As dental professionals, most can agree that oral health is an important part of overall health. We know this as dental healthcare providers, but what motivates patients to take their oral health seriously? This can often be determined by patient reported outcomes. In an article published September 19, 2018 in the Journal of Evidence-based Dental Practice the author examined what aspects of oral health elicited concern from patients and how that may apply to patient perceived disease impact.1
According to the Application of the International Classification of Diseases to Dentistry and Stomatology ICD-DA there is a total of 1323 oral conditions. Of these, untreated caries was the most prevalent for the entire world according to the Global Burden of Disease 2010 study. Oral diseases often have a subjective and objective aspect. This can influence the way a patient perceives the seriousness of the oral disease. Patient’s concerns with oral disease have a narrower scope than that of medical concerns. This is often true because many oral diseases aren’t uncomfortable nor do they cause appearance concerns early in the disease process. Though it is evident to dental healthcare providers, patients often don’t understand the concern in the absence of pain or visual changes.
Studies indicate patients seek dental care for four reasons, 1) dental, oral and orofacial pain, 2) functional jaw problems, 3) impaired dental and orofacial appearance, and 4) broader psychosocial concerns. Typically, dental diseases such as dental caries and periodontal disease aren’t concerning to patients because they don’t perceive the outcome as death or mortality as is often associated with medical concerns. Rather, patients seek dental care when their disease affect quality of life.
Due to the patient’s perception regarding oral health, it is important to interview patients to better understand their motivation and goals. The author of this article has suggested referring to this type of information as dPRO’s. He defines this as “any report of the status of a patient’s oral health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else.”
A dPRO is a mental image and is subjective, it is not necessarily observed. This can be achieved using something like the Orofacial Esthetic Scale, an eight-item questionnaire measuring a patient’s perception of orofacial appearance. This is an attempt to capture what matters the most to the patient, leading to more satisfaction from the patient and better compliance from the patient to achieve their goals.
Do you currently use any type of questionnaire to assess what is most important to your patients? Do you interview your patient regarding their personal concerns and goals? Do you think incorporating this type of interview would benefit patient’s overall oral health?
- John MT. Health Outcomes Reported by Dental Patients. J Evid Based Dent Pract. 2018 Dec;18(4):332-335. doi: 10.1016/j.jebdp.2018.09.001. Epub 2018 Sep 19. PMID: 30514446.