Psychometric Validation of the Ultrashort Slovenian (OHIP-SVN5) and Croatian (OHIP-CRO5) Oral Health Impact Profile Questionnaires

Rener-Sitar, Ksenija; Čelebić, Asja; Križaj, Miha; Petričević, Nikola

doi:10.2478/sjph-2025-0022

Abstract

Aim

The study tested the validity, reliability and responsiveness of the ultrashort Slovenian and Croatian versions of the 5-item Oral Health Impact Profile (OHIP-5).

Methods

A total of 663 participants from the general population (400 from Slovenia and 223 from Croatia), 68 students (38 from Slovenia and 30 from Croatia), and 60 dental patients with treatment needs (30 from Slovenia and 30 from Croatia) were included in this investigation. Internal consistency was assessed using Cronbach’s alpha, and test-retest reliability was evaluated with intraclass correlation coefficients (ICC). Exploratory factor analysis (EFA) was performed to test whether the data fit the unidimensional model, and two types of validity were assessed: concurrent validity and known-group validity.

Results

The internal consistency of the Slovenian and Croatian ultrashort OHIP versions was confirmed by Cronbach’s alpha coefficients greater than 0.7 and the test-retest reliability, with sufficient ICC values. The factor analysis for both OHIP-5 versions showed a one-dimensional model and good factor loadings. Concurrent validity was confirmed through significant associations between self-reported oral health and the OHIP-5 summary scores. The OHIP-SVN5 and OHIP-CRO5 distinctly and significantly distinguished between different groups with differences in oral health impairment. Responsiveness to change of the OHIP-5 questionnaires showed that in Slovenian patients, three items decreased after treatment, while in Croatia, the scores of all OHIP-5 items and the summary score were significantly reduced after the treatment.

Conclusions

Slovenian and Croatian ultrashort OHIP-5 questionnaires are adequate one-dimensional instruments consistent with the four-dimensional model of oral health.

