The aim of this study was to investigate how oral health affects the quality of life among patients attending a dental clinic in Livingstone, and patients attending the Dental training school in Lusaka, Zambia. A total of 160 patients was consecutively selected and participated in the study, between the ages 16-68 (32 ± 11.8; mean ± SD). Interviews were done using a questionnaire “The oral impacts on daily performances” (OIDP). Of all the patients, 80% reported that they were affected by their oral health with at least one problem. Difficulty with “eating and enjoying food” was the most frequently performance affected (54%) and “speaking and pronouncing” was the least performance reported (16%). Overall, 20% of the participants reported that they did not have any problems. When reported having a problem, 3 and 4 number of problems were the most frequently occurring. Two open questions were asked, “What is the reason for your visit” and “What do you think is the problem”. The most common answer to the first question was “pain” (38.8%) and to the second question, “don´t know” (23.1%). This study found that 80% felt that their oral health affected their daily activities and QoL. / Syftet med studien var att undersöka hur den orala hälsan påverkar livskvalitéten bland patienter som besökte en tandklinik i Livingstone samt på kliniken vid Dental training school i Lusaka, Zambia. Sammanlagt 160 patienter valdes konsekutivt ut och var i åldrarna 16-68 år (32 ± 11,8; medel ± SD). Studien utfördes genom intervjuer med hjälp av en enkät, ”The Oral Impacts on Daily Performances” (OIDP). Av patienterna svarade 80% att de blev påverkade av deras orala hälsa med minst ett problem. Svårigheter med att ”äta och njuta av mat” var det vanligaste problemet (54%) medan ”att tala och ha bra uttal” var det problem som var minst rapporterat (16%). Överlag, rapporterade 20% att de inte hade några problem alls. När de rapporterade att de hade problem var det vanligaste 3 och 4 antal problem. Två öppna frågor ställdes, ”Varför kom du till kliniken” och ”Vad tror du är problemet”. Det vanligaste svaret på första frågan var ”smärta” (38.9%) och på andra frågan ”vet inte” (23.1%). Denna studie kom fram till att 80% tyckte att deras orala hälsa påverkade deras liv och livskvalité.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.