Top

Health and Quality of Life Outcomes

Published in:

Open Access 01-12-2010 | Review

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

Authors: Anneloes E Gerritsen, P Finbarr Allen, Dick J Witter, Ewald M Bronkhorst, Nico HJ Creugers

Published in: Health and Quality of Life Outcomes | Issue 1/2010

Abstract

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.

Available only for authorised users

Decker SD, Schultz R, Wood D: Determinants of well-being in primary caregivers of spinal cord injured persons. Rehabil Nurs 1989, 14: 6–8.PubMedCrossRef

Sprangers MA, Aaronson NK: The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: a review. J Clin Epidemiol 1992, 45: 743–760. 10.1016/0895-4356(92)90052-OPubMedCrossRef

Mack F, Schwahn C, Feine JS, Mundt T, Bernhardt O, John U, Kocher PT, Biffar R: The impact of tooth loss on general health related to quality of life among elderly Pomeranians: results from the study of health in Pomerania (SHIP-O). Int J Prosthodont 2005, 18: 414–419.PubMed

Marino R, Schofield M, Wright C, Calache H, Minichiello V: Self-reported and clinically determined oral health status predictors for quality of life in dentate older migrant adults. Community Dent Oral Epidemiol 2008, 36: 85–94.PubMed

Tsakos G, Steele JG, Marcenes W, Walls AW, Sheiham A: Clinical correlates of oral health-related quality of life: evidence from a national sample of British older people. Eur J Oral Sci 2006, 114: 391–395. 10.1111/j.1600-0722.2006.00398.xPubMedCrossRef

Allen PF: Assessment of oral health related quality of life. Health Qual Life Outcomes 2003, 1: 40. 10.1186/1477-7525-1-40PubMedCentralPubMedCrossRef

Locker D: Measuring oral health: a conceptual framework. Community Dent Health 1988, 5: 3–18.PubMed

Slade GD, Spencer AJ: Development and evaluation of the Oral Health Impact Profile. Community Dent Health 1994, 11: 3–11.PubMed

Thomason JM, Heydecke G, Feine JS, Ellis JS: How do patients perceive the benefit of reconstructive dentistry with regard to oral health-related quality of life and patient satisfaction? A systematic review. Clin Oral Implants Res 2007,18(Suppl 3):168–188. 10.1111/j.1600-0501.2007.01461.xPubMedCrossRef

10.

Ekanayake L, Perera I: The association between clinical oral health status and oral impacts experienced by older individuals in Sri Lanka. J Oral Rehabil 2004, 31: 831–836. 10.1111/j.1365-2842.2004.01311.xPubMedCrossRef

11.

Ashing-Giwa KT, Tejero JS, Kim J, Padilla GV, Hellemann G: Examining predictive models of HRQOL in a population-based, multiethnic sample of women with breast carcinoma. Qual Life Res 2007, 16: 413–428. 10.1007/s11136-006-9138-4PubMedCrossRef

12.

Ide R, Yamamoto R, Mizoue T: The Japanese version of the Oral Health Impact Profile (OHIP)--validation among young and middle-aged adults. Community Dent Health 2006, 23: 158–163.PubMed

13.

Higgings JPT, Green S: Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Library; 2009. [http://www.cochrane-handbook.org]

14.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB: Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama 2000, 283: 2008–2012. 10.1001/jama.283.15.2008PubMedCrossRef

15.

Cochran WG: The combination of estimates from different experiments. Biometrics 1954, 10: 101–129. 10.2307/3001666CrossRef

16.

DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986, 7: 177–188. 10.1016/0197-2456(86)90046-2PubMedCrossRef

17.

Woolf B: On estimating the relation between blood group and disease. Ann Hum Genet 1955, 19: 251–253. 10.1111/j.1469-1809.1955.tb01348.xPubMedCrossRef

18.

Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 1959, 22: 719–748.PubMed

19.

Atchison KA, Dolan TA: Development of the Geriatric Oral Health Assessment Index. J Dent Educ 1990, 54: 680–687.PubMed

20.

Baba K, Igarashi Y, Nishiyama A, John MT, Akagawa Y, Ikebe K, Ishigami T, Kobayashi H, Yamashita S: The relationship between missing occlusal units and oral health-related quality of life in patients with shortened dental arches. Int J Prosthodont 2008, 21: 72–74.PubMed

21.

Baba K, Igarashi Y, Nishiyama A, John MT, Akagawa Y, Ikebe K, Ishigami T, Kobayashi H, Yamashita S: Patterns of missing occlusal units and oral health-related quality of life in SDA patients. J Oral Rehabil 2008, 35: 621–628. 10.1111/j.1365-2842.2007.01803.xPubMedCrossRef

22.