References

Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994 Mar;11:3–11.
Search in Google Scholar Back to article
Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25:284–290. doi: 10.1111/j.1600-0528.1997.tb00941.x.
Open DOI Search in Google Scholar Back to article
Naik A, John MT, Kohli N, Self K, Flynn P. Validation of the English-language version of the 5-item Oral Health Impact Profile. J Prosthodont Res. 2016 Apr 1;60(2):85–91. doi: 10.1016/j.jpor.2015.12.003.
Open DOI Search in Google Scholar Back to article
Allen F, Locker D. A modified short version of the oral health impact profile for assessing health-related quality of life in edentulous adults. Int J Prosthodont. 2002 Sep–Oct;15(5):446–450.
Search in Google Scholar Back to article
van der Meulen MJ, John MT, Naeije M, Lobbezoo F. Developing abbreviated OHIP versions for TMD patients. J Oral Rehabil. 2012 Jan;39(1):18–27. doi: 10.1111/j.1365-2842.2011.02242.x.
Open DOI Search in Google Scholar Back to article
Segù M, Collesano V, Lobbia S, Rezzani C. Cross-cultural validation of a short form of the Oral Health Impact Profile for temporomandibular disorders. Community Dent Oral Epidemiol. 2005 Apr;33(2):125–130. doi: 10.1111/j.1600-0528.2005.00215.x.
Open DOI Search in Google Scholar Back to article
Wong AHH, Cheung CS, McGrath C. Developing a short form of Oral Health Impact Profile (OHIP) for dental aesthetics: OHIP-aesthetic. Community Dent Oral Epidemiol. 2007 Feb;35(1):64–72. doi: 10.1111/j.1600-0528.2007.00330.x.
Open DOI Search in Google Scholar Back to article
John MT, Reißmann DR, Feuerstahler L, Waller N, Baba K, Larsson P, et al. Factor analyses of the Oral Health Impact Profile - overview and studied population. J Prosthodont Res. 2014 Jan;58(1):26–34. doi: 10.1016/j.jpor.2013.11.002.
Open DOI Search in Google Scholar Back to article
John MT, Feuerstahler L, Waller N, Baba K, Larsson P, Čelebić A, et al. Confirmatory factor analysis of the oral health impact profile. J Oral Rehabil. 2014 Sep;41(9):644–652. doi: 10.1111/joor.12191.
Open DOI Search in Google Scholar Back to article
John MT, Reissmann DR, Feuerstahler L, Waller N, Baba K, Larsson P, et al. Exploratory factor analysis of the oral health impact profile. J Oral Rehabil. 2014 Sep;41(9):635–643. doi: 10.1111/joor.12192.
Open DOI Search in Google Scholar Back to article
Rener-Sitar K, John MT, Truong V, Tambe S, Theis-Mahon N. Nonmalignant oral disease–specific dental patient-reported outcome measures for adult patients: A systematic review. J Evid Based Dent Pract. 2021 Mar;21(1):101529. doi: 10.1016/j.jebdp.2021.101529.
Open DOI Search in Google Scholar Back to article
John MT, Omara M, Su N, List T, Sekulic S, Häggman-Henrikson B, at al. Recommendations for use and scoring of Oral Health Impact Profile versions. J Evid Based Dent Pract. 2022 Mar;22(1):101619. doi: 10.1016/j.jebdp.2021.101619.
Open DOI Search in Google Scholar Back to article
John MT. Standardization of dental patient-reported outcomes measurement using OHIP-5 - validation of “recommendations for use and scoring of oral health impact profile versions”. J Evid Based Dent Pract. 2022 Jan;22 Suppl 1:101645. doi: 10.1016/j.jebdp.2021.101645.
Open DOI Search in Google Scholar Back to article
Reissmann DR. Methodological considerations when measuring oral health-related quality of life. J Oral Rehabil. 2021 Mar;48(3):233–245. doi: 10.1111/joor.12983.
Open DOI Search in Google Scholar Back to article
Rener-Sitar K, Celebić A, Petricević N, Papić M, Sapundzhiev D, Kansky A, et al. The Slovenian version of the Oral Health Impact Profile Questionnaire (OHIP-SVN): Translation and psychometric properties. Coll Antropol. 2009 Dec;33(4):1177–1183.
Search in Google Scholar Back to article
Rener-Sitar K, Petricević N, Celebić A, Marion L. Psychometric properties of Croatian and Slovenian short form of oral health impact profile questionnaires. Croat Med J. 2008 Aug;49(4):536–544. doi: 10.3325/cmj.2008.4.536.
