Do health provider–patient relationships matter? Exploring dentist-patient relationships and oral health-related quality of life in older people

Muirhead, Vanessa Elaine
Marcenes, Wagner
Wright, Desmond

¹Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
²Public Health England, London Region, London, UK

Address correspondence to: V. E. Muirhead. Tel: 0207 882 8637; Fax: 0207 882 5842. Email: [email protected]

Published electronically 25 November 2013

Received 16 May 2013; accepted in revised form 6 September 2013

Age and Ageing 43(3):p 399-405, May 2014. | DOI: 10.1093/ageing/aft183

Abstract

Background:

patient experience is now a key parameter in health care. Yet, very little is known about the possible impact of dentist–patient relationships on patient-centred outcomes including older peoples' oral health-related quality of life (OHRQoL).

Objective:

this study assessed the relationship between OHRQoL and dentist–patient relationships related to perceived unmet dental needs; shared decision-making; time spent discussing oral health problems; respect and confidence and trust.

Participants:

older people aged 65 years and over living in East London, UK in 2011.

Methods:

a cross-sectional study using stratified random sampling recruited a representative sample of older people (n = 772). Participants completed an oral examination and a structured questionnaire including the Oral Health Impact Profile-14 (OHIP-14) measuring OHRQoL and five dentist–patient relationship questions taken from the UK 2009 Adult Dental Health Survey. Multivariate Poisson regressions modelled the association between OHRQoL and dentist–patient factors adjusting for socio-demographic factors, clinical oral indicators, and dental attendance.

Results:

having a perceived unmet need for dental treatment (PRR = 1.84; 95% CI: 1.32, 2.56) and expressing a lack of trust and confidence in one's dentist (PRR = 1.74; 95% CI: 1.01, 2.98) were significant predictors of poor OHRQoL among older people.

Conclusions:

these findings suggest that older people with unmet dental needs and those who expressed a lack of trust and confidence in their dentist were more likely to experience poor OHRQoL reinforcing the importance of the dental patient experience in healthy ageing and well-being.