Adolescents’ Perceptions, understanding and experiences regarding oral health care, Johannesburg, South Africa: Oral-health-related quality of life factors

Objectives: The study explored the understanding, perceptions and experiences of the adolescents’ in Johannesburg regarding their oral health and oral health-related quality of life.
Methods:
An exploratory sequential qualitative approach was used to probe the oral health phenomenon as expressed by the HIV-infected and HIV-undiagnosed adolescents in Johannesburg. Twenty-five adolescents (14-19 years) participated in the in-depth-interviews (IDIs); fourteen females and eleven males from the school and the HIV-wellness sites in Johannesburg. Structured audio-taped IDIs were conducted by two interviewers. Thematic content analysis was used to synthesise the data corpus from interviews guided by the conceptual framework of OHRQoL.
Results: Adolescents’ oral health understanding was optimal. They experienced impacts related to oral symptoms and their daily oral activities such as eating/speaking were affected. They experienced bad dental treatment and had to endure pain due to limited choices on access to dental care. Oral conditions impacted severely on the self-awareness and resulted in self-stigma. The concern about self-awareness was more nuanced in the adolescents from the HIV-wellness site. ‘“I hurt , I feel bad. I cry because it makes me worry about my condition”. Few participants mentioned sadness and urge to isolate self, due to bad breath and bleeding gums.
Conclusions: Oral conditions affected the adolescents on the individual level (oral symptoms and functioning); external level (poor dental-access, negative dental experiences); and lastly social level (self-image and stigma). Quantitative OHRQoL measurement should incorporate these themes when measuring quality of life impacts to see the emergence of these factors in the South-African context. Pilot testing the application of these themes in the OHRQoL tool is recommended.