title: Do health provider-patient relationships matter? Exploring dentist-patient relationships and oral health-related quality of life in older people.
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.
  
  
  METHODS
  older people aged 65 years and over living in East London, U.K. 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 U.K. 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.
authors.affiliation: Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.
authors.forename: Vanessa Elaine
authors.initials: VE
authors.lastname: Muirhead
authors.forename: Wagner
authors.initials: W
authors.lastname: Marcenes
authors.forename: Desmond
authors.initials: D
authors.lastname: Wright
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003625:Data Collection; D003812:Dentist-Patient Relations; D003945:Diagnosis, Oral / Q000941:ethics / Q000592:standards; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D009059:Mouth Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D009909:Oral Health / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D057240:Patient Preference; D058996:Quality Improvement; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: dentists; older people; oral health; patient–provider relationships; quality of life