The Association between Quantified Dentition and Self-Reported Oral Health

Objectives: This was conducted to firstly, establish the influence of remaining functional tooth structure on self-reported oral health, and secondly, to contribute to the validation of existing and newly developed composite indices of oral health status. Methods: The clinical oral health status of a disproportionate adult sample of 483 subjects demanding routine dental examinations at a staff model HMO in the public service of South Africa was recorded between 1 July 1999 and 31 December 2000. Additionally subjects reported their oral health status based on a four-point Likert scale (Excellent, Good, Fair and Poor), and subjects 45 years and older were requested to complete the OHIP-49. The OHSI, FST, T-Health indices, DHI, and twelve newly created indices (Tooth Structure Index (TSI)) measuring varying levels of remaining tooth structure were computed and compared with self-reported oral health, and the OHIP-49 and its domains, using sensitivity, bivariate and multivariate analyses. Results: All tested indices, to some degree, affected self-reported oral health significantly; however, the OHSI and TSI-8 (Includes missing teeth, adjustments for absent third molars, free ends and closed spaces, decayed surfaces and periodontal pockets) were the most sensitive towards demonstrating variance in self-reported oral health. TSI-5, TSI-6, TSI-7, TSI-8, TSI-9 and TSI-10 were the only indices sensitive enough to demonstrate significant variance in the Psychological Discomfort domain of the OHIP-49, while TSI-8 demonstrated the most variance in the OHIP-49 scores, and its domains, in the older sample. Conclusion: There are indications that remaining tooth structure significantly influences self-reported oral health in patients demanding routine care, with those with the lowest levels of dental impairment reporting better levels of oral health. This study supports the validity of the indices tested, with TSI-8 probably performing the best.