Validation of the oral health impact profile - 14 in patients with head and neck cancer

The Oral Health Impact Profile-14 (OHIP-14) was designed to assess patients? perception of the impact of oral disorders on their quality of life (QoL). Although the OHIP-14 is now frequently used in patients with head and neck cancer, data related to its measurement properties in this population are scarce. The aim of the present study was to evaluate the reliability and validity of the OHIP-14 in a sample of Serbian patients with head and neck cancer. Data were available for 345 patients (257 [74.5%] males; aged 30-92 years), with head and neck cancer. All patients completed the OHIP-14 and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35. Factor analyses, internal consistency reliability (i.e., Cronbach?s ? coefficient), and construct validity were analyzed. The factor analyses confirmed that 14 OHIP items were measuring a single underlying factor. Cronbach?s ? coefficient was 0.98 and corrected item-total correlations ranged 0.77-0.93. Lower OHIP-14 scores (i.e., lower impacts on oral health) were more frequently present among patients who had only surgery as a therapeutic procedure compared to those who had surgery accompanied with radio- and chemotherapy (p< 0.01). Patients with a tumor stage 0-II also had lower OHIP-14 scores compared to those who had a tumor stage III-IV (p< 0.01). The OHIP-14 correlated significantly with the QLQ-C30 and QLQ-H&N35 scales. As a unidimensional instrument, the OHIP-14 provides oral QoL assessments with sound internal consistency reliability and construct validity among patients with head and neck cancer

Predictors of health-related quality of life in Serbian patients with head and neck cancer

The aim of this study was to identify predictors of the Health-Related Quality of Life (HRQoL) in patients with head and neck cancers (HNCs). In total, 345 patients with HNCs were interviewed. A self-report questionnaire was administered to collect data about demographic characteristics, health status, smoking, alcohol consumption habits, and HRQoL. It were used the EORTC Instruments - Quality of Life Questionnaire-Core 30-questions (QLQ-C30), Quality of Life Questionnaire - Head and Neck Module 35-questions (QLQ-H&N 35) and OHIP-14 instrument for HRQoL assessments. Clinical information and treatment data were collected from medical records. Five groups of HRQoL predictors were identified: demographic, socioeconomic, behavioral, psychophysical, and clinical/treatment. These HRQoL predictors had a strong (i.e., age, level of social support and social contact, level of education, depression, fatigue, presence of gastrostomy, comorbidities, and use of pain medications and supplements), a moderate (i.e., marital status, smoking, sexuality problems, time since diagnosis, presence of tracheostomy, and side effects outcomes of radio and chemotherapy) and a small impact (i.e., employment/financial difficulties, tumor site and stage, and surgical procedure). Study identified nineteen predictors that had significant, moderate and small impact on the HRQoL of patients with HNCs. Some of the predictors, like levels of social support and social contact, depression, and comorbidities could be targets for innervations to improve HRQoL

Oral mucosa lesions and risk habits: a cross-sectional study in North Serbia student population

BACKGROUND AND AIM: Epidemiological studies have established a wide variation in the prevalence of oral lesions in different population. Officially oral mucosa diseases can occur in 25-50% of cases, depending on the population to which the survey was conducted. We examined the relationship between oral mucosal lesions, tongue pH level, gingivitis, oral hygiene, and oral health behaviors in students’ population. METHODS: The study was conducted among 100 dental and medical final year students with age ranges of 23-26 years at the University of Novi Sad, School of Medicine. Information about the habits and the presence of the oral mucosa lesions (OML) were collected by interview and clinical examination. Tongue pH level, gingival and approximal plaque-space index (API) was measured. Association between variables was tested with univariate and multivariate analysis. RESULTS: Lesions of the oral mucosa were found in 61.0% of the students. Analysis showed relationship between oral hygiene accessories and tongue lesions (P < 0.010), male students who do not consume alcohol or tea and gingivitis (P < 0.050). It was determined that coffee consumption has a significant effect on tongue pH level (P < 0.050) and prevalence of melanin pigmentation (P < 0.010). Students who consume tea showed significantly more often appearance of fissured tongue (P < 0.050) and leukoedema of buccal mucosa (P < 0.050). Significant association regarding gender was found in prevalence of tongue impressions (P < 0.050), paleness of the oral mucosa (P < 0.010) and recurrent aphthous ulcers (P < 0.050), along with acid tongue pH and oral hygiene level. CONCLUSION: According to the results, there is a high prevalence of oral mucosal lesions, as well as the existence of the association between some oral mucosal lesions, gender, harmful habits and oral hygiene accessories. KEYWORDS: Oral Mucosa Lesions, Tongue Diseases, Gingivitis, Oral Hygiene, Students Population, Oral Health Behavio

The histological characteristics of clinically normal mucosa adjacent to oral cancer

Background: The ′field cancerization′ theory tries to explain the risk of local recurrences and development of second primary tumors in oral sqamous cell carcinoma (OSCC) patients. According to this theory it is assumed that clinically normal mucosa adjacent to oral cancer, except molecular, has already developed certain premalignant histopathological changes. Aims: The aim of this study was to determine histological characteristics of clinically normal-looking mucosa at different distances from the apparent tumor lesion margins in OSCC patients. Materials and Methods: Normal-appearing oral mucosa biopsy specimens were obtained from 30 new (untreated) oral cancer patients from sites at a distance of 10 mm and 20 mm from the tumor lesion margins and were compared with normal oral mucosa from 30 control patients with benign oral lesions. Results: A total of 21 patients (70%) in the OSCC group demonstrated histological abnormalities under microscopic examination versus 7 (23.3%) control patients (P<0.01). Seventeen oral cancer patients (57%) showed significant difference in incidence and type of histological changes of normal-looking mucosa at a distance of 10 mm from the tumor lesion; 8 (27%) demonstrated reactive changes, 6 (20%) mild dysplasia and 3 (10%) squamous cell carcinoma, compared to histological abnormalities registered in 11 (OSCC) patients (36%) at a distance of 20 mm from the tumor; 10 (33%) displayed reactive changes and 1 (3%) mild dysplasia. Conclusions: Histological abnormalities of clinically normal-looking oral mucosa taken at different distances from the tumor lesion indicated the existence of subclinical field change and represent an important parameter during the assessment of the adequacy of surgical resection margins in oral cancer management