ORAL HEALTH IMPACT PROFILE 1.

Background and References Knowledge of the extent of dental disease gives a clinical indication of the experience of dental problems but it does not necessarily reflect the problems that people experience as a result of their dentition. There are differences between clinicians' and the public's evaluation of oral health. For example, dentists often appear to be most concerned about the integrity of previous dental work whereas patients often seem most concerned with the appearance of their teeth. [From a review by Nuttall in Tuith]. The capacity of dental clinicians and researchers to assess oral health and to advocate for dental care has been hampered by limitations in measurements of the levels of dysfunction, discomfort and disability associated with oral disorders. The purpose of the Oral Health Impact Profile (OHIP) (Slade and Spencer, 1994), is to provide a measure of the social impact of oral disorders and draws on a theoretical hierarchy of oral health outcomes. The aim of this index is to provide a comprehensive measure of self-reported dysfunction, discomfort and disability arising from oral conditions. It is based on Locker's adaptation of the World Health Organisation's classification of impairments, disabilities and handicaps (Locker, 1988). In the WHO model, impacts are organized linearly to move from a biological to a behavioural to a social level of analysis. Slade and Spencer adapted this by proposing seven dimensions of impact of oral condition. Each of the 7 dimensions in the original scale was assessed from questions on the type of problems experienced (a total of 49 questions). A shortened version (OHIP-14) was later developed based on a subset of 2 questions for each of the 7 dimensions (Slade, 1997b). [From a review by Nuttall in Tuith]

References Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994 Mar;11(1):3-11. Kelly, M., Steele, J., Nuttall, N., Bradnock, G., Morris, J., Nunn, J., Pine, C., Pitts, N., Treasure, E., and White, D. (2000) Adult Dental Health Survey - Oral Health in the United Kingdom 1998. London: The Stationery Office. Slade, G. (ed). (1997a) Measuring oral health and quality of life Chapel Hill: University of North Carolina, Dental Ecology. Slade, G.D. (1997b) Derivation and validation of a short-form oral health impact profile. Community Dentistry Oral Epidemiology 25: 284-290. Locker, D. (1998) Measuring oral health: a conceptual framework. Community Dental health 5: 5-13. Tuith Online; http://www.dundee.ac.uk/tuith/Articles/rt04b3.htm (January 2001)

2. Summary Statistics The OHIP consists of forty nine unique statements describing the consequences of oral disorders,

3. Reliability and Validity David Locker, Aleksandra Jokovic, Martha Clarke Assessing the responsiveness of measures of oral health-related quality of life. Community Dentistry and Oral Epidemiology Vol. 32 Issue 1 Page 10 February 2004 The reliability of the instrument was evaluated in a cohort of 122 persons aged 60 years and over (Slade and Spencer, 1994). Internal reliability of six subscales was high (Cronbach's alpha, 0.70-0.83) and test-retest reliability (intraclass correlation coefficient, 0.42-0.77) demonstrated stability. Validity was examined using longitudinal data from the 60 years and over cohort where the OHIP's capacity to detect previously observed associations with perceived need for a dental visit (ANOVA, p < 0.05 in five subscales) provided evidence of its construct validity. The Oral Health Impact Profile offers a reliable and valid instrument for detailed measurement of the social impact of oral disorders and has potential benefits for clinical decision-making and research.