Developing a questionnaire to measure psychological disturbance associated with tooth loss.

Objectives: To develop and validate a self-reporting measure to assess the psychological disturbance in adult patients with tooth loss and dentures Methods: Ethical approval obtained from the Health Research Authority NHS England (Ref:17/NI/0098). 128 participants (100 patients - 28 clinicians) were recruited to participate in the development and validation of the questionnaire. Inclusion criteria included adults (age ≥18) with tooth loss/dentures. Exclusion criteria included patients with a history of psychotic mental illness or patients who had treatment with dental implants. The development processes included: Phase 1. Development of questionnaire: describing the aims/target population of the questionnaire, generating a pool of items, defining the constructs to be measured, adapting psychological morbidity screening tools, Items reduction and producing a preliminary questionnaire. Phase 2. Validation of questionnaire: content validation, face validation, establishing construct validity, pilot testing and establishing reliability.

Results: Face and content validation indicated that the questionnaire was an appropriate tool to measure the impact of tooth loss and related psychological morbidities. Reliability analysis (Test re-test reliability/internal consistency) indicated the questionnaire has satisfactory reliability (correlation >0.7). Testing the theoretical hypothesis structure of the impact of tooth loss has also enhanced the construct validity of the questionnaire (domains correlated mildly (r>5 & <3) to strongly (r>5). Pilot testing confirmed the scale adequacy and wording clarity (>90 % of respondents). Results indicated that the developed questionnaire has adequate psychometric properties.

Conclusion: A disease-specific measure that assesses the psychological impact of tooth loss and the effectiveness of interventions (i.e. dentures) has been developed and validated.

Clinical Significant: A patient outcome measure was developed which could be used to assess the psychological impact of tooth loss and compare the effectiveness of various interventions like dentures and implants.