Dental patients' functional, pain-related, aesthetic, and psychosocial impact of oral conditions on quality of life-Project overview, data collection, quality assessment, and publication bias

Abstract

Background: Knowledge about the magnitude of Oral Health-Related Quality of Life (OHRQoL) impairment across dental patient populations is essential for clinical practice, public health and research. Within the project Mapping Oral Disease Impact with a Common Metric, this systematic review aimed to describe functional, pain-related, aesthetic and broader psychosocial impact of oral conditions with a single metric using OHRQoL dimensions Oral Function, Oro facial Pain, Oro facial Appearance and Psychosocial Impact.

Methods: A search using PubMed, EMBASE, Cochrane, CINAHL and PsycINFO was performed on 8 June 2017, and updated on 14 January 2019. Only publications in the English language were considered. To characterise the extent of available standardised and clinically relevant OHRQoL information, we determined the number of publications, dental patient populations, which are clinically similar, and patient samples within each population with four-dimensional OHRQoL information using the Oral Health Impact Profile (OHIP) questionnaire. A quality assessment and a publication bias assessment were performed.

Results: We identified 171 publications that characterised 199 dental populations and 329 patient samples with four-dimensional OHRQoL information. The vast majority of populations were only characterised by one patient sample. Study quality was not related to OHRQoL magnitude, and substantial publication bias could be excluded.

Conclusions: Standardised and clinically relevant information using the four OHRQoL dimensions Oral Function, Oro facial Pain, Oro facial Appearance and Psychosocial Impact was available for a significant number of dental patient populations. Findings can provide a framework to interpret OHRQoL impairment of individual patients, or groups of patients, for clinical practice, public health and research.

Keywords: OHIP; Oro facial appearance; Oro facial pain; oral function; oral health-related quality of life; psychosocial impact.

Fig. 1.

PRISMA diagram of publications’ inclusion process.

Fig. 2.

Bias graph presenting an overall risk of bias of the four-dimensional Oral Health-Related Quality of Life publications (n=171) covering the representativeness of the studied population, appropriateness of patients’ recruitment and characterization, adequateness of dental patient samples’ inclusion, and commonness principles and soundness of measurement.

Fig. 3.

Four-dimensional Oral Health-Related Quality of Life impairment magnitude in 171 publications with low or unclear risk of bias (n=273) and high study bias (n=56).

Fig. 4.

Scatterplot of the impact factor magnitude versus four-dimensional Oral Health-Related Quality of Life impairment with flexible curve fitted to the data displaying the relationship between the two variables in 329 dental patient samples.