Patient Perspectives of Oral Health and International Classification of Functioning

Objectives: A qualitative interview study was undertaken to explore the experience and perception of the mouth, oral health, functioning and the social environment amongst adults with disabilities and complex health conditions. The aim of the current study was to link the patients’ experience of oral health, as reported in the qualitative study, to the WHO International Classification of Functioning (ICF) using established ICF linking rules and to identify the ICF categories that best represent the patient’s perspective of oral health.
Methods: The full transcripts of all 17 interviews (18 participants) were analysed by two investigators to identify all meaningful concepts. The two lists were then rediscussed for consensus. The meaningful concepts were independently linked to ICF categories by two investigators and discrepancies resolved by discussion.
Results: 289 ICF categories were identified overall, of which 116 categories were cited in at least three interviews. The participants each gave a personal vision of oral health that covered a wide range of ICF categories in all domains (body functions, body structures, activities and participation, and environment). When compared to other ICF studies from different perspectives, the data was rich and emphasised social context, such as relationships, recreation or employment for example, that were less often cited from the clinical or research perspective.
Conclusions: This study provides evidence that the patient perspective provides important insight into what factors influence, or are influenced by, oral health. The development of an ICF Core Set for Oral Health is currently underway and this evidence will be an important contribution to this process.