GD Slade*

The public health significance of diseases that are rarely fatal is determined by their impact on quality of life and their cost to society. Health-related quality of life is now at the forefront of national health policy and has been embodied in national health targets. Objectives: To review population-based studies of oral health related quality of life in Australian adults and compare findings with the populations of UK, Germany. Methods: In 1998-2002, cross-sectional studies of national probability samples of adults were conducted in Australia (n=3,910), the UK (n=5,270), Finland (n=6,589) and Germany (2,050). All studies used 14-items of the Oral Health Impact Profile (OHIP-14) to measure adverse impacts of oral health on quality of life. The percentage of people reporting one or more impacts and mean OHIP-14 scores were compared among countries. Associations were evaluated between OHIP-14 levels and age and between OHIP-14 levels and tooth loss. Results: The percentage of people reporting one or more impacts showed little variation, ranging from 16% 95% CI=14-17%) in the UK to 18% (95%CI = 17-19%) in Australia. OHIP-14 scores were higher for dentate than edentulous people, and were positively correlated with the number of missing teeth. OHIP-14 scores tended to increase with age, although the trend was not consistent among countries. However, when the analysis was limited to dentate people who did not wear dentures there was an inverted U distribution, in which OHIP-scores were greatest for 40-59 year olds, but were lower for younger and older groups. Conclusions: One in six adults in these four nations experienced adverse impacts on quality of life due to oral problems. In contrast to commonly held assumptions, adverse impacts were most frequent among people aged 40-59 in most countries and declined in old age.

Note: * indicates presenter