Abstract
Purpose
This prospective cohort study of Japanese university students aimed to identify factors that might affect oral health-related quality of life (OHRQoL) and longitudinal relationships over a period of 3 years.
Methods
Students (n = 487) provided complete data before entering and 3 years later (before university graduation) participated in the present study. Decayed, missing, and filled teeth (DMFT) scores, community periodontal index, ratios (%) of teeth with bleeding on probing, and malocclusion were determined during oral examinations. The questionnaire addressed age, sex, self-rated oral health, oral health behavior, subjective oral symptoms, and OHRQoL determined using the oral health impact profile (OHIP)-14. Associations were analyzed using structural equation modeling (SEM).
Results
The OHRQoL significantly worsened according to OHIP-14 total score (p = 0.001). The final model in the symptoms of SEM analysis showed that OHRQoL at follow-up positively correlated with OHRQoL at baseline. Self-rated oral health was directly associated with the OHRQoL at baseline (p < 0.05).
Conclusions
This study determined that OHRQoL at baseline was a direct predictor, and that self-rated oral health were indirect predictors of OHRQoL at follow-up among Japanese university students.
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Acknowledgements
The authors are grateful to Dr. Chiaki Inabu (Junpukai Daiku Dental Clinic, Okayama, Japan) for data entry, and to Dr. Tetsuji Azuma (Department of Community Oral Health, Asahi University School of Dentistry, Mizuho, Japan), Dr. Mayu Yamane-Takeuchi, and Dr. Shinsuke Mizutani (Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University; OBT Research Center, Faculty of Dental Science, Kyushu University, Japan) for data collection.
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This study was self-supported.
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Appendices
Appendix 1: Question items of oral health impact profile-14
Subscale | Question item |
|---|---|
Functional limitation | Have you had trouble pronouncing any words because of problems with your teeth, mouth or dentures? |
Have you felt that your sense of taste has worsened because of problems with your teeth, mouth or dentures? | |
Physical pain | Have you had painful aching in your mouth? |
Have you found it uncomfortable to eat any foods because of problems with your teeth, mouth or dentures? | |
Psychological discomfort | Have you felt self-conscious because of problems with your teeth, mouth or dentures? |
Have you felt tense because of problems with your teeth, mouth or dentures? | |
Physical disability | Has your diet been unsatisfactory because of problems with your teeth, mouth or dentures? |
Have you had to interrupt meals because of problems with your teeth, mouth or dentures? | |
Psychological disability | Have you found it difficult to relax because of problems with your teeth, mouth or dentures? |
Have you been a bit embarrassed because of problems with your teeth, mouth or dentures? | |
Social disability | Have you been a bit irritable with other people because of problems with your teeth, mouth or dentures? |
Have you had difficulty doing your usual jobs because of problems with your teeth, mouth or dentures? | |
Handicap | Have you felt that life in general was less satisfying because of problems with your teeth, mouth or dentures? |
Have you been totally unable to function because of problems with your teeth, mouth or dentures? |
Appendix 2: Change in OHRQoL from baseline to follow-up
Oral health impact profile-14 | Self-rated oral health | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total | Very good | Good | Fair | Poor | Very poor | |||||||||||||
