J Am Dent Assoc. 2020 Jul;151(7):527-535. doi: 10.1016/j.adaj.2020.04.013.
Oral health-related quality of life (OHRQoL) is a multidimensional, perception-based measure of how oral health affects social and physical functioning and self-image. OHRQoL is important for assessing women living with HIV (WLWH) who may have unmet dental needs and experience disparities that impact dental care accessibility.
In 2016, the authors conducted an assessment of OHRQoL among a national sample of 1,526 WLWH in the Women's Interagency HIV Study using the Oral Health Impact Profile instrument, which assesses the frequency of 14 oral health impact items. OHRQoL was measured using multivariable linear regression with a negative binomial distribution to assess the association between report of a recent unmet dental need and OHRQoL.
"Fair or poor" oral health condition was reported by 37.8% (n = 576) of WLWH. Multivariable linear regression showed that unmet dental needs had the strongest positive association with poor OHRQoL (difference in Oral Health Impact Profile mean, 2.675; P < .001) compared with not having unmet needs. The frequency of dental care utilization was not associated with higher OHRQoL. Older age, fair or poor dental condition, smoking, symptoms of anxiety and loneliness, and poor OHRQoL were also associated with worse OHRQoL.
Self-perceived impact of oral health on social and physical function and self-image, as measured by OHRQoL, may be an easily assessable but underrecognized aspect of OHRQoL, particularly among women aging with HIV.
Dentists should implement OHRQoL assessments in their management of the care of patients with HIV to identify those who do have significant oral health impacts.
口腔健康相关生活质量(OHRQoL)是一种多维的、基于感知的衡量方法,用于评估口腔健康如何影响社交和身体功能以及自我形象。OHRQoL 对于评估可能存在未满足的牙科需求并经历影响牙科保健可及性的差异的 HIV 阳性女性(WLWH)很重要。
2016 年,作者使用口腔健康影响简表(OHIP)对妇女健康倡议 HIV 研究中的 1526 名全国性 WLWH 样本进行了 OHRQoL 评估,该工具评估了 14 项口腔健康影响项目的频率。使用负二项式分布的多变量线性回归来评估最近未满足的牙科需求与 OHRQoL 之间的关系。
37.8%(n=576)的 WLWH 报告口腔健康状况“一般或较差”。多变量线性回归显示,未满足的牙科需求与较差的 OHRQoL 呈最强的正相关(Oral Health Impact Profile 平均值差异为 2.675;P<.001),而未满足需求则相反。牙科保健利用率的频率与较高的 OHRQoL 无关。年龄较大、口腔健康状况一般或较差、吸烟、焦虑和孤独症状以及较差的 OHRQoL 也与较差的 OHRQoL 相关。
OHRQoL 衡量的口腔健康对社交和身体功能以及自我形象的自我感知影响可能是 OHRQoL 一个容易评估但尚未被充分认识的方面,特别是在 HIV 感染女性中。
牙医应在管理 HIV 患者的护理时实施 OHRQoL 评估,以识别那些口腔健康影响较大的患者。