Patient-Reported Outcome Measures in Dentistry: Conceptual Foundations, Clinical Applications, and Comparative Evaluation
Patient reported outcomes in dentistry.
Abstract
Dentistry is increasingly transitioning from a disease-centered model toward a patient-centered approach, emphasizing outcomes that matter most to patients. Patient-Reported Outcome Measures (PROMs) have emerged as essential tools for capturing patients’ perceptions of oral health, functional status, psychosocial well-being, and quality of life without clinician interpretation. This literature review aims to explore the conceptual foundations, evolution, classification, commonly used instruments, and clinical applications of PROMs in dentistry, with particular emphasis on prosthodontics and other dental specialties.
PROMs are grounded in health-related and oral health–related quality of life frameworks, including Locker’s model, Wilson and Cleary’s model, and the World Health Organization’s International Classification of Functioning (ICF). Over time, dentistry has progressed from reliance on clinician-reported indices to the incorporation of validated generic, oral health–specific, age-specific, and disease-specific PROMs such as OHIP, GOHAI, OIDP, PIDAQ, CPQ, and ECOHIS. These instruments have demonstrated value in assessing outcomes related to pain, function, esthetics, psychological well-being, and social participation across dental disciplines including prosthodontics, periodontology, orthodontics, oral surgery, and pediatric dentistry.
The integration of PROMs into clinical practice enhances patient–provider communication, supports shared decision-making, and improves evaluation of treatment effectiveness beyond traditional clinical measures. However, challenges such as time constraints, cultural adaptation, response bias, and lack of routine implementation remain. Emerging digital PROMs (ePROMs), artificial intelligence–based adaptive tools, and integration with electronic health records offer promising solutions.
In conclusion, PROMs represent indispensable components of modern, evidence-based, and value-driven dental care. Their systematic adoption, supported by robust validation, digital integration, and policy endorsement, is essential for advancing patient-centered dentistry and improving both clinical outcomes and patient satisfaction.
References
2. Allik H, Larsson J- O, Smedje H. Guidance for industry: patient- reported outcome measures: use in medical product development to support labeling claims: draft guidance. Health Qual Life Outcomes 2006;4:1–20.
3. Manohar PS. Patient Reported Outcome Measures as an effective evaluation tool in Prosthodontics. J Clin Prosth Impl 2025;7(1):43-45.
4. Kluzek S, Dean B, Wartolowska KA. BMJ Evidence-Based Medicine 2022;27:153–155.
5. Boyce MB, Browne JP. Does providing feedback on patient-reported outcomes to healthcare professionals result in better outcomes for patients? A systematic review. Qual Life Res. 2013 Nov;22(9):2265-78.
6. Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five- level version of EQ- 5D (EQ- 5D- 5L). Qual Life Res. 2011;20(10):1727- 1736.
7. Mittal H, John MT, Sekulić S, Theis-Mahon N, Rener-Sitar K. Patient-Reported Outcome Measures for Adult Dental Patients: A Systematic Review. J Evid Based Dent Pract. 2019 Mar;19(1):53–70.
8. Locker D. Measuring oral health: a conceptual framework. Community Dent Health. 1988;5(1):3–18.
9. Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes. JAMA. 1995;273(1):59–65.
10. World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: WHO; 2001.
11. Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994;11(1):3–11.
12. Atchison KA, Dolan TA. Development of the Geriatric Oral Health Assessment Index. J Dent Educ. 1990;54(11):680–7.
13. Adulyanon S, Vourapukjaru J, Sheiham A. Oral impacts affecting daily performance in a low dental disease Thai population. Community Dent Oral Epidemiol. 1996;24(6):385–9.
14. Klages U, Claus N, Wehrbein H, Zentner A. Development of a questionnaire for assessment of psychosocial impact of dental aesthetics in young adults. Eur J Orthod. 2006;28(2):103–11.
15. Pahel BT, Rozier RG, Slade GD. Parental perceptions of children's oral health: the Early Childhood Oral Health Impact Scale (ECOHIS). Health Qual Life Outcomes. 2007;5:6.
16. Ellis JS, Thomason JM, McAndrew R. A pilot study examining the possible influence of prosthesis design on patient satisfaction with mandibular implant overdentures. Clin Oral Implants Res. 2007;18(3):304–8.
17. Allen PF. Assessment of oral health-related quality of life. Health Qual Life Outcomes. 2003;1:40.
18. McGrath C, Bedi R. An evaluation of a new measure of oral health-related quality of life—OHQoL-UK(W). Community Dent Health. 2001;18(3):138–43.
19. Rogers SN, Lowe D, Fisher SE, Brown JS, Vaughan ED. Health-related quality of life and clinical function after primary surgery for oral cancer. Br J Oral Maxillofac Surg. 2002;40(1):11–8.
20. Jokovic A, Locker D, Stephens M, Kenny D, Tompson B, Guyatt G. Validity and reliability of a measure of child oral health-related quality of life. Community Dent Oral Epidemiol. 2002;30(6):430–8.
21. Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34(6):557–65.