Bae KH, Kim HD, Jung SH, Park DY, Kim JB, Paik DI, Chung SC: Validation of the Korean version of the oral health impact profile among the Korean elderly. Community Dent Oral Epidemiol 2007, 35: 73–79. 10.1111/j.1600-0528.2007.00331.xPubMedCrossRef

23.

Hassel AJ, Koke U, Schmitter M, Rammelsberg P: Factors associated with oral health-related quality of life in institutionalized elderly. Acta Odontol Scand 2006, 64: 9–15. 10.1080/00016350500326211PubMedCrossRef

24.

Kida IA, Astrom AN, Strand GV, Masalu JR, Tsakos G: Psychometric properties and the prevalence, intensity and causes of oral impacts on daily performance (OIDP) in a population of older Tanzanians. Health Qual Life Outcomes 2006, 4: 56. 10.1186/1477-7525-4-56PubMedCentralPubMedCrossRef

25.

Lahti S, Suominen-Taipale L, Hausen H: Oral health impacts among adults in Finland: competing effects of age, number of teeth, and removable dentures. Eur J Oral Sci 2008, 116: 260–266. 10.1111/j.1600-0722.2008.00540.xPubMedCrossRef

26.

Lawrence HP, Thomson WM, Broadbent JM, Poulton R: Oral health-related quality of life in a birth cohort of 32-year olds. Community Dent Oral Epidemiol 2008, 36: 305–316. 10.1111/j.1600-0528.2007.00395.xPubMedCentralPubMedCrossRef

27.

Leake JL, Hawkins R, Locker D: Social and functional impact of reduced posterior dental units in older adults. J Oral Rehabil 1994, 21: 1–10. 10.1111/j.1365-2842.1994.tb01119.xPubMedCrossRef

28.

Leao A, Sheiham A: Relation between clinical dental status and subjective impacts on daily living. J Dent Res 1995, 74: 1408–1413. 10.1177/00220345950740071301PubMedCrossRef

29.

Locker D, Slade G: Association between clinical and subjective indicators of oral health status in an older adult population. Gerodontology 1994, 11: 108–114. 10.1111/j.1741-2358.1994.tb00116.xPubMedCrossRef

30.

Mason J, Pearce MS, Walls AW, Parker L, Steele JG: How do factors at different stages of the lifecourse contribute to oral-health-related quality of life in middle age for men and women? J Dent Res 2006, 85: 257–261. 10.1177/154405910608500310PubMedCrossRef

31.

McGrath C, Alkhatib MN, Al-Munif M, Bedi R, Zaki AS: Translation and validation of an Arabic version of the UK oral health related quality of life measure (OHQoL-UK) in Syria, Egypt and Saudi Arabia. Community Dent Health 2003, 20: 241–245.PubMed

32.

McGrath C, Bedi R: Can dentures improve the quality of life of those who have experienced considerable tooth loss? J Dent 2001, 29: 243–246. 10.1016/S0300-5712(00)00063-4PubMedCrossRef

33.

McGrath C, Bedi R: An evaluation of a new measure of oral health related quality of life--OHQoL-UK(W). Community Dent Health 2001, 18: 138–143.PubMed

34.

McGrath C, Bedi R: Population based norming of the UK oral health related quality of life measure (OHQoL-UK). Br Dent J 2002, 193: 521–524. discussion 517 10.1038/sj.bdj.4801616PubMedCrossRef

35.

McGrath C, Bedi R: Why are we "weighting"? An assessment of a self-weighting approach to measuring oral health-related quality of life. Community Dent Oral Epidemiol 2004, 32: 19–24. 10.1046/j.0301-5661.2003.00110.xPubMedCrossRef

36.

Meeuwissen JH, van Waas MA, Meeuwissen R, Kayser AF, van 't Hof MA, Kalk W: Satisfaction with reduced dentitions in elderly people. J Oral Rehabil 1995, 22: 397–401. 10.1111/j.1365-2842.1995.tb00791.xPubMedCrossRef

37.

Mesas AE, de Andrade SM, Cabrera MA: Factors associated with negative self-perception of oral health among elderly people in a Brazilian community. Gerodontology 2008, 25: 49–56. 10.1111/j.1741-2358.2007.00196.xPubMedCrossRef

38.

Naito M, Suzukamo Y, Nakayama T, Hamajima N, Fukuhara S: Linguistic adaptation and validation of the General Oral Health Assessment Index (GOHAI) in an elderly Japanese population. J Public Health Dent 2006, 66: 273–275. 10.1111/j.1752-7325.2006.tb04081.xPubMedCrossRef

39.

Oliveira BH, Nadanovsky P: Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form. Community Dent Oral Epidemiol 2005, 33: 307–314. 10.1111/j.1600-0528.2005.00225.xPubMedCrossRef

40.

Pallegedara C, Ekanayake L: Effect of tooth loss and denture status on oral health-related quality of life of older individuals from Sri Lanka. Community Dent Health 2008, 25: 196–200.PubMed

41.

