Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Save to My Library
Look up keyword
Like this
1Activity
0 of .
Results for:
No results containing your search query
P. 1
00005151-200605000-00002

00005151-200605000-00002

Ratings:

4.0

(1)
|Views: 25 |Likes:
Published by api-3710948

More info:

Published by: api-3710948 on Oct 15, 2008
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

05/09/2014

pdf

text

original

Quality of life and masticatory function in denture wearers
H. KOSHINO*, T. HIRAI*, T. ISHIJIMA*, H. TSUKAGOSHI*, T. ISHIGAMI\u2020 &
Y. TANAKA\u2021*Department of Removable Prosthodontics, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-
Tobetsu, Japan,\u2020Department of Removable Partial Denture, School of Dentistry, Nihon University, Tokyo, Japan and \u2021Department of
Removable Partial Denture, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
SUMMARYSuccessful prosthodontic treatments for a

patient with removable partial dentures including maxillofacial prostheses hopefully brings about psy- chological wellbeing as well as improved health. The purpose of this study was to investigate the rela- tionship between quality of life (QOL) and the various aspects of denture function. At \ufb01rst, a questionnaire with a visual analog scale with 16 question items concerning denture and/or eating problems, the present state of health, psychological and physical wellbeing, life satisfaction, and QOL was developed. To discuss the validity and reliabil- ity of the questionnaire, 48 outpatients who wore a denture were asked to \ufb01ll it out. Next, to discuss the difference in QOL of the patient with various kinds of dentures and conditions, 103 outpatients were

asked to complete the newly developed question- naire. The questionnaire which contained four fac- tor areas with eight questions for denture patients was developed by factor analysis with Varimax rotation. The reliability of the QOL scale was con- \ufb01rmed by reliability analysis (Cronbach\u2019sa= 0\u00c6784). The QOL score of edentulous patients with a com- plete denture having some trouble chewing was signi\ufb01cantly lower than that of other denture patients. It was suggested that the wearing of a denture signi\ufb01cantly affected the QOL of elderly persons.

KEYWORDS: QOL, denture wearers, prosthodontic
treatment, elderly person
Accepted for publication 19 March 2002
Introduction

Epidemiological surveys in recent years have revealed the close relationship between oral health status and quality of life (QOL) (1\u20133). Osterberget al. (4) reported that dental impairment was associated signi\ufb01cantly with a lower capacity for cognition, sight, hearing, lung volume, heart volume, muscle strength and bone mineral content, as well as an overall self-assessment of health. They also reported that the amount of occlusal support in men was related to the survival rate in those subjects who were between 70 and 79 years of age. Yamamoto (5) reported the close relationship between QOL and exercise and/or sports. We con\ufb01rmed through our research that a close relationship exists between teeth clenching and phys- ical exercise, such as elbow \ufb02exion strength, knee

extension strength, back strength, maximal anaerobic power activity, and reaction time in a vertical jump (6\u20138). A previous study on rats also suggested that the decrease of masticatory function caused by tooth loss leads to a decrease in cerebral blood \ufb02ow volume and acetylcholine synthesis resulting in a learning memory disorder similar to the symptom displayed in dementia (9). Another investigation suggested that ageing, soft diet, malnutrition and loss of occlusal support could accelerate osteoporotic changes of the mandibular bone and femur, and cause a decrease of bodily activities and sensory deprivation (10). From the above results, we have speculated that the recovery of occlusion and/or dental arch by prosthodontic treatment are important factors to secure QOL. The need to \ufb01nd accurate, reliable indicators on which to base planning, provision and evaluation of health services has given impetus

\u00aa2006 Blackwell Publishing Ltd
doi: 10.1111/j.1365-2842.2005.01152.x
Journal of Oral Rehabilitation200633; 323\u2013329

to the continued search for accurate information. The development of simple standardized indicators of QOL is thus important in the assessment of health services and health care.

Successful prosthodontic treatments for a patient with removable partial dentures including maxillofacial prostheses are supposed to bring about psychological wellbeing as well as improved health and/or a sense of wellness. It is necessary to establish the objective criteria for judging the contribution of prosthodontic treatments for patients.

