Confirmatory factor analysis of the Oral Health Impact Profile

Abstract

Previous exploratory analyses suggest that the Oral Health Impact Profile (OHIP) consists of four correlated dimensions and that individual differences in OHIP total scores reflect an underlying higher-order factor. The aim of this report is to corroborate these findings in the Dimensions of Oral Health-Related Quality of Life (DOQ) Project, an international study of general population subjects and prosthodontics patients. Using the project's Validation Sample (N=5,022), we conducted confirmatory factor analyses in a sample of 4,993 subjects with sufficiently complete data. In particular, we compared the psychometric performance of three models: a unidimensional model, a four-factor model, and a bifactor model that included one general factor and four group factors. Using model fit criteria and factor interpretability as guides, the four-factor model was deemed best in terms of strong item loadings, model fit (RMSEA=0.05, CFI=0.99), and interpretability. These results corroborate our previous findings that four highly correlated factors—which we have named Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact —can be reliably extracted from the OHIP item pool. However, the good fit of the unidimensional model and the high inter-factor correlations in the four-factor solution suggest that OHRQoL can also be sufficiently described with one score.

Association of overjet and overbite with esthetic impairments of oral health-related quality of life

“…The need for patient-based data on esthetics has led to the development of specific instruments like the Oral Aesthetic Subjective Impact Scale (OASIS) [27], the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) [23], or the Orofacial Esthetic Scale (OES) [24]. At the same time, esthetics is an important component of OHRQoL [19,20] and should thus be measurable via established OHRQoL instruments. In adults, one of the most extensively investigated and most widely used instrument of this type is the Oral Health Impact Profile (OHIP) [41].…”

“…In adults, one of the most extensively investigated and most widely used instrument of this type is the Oral Health Impact Profile (OHIP) [41]. Although both the complete version and a short version focusing on esthetics [43] have raised questions regarding their usefulness in capturing esthetic impairment [29], the OHIP does include a number of appropriate questions capable of measuring impacts of esthetic impairments on perceived oral health [20].…”

“…Die Notwendigkeit der Erfassbarkeit der vom Patienten wahrgenommenen Ästhetik hat zur Entwicklung spezifischer Instrumente geführt, wie der OASIS (Oral Aesthetic Subjective Impact Scale) [27], dem PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire) [23] und der OES (Orofacial Esthetic Scale) [24]. Gleichzeitig ist die Ästhetik eine wichtige Komponente der mundgesundheitsbezogenen Lebensqualität insgesamt [19,20] …”

“…For our analysis of esthetic impairments in OHRQoL, we chose those four out of the six items from the dimension "Esthetics" [20] which directly address esthetics by content. We excluded the two questions dealing with psychosocial phenomena ("Worried", "Self-conscious") which are only indirectly related to esthetics.…”

“…The internal consistency for these four quesProfile) [41]. Auch wenn die generelle Eignung des gesamten OHIP sowie einer speziellen Kurzversion (OHIP-aesthetic; [43]) zum Erfassen von ästhetischen Beeinträchtigungen in Frage gestellt wurde [29], so enthält das OHIP doch mehrere Fragen, die Auswirkungen einer eingeschränkten Ästhetik auf die wahrgenommene Mundgesundheit erfassen können [20].…”