Page 101 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Speech, OMF and OHRQoL in OD on MDI in the maxilla
Oromyofunctional behavior
The oromyofunctional behavior was examined by means of the protocol of Lembrechts et al. (1999).28 Patients were asked to perform certain tasks with their oral muscles. This protocol contains an evaluation of the tongue function (tongue position at rest, tongue protrusion, tongue retraction, tongue lifting against the upper lip, tongue lifting against the lower lip, lateral movements of the tongue, click one’s tongue), jaw movement (lateral movement of the jaw, jaw opening), lip movement (lip position at rest, lip closure, dispersion of the corners of the mouth, lip protrusion, lip strength), facial muscles, spontaneous mime and integrated movements (blowing, sucking, whistling). Swallowing water and saliva were observed to evaluate the tongue position and muscle tension of the lip during swallowing. The oromyofunctional behavior was measured and video recorded as proposed in the protocol. A three-point rating scale was used for function (0= normal, 1= disturbed, 2= impossible). At last the presence of the following oromyofunctional disorders was verified with a questionnaire: presence of sucking habits, mouth breathing, lip incompetence, slavering, nail biting and bruxism.
Satisfaction and quality of life
To measure the Oral health related Quality of Life the Dutch version of the shortened Oral Health Impact Profile (OHIP-14) 29 was used. This questionnaire consists of 14 items divided in 7 domains being: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and handicap. We used one question of the domain ‘functional limitation’ (Have you had trouble pronouncing any words because of problems with your teeth, mouth, dentures or jaw?) to determine the impact of the prosthesis on speech. The items were rated by a Likert-scale ranging from 0 (no discomfort) to 4 (high discomfort). A total OHIP-14 score is assessed by counting the scores of the 14 individuals questions. A score of 56/56 is indicative for maximal negative appreciation and 0/56 indicates that there are no issues at all. Subjects were also asked to rate overall satisfaction with their oral health and the satisfaction with their speech on a visual analogue scale of 10 cm (VAS) with on the end of the scale reflecting 100% maximal satisfaction and the other end of the scale corresponding 0% to complete dissatisfaction. To minimize bias, the patients were asked to fill in the questionnaires prior to the speech assessment and prior to the clinical assessment of the dental situation.
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