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Objectives: Essential oils and other plant extracts have evoked interest as sources of natural medicinal products. They have been proven to exert antibacterial, antifungal, antiviral and antioxidant properties, but the mechanism of action has not been fully elucidated. Aim: This study aims to evaluate the potential of a sage-containing mouthwash to alleviate inflammatory signs of intra-oral mucosa and gingiva in comparison with a water/alcohol-based placebo. Material and methods: This study was conducted as a randomised, placebo-controlled, double-blind, parallel design clinical study. Forty-eight dentate subjects were randomly assigned to a test (sage-containing mouthwash) or a placebo group (water/alcohol-based solution). Subjects rinsed once daily for 30 s over a period of 6 weeks. Sulcus Bleeding Index (SBI), Plaque Index (PLI), tooth staining, xerostomia and degree of stomatitis were assessed at baseline and after 6 weeks. Results: Subjects' mean age was 77.5 ± 7.3 years. SBI was reduced from 1.3 ± 0.9 to 0.8 ± 0.7 (test, p = 0.0029) and 1.4 ± 0.9 to 1.1 ± 0.7 (placebo, p = 0.0105). Similarly, PLI was reduced from 1.2 ± 0.5 to 1.0 ± 0.3 (test, p = 0.0080) and 1.3 ± 0.4 to 1.1 ± 0.6 (placebo, p = 0.0087); no between-group differences were found (p > 0.05). Stomatitis, xerostomia and tooth staining revealed no change after 6 weeks. Conclusion: The irrigation with a sage-containing mouthwash did not result in a superior beneficial effect on inflammatory parameters and plaque indices compared with the placebo. The expected contribution of the plant extracts to their potential impact on oral health may need further investigation. Clinical relevance: The proposed mouthwash might be suitable for patients with inflammatory signs of the gingiva who prefer natural remedies. [ABSTRACT FROM AUTHOR]

Objectives: To compare oral health, access barriers to dental care, oral health behavior and oral hygiene behavior of elderly German residents with and without immigration background. Design: In this cross-sectional explorative study, a convenience sample (N = 112, age ≥ 60 years, 54% immigrants) was recruited in four dental practices in Hamburg, Germany. Oral health was assessed with Decayed/Missing/Filled Teeth (DMFT), Papillary Bleeding Index (PBI), and Approximal Plaque Index (API). Dental health was operationalized as number of decayed teeth, and poor oral hygiene based on a PBI ≥ 40%. Access barriers and oral health behavior were assessed with a standardized questionnaire. Results: While caries experience was similar in migrants and non-migrants (DMFT mean: 24.8 vs. 23.4, n.s.), significantly more teeth were decayed (5.3 vs. 2.1, p < 0.001), and API (55.3% vs. 33.0%, p = 0.002) and PBI (46.3% vs. 30.5%, p = 0.016) were significantly higher in migrants. After adjusting for age, sex, income, education, and number of teeth, migrants still had on average 3 decayed teeth more than non-migrants. However, impact of migration background on poor oral health changed from OR = 3.61 (p = 0.007) to OR = 1.05 (n.s.) after adjusting for confounders, mainly due to lower income in migrants. Fewer migrants had visited a dentist within the past 12 months, and migrants were less likely to have a regular dentist that they visit and more often indicated language or cost barriers than non-migrants. Conclusion: Elderly German migrants have higher treatment needs than non-migrants. Likely causes are poorer oral hygiene and lower utilization of dental care services. Specific prevention programs targeting migrants are warranted to improve oral health in this disadvantaged group. [ABSTRACT FROM AUTHOR]

Purpose: Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance.Methods: In this prospective clinical study, a sample of 126 adult patients (age 17-83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients' ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments.Results: Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment.Conclusion: Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change. [ABSTRACT FROM AUTHOR]

Purpose: Oral health-related quality of life (OHRQoL) in children and adolescents can be assessed with two different approaches: children can directly report their own perceptions or parents can serve as proxies and rate their child's OHRQoL from their perspectives. It was the aim to investigate whether parents can accurately rate their children's OHRQoL and to compare agreement between OHRQoL domains and between age groups.Methods: In this cross-sectional study, a sample of 140 children aged 7-17 years was consecutively recruited at a university-based orthodontic clinic and a public school. OHRQoL was assessed with the 19-item Child Oral Health Impact Profile (COHIP) with one version for the child and one for the parent. Correlation between child and parent ratings and diagnostic accuracy of the parental rating to assess children's OHRQoL was calculated, and findings were compared between 7-11- and 12-17-year-old children.Results: COHIP summary score differed only slightly between parents (mean 60.7 ± 9.8 points) and children (mean 61.9 ± 8.9 points). Correlation of summary scores was r = 0.38, corresponding to a moderate agreement. Median of item prevalence of all 19 items was 29.5 % for children and 41.7 % for parents. Median of positive predictive values was 50.9 % and median of negative predictive values 76.7 %, with no substantial differences in age groups.Conclusions: Parents' perception of their children's OHRQoL is not accurate enough to detect oral health problems in an individual child aged between 7 and 17 years, and therefore, proxy OHRQoL assessment for individuals in this age group cannot be recommended. [ABSTRACT FROM AUTHOR]

