An intervention study to test Locker's conceptual framework of oral health in edentulous elders.

Objective: To test a previously described conceptual framework of oral health in edentulous elders using an intervention study that included complete denture replacement. Confirmatory factor analysis (CFA) was also conducted to substantiate construct validity.

Background Data: To date, the model proposed by Locker has been tested on edentulous elders using structural equation model (SEM) analysis. However, cross-sectional designs and the Short-Form Oral Health Impact Profile (OHIP-14) cannot adequately express cause-effect relationships and distribution in edentulous patients. Accordingly, the authors investigated Locker's model using an interventional design that included complete denture replacement using the OHIP for edentulous subjects (OHIP-EDENT).

Methods: A total of 265 edentulous participants who visited the Dental Hospital of Tokyo Medical and Dental University (Tokyo, Japan) for new complete dentures were recruited. Locker's model was investigated, and CFA was performed using the change in subscale scores in the Japanese version of the OHIP-EDENT before and after complete denture replacement.

Results: CFA demonstrated an excellent model fit after adding several covariates. The Locker model also met the criteria of fit in all indices after 1 nonsignificant path was omitted. All path coefficients were significant.

Conclusion: The findings of the present interventional study demonstrated an empirical fit to Locker's model in edentulous elders using SEM analysis, which included complete denture replacement. It is anticipated that clarification of causal mechanisms of oral health-related quality of life will lead to improvement of overall quality of life, thus maintaining or improving the activities of normal daily life for edentulous elders.