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Thirty years of portraying oral health through models: what have we accomplished in oral health-related quality of life research?

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Abstract

Objectives

This paper critically examines the different models of oral health aimed at representing oral health-related quality of life (OHRQoL) and explores the extent to which such models changed conceptually to accommodate current theories and empirical knowledge of oral function, impairment and disability.

Methods

A critical synthesis of the existing literature based on a comprehensive yet non-systematic review using Ovid-MEDLINE was performed. Full text of manuscripts available on models of oral health and OHRQoL published in English between 1 January 1950 and 30 June 2013 were identified.

Results

Nineteen manuscripts were identified presenting and discussing various models of oral health and OHRQoL that are predominantly negative and linear. These models are mostly based on sick role-related theories and do not readily accommodate the biopsychosocial theories of oral health. Alternative portrayals have emerged to include positive behaviours and adaptive strategies dynamically, but have yet to influence patient care and the development of subjective OHRQoL indicators.

Conclusion

Despite the multitude of graphical representations of concepts, dental research has remained somewhat ‘linear’ in portraying the consequences of oral diseases as a one-way street. Although the conceptualization of oral health has evolved in the past 30 years, dental research still refers to it as the absence of disease in more than half a dozen models of OHRQoL focused mostly on dysfunction and disability.

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Notes

  1. Disability can encompass any or all of: impairment of body structure or function; limitation in activities; or restriction in participation. Within limitations and restrictions, disability is seen as a gap between an individual’s capabilities and the demands of the environment. Impairments can occur at the level of organs, tissues and cells, and at the subcellular level [48].

Abbreviations

CHMS:

Canadian Health Measures Survey

ICF:

International Classification of Functioning, Disability and Health

ICIDH:

International Classification of Impairments, Disability and Handicap

OHRQoL:

Oral health-related quality of life

OHIP:

Oral Health Impact Profile

WHO:

World Health Organization

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Acknowledgments

The authors would like to also express their gratitude to Dr. S. Ross Bryant for his constant encouragement and challenging ideas. A special thanks goes to Jaesung Seo, who was a Master’s Student under the supervision of both authors between 2009 and 2011 and offered a critical review on the concept of oral health and quality of life, as well as validity theory.

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Authors and Affiliations

  1. Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada

    Mario A. Brondani & Michael I. MacEntee

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  1. Mario A. Brondani
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Correspondence to Mario A. Brondani.

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Brondani, M.A., MacEntee, M.I. Thirty years of portraying oral health through models: what have we accomplished in oral health-related quality of life research?. Qual Life Res 23, 1087–1096 (2014). https://doi.org/10.1007/s11136-013-0541-3

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