Open DOI Search in Google Scholar Back to article
Petricevic N, Celebic A, Papic M, Rener-Sitar K. The Croatian version of the Oral Health Impact Profile Questionnaire. Coll Antropol. 2009 Sep;33(3):841–847.
Search in Google Scholar Back to article
Čelebić A, Stančić I, Kovačić I, Popovac A, Topić J, Mehulić K, et al. Psychometric characteristics of the Croatian and the Serbian versions of the Oral Health Impact Profile for edentulous subjects, with a pilot study on the dimensionality. Zdr Varst. 2021;60(1):55–64. doi: 10.2478/sjph-2021-0009.
Open DOI Search in Google Scholar Back to article
Čelebić A, Peršić S, Kovačić I, Buković D, Lešić N, Rener-Sitar K. Comparison of three prosthodontic treatment modalities for patients with periodontally compromised anterior mandibular teeth: A 2-year follow-up study. Acta Stomatol Croat. 2019 Mar;53(1):4–16. doi: 10.15644/asc53/1/1.
Open DOI Search in Google Scholar Back to article
Persic S, Palac A, Vojvodic D, Celebic A. The initial effects of a treatment with fixed partial dentures supported by mini dental implants are from a patient’s point of view. Coll Antropol. 2014 Mar;38(1):275–278.
Search in Google Scholar Back to article
Coric A, Kovacic I, Kirsic SP, Celebic A. Are mini dental implants suitable for support of crowns or small bridges in the mandibular incisor region? A 5-year longitudinal study. J Oral Maxillofac Surg. 2022 Nov;80(11):1811–1826. doi: 10.1016/j.joms.2022.07.145
Open DOI Search in Google Scholar Back to article
Disha V, Čelebić A, Rener-Sitar K, Kovačić I, Zore IF, Peršić S. Mini dental implant-retained removable partial dentures: Treatment effect size and 6-months follow-up. Acta Stomatol Croat. 2018 Sep;52(3):184–192. doi: 10.15644/asc52/3/2.
Open DOI Search in Google Scholar Back to article
Peršić S, Ćelić R, Vojvodić D, Petričević N, Kranjčić J, Zlatarić D, et al. Oral health–related quality of life in different types of mandibular implant overdentures in function longer than 3 years. Int J Prosthodont. 2016 Jan–Feb;29(1):28–30. doi: 10.11607/ijp.4457
Open DOI Search in Google Scholar Back to article
Batinjan G, Zore Z, Čelebić A, Papić M, Gabrić Pandurić D, Filipović Zore I. Thermographic monitoring of wound healing and oral health-related quality of life in patients treated with laser (aPDT) after impacted mandibular third molar removal. Int J Oral Maxillofac Surg. 2014 Dec;43(12):1503–1508. doi: 10.1016/j.ijom.2014.09.003.
Open DOI Search in Google Scholar Back to article
Peršić S, Kranjčić J, Pavičić DK, Mikić VL, Čelebić A. Treatment outcomes based on patients’ self-reported measures after receiving new clasp or precision attachment-retained removable partial dentures. J Prosthodont. 2017 Feb;26(2):115–122. doi: 10.1111/jopr.12395.
Open DOI Search in Google Scholar Back to article
Peršić S, Čelebić A. Influence of different prosthodontic rehabilitation options on oral health-related quality of life, orofacial esthetics and chewing function based on patient-reported outcomes. Qual Life Res. 2015 Apr;24(4):919–926. doi: 10.1007/s11136-014-0817-2.
Open DOI Search in Google Scholar Back to article
Uzarevic Z, Bulj A. Oral health-related quality of life among Croatian university students. Int J Environ Res Public Health. 2021 Jun 16;18(12):6483. doi: 10.3390/ijerph18126483.
Open DOI Search in Google Scholar Back to article
Lončar-Brzak B, Škrinjar I, Brailo V, Vidović-Juras D, Šumilin L, Andabak-Rogulj A. Burning Mouth Syndrome (BMS)—treatment with verbal and written information, B vitamins, probiotics, and low-level laser therapy: A randomized clinical trial. Dent J (Basel). 2022 Mar 1;10(3). doi: 10.3390/dj10030044.
Open DOI Search in Google Scholar Back to article