Background: Prospective assessments of oral health-related quality of life (OHRQoL) changes are prone to response shift effects when patients reconceptualize, reprioritize, or recalibrate the perceived meanings of OHRQoL test items. If this occurs, OHRQoL measurements are not "invariant" and may reflect changes in problem profiles or perceptions of OHRQoL test items. This suggests that response shift effects must be measured and controlled to achieve valid prospective OHRQoL measurement. The aim of this study was to quantify response shift effects of Oral Health Impact Profile (OHIP) scores in prospective studies of prosthodontic patients.Methods: Data came from the Dimensions of Oral Health-Related Quality of Life Project. The final sample included 554 patients who completed the OHIP questionnaire on two occasions: pre- and post-treatment. Only items that compose the 14-item OHIP were analyzed. Structural equation models that included pre- and post-treatment latent factors of OHRQoL with different across-occasion constraints for factor loadings, intercepts, and residual variances were fit to the data using confirmatory factor analysis.Results: Data fit both the unconstrained model (RMSEA = .038, SRMR = .051, CFI = .92, TLI = .91) and the partially constrained model with freed residual variances (RMSEA = .037, SRMR = .064, CFI = .92, TLI = .92) well, meaning that the data are well approximated by a one-factor model at each occasion, and suggesting strong factorial across-occasion measurement invariance.Conclusions: The results provided cogent evidence for the absence of response shift in single factor OHIP models, indicating that longitudinal OHIP assessments of OHRQoL measure similar constructs across occasions. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: A desideratum of oral health-related quality of life (OHRQoL) instruments – such as the Oral Health Impact Profile (OHIP) – is that they accurately reflect the structure of the measured construct(s). With this goal in mind, the Dimensions of Oral Health-Related Quality of Life (DOQ) Project was proposed to investigate the number and nature of OHRQoL dimensions measured by OHIP. In this report, we describe our aggregate data set for the factor analyses in the project, which consists of responses to the 49-item OHIP from general population subjects and prosthodontics patients from 6 countries, including a large age range of adult subjects and both genders. Materials and methods: The DOQ Project's aggregate data set combines data from 35 individual studies conducted in Croatia, Germany, Hungary, Japan, Slovenia, and Sweden. Results: The combined data set includes 10778 OHIPs from 9348 individuals (N =6349 general population subjects, N =2999 prosthodontic patients). To elucidate the OHIP latent structure, the aggregated data were split into a Learning Sample (N =5173) for exploratory analyses and a Validation Sample (N =5022) for confirmatory analyses. Additional data (N =583) were assigned to a third data set. Conclusion: The Dimensions of Oral Health-Related Quality of Life Project contains a large amount of international data and is representative of populations where OHIP is intended to be used. It is well-suited to assess the dimensionality of the questionnaire. [Copyright &y& Elsevier]

Objectives: The aim of this study was to determine the magnitude of the association between perceived oral and general health-related quality of life (O/HRQoL) in the German general population and to compare it with the correlation of both constructs in dental patients. Methods: OHRQoL was assessed using the OHIP-49 and HRQoL using the SF-36 in a sample (N = 811) representative of the adult general population of Germany (age: 18-99 years), and in a sample (N = 313) of consecutive adult dental patients at least 18 years of age seeking prosthodontic care or attending their annual checkup. Correlation between OHRQoL and HRQoL was computed using structural equation modelling-based confirmatory factor analysis and path analysis. Based on the correlation coefficients, the coefficients of determination (r2) were calculated. Results: Correlation between OHRQoL and HRQoL after partialling out effects of age, gender and level of depression in general population subjects was rho = 0.28 resulting in an explanation of the variance of HRQoL by OHRQoL of 7.8%. In dental patients the correlation coefficient was somewhat lower (rho = 0.24) corresponding to an explanation of the variance of HRQoL by OHRQoL of 5.6%. Difference between correlation coefficients was not significant ( p = 0.514). Conclusion: Our findings provide evidence for the inseparable, intertwined relationship between perceived oral and general health. [ABSTRACT FROM AUTHOR]

Background: Interpretation of scores from oral health-related quality of life (OHRQoL) instruments, such as the Oral Health Impact Profile (OHIP) is challenging. It was the aim of this study to determine how many oral impacts correspond to one point of the 49-item OHIP using a new approach which translates numeric problem counts into the traditionally used ordinal OHIP response categories Methods: A sample of 145 consecutively recruited prosthodontic patients seeking treatment or having a routine examination completed the German version of the 49-item OHIP with the original ordinal response format as a self-administered questionnaire. In addition, the numerical frequencies of impairment during the previous month were requested in personal interviews. Based on a multilevel mixed-effects linear regression, we estimated the mean difference with 95% confidence interval (CI) in numerical frequency between two adjacent ordinal responses. Results: A numerical frequency of 15.2 (CI: 14.8 - 15.7) impacts per month corresponded to one OHIP point. This translates to approximately one impact every other day in the past month. Conclusions: The oral problem count per day that corresponds to one OHIP-49 point can be used to interpret this instrument's scores in cross-sectional and longitudinal studies. This number can help to better understand OHRQoL burden for patients, clinicians, and researchers alike [ABSTRACT FROM AUTHOR]

