Development and evaluation of a new multidimensional oral health indicator

TL;DR

This paper introduces a new tool called MOHi to measure overall oral health by combining multiple factors like patient surveys and dental exams.

Contribution

The novel contribution is the development of a multidimensional oral health indicator (MOHi) that integrates clinical and self-reported data.

Findings

MOHi scores were significantly higher in patients with periodontitis, smokers, and those with lower education levels.

The final model showed strong predictive ability with an AUC of 0.81 for degraded oral health conditions.

Age, sex, smoking status, and education level were identified as significant predictors of oral health status.

Abstract

To develop a new multidimensional oral health indicator (MOHi) to ascertain and characterize overall oral health status.

MOHi was developed using data from first-time patients (N = 1,034) attending a university dental clinic over an 18-month period. Participants completed the Oral Health Value Scale (OHVS), the Oral Health Impact Profile-14 (OHIP-14) and self-reported periodontal status questionnaires. Caries experience through Decayed, Missing and Filled Teeth (DMFT) index, was combined with radiographs. MOHi was built as a linear combination of the normalized OHVS, OHIP-14 and DMFT scores, in a continuous scale from 0 to 3, with higher scores representing a more degraded oral health condition. MOHi was evaluated according to sociodemographic, behavioral characteristics, and periodontal self-reported status. We compared MOHi mean values with t- Student's test and ANOVA one-way. Stepwise multivariate logistic regression methodologies modelled MOHi and identified significant predictors. Model performance was evaluated by ROC/AUC analysis.

MOHi had a normal distribution adequacy (ranging 0.29–2.47), with an average of 1.22 (±0.41). Significantly higher MOHi scores were found in patients with self-reported periodontitis (p < 0.001), former/active smokers (p < 0.001), elementary/middle education level (p < 0.001), employed/retired (p < 0.001), age >= 45 years (p < 0.001) and married/divorced/widowed (p < 0.001). The final reduced logistic regression model identified age (OR = 1.05), self-reported periodontitis (OR = 1.94), sex—female (OR = 1.80), smoking status active/former (OR = 3.12/OR = 1.62), education level—elementary/middle (OR = 2.94/OR = 2.27) as predictor conditions towards a more degraded oral health condition (AUC = 0.81).

MOHi has shown to be a promising tool to comprehensively characterize the overall oral health status.

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