A review of the influences of oral health on the quality of life

Abstract

Quality of life has emerged as the main focus of initiatives across a number of disciplines. With the growing recognition that health is of central importance to quality of life, there has been an explosion of interest in this factor in the medical context. This is equally true in dentistry and this, in turn, has led to advances in defining the concept of 'oral health related quality of life' and attempts to measure it. Along with other groups, oral health promoters have embraced this issue as a means of bringing about behavioural change. However, central to developing this area is an assessment of the tools available for measuring it. This paper explores the concepts of 'quality of life', 'health related quality of life' and 'oral health related quality of life'. It explores how they have arisen and reviews the current oral health related quality of life indicators in the dental literature, their development, their content, their reliability and their validity. The point is made that these indicators are not population based in their development and largely reflect either the profession 'normative' opinion or that of older dentally ill patients. The outcome of this is that the indicators measure only the negative impact of oral health on the quality of life. Furthermore, the majority of the indicators are just inventories of the adverse social conditions relating to oral ill health and fail to incorporate perception of the severity of these events. Also concerns are raised about the cross-cultural validity of utilising indicators developed abroad in Britain and suggest that their widespread use should be undertaken with caution.