Sheiham A, Steele JG, Marcenes W, Tsakos G, Finch S, Walls AW: Prevalence of impacts of dental and oral disorders and their effects on eating among older people; a national survey in Great Britain. Community Dent Oral Epidemiol 2001, 29: 195–203. 10.1034/j.1600-0528.2001.290305.xPubMedCrossRef

42.

Steele JG, Ayatollahi SM, Walls AW, Murray JJ: Clinical factors related to reported satisfaction with oral function amongst dentate older adults in England. Community Dent Oral Epidemiol 1997, 25: 143–149. 10.1111/j.1600-0528.1997.tb00912.xPubMedCrossRef

43.

Steele JG, Sanders AE, Slade GD, Allen PF, Lahti S, Nuttall N, Spencer AJ: How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent Oral Epidemiol 2004, 32: 107–114. 10.1111/j.0301-5661.2004.00131.xPubMedCrossRef

44.

Swoboda J, Kiyak HA, Persson RE, Persson GR, Yamaguchi DK, MacEntee MI, Wyatt CC: Predictors of oral health quality of life in older adults. Spec Care Dentist 2006, 26: 137–144. 10.1111/j.1754-4505.2006.tb01714.xPubMedCrossRef

45.

Tsakos G, Marcenes W, Sheiham A: The relationship between clinical dental status and oral impacts in an elderly population. Oral Health Prev Dent 2004, 2: 211–220.PubMed

46.

Tubert-Jeannin S, Riordan PJ, Morel-Papernot A, Porcheray S, Saby-Collet S: Validation of an oral health quality of life index (GOHAI) in France. Community Dent Oral Epidemiol 2003, 31: 275–284. 10.1034/j.1600-0528.2003.t01-1-00006.xPubMedCrossRef

47.

Tubert-Jeannin S, Riordan PJ, Morel-Papernot A, Roland M: Dental status and oral health quality of life in economically disadvantaged French adults. Spec Care Dentist 2004, 24: 264–269. 10.1111/j.1754-4505.2004.tb01704.xPubMedCrossRef

48.

Walter MH, Woronuk JI, Tan HK, Lenz U, Koch R, Boening KW, Pinchbeck YJ: Oral health related quality of life and its association with sociodemographic and clinical findings in 3 northern outreach clinics. J Can Dent Assoc 2007, 73: 153.PubMed

49.

Wong MC, McMillan AS: Tooth loss, denture wearing and oral health-related quality of life in elderly Chinese people. Community Dent Health 2005, 22: 156–161.PubMed

50.

Cronin M, Meaney S, Jepson NJ, Allen PF: A qualitative study of trends in patient preferences for the management of the partially dentate state. Gerodontology 2009, 26: 137–142. 10.1111/j.1741-2358.2008.00239.xPubMedCrossRef

51.

Locker D: Applications of self-reported assessments of oral health outcomes. J Dent Educ 1996, 60: 494–500.PubMed

52.

Fitzpatrick R, Davey C, Buxton MJ, Jones DR: Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess 1998, 2: 1–74. i-ivPubMed

53.

Allen PF, Thomason JM, Jepson NJ, Nohl F, Smith DG, Ellis J: A randomized controlled trial of implant-retained mandibular overdentures. J Dent Res 2006, 85: 547–551. 10.1177/154405910608500613PubMedCrossRef

54.

Nguyen TC, Witter DJ, Bronkhorst EM, Pham L, Creugers N: Dental functional status in a Southern Vietnamese adult population - an analysis by a combined quantitative and qualitative classification system. Int J Prosthodont, in press

55.

Gotfredsen K, Walls AW: What dentition assures oral function? Clin Oral Implants Res 2007,18(Suppl 3):34–45. 10.1111/j.1600-0501.2007.01436.xPubMedCrossRef

56.

Petersen PE, Yamamoto T: Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2005, 33: 81–92. 10.1111/j.1600-0528.2004.00219.xPubMedCrossRef

Title: Tooth loss and oral health-related quality of life: a systematic review and meta-analysis
Authors: Anneloes E Gerritsen
P Finbarr Allen
Dick J Witter
Ewald M Bronkhorst
Nico HJ Creugers
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2010
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-8-126

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool

Quality of life of children and their caregivers during an AOM episode: development and use of a telephone questionnaire

Using qualitative methods to inform the trade-off between content validity and consistency in utility assessment: the example of type 2 diabetes and Alzheimer's Disease

Use of rasch methodology to develop a short version of the Health Related Quality of life for Eating Disorders questionnaire: a prospective study

Feasibility, reliability and validity of health-related quality of life questionnaire among adult pulmonary tuberculosis patients in urban Uganda: cross-sectional study

A review of health utilities across conditions common in paediatric and adult populations