Impairment effects, disability and dry mouth

Debates on disability have highlighted an apparent split between the individualised (biomedical) versus the social model of disability. Individualised approaches, criticised for isolating individuals and reinforcing the biomedical paradigm are the mainstay of research into the impacts of oral conditions on oral health related quality of life. One attempt to resolve the split between both models has been the use of the concept of ‘impairment effects'. Impairment effects are described as the direct and unavoidable impacts that impairments have on an individuals' functioning. They are described as simultaneously private and public, personal and political. Objective: To explore the impairment effects associated with dry mouth. Methods: This study involved a secondary analysis of data collected through semi-structured interviews with individuals who identified themselves as suffering from dry mouth. Data were analysed by exploring how the impairment effects associated with dry mouth were both personal (private) and simultaneously political (public). Results: The social and private dimensions of impairment were found to be problematic and the boundary between social disability and personal impairment hard to fix. Eating out whilst experiencing a dry mouth was expressed as a deeply private experience but that also had important social dimensions. The impact of assumptions associated with the place of moisture in meals whilst eating out was found to have particular disabling impacts. Other impairment effects, for example, the embarrassment resulting from gagging and coughing at the cinema because of a dry mouth, was less easily explained as a form of social oppression since the effect is less direct. Conclusions: Models of impact in dentistry fail to consider the social dimension of impairment adequately. By exploring oral impacts through the concept of impairment effects it may be possible to establish boundaries between personal impact and social disability in dry mouth.

* Funded by GlaxoSmithKline Consumer Healthcare.