The purpose of this study was to investigate the
relationship between the QOL and denture function.
Development of QOL scale for denture
wearers
Method

To measure QOL of denture wearers, an index the QOLD was developed by the authors. This was com- posed of 16 questions suggested by Padilla and Grant (11) concerning denture and/or eating problems, pre- sent state of health, psychological and physical wellbe- ing, life satisfaction, and QOL (Table 1).

Forty-eight outpatients with either maxillofacial prostheses (17 persons) and/or complete dentures (31 persons) in our university hospitals were asked to \ufb01ll out a questionnaire. Informed consent was obtained

from these subjects participating in this study. The list of questions had an analog scale with straight lines (10 cm in length), a random question sequence and a reversed polarity of questions, the so-called visual analog scale (VAS). Filling out of the items was performed by way of an interview. The evaluation was carried out by points, each represented by 10 cm.

Statistical analysis

Statistical analysis of the validity and reliability of the each item in the questionnaire were performed by the factor and reliability analysis (SPSS for Windows 9.0, SPSS Inc.).

Results

Five factors were obtained by the factor analysis with Varimax rotation, and the results of Q4 and Q13 were eliminated. After that, the factor analysis with Varimax rotation was performed again. Four factors were obtained, which could be classi\ufb01ed as psychological health (Psy), physical health (Phy), eating satisfaction (Eat) and pain experienced with denture use (Den) (Table 2). Two high-loading items for each factor were selected (Table 3). In the questionnaire with four factors composed of eight questions, the reliability coef\ufb01cient (Cronbach\u2019sa) was 0\u00c6784.

Table 1.Sixteen items of QOLD for denture wearers
Q1. How much physical strength do you feel you have?
Q2. Is the amount of time you sleep suf\ufb01cient to meet your needs?

Q3. Do you tire easily?
Q4. Do you feel your present weight is a problem?
Q5. How would you rate your present state of health?
Q6. How much fun do you have (hobbies, recreation, social

activities)?

Q7. Do you \ufb01nd eating a pleasure?
Q8. Is the amount you eat suf\ufb01cient to meet your needs?
Q9. How useful do you feel?
Q10. How much happiness do you feel?
Q11. How satisfying is your life?
Q12. How good is the quality of your life?
Q13. Do you worry (fearful or anxious) about your denture?
Q14. How much pain do you feel when wearing your denture?
Q15. How often do you feel pain when wearing your denture?
Q16. Do you have any concern about bad odors being emitted
from your denture?

Table 2.Factor analysis with Varimax rotation matrix (second
rotated component)
Component
1
2
3
4
Q1
0\u00c6250
0\u00c6542*
)0\u00c6028
0\u00c6149
Q2
0\u00c6016
0\u00c6691*
0\u00c6237
)0\u00c6096
Q3
0\u00c6131
0\u00c6804*
)0\u00c6368
)0\u00c6055
Q5
0\u00c6134
0\u00c6791*
0\u00c6006
0\u00c6064
Q6
0\u00c6835*
0\u00c6334
0\u00c6246
0\u00c6016
Q7
0\u00c6240
)0\u00c6005
0\u00c6842*
0\u00c6267
Q8
0\u00c6168
0\u00c6091
0\u00c6900*
0\u00c6130
Q9
0\u00c6177
0\u00c6603*
0\u00c6296
0\u00c6350
Q10
0\u00c6856*
0\u00c6220
0\u00c6332
)0\u00c6039
Q11
0\u00c6771*
0\u00c6101
0\u00c6436
0\u00c6221
Q12
0\u00c6784*
0\u00c6291
0\u00c6144
0\u00c6271
Q14
0\u00c6243
0\u00c6028
0\u00c6105
0\u00c6921*
Q15
0\u00c6096
0\u00c6106
0\u00c6258
0\u00c6915*
Q16
0\u00c6762*
)0\u00c6038
)0\u00c6200
0\u00c6209
*Questions selected.
Text in bold; 2 high-loading items selected.
H. KOSHINOet al.
324
\u00aa2006 Blackwell Publishing Ltd,Journal of Oral Rehabilitation33; 323\u2013329
QOLD in the patients with various kinds
of dentures
Method

