  In a qualitative study, Gregory, Gibson and Robinson proposed a framework of
items grouped in seven dimensions reflecting oral health related perceptions,
attitudes and behavior to encompass what is relevant when patients assess their
own oral health related quality of life (OHRQOL). The aim of this study is to
quantify the dimensions of Gregory relevance framework and confirm, or
otherwise, the influence on the change in the OHIP-14, an instrument widely
used to measure OHRQOL. The study was observational and longitudinal with the
OHIP-14 measured before a tooth extraction, and two and four weeks thereafter.
Statistical methods of analysis consisted of generalised estimating equations.
Responsiveness (or sensitivity to change) of the OHIP-14 was established in our
patient population. The dimensions of Gregory relevance framework featured
significantly in the models. Patients trust in dental products, perception of
own oral health as normal in relation to the average person, preference for
natural teeth, character bias in judgement and control by adherence to dentists
instructions, were all found to be significant factors in the longitudinal
change of the OHIP-14. Borderline significance was found in terms of dental
anxiety and symptoms. Perceptions, behaviour and attitudes, rather than
socio-demographic characteristics or oral health related knowledge, influence
change in OHRQOL. Trusting that the dentist values the patient as a person and
the importance the patient gives to having good oral health, are not found
significant, yet adhering to dentists advice has a beneficial effect on OHRQOL.

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