Rogulj AA, Z Alajbeg I, Brailo V, Škrinjar I, Žužul I, Vučićević-Boras V, et al. Topical NAVS naphthalan for the treatment of oral lichen planus and recurrent aphthous stomatitis: A double blind, randomized, parallel group study. PLoS One. 2021 Apr 8;16(4):e0249862. doi: 10.1371/journal.pone.0249862.
Open DOI Search in Google Scholar Back to article
Radić J, Vučković M, Gelemanović A, Roguljić M, Orešković J, Kovačević K, et al. Interconnectedness between periodontitis stage, oral hygiene habits, adherence to the Mediterranean diet and nutritional status in Dalmatian kidney transplant recipients: A cross-sectional study. Sci Rep. 2022 Jul 8;12(1):11614. doi: 10.1038/s41598-022-15589-6.
Open DOI Search in Google Scholar Back to article
Belusic Gobic M, Kralj M, Harmicar D, Cerovic R, Mady Maricic B, Spalj S. Dentofacial deformity and orthognatic surgery: Influence on self-esteem and aspects of quality of life. J Craniomaxillofac Surg. 2021 Apr;49(4):277–281. doi: 10.1016/j.jcms.2021.01.024.
Open DOI Search in Google Scholar Back to article
Petricevic N, Celebic A, Rener-Sitar K. A 3-year longitudinal study of quality-of-life outcomes of elderly patients with implant- and tooth-supported fixed partial dentures in posterior dental regions. Gerodontology. 2012 Jun;29(2):e956–e963. doi: 10.1111/j.1741-2358.2011.00592.x.
Open DOI Search in Google Scholar Back to article
Simancas-Pallares M, John MT, Enstad C, Lenton P. The Spanish language 5-item Oral Health Impact Profile. Int Dent J. 2020 Apr;70(2):127–135. doi: 10.1111/idj.12534.
Open DOI Search in Google Scholar Back to article
Lü H, He FM. Reliability and validity of the Chinese version of the 5-item Oral Health Impact Profile. Hua Xi Kou Qiang Yi Xue Za Zhi. 2020 Apr 1;38(2):145–148. Chinese. doi: 10.7518/hxkq.2020.02.006.
Open DOI Search in Google Scholar Back to article
Alhajj MN, Halboub E, Khalifa N, Amran AG, Reissmann DR, Abdullah AG, et al. Translation and validation of the Arabic version of the 5-item Oral Health Impact Profile: OHIP5-Ar. Health Qual Life Outcomes. 2018 Nov 20;16(1):218. doi: 10.1186/s12955-018-1046-0.
Open DOI Search in Google Scholar Back to article
John MT, Miglioretti DL, LeResche L, Koepsell TD, Hujoel P, Micheelis W. German short forms of the Oral Health Impact Profile. Community Dent Oral Epidemiol. 2006 Aug;34(4):277–288. doi: 10.1111/j.1600-0528.2006.00279.x.
Open DOI Search in Google Scholar Back to article
Nazeri AM, Nakhaee N, Navabi N. Validation of an ultrashort Persian version of Oral Health Impact Profile (OHIP-5) questionnaire. Pesqui. Bras. Odontopediatria Clin Integr. 2020;20:e5073. doi: 10.1590/pboci.2020.001
Open DOI Search in Google Scholar Back to article
Larsson P, John MT, Hakeberg M, Nilner K, List T. General population norms of the Swedish short forms of Oral Health Impact Profile. J Oral Rehabil. 2014 Apr;41(4):275–281. doi: 10.1111/joor.12137.
Open DOI Search in Google Scholar Back to article
Baba K, Inukai M, John MT. Feasibility of oral health-related quality of life assessment in prosthodontic patients using abbreviated Oral Health Impact Profile questionnaires. J Oral Rehabil. 2008 Mar;35(3):224–228. doi: 10.1111/j.1365-2842.2007.01761.x.
Open DOI Search in Google Scholar Back to article
Ingleshwar A, John MT. Cross-cultural adaptations of the oral health impact profile - An assessment of global availability of 4-dimensional oral health impact characterization. J Evid Based Dent Pract. 2023;23 Suppl 1:101787. doi: 10.1016/j.jebdp.2022.101787.
Open DOI Search in Google Scholar Back to article
León S, Correa-Beltrán G, De Marchi RJ, Giacaman RA. Ultra-short version of the Oral Health Impact Profile in elderly Chileans. Geriatr Gerontol Int. 2017 Feb;17(2):277–285. doi: 10.1111/ggi.12710.
Open DOI Search in Google Scholar Back to article
Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. J Clin Epidemiol. 1993 Dec;46(12):1417–1432. doi: 10.1016/0895-4356(93)90142-n.
Open DOI Search in Google Scholar Back to article
