Oral health-related quality of life is important for patients, but what about populations?

OBJECTIVES: To review population-based research into oral health-related quality of life.
METHODS: Narrative review of selected publications.
RESULTS: In the 1970s, there were two incentives to assess nonclinical aspects of health: (i) a desire to understand the impacts of disease on individuals' quality of life; and (ii) a search for population-level measures that might better quantify the impact of health care systems on populations. Dental researchers responded to those incentives, creating dozens of questionnaires that assess individuals' ratings of subjective oral health and quality of life. This has been a boon for clinical dental research, for example, by showing marked improvements in subjective oral health in patients receiving implant-supported dentures. Also, health surveys show poorer subjective oral health among disadvantaged population groups. However, the same measures show only modest benefits of general dental care. Furthermore, several population surveys show that today's young adults, who grew up with widespread exposure to preventive dental programs, have poorer subjective oral health than earlier generations that experienced unprecedented levels of oral disease. Yet to materialize is the hope that 'socio-dental indicators' of subjective oral health might provide a meaningful metric to demonstrate population-level benefits of dental care. A fundamental limitation is that population health is a contextual measure, not merely the aggregated health status of individuals within the population.
CONCLUSION: While researchers have successfully broken with clinical dogma by assessing subjective dimensions of individuals' oral health, they have failed to explicitly ask people to assess the oral health of the community in which they live.