One hundred and three outpatients in our university hospitals with various kinds of dentures were asked to \ufb01ll out the QOLD questionnaire. Informed consent was obtained from these subjects participating in this study. They were divided into \ufb01ve groups. They were (i) 10 edentulous patients with complete denture having some trouble chewing and diagnosed as requiring prosthodontic treatment (TFD; mean age 77\u00c60\u00c6 11\u00c63 years), (ii) 23 fully edentulous patients with newly fabricated complete dentures that had been adjusted (NFD; mean age 77\u00c65\u00c6 6\u00c67 years), (iii) 21 single edentulous patients with newly fabricated upper or lower complete dentures that had been adjusted (SFD; mean age 73\u00c67\u00c6 8\u00c63 years), (iv) 31 partially edentu- lous patients with newly fabricated removable partial dentures that had been adjusted (NPD; mean age 67\u00c64\u00c6 9\u00c67 years), and (v) 18 patients with defective jaws and newly fabricated maxillofacial prostheses that had been adjusted (NMP; mean age 59\u00c62\u00c6 17\u00c67 years).

The score of the QOLD in each patient was repre- sented by showing the VAS on a 10-cm line. Each score of four factors in the QOLD was represented by the average point of two question items. The \u2018QOLD score\u2019 was represented by the average score of four factors.

\u2018Masticatory score\u2019 (MS score) was also calculated by using the food intake questionnaire method developed by the authors for complete denture wearers (12). In this study, the questionnaire on eating was answered during a personal interview with the authors.

Statistical analysis

Statistical analysis of the difference in each group was performed by one-way analysis of variance (ANOVA) with multiple range test (Duncan) (SPSS for Windows 9.0, SPSS Inc.). A correlation among factors was performed by simple linear regression analysis (SPSS for Windows 9.0, SPSS Inc.).

Results

Regarding the average age of each group, there was no statistical difference among the TFD group, NFD group, SFD group and NPD group. However, the average age of the NMP group was statistically lower than that of the other four groups.

Figure 1 shows the score of four factors (Psy, Phy, Eat and Den) of the QOLD, the \u2018QOLD score\u2019. The \u2018MS score\u2019 in each group were 25\u00c69\u00c6 13\u00c69, 55\u00c67\u00c6 23\u00c66, 65\u00c65\u00c6 20\u00c68, 69\u00c68\u00c6 21\u00c67, 57\u00c66\u00c6 20\u00c65%, respectively. The \u2018MS score\u2019 in the TFD group was statistically lower than that of the other four groups. As to the average of Psy score, Eat score, Den score and MS score in each group, the score of the TFD group was signi\ufb01cantly lower than that of other groups. Moreover, in this group, the average of Phy score was the lowest among all the groups, although it was not signi\ufb01cant. As a result, the QOLD score of the TFD group was signi\ufb01- cantly lower than that of other groups. The Den score was the lowest among the four factors in this group.

The correlation among the score of the four factors, the QOLD score and the MS score were analysed. The relationship between the four factors and the QOLD score (Fig. 2), Phy score and Psy score, Psy score and Eat score, Eat score and Den score (Fig. 3), the MS score and the four factors (Fig. 4), and MS score and QOLD score (Fig. 5) were statistically signi\ufb01cant.

Discussion

Quality of life measurements are used to justify or refute different forms of medical treatment (13). Pre- santet al. (14) and Padillaet al. (15) developed a multidimensional instrument for measuring QOL, and reported that initial testing of the model using data from 135 colostomy patients showed how satisfaction regarding nursing care and personal control act as cognitive mediators of self-worth, which then impacts the dimensions of QOL.

Table 3.Components and questions
1. Psychological health (Psy)
Q6. How much fun do you have (hobbies, recreation, social
activities)?
Q10. How much happiness do you feel?

2. Physical health (Phy)
Q3. Do you tire easily?
Q5. How would you rate your present state of health?

3. Eating satisfaction (Eat)
Q7. Do you \ufb01nd eating a pleasure?
Q8. Is the amount you eat suf\ufb01cient to meet your needs?

4. Pain by denture (Den)
Q14. How much pain do you feel when wearing your denture?
Q15. How often do you feel pain when wearing your denture?
Q U A L I T Y O F L I F E A N D M A S T I C A T O R Y F U N C T I O N 325
\u00aa2006 Blackwell Publishing Ltd,Journal of Oral Rehabilitation33; 323\u2013329

You're Reading a Free Preview

Download
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->