The assessment of changes in oral health-related quality of life ( OHRQo L) is challenging because individuals' concepts and internal standards of OHRQo L may change over time. The aim of this study was to detect response shifts in OHRQoL assessments made using the Oral Health Impact Profile ( OHIP). Oral health-related quality of life was assessed in a consecutive sample of 126 patients seeking prosthodontic care. Patients were asked to rate their OHRQo L before treatment started and 1 month after treatment was finished, using the German 49-item version of the OHIP. When rating their OHRQo L after treatment, patients were also asked to rate their pre-treatment OHRQo L without having access to their baseline data. The response shift was calculated as the difference in OHIP summary scores between the initial assessment and the retrospective baseline assessment. The OHIP mean scores decreased from 31.8 at the initial baseline assessment to 24.4 after treatment. The retrospective baseline assessment resulted in an OHIP mean score of 38.1, corresponding to a response shift of 6.3 OHIP points. The effect size ( Cohen's d = 0.21) of the response shift was considered small. The response shift phenomenon and its magnitude have important implications for dental practice, where patients and dentists often assess perceived treatment effects retrospectively. [ABSTRACT FROM AUTHOR]

Purpose: The concept of the minimal important difference (MID) of an oral health-related quality of life (OHRQoL) questionnaire has been proposed to refer to the smallest OHRQoL score difference considered to be clinically important in oral health. This study determined the MID for the 49-item Oral Health Impact Profile (OHIP) in prosthodontic patients. This could serve as a patient-based approach to define clinical significance for prosthodontic interventions. Materials and Methods: A consecutive sample of 224 adult patients completed the OHIP questionnaires twice before treatment was performed and 4 to 6 weeks after prosthodontic treatment was finished. At follow-up patients were asked about their overall impression of the treatment (global transition; answer categories “improved a lot,”“improved a little,”“stayed the same,”“worsened a little,” and “worsened a lot”). Results: The median of baseline and follow-up differences in OHIP (change scores) was computed for subjects (N = 47) reporting a “little improvement.” This figure was considered the MID for the OHIP, and it was found to be 6 OHIP units (95% confidence interval: 2 to 9). Conclusion: The MID of the OHIP is an important benchmark to assess individual and group treatment effects in prosthodontics and could be used to approach what is clinically significant in terms of patient-based outcomes. [ABSTRACT FROM AUTHOR]

Objective. To investigate retest effects in assessment of the Oral Health Impact Profile (OHIP) in patients requiring prosthodontic treatment. Material and methods. The German 49-item OHIP was administered in 21 patients requiring prosthodontic treatment on three pretreatment occasions: twice (t1 and t2) on day 1, 1-2 h apart, and on day 2 (t3), 3-78 days later. Differences in reliability coefficients, OHIP summary scores, and item responses, and the influence of time on score differences were analyzed. Results. Some evidence of retest effects in oral health-related quality of life (OHRQoL) was found (the difference in reliability coefficients between t1-t2 and t2-t3 was 0.08; p=0.02). Conclusions. The findings support repeated OHRQoL assessment over short periods of time when perceived oral health is rapidly changing. This is important because many oral conditions have acute symptoms and treatments have immediate OHRQoL effects that need to be measured. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to translate and validate an Arabic version of the 5-item Oral Health Impact Profile (OHIP).Methods: A total of 320 subjects (aged 18 years and above) were consecutively recruited from dental clinics. The self-administered OHIP5-Ar was distributed and the data were collected and analyzed. The dimensionality of the instrument was investigated using confirmatory factor analyses (CFA). Reliability was assessed as the instruments internal consistency using Cronbach's alpha and test-retest-reliability using intraclass correlation coefficient (ICC). Convergent validity was tested by correlation between perceived global oral and general health questions with the latent factor (OHRQoL) using structural equation modelling analysis and with OHIP5-Ar total score using spearman's correlation coefficient. Known-groups validity was tested among groups with known differences and sensitivity to change was also investigated after dental treatments.Results: The OHIP5-Ar was fitted well in the unidimensional model as indicated by the CFA with fit indices (RMSEA: 0.00, SRMR: 0.010, GFI: 0.998, TLI: 1). Cronbach's alpha was 0.78 and the ICC agreement was 0.88. The validity tests indicated satisfactory validity of the instrument and the sensitivity to change of the instrument revealed significant change in the OHIP5-Ar total score after the provision of dental treatments (effect sizes: 0.55-1.49).Conclusion: The OHIP5-Ar showed satisfactory psychometric properties among Arabic-speaking population. This instrument is sensitive to the changes of oral health and can be used to measure the OHRQoL with one total score. [ABSTRACT FROM AUTHOR]