The development and evaluation of an oral health related quality of life measure (OHQoL-UK©)

There is a growing interest in how oral health affects quality of life and this in turn has led to the development of a plethora of oral health related quality of life measures. Their development, in many cases has reflected normative opinion as to what constitutes oral health related quality of life or ad hoc approaches to item selection. When public opinion has been used in the development process, it has largely been the views of older people with a life time experience of oral health problems or patient groups. Little consideration has been given to the general public's opinion in determining how oral health affects life quality and what aspects are most important to quality of life. Interviews were conducted with a large random probability sample of UK residents to determine how they perceived oral health as affecting quality of life and what aspects were most important. The findings demonstrated that the public perceived oral health's influences on life quality to be largely positive and enhancing, a dimension most often not considered by existing instruments. Moreover, the public cited certain domains ('ways') as being the most important influence oral health had on life quality, which existing measures frequently fail to capture. This led to the development of a new instrument. The performance of the new measure, which incorporated an individual weighting system to capture the importance of each effect to overall quality of life, was evaluated in a community setting. A quota sample of 500 adults was utilised to test the validity and reliability of the measure. The instrument demonstrated satisfactory face, construct and criterion validity, as well as good internal reliability, although concerns were raised about the value of utilising the weighting system. The instrument was then tested in the clinical setting, utilising a simpler unweighted version, among 400 patients attending a primary dental practice. The results demonstrated the instrument's face, construct, criterion and convergent validity. In addition, the instrument had good internal reliability and test retest reliability. Regression analysis identified clinical factors, number of decayed teeth and experience of prosthetic problems in the past year (self reported) as very important predictors of oral health related quality of life as captured by this new instrument.