Waller N, John MT, Feuerstahler L, Baba K, Larsson P, Peršić S, et al. A 7-day recall period for a clinical application of the Oral Health Impact Profile questionnaire. Clin Oral Investig. 2016 Jan 1;20(1):91–99. doi: 10.1007/s00784-015-1484-6.
Open DOI Search in Google Scholar Back to article
Cronbach LJ Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334. doi: 10.1007/BF02310555.
Open DOI Search in Google Scholar Back to article
Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997 Feb 22;314(7080):572. doi: 10.1136/bmj.314.7080.572.
Open DOI Search in Google Scholar Back to article
Cohen R J, Swerdlik ME. Psychological testing and assessment: An introduction to tests and measurement. 6th ed. New York: McGraw-Hill; 2005.
Search in Google Scholar Back to article
Shrout PE, Fleiss JL. Intraclass correlations: Uses in assessing rater reliability. Psychol Bull. 1979;86:420–428. doi: 10.1037/0033-2909.86.2.420.
Open DOI Search in Google Scholar Back to article
Allen PF, McMillan AS, Locker D. An assessment of sensitivity to change of the Oral Health Impact Profile in a clinical trial. Community Dent Oral Epidemiol. 2001 Jun;29(3):175–182. doi: 10.1034/j.1600-0528.2001.290303.x.
Open DOI Search in Google Scholar Back to article
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Erlbaum; 1988.
Search in Google Scholar Back to article
Limpuangthip N, Somkotra T, Arksornnukit M. Modified retention and stability criteria for complete denture wearers: A risk assessment tool for impaired masticatory ability and oral health-related quality of life. J Prosthet Dent. 2018 Jul;120(1):43–49. doi: 10.1016/j.prosdent.2017.09.010.
Open DOI Search in Google Scholar Back to article
Likar Ostrc L, Frankovic S, Pavlic A. The development and evaluation of the Slovenian version of the Early Childhood Oral Health Impact Scale (ECOHIS-SVN). Zdr Varst. 2023 Dec;62(4):173–181. doi: 10.2478/sjph-2023-0025.
Open DOI Search in Google Scholar Back to article
Ali Z, Baker SR, Shahrbaf S, Martin N, Vettore MV. Oral health-related quality of life after prosthodontic treatment for patients with partial edentulism: A systematic review and meta-analysis. J Prosthet Dent. 2019 Jan;121(1):59–68. doi: 10.1016/j.prosdent.2018.03.003.
Open DOI Search in Google Scholar Back to article
Nedeljković Đ, Milić Lemić A, Kuzmanović Pfićer J, Stančić I, Popovac A, Čelebić A. Subjective and objective assessment of chewing performance in older adults with different dental occlusion. Med Princ Pract. 2023;32(2):110–116. doi: 10.1159/000529240.
Open DOI Search in Google Scholar Back to article
Celebić A, Valentić-Peruzović M, Stipetić J, Delić Z, Stanicić T, Ibrahimagić L. The patient’s and the therapist’s evaluation of complete denture therapy. Coll Antropol. 2000 Jul;24 Suppl 1:71–77.
Search in Google Scholar Back to article
Hocevar T, Anstiss T, Rotar Pavlic D. Content validity and cognitive testing in the development of a motivational interviewing self-assessment questionnaire. Zdr Varst. 2024 Mar;63(1):46–54. doi: 10.2478/sjph-2024-000754.
Open DOI Search in Google Scholar Back to article
Popovac A, Čelebić A, Peršić S, Stefanova E, Milić Lemić A, Stančić I. Oral health status and nutritional habits as predictors for developing Alzheimer’s disease. Med Princ Pract. 2021;30(5):448–454. doi: 10.1159/000518258.
Open DOI Search in Google Scholar Back to article
Elenčevski S, Čelebić A, Popovac A, Apostolska S, Nikolovska J, Stančić I. Psychometric validation of the Macedonian-language version of the ultrashort five-item Oral Health Impact Profile in the North Macedonian population (OHIP5-MAC). Medicina (Kaunas). 2025;61(4):655. doi: 10.3390/medicina61040655.
Open DOI Search in Google Scholar Back to article

Psychometric Validation of the Ultrashort Slovenian (OHIP-SVN5) and Croatian (OHIP-CRO5) Oral Health Impact Profile Questionnaires

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