaining natural teeth and the type of denture were also recorded. Hierarchical multiple regression analysis was performed using GOHAI-T scores as the dependent variable.

          Results

          All the predictors together accounted for 50% of the variance in GOHAI-T scores. Further, education level, number of natural teeth, denture status, perceived loose denture, perceived oral ulcer, and perceived total denture satisfaction scores had statistically significant influences on OHRQoL. When compared with other variables, factors related to denture wearing, especially perceived total denture satisfaction scores, had the greatest impact on GOHAI-T scores.

          Conclusions

          Of the factors analyzed in this study, denture satisfaction was the strongest predictor of OHRQoL. This suggests that denture satisfaction is useful for assessing the effect of denture treatment on the OHRQoL of elderly individuals wearing removable dentures.

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          Most cited references36

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          Tooth loss and oral health-related quality of life: a systematic review and meta-analysis

          Background It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this. Methods Relevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only. Results From a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts κ = 0.84 ± 0.03; full-texts: κ = 0.68 ± 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss. Conclusions This study provides fairly strong evidence that tooth loss is associated with impairment of OHRQoL and location and distribution of tooth loss affect the severity of the impairment. This association seems to be independent from the OHRQoL instrument used and context of the included samples.
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            Development of the Geriatric Oral Health Assessment Index.

            The development of measures for assessing oral health status is essential to the evolution and maturation of a scientific knowledge base in geriatric dentistry. The literature suggests a high prevalence of dental diseases in older adults, yet valid and reliable instruments to assess the impact of oral diseases on older individuals or populations are lacking. This paper describes the rationale for and the development of the Geriatric Oral Health Assessment Index (GOHAI), a self-reported measure designed to assess the oral health problems of older adults. Following a review of the literature and consultation with health care providers and patients, a pilot instrument was developed. The GOHAI was initially tested on a convenience sample of 87 older adults. A revised instrument was then administered to a sample of 1755 Medicare recipients in Los Angeles County. The GOHAI demonstrated a high level of internal consistency and reliability as measured by a Cronbach's alpha of 0.79. Associations of the GOHAI with a single-item rating of dental health and with clinical and sociodemographic supported the construct validity of the index. Having fewer teeth, wearing a removable denture and perceiving the need for dental treatment were significantly related to a worse (lower) GOHAI score. Respondents who were white, well educated, and with a higher annual household income were more likely to have a high GOHAI score, indicating fewer dental problems. Additional applications of the GOHAI are necessary to further evaluate the instrument's validity and reliability, and to establish population norms of oral health in older adult populations as measured by the GOHAI.
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              The future of complete dentures in oral rehabilitation. A critical review.

              Based on available investigations and current trends in oral rehabilitation published in the dental literature, an attempt is made to describe the possible future role of complete dentures. For edentulous patients, complete dentures have for long been the only prosthodontic treatment option. Whereas a large number of edentulous patients report satisfaction with denture usage, a smaller number are unable to adapt; for such patients, sophistication of clinical and technical processes or quality of denture-supporting tissues, appear to have little influence on patient-perceived outcomes. Since the 1980s, osseointegrated dental implants have dramatically improved the therapeutic possibilities, especially so for maladaptive patients. Those able to access such treatment can expect significant improvements in oral functional status and quality of life. While there is a downward trend in edentulism in several countries, it is region-specific, confirming the overriding influence of socio-economic factors on health status. In most societies, despite ageing populations, the need for complete dentures is not likely to reduce in the near future. Whereas a two- or even a one-implant overdenture for the edentulous mandible is increasingly regarded as a minimum standard of care in many developed countries, its routine prescription for the majority in the world who are disadvantaged is unrealistic; for them, even 'low-tech' therapies like conventional dentures are beyond their reach. Improving the conventional management of edentulous patients is a necessity and requires a keener focus by researchers, educators and clinicians in the developed world on the needs of populations with fewer resources.
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                Author and article information

                Contributors
                yyyen0302@gmail.com
                huerle@kmu.edu.tw
                yimin@kum.edu.tw
                sjlan@asia.edu.tw
                wcwang@kmu.edu.tw
                dujekang@gmail.com
                shuntehuang@gmail.com
                taihen.n4545@msa.hinet.net
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                5 January 2015
                5 January 2015
                2015
                : 15
                : 1
                : 1
                Affiliations
                [ ]Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
                [ ]School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
                [ ]Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
                [ ]Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
                [ ]Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan
                [ ]Division of Oral Pathology, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
                [ ]Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
                [ ]Division of Pediatric Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
                [ ]Division of Family Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
                [ ]Department of Dentistry, Kaohsiung Municipal Ci-Jin Hospital, Kaohsiung, Taiwan
                Article
                487
                10.1186/1472-6831-15-1
                4298049
                25559722
                e2b19c34-3bd8-4998-b636-0b41289ca335
                © Yen et al.; licensee BioMed Central. 2015

                This article is published under license to BioMed Central Ltd. 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 credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 3 August 2014
                : 22 December 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Dentistry
                elderly,removable dental prostheses,oral health-related quality of life,geriatric oral health assessment index,denture satisfaction,dental care service

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