Mean ± standard deviation (SD) | 95% confidence interval (CI) | Median | Mean ± SD | 95% CI | Median | Mean ± SD | 95% CI | Median | Mean ± SD | 95% CI | Median | Mean ± SD | 95% CI | Median | Mean ± SD | 95% CI | Median | |
Total | 2.0 ± 12.1 | 1.0–3.1 | 0.0 | 1.9 ± 12.4 | 1.2–4.9 | 0.0 | 1.7 ± 12.1 | 0.5–3.9 | 0.0 | 3.1 ± 12.8 | 1.5–4.8 | 0.0 | 0.3 ± 5.5 | 1.2–0.8 | 0.0 | − 6.8 ± 13.2 | − 15.2– 1.5 | − 2.5 |
Subscale | ||||||||||||||||||
Functional limitation | 0.3 ± 1.8 | 0.2–0.5 | 0.0 | 0.3 ± 1.8 | − 0.3–0.6 | 0.0 | 0.2 ± 1.9 | − 0.2–0.5 | 0.0 | 0.5 ± 1.8 | 0.3–0.7 | 0.0 | 0.3 ± 0.9 | 0.0–0.5 | 0.0 | − 1.2 ± 2.4 | − 2.7– 0.4 | 0.0 |
Physical pain | 0.2 ± 2.0 | 0.0–0.4 | 0.0 | 0.2 ± 1.9 | − 0.3–0.6 | 0.0 | 0.2 ± 0.9 | − 0.1–0.6 | 0.0 | 0.3 ± 2.2 | 0.1–0.6 | 0.0 | − 0.1 ±1.5 | − 0.5–0.3 | 0.0 | − 1.4 ± 2.8 | − 3.2–0.4 | 0.0 |
Psychological discomfort | 0.2 ± 2.0 | 0.1–0.4 | 0.0 | 0.2 ± 2.0 | − 0.2–0.8 | 0.0 | 0.2 ± 2.0 | − 0.2–0.6 | 0.0 | 0.4 ± 2.0 | 0.2–0.7 | 0.0. | − 0.3 ± 1.5 | − 0.7–0.1 | 0.0 | − 1.3 ± 2.5 | − 2.9–0.3 | − 0.5 |
Physical disability | 0.3 ± 1.8 | 0.2–0.5 | 0.0 | 0.3 ± 2.0 | − 0.2–0.7 | 0.0 | 0.3 ± 1.8 | 0.0–0.6 | 0.0 | 0.5 ± 2.0 | 0.2–0.7 | 0.0 | 0.2 ± 0.8 | 0.0–0.4 | 0.0 | − 0.4 ± 0.0 | − 1.8–1.0 | 0.0 |
Psychological disability | 0.4 ± 1.9 | 0.3–0.6 | 0.0 | 0.5 ± 2.0 | 0.0–0.9 | 0.0 | 0.4 ±1.9 | 0.0–0.7 | 0.0 | 0.6 ± 2.0 | 0.3–0.8 | 0.0 | 0.3 ± 1.0 | 0.0–0.5 | 0.0 | − 0.6 ± 2.4 | − 2.1–0.9 | 0.0 |
Social disability | 0.3 ± 1.8 | 0.2–0.5 | 0.0 | 0.3 ± 1.7 | − 0.2–0.7 | 0.0. | 0.3 ± 1.8 | 0.0–0.6 | 0.0 | 0.5 ± 2.0 | 0.2–0.7 | 0.0 | 0.2 ± 1.0 | − 0.1–0.5 | 0.0 | − 0.4 ± 1.6 | − 1.4–0.6 | 0.0 |
Handicap | 0.3 ± 1.8 | 0.1–0.5 | 0.0 | 0.2 ± 1.8 | − 0.2–0.7 | 0.0 | 0.2 ± 1.7 | − 0.1–0.5 | 0.0 | 0.5 ± 1.9 | 0.2–0.7 | 0.0 | − 0.2 ± 1.1 | − 0.2–0.4 | 0.0 | − 0.9 ± 1.8 | − 2.0–0.2 | 0.0 |
Appendix 3: Baseline data comparison between follow-up and non-follow-up students
Variable | Follow-up students (n = 487) n (%)/mean ± standard deviation (SD) | Non-follow-up students (n = 1719) N (%)/mean ± SD | p a |
|---|---|---|---|
Male | 273 (56.1) | 1001 (58.2) | 0.391 |
Age (years) | 18.23 ± 0.53 | 18.58 ± 2.23 | < 0.001 |
Self-rated oral health | |||
≥ Good | 185 (38.0) | 612 (35.3) | |
≤ Fair | 302 (62.0) | 1107 (64.4) | 0.333 |
Oral health behavior | |||
Regular dental checks | |||
Yes | 82 (16.8) | 294 (17.1) | 0.891 |
Dental floss | |||
Yes | 66 (13.6) | 227 (13.2) | 0.842 |
Daily frequency of tooth brushing | |||
≤ 1 | 61 (12.5) | 239 (13.9) | |
≥ 2 | 426 (87.5) | 1480 (86.1) | 0.434 |
Subjective oral symptoms | |||
Oral pain | |||
Yes | 15 (3.1) | 45 (2.6) | 0.580 |
Recurrent aphthous stomatitis | |||
Yes | 107 (22.0) | 352 (20.5) | 0.473 |
Temporomandibular disorders | |||
Temporomandibular joint pain | |||
≤ Rarely | 450 (92.4) | 1568 (91.2) | |
≥ Sometimes | 37 (7.6) | 151 (8.8) | 0.408 |
Clicking | |||
≤ Rarely | 363 (74.5) | 1277 (74.3) | |
≥ Sometimes | 124 (25.5) | 442 (25.7) | 0.911 |
Difficulty opening mouth | |||
≤ Rarely | 435 (89.3) | 1551 (90.2) | |
≥ Sometimes | 52 (10.7) | 168 (9.8) | 0.557 |
Clinical status | |||
Decayed, missing, and filled teeth (number) | 1.91 ± 2.79 | 2.17 ± 3.05 | 0.122 |
Community periodontal index | |||
≤ 1 | 173 (35.5) | 605 (35.2) | |
≥ 2 | 314 (64.5) | 1114 (64.8) | 0.893 |
Ratio (%) of bleeding on probing | 31.15 ± 27.77 | 34.42 ± 28.17 | 0.016 |
Malocclusion | 112 (23.0) | 490 (28.5) | 0.012 |
The total score of OHIP-14 | 2.02 ± 5.95 | 2.04 ± 5.77 | 0.900 |
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Saho, H., Ekuni, D., Kataoka, K. et al. Structural equation modeling to detect predictors of oral health-related quality of life among Japanese university students: a prospective cohort study. Qual Life Res 28, 3213–3224 (2019). https://doi.org/10.1007/s11136-019-02251-4
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DOI: https://doi.org/10.1007/s11136-019-02251-4