Quality of life in patients with dental conditions: comparing patients' and providers' evaluation

To measure the agreement between patients and their caregivers in evaluating patients' oral quality of life.

Cross-sectional study.

Data collected in four Swedish dental clinics in 2004.

Consecutive patients. Data were completed for 444 patients. Fifteen dentists and 12 dental hygienists agreed to participate.

For each patient, the patient him/herself and his/her caregiver completed the 14-item Oral Health Impact Profile (OHIP-14), a specific instrument used to measure quality of life in oral conditions, with higher scores indicating a worse quality of life. Information on personal and clinical characteristics of patients were also collected.

Median OHIP-14 scores given by caregivers and patients were calculated and compared in different subgroups of patients. Cohen's kappa was calculated to measure the agreement between the evaluation of patients and caregivers.

OHIP-14 scores median values were 3.0 among patients and 9.0 among caregivers. Caregivers always gave a higher score than patients, especially in older patients and patients with lower education. The concordance between patients' and caregivers' evaluation was very low (for different OHIP-14 cutoffs: Cohen's kappa from 0.10 to 0.15).

In this study, great discrepancies were observed between patients and caregivers in the evaluation of patients' oral quality of life, with caregivers overestimating the burden of dental conditions on patients. It is important to improve patient-caregiver communication, in order to increase patient satisfaction and provide better care. A good patient-caregiver relationship is essential for the patients' well-being and their adherence to treatment.